In Massachusetts, Strengthening Health Systems Is Key to Curbing Pandemic

On the piers of New Bedford, timeworn boats idle at the dock, as they have done for decades, loaded with crate after crate of the catch of the day. The boats are fixtures in the Whaling City, the economic center of southeastern Massachusetts and home to the most lucrative fishing port in the United States. But during COVID-19, that rich history came with its own set of challenges. And it was the job of local health liaisons like Amrith Fernandes Prabhu to help the city find solutions, as officials took action to protect workers in the seafood industry.

As part of the Massachusetts Community Tracing Collaborative (CTC), Fernandes Prabhu was tasked with accompanying city officials in New Bedford as they navigated the COVID-19 response—from contact tracing to care resource coordination.

“A lot of the clusters we were seeing earlier on, like last summer and into the fall, were around fishing boats,” she recalls. “The clusters would just sort of expand because people couldn’t quarantine on the boats.”

The CTC was launched by Partners In Health in April 2020, in collaboration with the Commonwealth of Massachusetts and local boards of health, combining PIH’s decades of experience in public health and contact tracing with local health departments’ deep community trust to strengthen the state’s response.

According to state databases, New Bedford was one of the hardest hit cities in Massachusetts, with its numbers peaking at 264 cases per day in January, making it a crucial partner for the CTC—and local health liaisons like Fernandes Prabhu made that partnership most effective.

Just A Phone Call Away

The local health liaison program was established in the summer of 2020, just months after the launch of the CTC, with 16 liaisons serving as the sole points of contact for health officials in 351 jurisdictions and two local tribes across Massachusetts.

These liaisons served as vital connectors between local health departments and the CTC’s dozens of contact tracers, care resource coordinators, and epidemic intelligence unit analysts, preventing gaps in communication, especially during the pandemic’s deadliest months. As city officials shifted to respond to the pandemic, often with limited resources and staff, local health liaisons were critical partners at every turn.

During New Bedford’s most difficult months of the pandemic, as well as the quieter stretches, Fernandes Prabhu was just a phone call away, always ready to help public health officials get the resources, information, and support they needed to serve the city’s population of over 95,000.

“If there was a car accident or a parade or anything, I was in it with them,” she recalls. “I knew what to expect, what kind of cases were going to drop.”

Each day, Fernandes Prabhu shared valuable insights on contact tracing, cluster outbreaks, and essential resources from across the entire CTC team, helping the city identify the places where support was most needed and where their resources would make the most difference. She provided important contact tracing related data to the city as it worked with the state to organize mass vaccination sites in February 2021 for the 15,000 seafood processing workers, fishermen, and other residents who were among the most vulnerable.

New Bedford wasn’t the only community where local health liaisons made an impact. More than 100 miles away, in the heart of western Massachusetts, liaisons provided crucial support in another hard-hit community: Holyoke.

From Contact Tracing To Food Support

An industrial town historically known for its paper mills, Holyoke sits just eight miles north of Springfield, the commercial hub of western Massachusetts, and is home to 40,241 people, with more than half of its population identifying as Hispanic. Like New Bedford, Holyoke saw its COVID-19 numbers peak in January, following the holidays.

In Holyoke, as in many cities in Massachusetts and beyond, the pandemic compounded longstanding challenges, including food and housing insecurity and a staggering unemployment rate—currently as high as 10.1%, nearly twice the national rate of 5.8%.

These challenges led to Holyoke joining New Bedford and 18 other cities and towns as part of Massachusetts’ COVID-19 Vaccine Equity Initiative, released in February 2021—a statewide effort to prioritize vaccine distribution and support for the 20 hardest-hit communities, as designated by Governor Charlie Baker’s administration.

But equity had long been essential to Holyoke’s pandemic response, says Sandra Aronson, the local health liaison assigned there. When she began working with the city, there wasn’t a liaison program. In fact, early in the pandemic, the city had opted to handle contact tracing and follow-up on its own, without assistance from the CTC.

But as case counts ticked upwards and the city’s needs shifted, the seeds for partnership, planted months earlier, took root. The city formally partnered with the CTC and its local health liaison program in August 2020.

“With the creation of the local health liaison program and having one person that they could respond to, I think that really made things a lot easier in terms of learning what the needs were for the community, learning what they were doing on the ground, and figuring out what was the best way we could support them,” says Aronson.

That support included monitoring COVID-19 cases, investigating outbreaks, and supporting the city’s efforts to distribute essential resources, such as food boxes and, later, gift cards to local grocery stores—a vital form of social support as families struggled to afford food amid a pandemic that left millions across the country unemployed.

“A common refrain at the CTC is that we are building the plane as we are flying it,” says Aronson. “It’s really been a progression, from them saying, ‘Please don’t follow cases or contacts, we are already doing the work’ to ‘Can you please help us with monitoring and support and care resource coordination?’ I feel like everything’s come full circle and it’s improved greatly.”

Strengthening Health Systems

Now, as vaccines are rolling out across the U.S. and as Massachusetts shifts federal dollars to local health departments to boost their own capacity, the CTC will continue to scale down—but lessons learned from the local health liaison program are still influential.

In New Bedford, the local health liaison program laid the groundwork for lasting partnerships, as shown by the ongoing work of PIH’s U.S. Public Health Accompaniment Unit there, which has helped the city orchestrate the vaccine rollout and develop public health campaigns—efforts that aim to strengthen New Bedford’s health system not only in response to COVID-19, but for years to come.

“What COVID has shown for a place like New Bedford is that health equity has to remain at the top of the agenda, even when there’s not a pandemic,” says Fernandes Prabhu. “Investing in long-term health, in livelihoods for all communities, building inclusivity and trust with folks who have historically not had the luxury of that trust…is really important.”

And in Holyoke, Aronson continues to accompany the city as it vaccinates its population and navigates evolving public health guidance—work that she continues to find both empowering and humbling.

“The local health departments—they know their community, they’re the experts on their communities. They are doing so much hard work on top of COVID and everything else,” she says. “I think that there’s a lot of good work that we can all do together and I’m looking forward to continuing to help them in any way that we can.”