Right: Five years ago, as COVID-19 cases were accelerating across the country, the US government leaned into years of investments in NIH to rapidly build and scale up vaccines and treatments through Operation Warp Speed. No question that was the biggest thing that we collectively got right.
Wrong: The thing I personally got wrong was my belief that we could ramp up testing quickly enough to stop the spread and allow normal life to resume (as it did in South Korea and elsewhere). Our testing infrastructure was deeply broken leading to a lack of visibility of where the virus was spreading and how we might curtail it.
Dr. James McDonald, former interim director Rhode Island Department of Health, current commissioner of New York State Department of Health
Right: One decision I was involved in regarding what we got right was the vaccine roll out. Rolling out vaccines in December 2020 through early 2021 was based on high-risk criteria such as being in a nursing home, increased health risk, and being a health care worker. Our approach was risk-based.
You may recall, we were criticized by a Harvard researcher who graded each state with the vaccine roll out. He gave Rhode Island a "F." Our strategy was not first come, first served; it was based on risk. When the same researcher reevaluated each state, we were assigned a "B." I thought his work was simplistic, unhelpful, and the type of work that distracted from our boots-on-the-ground work at the time.
The data that mattered to me at the time was improved survival and decreased hospitalization. Our vaccine roll out showed data that illustrated the significant decreases in mortality and hospitalizations in Rhode Island compared to all the other states. Letter grades work in school, yet not in the real world.
Wrong: I recall being in the fourth floor conference room very early in the pandemic, and I remember how challenging it all was - we were short of supplies for everything. We were waiting for the federal government to help. We had almost no testing supplies, what we had were our existing supplies and what we borrowed from researchers at Brown. We had no stockpile of personal protective equipment coming from the Strategic National Stockpile.
There was a moment in the room, when General Chris Callahan from the Rhode Island National Guard said "there is an expression in the Army: no one is coming." He went on to explain that we were on our own and there was no help coming from the federal government. He was right; it was a crystallizing moment at the Rhode Island Department of Health.
All of a sudden, it became a lot easier to make decisions and problems got solved quickly. No one was coming. In the first few months of the pandemic, every day started with impossible problems and most every night, there was somehow a solution.
Angélica Infante-Green, Rhode Island education commissioner
Right: Taking a whole-of-government approach to mitigating the impact of COVID-19, from prioritizing educators for vaccination, to keeping schools open for in-person learning with appropriate ventilation.
RIDE worked hard in coordination with the Governor, RIDOH, other state agencies, and local school districts to respond to the dynamic challenges, including decentralizing vaccine distribution and opening up clinics in schools or other trusted community spaces. In the end, this cohesive and coherent approach made Rhode Island a leader, and was recognized nationally by The New York Times.
Wrong: Thinking the disruption would be short. Initially, it was believed that schools were going to close for April break and return after.
Dr. Megan Ranney, former deputy dean of Brown University School of Public Health, current dean of Yale School of Public Health
Right: COVID was airborne, and our public health and health care systems were not (and still aren't!) adequately prepared to respond to it.
Wrong: Contact tracing quickly stopped being useful, and we should have stopped it earlier. And although I am proud that we got most kids back into schools in Rhode Island (and Connecticut) in fall 2020, I should have advocated more forcefully for early school re-openings in other states.
Thomas McCarthy, Executive Director, COVID Response
Right: What I got right, and something I am proud of, was the interagency approach to reopening schools. I joined state government because of the pandemic, so I arrived shortly after school closed. My job was to find a way to get kids back to school safely, and the way I had always worked in the past was to get the right people, with the right expertise, to the table, so the interagency task force, anchored by the Rhode Island National Guard, was a natural way to approach it for me.
Wrong: What I got wrong at the beginning, as someone new to state government, was how naive I was about the willingness of people and institutions to do the right thing when it's hard, when there's no credit or glory to be had. As with any significant event, it brings about the best and the worst in people. I was fortunate to serve alongside some of the best public servants and leaders I had ever worked with, but I was also dismayed by how many people tucked tail until it was convenient or took the easy path over the right path. Not only did it personally disappoint me, but it hampered our ability to operationalize the statewide response effectively.