COVID-19 pandemic in Massachusetts

Marriott Long Wharf hotel in Boston, the site of the Biogen company meeting to which most early COVID-19 cases in Massachusetts were traced.

The first case of COVID-19 was confirmed by state health officials on February 1. Massachusetts became the fifth state in the U.S. to report a case of COVID-19.[8] The individual, a University of Massachusetts Boston student, had returned to Boston from Wuhan, China. Upon returning to Boston he began experiencing symptoms and sought medical care.[9][10]

175 executives of Biogen, a biotechnology company based in Cambridge, held a two-day leadership conference from February 26–28 at the Boston Marriott Long Wharf hotel.[11] On February 29, a Biogen executive began to develop symptoms and sought treatment at a Boston area hospital. Suspecting COVID-19 was the cause of the illness, the executive requested a test, but was told by hospital staff that it was not necessary.[11][12][13]

Empty shelves in the Waltham Costco after a weekend of heavy buying.

On March 2, the second confirmed case in Massachusetts was reported. The patient was a woman in her 20s from Norfolk County. She had recently traveled to Italy with a school group from Saint Raphael Academy in Pawtucket, Rhode Island. She was the third person from the trip to test positive, with two people from Rhode Island who had gone on the trip also testing positive.[14]

On March 4, staff from Biogen contacted the Massachusetts Department of Public Health (MDPH) to report that two executives who had recently traveled from Europe to Boston and had attended the February employee meeting had tested positive for SARS-CoV-2 upon returning home. The same day, a "significant number" of Biogen employees asked to be tested for the virus at Massachusetts General Hospital (MGH), which had not been informed that anyone at the company had been exposed. The state police announced Shattuck Street would be closed because a group of 60 individuals were being transported along the route to Brigham and Women's Hospital.[15] On March 5, Biogen reported that three individuals who had attended the company event in Boston the previous week had tested positive for SARS-CoV-2.[16][17]

On March 6, public health officials reported five new cases bringing the state total to eight.[1][18] Four cases were in Suffolk County, three in Norfolk County, and one in Middlesex County. Two cases were associated with travel to Italy and one to Wuhan. All five new cases were associated with the Biogen meeting.[19][20][21]

On March 7, five more presumptive positive cases of COVID-19 were reported, bringing the total to 13.[22] Among those cases was the index case in Berkshire County, a man in his 60s from Clarksburg whose infection could not be traced.[23]

On March 8, the MDPH reported 15 more presumptive cases of COVID-19,[21] all of which were individuals present at the Biogen conference,[19] bringing the total to 28.[1] In response to the outbreak, Biogen ordered all its employees to work from home.[24] The fifteen new presumptive cases included five from Suffolk County, five from Middlesex County, four from Norfolk County, and one whose county of residence was unknown.[25] Officials in North Carolina reported that five residents of Wake County tested positive for COVID-19; all five were participants in the previous week's Biogen meeting in Boston.[26]

Items out of stock at a CVS Pharmacy in Westford, March 10, 2020.

On March 10, the first evidence of community transmission, also known as community spread, was found in a handful of cases in the Berkshires.[27] A man in Sudbury tested presumptive positive for COVID-19,[28] and the first case in Essex County was also reported.[29]

On March 12, there were 108 people in Massachusetts with confirmed or presumptive cases of COVID-19. Among those cases, 82 (75% of the total) were associates or employees of Biogen.[30] Governor Baker said the state had tested more than 200 patients and had the capacity to test up to 5,000.[31] The Boston Marriott Long Wharf hotel, which had hosted the Biogen company gathering, closed temporarily. In a letter to their guests, the hotel said it made the decision in cooperation with the Boston Public Health Commission.[32][33] Acton-Boxborough announced school closures from March 13 until March 20.[34]

On March 13, the Boston Marathon was postponed from April 20 until September 14.[35] A few hours later, Governor Baker prohibited gatherings of more than 250 people. The measure was targeted at large events and exempted most workplaces, transit buildings, polling locations, government buildings, and schools.[36] Cardinal O'Malley, the Roman Catholic Archbishop of Boston, announced that all daily and Sunday masses and other religious services would be suspended in the Archdiocese of Boston until further notice.[37] Boston Mayor Marty Walsh announced that Boston Public Schools would be closed starting on March 17 until April 27.[38] Woburn announced that a presumptive positive case in the city had been confirmed as negative.[39]

On March 14, Cape Cod (Barnstable County) confirmed its first case,[40][41] a man in his 60s from Sandwich.[42] Officials in Worcester and Malden both announced their respective cities' first confirmed case of COVID-19, both linked to Biogen.[43][44][45] Of the state's 138 cases, 104 (75%) could be traced to employees or contacts of Biogen.[1]

A 59-year-old Worcester man died on a flight from Dubai to Boston, sparking speculation that he had died from COVID-19.[46] He had been sick with gastrointestinal problems and was in cardiac arrest during the flight. On March 16, Massachusetts State Police said an autopsy revealed he did not have COVID-19.[47]

On March 15, Baker ordered all public and private schools in Massachusetts to close for three weeks, from March 17 through April 7. The same day, he also banned eating at restaurants, banned gatherings of more than 25 people, relaxed unemployment claim requirements, and enacted other interventions to try to slow the spread of COVID-19.[48] Hampden and Plymouth counties had their first cases.[1] Plymouth County's first case, in Hanover, resulted from travel.[49] Hampden County's first case tested positive at Baystate Medical Center in Springfield; the hospital noted an additional 23 suspected cases.[50]

Digital signs in a MBTA subway station displaying reduced hours and cancelled service.

On March 16, Brockton announced its first case, and the mayor declared a state of emergency for the city.[51] Boston Mayor Marty Walsh ordered construction projects to shut down by March 23, maintaining only minimal staff for security. He also announced that all branches of the Boston Public Library would close beginning that night.[52] The Massachusetts Bay Transportation Authority (MBTA) announced that, starting March 17, it would run the subway and buses at Saturday levels of service during the week, with express buses still running, ferries not running, and commuter rail running on a modified schedule.[53] The next day, service was increased on the Blue Line, Green Line E branch (which serves Longwood Medical Area), and some bus lines to reduce crowding. Frequency on Massport shuttles to Logan International Airport was reduced or canceled.[54]

The number of hospitalized patients with suspected or known infections quadrupled to 53 between March 16 and 17. Major hospitals began reusing protective gear or asking the public for donations of masks.[55]

The number of cases where initial exposure was under investigation began to rise rapidly, whereas cases tracked to Biogen attendees and household contacts continued an overall mild decline.[note 2] On March 19, Governor Baker activated up to 2,000 Massachusetts National Guard to assist in the management of the pandemic.[56] The number of cases increased by 72, putting the total at 328, with 119 in Middlesex County.[57] Franklin and Hampshire counties – both in Western Massachusetts and the last non-island counties – had their first confirmed cases of COVID-19.[1]

On March 20, Massachusetts experienced its first death due to COVID-19. The fatality was an 87-year-old man from Suffolk County, who was hospitalized and who had preexisting health conditions.[58][59] Martha's Vineyard in Dukes County had its first case, a 50-year-old man in Tisbury.[60][61] This was the thirteenth of 14 counties in Massachusetts to report a case of COVID-19.[62] The cities of Somerville and Cambridge closed non-essential businesses.[63][64]

Social distancing in a Trader Joe's line in Cambridgeport, Cambridge, Massachusetts on March 21, 2020.

Closed picnic area at the Natick Service Plaza.

Governor Baker announced that 5,207 people had been tested for COVID-19 in Massachusetts through state and commercial laboratories.[65] That night the state announced its second death due to COVID-19, a woman from Middlesex County in her 50s who had a preexisting health condition.[66][67] Nantucket County, the last county to have no cases of the virus, reported its first COVID-19 case.[68] In order to reduce contact between drivers and customers, the MBTA began rear-door boarding on above-ground stops for buses, the Green Line, and the Mattapan Trolley, except for passengers with disabilities who need to use the front door.[69]

On March 22, Nantucket issued a shelter-in-place order, to start March 23 and end on April 6. Exceptions were made for essential services to remain open.[70] Governor Baker instructed people in mainland Massachusetts with second homes in Nantucket and Dukes County to stay on the mainland.[71] Three new deaths were reported by Massachusetts DPH, two men, both in their 70s, from Hampden and Berkshire counties, and a man in his 90s from Suffolk County.[note 3][72]

On March 23, Governor Baker announced a stay-at-home advisory effective from noon March 24 until noon April 7. Nonessential businesses were ordered to close physical workplaces, and restaurants and bars were restricted to offering takeout and delivery. People were told they could go out to obtain essential goods and services, such as groceries and medicine, but should follow social distancing protocols.[73]

On March 24, the number of cases jumped by 382 to 1,159, with two new deaths attributed to COVID-19.[note 4] This unusually large jump in cases (49%, versus 20–28% in the previous five days) was attributable to Quest Diagnostics processing 3,843 tests in one day, yielding 267 of the state's 382 new positive results.[1]

On March 25, the Commissioner of Public Health issued emergency regulations for grocery stores and pharmacies, requiring them to designate a daily shopping hour for senior citizens and provide checkout line distancing markers, hand washing and sanitizer for employees, disinfecting wipes for customers to use on carts. A ban on reusable bags became mandatory, overriding local bans on single-use plastic bags and eliminating fees for store-provided bags. Self-service food stations were ordered to be closed, and regular sanitization was required.[74]

On March 27, the state extended the tax filing deadline to July 15 and announced new travel guidelines.[75][76][77] State officials announced that the Massachusetts Department of Public Health Commissioner, Monica Bharel, had tested positive for SARS-CoV-2; she had mild symptoms and planned to recover at home.[78]

On March 30, the state announced that it had conducted almost 43,000 tests of Massachusetts residents, with Quest Diagnostics having conducted 21,321 (almost half) of the total tests administered.[note 5] Later that evening, the MBTA announced that 18 transit workers had tested positive for the virus.[79] In addition, the Boston Police Department confirmed that 19 officers and three civilian employees had all tested positive.[80]

The Archdiocese of Boston announced that eight priests had tested positive for the disease.[81] On April 2 Boston Mayor Walsh announced plans to convert the Boston Convention and Exhibition Center (BCEC) into a field hospital with 500 beds assigned to the homeless and 500 to accept COVID-19 patients from city hospitals.[82]

On April 2, more than 500 healthcare workers in Boston hospitals were reported to have tested positive for COVID-19.[83][84][85]

Closed playground in Salem on April 4, 2020.

On April 5, Boston Mayor Walsh announced a voluntary city-wide curfew for non-emergency workers in Boston from 9 p.m. to 6 a.m.,[86] and asked all Bostonians to wear face coverings in public.[87]

On April 9, the Massachusetts Institute of Technology published a preliminary study of sewage samples taken in the Boston area on March 25, in an effort to determine the extent of COVID-19 infections. Based on concentrations of the virus found in the samples, the study suggested that approximately 115,000 of the Boston region's 2.3 million people were infected. At the time of sampling, Massachusetts had only 646 confirmed cases in the area.[88][89]

Starting the evening of Friday April 10, the Massachusetts Department of Conservation and Recreation closed some parkways to vehicle traffic to allow recreational pedestrians to spread out, and reduced parking availability at some state parks. The city of Boston also reduced parking near the Arnold Arboretum.[90] The Massachusetts Education Commissioner canceled MCAS standardized tests for the first time, taking advantage of a federal waiver.[91]

On April 12, there were 25,475 total cases, with 2,615 new cases, making Massachusetts the state with the third-most cases in the United States, behind only New York and New Jersey.[note 6] Massachusetts officials warned of ebb and flow of the spread of COVID-19.[92]

On April 15, the Massachusetts DPH announced a plan to release town-by-town infection rates. This was a reversal from the earlier policy of discouraging the release of town-specific information concerning the number of infected in each particular community.[93]

On April 18, Baker announced that a third field hospital has opened in Cape Cod.[94]

On April 21, Governor Baker announced that Massachusetts schools would not return to in-person learning for the remainder of the academic year. He also extended through June 29 a previous order to close non-emergency childcare services.[95]

On April 22, former 2020 Democratic presidential candidate and U.S. Senator Elizabeth Warren from Massachusetts announced that her oldest brother had died from COVID-19 in Oklahoma.[96]

On April 24, Governor Baker announced that while COVID-19 cases and testing were up in Massachusetts, hospitalizations have started to decrease and reached the lowest point since early April.[97] Massachusetts recorded 4,946 new cases partially due to an error by Quest Diagnostics in missing more than 10,000 test results, both positive and negative, recorded in April 24 data.[note 7]

On April 25, Governor Baker addressed the topic of when stay-at-home measures and closures of non-essential businesses would end. When restrictions were originally announced in mid-March, they were slated to end at noon on April 7; later their projected end date was pushed to May 4. Baker said it was unlikely restrictions would be lifted by then because the surge of cases had hit later than expected – May 4 presumed a surge in early April. Baker said the process of reopening will begin when hospitalizations start to decline consistently, and when there is "some evidence that we are in fact over the hump ... with respect to the surge."[98]

On April 28, Governor Baker extended the statewide stay-at-home advisory by two weeks, to May 18. He also said that once the advisory expires, the process of reopening will begin in stages, and not happen all at once.[99]

Also on April 28, it was reported that at the Soldiers' Home in Holyoke, at least 68 veterans – nearly 30 percent of the home's residents – had died of COVID-19 in what is believed to be the deadliest outbreak at a long-term care facility in the United States during the COVID-19 pandemic.[100]

On May 1, Governor Baker issued an order, effective May 6, to require people to cover their faces in public when in situations where they are unable to keep six feet away from others.[101]

On May 4, a group of several hundred anti-lockdown protesters gathered outside the Massachusetts State House to urge Governor Baker to lift the state's stay-at-home advisory and reopen businesses.[102] Organizers had planned to hold the protest, named the "Liberty Rally", if businesses were not reopened by May 1. The event was promoted by conservative talk radio host Jeffrey Kuhner and Super Happy Fun America, the group responsible for organizing the controversial 2019 Boston Straight Pride Parade.[103]

On May 8, Boston Mayor Walsh announced that parades and festivals would not take place in Boston at least until Labor Day (September 7).[104]

On May 11, Governor Baker announced a four-phased plan to reopen the state. In phase one, a small number of industries that do not involve much face-to-face interaction will be allowed to return to operating, with strict restrictions in place. In phase two, more industries will be allowed to open, with restrictions including limits on the number of people allowed to gather in one place. In phase three, more industries will open, with guidance on how to operate safely. Phase four is set to occur if a vaccine or therapy is developed allowing restrictions to be loosened. The state also published Mandatory Workplace Safety Standards to be followed by industries that will open as a part of phase one. These standards include requirements for social distancing, hygiene, staffing policies, and cleaning and disinfecting.[105]

On May 18, Governor Baker released the details of the plan to reopen businesses in Massachusetts, and renamed the stay-at-home advisory to a "safer at home" advisory. The plan allows places of worship, essential businesses, manufacturing businesses, and construction sites to reopen with strict restrictions on May 18. Also as of May 18, hospitals and health centers may begin providing urgent preventative care and treatment services to high-risk patients. Baker also announced that people who choose to ride the MBTA will be required to wear masks. Beginning on May 25, additional businesses will be able to open, also with restrictions. Although Baker's plan includes office buildings in the list of businesses allowed to open on May 25, offices within Boston will not be allowed to open until June 1.[106]

On May 26, Baker said in a press conference that the surge in COVID-19 cases in Massachusetts is over, as evidenced by declining numbers of people hospitalized by the disease. He announced that the Boston Hope field hospital, located in the Boston Convention and Exhibition Center, would no longer be accepting new patients. The facility has treated more than 700 people with COVID-19, and has also provided shelter to some of Boston's homeless community. Baker also said that other field hospitals around the state would begin to close.[107] Baker also announced $6 million in grants to go to small businesses to help them purchase protective equipment and implement the safety precautions indicated in the reopening plan.[108]

The Boston Athletic Association announced on May 28 that the 2020 Boston Marathon, which had already been postponed to September, would be canceled.[109]

On June 1, Massachusetts began reporting probable cases of and deaths due to COVID-19 in their data, when previously they had only been reporting confirmed cases and deaths. This change follows guidance from the U.S. CDC. The Massachusetts Department of Public Health said in a statement that probable cases are recorded for people who "have either 1) had a positive antibody test and either had COVID symptoms or were likely to be exposed to a positive case or 2) did not have an antibody test but had COVID symptoms and were known to be exposed to a positive case." Probable deaths are defined as deaths where COVID-19 was listed on the death certificate as the cause of death, but where no test was administered. Due to these changes in reporting, Massachusetts became the 5th state in the U.S. to report over 100,000 cases of the contagious disease.[110]

On June 3, Massachusetts began reporting recoveries in their weekly data report. Previously, they had not been reporting the number of cumulative recoveries in their data. A patient is considered to be recovered if they have either been sick for 21 days or 21 days have passed since they tested positive.[111]

Governor Baker announced on June 6 that Massachusetts would begin entering phase two of the reopening plan starting on Monday, June 8, following positive trends in access to testing and decreasing hospitalizations. The first portion of the phase will allow childcare, day camps, lodging retail stores, outdoor seating at restaurants, and children's sports programs to reopen with strict precautions. Additional services, including indoor dining and nail and tanning salons, will be allowed to reopen at an unspecified later date as a part of phase two if the positive trends in COVID-19 cases continue.[112]

Boston entered phase two of their reopening plan on June 8.[112]

Amid ongoing protests over the May killing of George Floyd, Governor Baker announced pop-up testing sites would open throughout the state on June 17 and 18 to provide free tests to protesters and anyone else who wished to be tested.[113] During the period 11-17 June, Worcester county had the second highest number of deaths in the state with 39.[1]

On June 22, WBUR reported that Massachusetts had become the state with the lowest COVID-19 transmission rate in the country. The current R_t, a value measuring the average rate of transmission of a virus at a point in time, is 0.67 in Massachusetts. According to rt.live, the website calculating the values, an R_t value of 1.0 or above is considered to signify "rapid spread".[114]

Systematic testing did not begin until mid-March, so it is unknown how the virus spread.

The index case of COVID-19 in Massachusetts was reported on February 1, 2020, in Boston. The patient, a University of Massachusetts Boston student in his 20s, had recently returned to Boston from Wuhan, China.[9] The second confirmed case in Massachusetts was reported on March 2. The patient was a woman in her 20s from Norfolk County, who had recently traveled to Italy with a school group from Saint Raphael Academy in Pawtucket, Rhode Island.[14] After a month of stasis, cases began growing rapidly on March 5, with most traceable to a Biogen employee meeting held in at the Marriott Long Wharf hotel in Boston from February 26–28.[note 8]

Exposure clusters were reported from mid to late March. Local transmission began being reported on March 16, slightly exceeding cases related to travel.[note 9] An outbreak cluster of untraced origin in the Berkshire Medical Center in Western Massachusetts was briefly tracked from March 11 through March 15. Cases that had been contact-traced to Biogen plateaued on March 13, and were surpassed by local transmissions on March 23. Cases of unknown exposure surpassed those of known exposure on March 19, then grew rapidly. When the Massachusetts Department of Public Health ceased updating statistics on exposure on March 27, there were 99 cases traced to Biogen, 163 cases of local transmission, 93 cases related to travel, and 2,885 cases where initial exposure was under investigation.[note 10]

The disease went undetected after entering Boston in Suffolk County in early February. It then re-emerged in early March and spread to the state's remaining 13 counties within three weeks. Suffolk County had its first reported case on February 1,[9] Norfolk County on March 2,[14] Middlesex County on March 6,[note 11] Berkshire County on March 7,[23] Essex County on March 10,[29] Barnstable and Worcester counties on March 14,[40][44] Hampden and Plymouth counties on March 15,[50][49] Franklin and Hampshire counties on March 19,[note 2] Dukes County on March 20,[60] and Nantucket County on March 21.[68][note 12]

Massachusetts has performed 1,020,867 molecular tests on 809,086 individuals, and has also performed antibody tests on 68,259 individuals as of June 26, 2020.[1]

The first four hospitalizations in Massachusetts were reported on March 9.[note 13] The number of hospitalizations surpassed 10 on March 12,[note 14] 100 on March 25,[note 5] and 500 on March 31.[note 15] As of June 26, 791 people were in the hospital because of COVID-19. 156 people were being treated in intensive care units, and 99 were intubated. The average age of people hospitalized for COVID-19 in Massachusetts is 68.[note 16]

Deaths due to COVID-19 have been concentrated among the elderly. As of June 26, 6,763 of 8,013 (84%) COVID-19 deaths in Massachusetts were in patients aged 70 or older, and the average age of death was 81.[1] More than half of the deaths in the state have been among residents of long-term care facilities.[115] The state's first death due to COVID-19 was on March 20: an 87-year-old man from Suffolk County, who was hospitalized and had preexisting health conditions.[58][59]

The Massachusetts Department of Public Health began publishing daily updates on COVID-19 in Massachusetts on March 6, 2020. Local media and the state also published intermittent reports beforehand.

Most COVID-19 cases and deaths were traced to a county by the Massachusetts Department of Public Health. The Massachusetts DPH releases an updated form with this data daily. This table counts cases on a cumulative basis.