Still Not Protected: Chelsea COVID study shows second wave hit workers hardest

A detailed study of COVID-19 cases in Chelsea for the second half of 2020 by researcher Cristina Alonso showed that – despite so many warnings – essential workers were still getting sick and taking it home to their children and families.

Alonso, a graduate student at Harvard’s T.H. Chan School of Public Health, has been helping in Chelsea through a state program for graduate students since last spring. She has filled many roles in that time from food distributor to vaccine registration clerk, but her primary focus has always been on analyzing the public health data related to Chelsea’s 2020 COVID experience. 

Already, her first effort was published last summer with great interest, showing the crux of the problem in Chelsea hit nursing homes and older/retired folks the worst. Now, she has analyzed 3,979 cases between Sept. 1, 2020 and Jan. 19, 2021, and – sadly – found that it was essential workers that paid the price in the second surge at the end of 2020.

“The big thing that should figure into vaccine access and equity is the shift we found,” she said. “The first wave affected the retired population and an older cohort of people and impacted hospitalizations and deaths. The second wave that starts in last November and run through January was essential workers…The average age came down to mid- to late-30s. The big finding is number one that despite being almost a year into this pandemic we’re still no taking care of workers on the job. They are still getting sick at work and bringing it home and giving it to their families. They’re giving to their kids too. We saw 25 percent of the cases were kids, which was a huge change. If we’re going to use this data, it will be to ask what is going on in workspaces? We need to find out why people are still not safe and still getting sick at work.”

Her findings showed that the second wave hit a much younger population between 30 and 50, and deaths and hospitalizations went down tremendously this time. The numbers of deaths was down significantly to only nine in the time period, but the disease prevalence did shift from the retired community to workers – both essential workers and non-essential workers.

Her work showed that cases were at about 100 per week at the beginning of the period, and then surged to about 250 per week in November – falling off from that number in mid-January.

One of the first conclusions Alonso said she drew was that workplaces were still not taking the virus seriously, and weren’t protecting their workers with PPE and adequate quarantines if necessary. That, she said, showed her it was a class of people that needed to jump the line for vaccinations.

“We need to prioritize essential workers in vaccine access,” she said. “It’s great to protect the elderly population, but if we think about who to go to next, essential workers have to be next…It’s pretty appalling at this point, a year in, people are still being exposed at work.”

Secondly, she said her research shows that teachers need to be vaccinated, but not because they are getting sick. The second half of 2020 revealed that in the second surge children were getting sick much more often than before. Some 25 percent of the cases in the second surge were in children. That has also been shown in neighboring Everett, where there has also been a surge of cases from November to January in the 0-18 age population.

“Having those numbers for children means we need to vaccinate teachers as a priority class,” she said. “If we’re going to get students back in school by April, teachers have to be vaccinated or they’ll get sick and they might live in multi-generational households or have other medical situations.”

One final conclusion she drew from her data of the second surge had to do with the numbers of holidays at the end of the year, from Halloween to Thanksgiving to Christmas to New Year’s. On all of those occasions, people would normally gather, but this time they were told by public health officials to stay home.

In short, no one did.

That, she said, made the surge predictable and points to the fact that public health officials should take a harm reduction approach to COVID-19 and gatherings.

“It seems to say we need to take a harm reduction approach to COVID-19 prevention and education,” she said. 

“There are so many rituals and things we celebrate then, and we told people as public health professionals not to get together and they did,” she said. “We need to be realistic that when people are in pain and lonely and slipping emotionally, we need to take an approach of telling them how they can get together safely and not just to don’t get together. There are definitely ways to get together and expose yourself to COVID-19 and there are ways to get together and reduce exposure…People will not stop getting together. I would say we need to be more realistic.”

Part of that would be to anticipate gatherings, and have vigorous campaigns telling people five steps for being safe at a gathering. It would also tell them what to do after and before, such as getting tested and quarantining. 

In the second installment of her study, though, Alonso said she just really focused on essential workers. She said if the economy is going to open, and the social services are going to be restored – then workers need to be vaccinated. She said in a place like Chelsea there are three access points to vaccine – and that’s good by many standards – but she is calling for much more.

“Everyone in Chelsea needs to get vaccinated,” she said. “We need more sites, more staff and a better appointment system,” she said.

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