Fast-moving crisis, fast-moving changes, and a plate full of what we’re still facing

Bill Walczak

In last week’s column, I questioned the continuing lack of tests, asked why we’re not told to wear masks, and mentioned that we know little about the impact of the pandemic on the state budget.

The rapidly growing pandemic is producing rapid decisions and rapid changes, and I’m pleased to report that we’ve been asked to wear masks in public, that we apparently will soon have a quick test available, and that there has been some work done on the impact on the state budget.

To continue the discussion: While riding my bike around the neighborhood on Monday, I found that, at least in the Savin Hill area, about half of the people I passed were wearing masks, and also that I felt uncomfortable wearing a medical mask. Not uncomfortable in a physical sense, just in a sense that I was either telling people I was sick or that I thought they were.

I realized that if I had a nice-looking mask, it would make a difference to me in how I feel about wearing one – that it was part of my outfit.

Hopefully, we’ll get some clothing manufacturers to make stylish masks, which might make a difference in persuading people to wear them as a fashion statement. Whatever it takes, our pandemic will be mitigated when we get to the point where all people are wearing masks in public.

On the testing front, people ask why people without symptoms should be tested.

When HIV/AIDS hit in the 1980s, initially there was no certainty as to how you could get it, and who might be positive for the virus. To find out, the government got medical establishments to give blood serum left over from blood tests to anonymously test populations to determine the prevalence of the disease.

I remember that at the Codman Square Health Center, our prevalence rate among patients at the time was .05 percent, meaning that about one in 2,000 patients had HIV but didn’t know it. These types of studies led to what are called “universal precautions,” i.e., treat everyone as if they carry the disease but don’t know it.

We currently do not know what percentage of people in Boston, our commonwealth, or the country carry the coronavirus and do not know it, though we know it has to be high since a high percentage of those testing positive for the coronavirus are asymptomatic, meaning they don’t have symptoms.

We won’t be able to put a lid on this pandemic until we have near universal testing (with far lower “false negatives” than we see currently) that gives results within minutes. When everyone knows his or her virus status, we will be able to prevent those with the virus, even those who do not have symptoms, from infecting others. If we had done this in February, we would have had a fighting chance to severely limit the spread of the virus.

Partners In Health is going to trace the spread of the virus in Massachusetts (detective work to determine whom the infected person interacted with and then quarantine them), but if we only test people with symptoms, we won’t be able to stop this virus from spreading in any major way.

We also need to utilize technology better. I was approached by a scientist from the MIT Media Lab more than a month ago about an application that could use the GPS feature on cell phones to determine whom those infected interacted with, and I made some referrals to government officials, but I’ve heard nothing since.

Lastly, we now have information on the impact of the pandemic on the state and national budgets, and it isn’t pretty. Tufts University’s Tisch College did an analysis that indicated the commonwealth will have a shortfall of $500-$750 million from April to June in this fiscal year, which ends June 30. The problem with this is that such a deficit has to be eliminated by June 30 by law, and $500 million over a quarter is a $2 billion annual budget cut.

Some of the money to make up this loss may come from the federal government, and we do have a rainy day fund, largely thanks to former Speaker Tom Finneran.

However, the Tisch report (and other analyses) also says that in fiscal year 2021, which begins on July 1, the likely deficit will be $1.3-$2.25 billion – if the economy starts improving in July and begins a positive track in January.

State House leadership began a process this week to figure out what to do, so brace yourself.

Bill Walczak is a co-founder and former president/CEO or Codman Square Health Center and the South End Community Health Center. He is a Dorchester resident and a regular contributor to the Reporter.

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