Boston knows how to handle a crisis. In 2013, moments after two bombs hit near the Boston Marathon finish line, people charged into action. Tragically, three individuals were killed. The 264 people injured made it to hospitals and survived their injuries. The suspects were apprehended within days. Our city and state proved resilient. We had planned, trained and drilled for years for this. It took many people, coming together in an instant, and doing what had to be done, all in order to save lives.
Fast forward to today.
I’ve been hesitant to criticize vaccine distribution efforts. I was optimistic that the new administration would quickly spring into action. When the Federal Emergency Management Agency, with their logistical acumen and resources inserted into the mix, I was assured that we could meet the challenge of that last mile of vaccines into arms. FEMA has done their part.
Recently, however, frustrated health officials, elected leaders and community members from across the state are calling me. They are confused and discouraged by what we are all experiencing here in Massachusetts. We can do better. The lessons of the Boston Marathon bombings response provide guidance on a pragmatic way forward.
Lesson One: Distribution. Gillette Stadium and other mega-sites have received more vaccine doses than they can distribute, while local communities have had them taken away or had orders canceled. Over the past week, many mega-sites reportedly had thousands of vaccination appointments available. However, at risk individuals across the state are struggling to get vaccinated. This is because these “mega-sites” do not benefit as many people as could multiple smaller vaccination sites. For many years we have had and do have plans for vaccination at the local level. There is a place for mega-sites, but that is after we have established multiple local sites with available appointments across the state.
Lesson Two: People. Don’t start with what works for the system. Start with what works for the people, and build from there. While I was at FEMA, we worked to change our first focus onto the survivors of disasters. What the state should do now is to be survivor centric — we need to do what is easy for people who want to get vaccinated, not what is easy for government. Start with what is best for vulnerable people: minorities, the 85-year-old woman with mobility issues and busy caregivers. Bring the vaccinations to them, in mobile vaccination sites close to their homes. Logistically, it can be done.
Lesson Three: Create successes. Clear and accurate internet sites, locally based and busily occupied vaccination centers and a clear plan with achievable benchmarks create confidence and support for the system. Local vaccination sites foster feelings of comfort and safety, reduce hesitancy among the community and help to improve vaccination disparities. Higher levels of trust, community knowledge and convenience will lead to higher vaccination rates, which translates into less circulating disease, lowered risks of the emergence of variants and the resilience of our community and economy.
Lesson Four: Staying in lanes. One of the mottos at FEMA is “Federally Supported, State Managed, Locally Executed.” Massachusetts has missed the local execution. By failing in coordination with local officials, the state has missed input from subject matter experts who know best the communities they serve. We need to bring people together, not drive them apart — as is happening now. We need the people who interact with citizens daily in their communities, and who understand the community’s needs — local leaders, tribal leaders, faith-based leaders, non-profits and business owners — who can come together and get their community vaccinated.
In our research on crisis leadership, my colleagues and I at the National Preparedness Leadership Initiative discovered the strength of the leaders at the front of the Marathon bombings response. We call it Swarm Leadership to rally collective collaboration, a whole community effort to get the job done.
Now is the time for us to work together to support communities and save lives at the local level.
Richard Serino is a Distinguished Senior Fellow at the Harvard T.H. Chan School of Public Health, National Preparedness Leadership Initiative; Senior Advisor at MIT Urban Risk Lab; FEMA’s 8th Deputy Administrator; Boston EMS Chief and Assistant Director of Health (retired).
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February 22, 2021 at 05:16PM
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Here’s what’s needed to solve the vaccine crisis - Boston Herald
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