Researchers Aid Chelsea, Epicenter of MA COVID-19 Outbreak.

This article originally appeared in BU Today.

The numbers startled Madeleine Scammell. The epidemiologist saw that in 10 days the number of confirmed COVID-19 cases climbed from seven to 82 in Chelsea—her city, just across the Mystic River from Boston.

“Eighty-two seemed like a big number,” Scammell recalls, “but not compared to tens of thousands in New York City.” How did Chelsea’s rate of positive cases compare with Boston, Brockton, or Lawrence? The state wasn’t making that data public yet. So Scammell compared the rate of COVID-19 confirmed infections among her Chelsea neighbors with the rates of Manhattan and Brooklyn, boroughs of New York City, the epicenter of the virus.

Chelsea’s rate was higher.

Now, Scammell (SPH’08), a School of Public Health associate professor of environmental health, was alarmed. It was the beginning of April. With more than 40,000 people, many of them low-wage workers, jammed into 1.8 square miles of industrial land, Chelsea was at high risk for a fast-spreading contagion. But outside of a few city leaders who were scrambling just to put together data, Scammell says, “nobody seemed to be paying attention.”

She set out to change that.

Scammell, who’s served on Chelsea’s Board of Health for 10 years and makes an effort to speak Spanish in a city where most residents are Latinx, shared her numbers with the city leaders she knew. On April 10, they sent an urgent letter to Governor Charlie Baker, telling him “the city of Chelsea is experiencing an alarming rate of COVID-19 infections,” with its per capita rate “higher than some of the hardest hit boroughs of New York City.” Their city “is in desperate need of state assistance,” they wrote.

A response came quickly. The next morning, Baker called Tom Ambrosino (CAS’83), Chelsea’s city manager, and put Chelsea at the top of his daily COVID-19 briefing. The commonwealth soon began sending aid to the city.

No one had expected the virus to spare Chelsea. But Scammell’s analysis, together with numbers from the police chief and Chelsea’s city planning department, convinced people Chelsea was in crisis. “I was saying, ‘Thank God we’re not New York, we’re not Italy,’” says Roseann Bongiovanni (CAS’99, SPH’01), executive director of GreenRoots, a Chelsea environmental justice nonprofit whose board Scammell chairs. Then Bongiovanni saw Scammell’s numbers, along with the city’s other data. “I said, ‘Oh my God, we are New York—we’re worse than New York.’”

This was not the first time BU would help Chelsea through a crisis. More than three decades ago, BU stepped in to take over Chelsea’s then-failing schools; it managed the system for two decades, turning it around. Out of that relationship grew the Boston University/Chelsea Partnership scholarships, awarded to outstanding graduating seniors from Chelsea High School. Bongiovanni went to BU on one of those scholarships, and with a master’s degree in environmental health, she had already been working with Scammell and Jonathan Levy, professor of environmental health, and other researchers to collect data on many of the health inequities—housing density, poverty, language isolation, industrial pollution, high rates of respiratory illness—that made Chelsea vulnerable to COVID-19.

Bongiovanni and her team turned GreenRoots into a 24-7 pandemic response organization practically overnight. They helped set up a citywide emergency food distribution hub, built a network of neighbors who would check in with one another, and put out the message, in more than eight languages, about information and issues from the urgent need for social distancing to the new statewide moratorium on evictions. They also advocated for urgently needed additional state and federal assistance.

Through the United Way of Massachusetts Bay and Merrimack Valley, and other community partners, GreenRoots set up the One Chelsea Fund, with donations going directly to families affected by the pandemic.

“Everybody is saying, ‘I can’t sleep at night, I have panic attacks, I’m scared,’” Bongiovanni says. “How can we help all these folks? It’s overwhelming. You have to say, ‘Okay, let’s take it one step at a time.’”

In Chelsea, the curve has not yet flattened. The number of confirmed COVID-19 cases has soared to 1,840, with rates of infection at about 4,800 cases per 100,000 people—the highest rates in the commonwealth, nearly triple those of Brockton, which has the second-highest rates, and about six times the statewide average.

And even as they scramble to quarantine the sick, in hotel rooms in Revere made available by the state, and help the thousands of others who are now out of work, Chelsea officials worry COVID-19 is still spreading. Its vulnerable residents include immigrant families, who, having fled poverty and violence in El Salvador, Nicaragua, Guatemala, and Mexico, can afford escalating rents in Chelsea only by doubling and tripling up in tenements and triple-deckers. These are men and women who hold down jobs—as supermarket cashiers, airport and hotel maintenance workers, hospital orderlies, and delivery drivers—that have been deemed essential during the pandemic.

“We suffer from so many of the problems people in low-income communities and communities of color face—food insecurity, high rates of respiratory illness, obesity, and diabetes,” Bongiovanni says. Residents also contend with high rates of industrial pollution, she adds, as Chelsea has long been a dumping ground for the rest of the state. And huge tanks along the Chelsea Creek waterfront hold all the jet fuel for nearby Logan Airport and 80 percent of New England’s heating fuel.

“Add it all up and we’re a perfect storm for COVID-19,” Bongiovanni says.

On five mornings a week, at a rotating list of parks and city squares, residents wearing masks line up for blocks to be given boxes of food—each box is supposed to feed two people for a week—by National Guardsmen in fatigues and masks, who were dispatched by the governor as part of the state’s efforts to augment Chelsea’s own pandemic response.

In the battle against the virus, Scammell, Bongiovanni, and the handful of city leaders who initially banded together have at least gotten Chelsea on the state and national radar. “The data is really powerful,” Bongiovanni says. “Not everyone has access to it. Madeleine can explain it in a way that everyone can understand it.”

Scammell knows the importance of data in public health. She has spent the past decade studying high rates of chronic kidney disease—and increasing rates of mortality—among sugar cane, corn, and plantain harvesters and construction workers in El Salvador and Nicaragua. She is one of the first US researchers to be awarded funding from the National Institute of Environmental Health Sciences to study the epidemic.

In late April, Scammell, who grew up on Cape Cod and moved to Chelsea 20 years ago to be near her mother, sits on a bench on a grassy hill near the Soldiers’ Home in Chelsea, where the flag flies at half-mast, honoring the eight veterans there who have died of COVID-19. They are eight of the 93 confirmed deaths from the virus in Chelsea.

“The numbers matter,” says Scammell. “Every number is a person. Every person counts.”

And, she adds, when it comes to vulnerable populations—like so many people in Chelsea—“they’re always the ones who are undercounted and left out.”

During the second week of March, Scammell began joining Chelsea’s daily coronavirus update phone call. She heard the daily count rise from seven cases on March 20 to 22 to 37 to 49 to 63, and on March 30, to 82.

“Was it appropriate to be alarmed? How alarmed should I be?” she says. “I had to know where Chelsea stood.”

At her house, with the view out a window of a blossoming cherry tree, and beyond that, the Tobin Bridge to Boston, she turned her computer into a COVID-19 tracking tool.

She tracked the rate of cases in Chelsea, Manhattan, and Brooklyn each morning on an Excel spreadsheet, entering the counts posted the afternoon before. After several days, she saw the steeper slope of Chelsea’s line compared to Brooklyn and Manhattan’s lines. “I realized that while our city had far fewer cases, we had surpassed the population percent of both NYC boroughs and were about to exceed 1 percent of the total population,” she says.

And that was a big number.

After Scammell shared her graph with Bongiovanni, and Mimi Graney, Chelsea’s planning and downtown development coordinator, they set up an email chain with other city leaders and the chief of police, as well as hospital physicians. “We all shared our data,” Scammell says.

Bongiovanni set up a strategy planning call: What did it mean? How should they respond?

On April 7, Scammell got a call from Damali Vidot, a Chelsea city councilor. “She wanted to know if it was true that Chelsea’s rate was higher than parts of Manhattan,” Scammell says. “I said it was. Damali did a Facebook Live that evening, sounding the alarm.”

In addition to a long list of city officials and other leaders, that April 10 letter to Baker was also signed by Peter Slavin, president of Massachusetts General Hospital, and Kevin Tabb, president and CEO of Beth Israel Lahey Health. Levy, chair of the SPH environmental health department, Patricia Fabian, associate professor of environmental health, who has also been studying health inequities in Chelsea, and a handful of other SPH faculty, also added their names.

On April 16, the Boston Globe put the crisis in Chelsea on the front page, and 10 days later, the New York Times did the same.

Scammell, Vidot, and other city leaders have joined Facebook Live sessions with US Senator Ed Markey (Hon.’04) (D-Mass.) and US Representative Ayanna Pressley (D-Mass.), whose district includes Chelsea. Markey and Pressley have been calling for federal officials to address long-standing health inequities and disparities in Chelsea—the ones Scammell, Bongiovanni, and others in town, along with SPH researchers, have been talking about for years.

In pre-pandemic times, Scammell says, she would have hesitated about doing those high-profile Facebook Lives.

But this crisis and the way it has unfolded in Chelsea, as in other places, has reminded her of a truism of her work. “Public health is political,” she says. “We have to make our voices heard.”

—Sara Rimer, with photos by Cydney Scott

GreenRoots has established the One Chelsea Fund, through the United Way of Massachusetts Bay and Merrimack Valley, to directly assist families affected by the COVID-19 pandemic. Find information on how to donate here.