How Boston Responded to the COVID-19 Crisis

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[00:00:06.820] Roberta Rewers: Welcome to this episode of the APA podcast. I'm Roberta Rewers, communications manager. Today, we're speaking with Brian Golden, the planning director for the City of Boston. Earlier this year, the city partnered with the McChrystal Group, consultants who specialize in strategic remote crisis management. The group was brought in to review the city's preparedness for emergency response to the coronavirus pandemic. Thanks, Brian, for joining us today. Can you tell us a little bit about how the city is doing overall right now?

[00:00:43.670] Brian Golden: Well, the, the, the surge is upon us. We expect peak to occur in Boston in the next several days. We're at mid-April now, and late April through the middle of May is expected to be peak and surge time in Boston. We are one of the hot zones, if you look nationally at where the, the infection and the crisis is greatest. Unfortunately we find ourselves in a dangerous position with regard to the numbers infected, the numbers hospitalized, and the numbers who are losing their lives. As of this morning or late last night, we were just under a thousand deaths in the state of Massachusetts. And we expect the hospitalization rate and the death rate to climb steadily for the next several days. And really, the surge will continue to put really significant demand on the health care system in metro Boston and throughout the state well into May.

[00:01:58.910] RR: Well, I think this is an interesting time to be talking about your work with the McChrystal Group in terms of crisis management. Can you share with us a little bit about the motivation for the city to work with the group and the process?

[00:02:15.290] BG: Sure. So the McChrystal Group has become a really important part of Boston's response to the COVID crisis. Earlier in, in March, the, the mayor of Boston, Marty Walsh, and senior staff were considering our response to what we knew was coming. Both globally and nationally COVID was becoming a greater and greater threat. And the mayor wanted to make sure that Boston's planning to deal with such a crisis was up to the task and that our ability to execute those plans was appropriate. And we collectively thought that an external set of eyes and ears would be appropriate, and — to validate our approach, to validate our plans, to validate our emergency response mechanism. So the McChrystal Group was known to me, given my background in the army. I've been in the army for 27 years, I'm still in reserve assignment, and I was familiar with General McChrystal and his work. Many people would recall that he was a four-star general with responsibility for Afghanistan and with a special eye towards special operations and managing a lot of different activity throughout the Afghanistan theater of operations and managing that activity remotely — their U.S. forces spread out all over the country and in the region. And so that, that operation had to be integrated through regular, effective remote communications. So both the McChrystal Group's background in responding to crises — in the military case, the crises were wars — and, but, but we thought that that crisis management background via remote communications was exactly the kind of background we wanted when we acquired the services of an outside consultant to look at our plans in dealing with the emergency and then making sure that our emergency operation mechanism was able to execute those plans.

[00:04:52.820] RR: I know it's not uncommon for planning departments to work with a variety of consultants. Has the city worked with this type of consultant before?

[00:05:02.560] BG: Not this type. This is, this is a response that was prompted by a, an unusual crisis. The worst pandemic in 102 years in the United States required us to think differently about what our needs were. The nature of the external critique that we needed was different because the, the threat, the need, was different. Obviously, we hire a lot of planning consultants — urban, urban planning consultants. We hire engineers. We, we own a lot of property. We do the city's major real estate permitting function. And we are the city's urban planning agency. So all of those buckets require different consultants at different times. And when the new mayor came into office — not so new anymore, he's been mayor for six years, we're midway through our second term. But when the, when the mayor came in in 2014, we had firms like KPMG in here. We had McKinsey come in to look at our operations and to recommend improvements. More, more conventional management consultants to look at our operation and see how we might improve it. This was a radically different animal that we were dealing with with regard to the COVID crisis, and we needed a radically different type of consultant to help us think through our response to the challenge.

[00:06:36.680] RR: Can you talk a little bit about how the McChrystal Group helped you or proposed to help the city prepare for a pandemic emergency? And like you said, the likes of which we haven't seen in over 100 years, so there's that a little bit of the unknown as well.

[00:06:52.870] BG: No question. And as is often used a phrase in the army, no, no plan survives contact with reality, or no plan survives contact with the enemy. And it doesn't mean the plans are worthless. It means that the plans have to be tailored to the reality on the ground. And so there were a variety of, of plans that the day the McChrystal Group showed up, we dropped on them. They showed up on a Sunday evening — I think it was March 22nd. And we'd had conversations a few days before that about the nature of the consultancy we needed. We began to drill down on the McChrystal Group. The mayor of Boston had an excellent conversation, I believe on a Friday or Saturday, with General McChrystal himself, and the McChrystal Group arrived late Sunday evening. And we brought them all the plans that we thought were relevant to the city's crisis response. They pored through them over the ensuing days and identified gaps and resource needs. And one of the first things they pointed out was that while a lot of the planning that had been done — I mean, there was a pandemic plan that the city had created years ago. There'd been a more recent, a very recent iteration in early March that, that sought to refine that pandemic plan and tailor it to COVID. But what was immediately identified as a gap was the fact that most agencies had plans that were very much vertically focused. What would that agency itself do given that agency's public service mission? And they were not as integrated as well as they could have been. They were not — the resources were not as clearly identified as they could have been. And, and when the resources aren't identified clearly, there is obviously the potential for conflict. Maybe different agencies expect to have access to the same resource, not realizing that there is the potential for a conflict in the competition for the limited resource. So what the McChrystal Group did fast and furious was to deconflict. To integrate all of these plans, identify the gaps and immediately fill those gaps. Identify resources that weren't essentially being cannibalized by other city agencies so that we had a clear view of reality — what the agencies would do and what the resources they would need to do their jobs were. And so we, we made sure each agency had what it needed, had appropriate goals and the ways and means and resources to accomplish those goals. But also in the context of a unity-of-government approach, this — what they really helped us build was a perspective that focused on the whole of government, really the sum of all its parts, working cohesively and collaboratively together. And, and within 48 hours, the McChrystal Group had stood up a whole-of-government crisis response mechanism. Literally, we began to meet, a couple days after their arrival, every morning virtually through a video teleconferencing [platform]. Every morning at 8 a.m., all of the relevant agencies' leaders are on a video teleconference talking to each other, briefing about what the current reality looked like, what the current demands on their agencies and their plans were, what needed to be adjusted, what needed to be supported by other agencies, so that in real time we are identifying the truth on the ground and who was going to do what with what resources to address that. So that not only we have clarity about the agency that was acting, but also what the support was from other agencies. So they really helped build us this infrastructure overnight that, that dealt with the sharing of information, critical thinking, and addressing day-to-day needs for as long as we need to be doing it.

[00:11:25.910] RR: Wow. Can you — so listeners can understand — how many agencies are approximately part of this meeting and group that you have together now?

[00:11:35.470] BG: There's about 40 people on the 8 a.m. video teleconference every day. And that's every day of the week; it's Saturdays and Sundays included.

[00:11:47.540] RR: OK. And tell us a little bit about how this whole process has maybe changed the role of planners or plan— the planning department within the city or how you see this moving forward postpandemic.

[00:12:03.100] BG: Sure. So I'll talk about right now what some people are doing. First of all, the planning department continues to function. A lot of what we do in the communities, in the neighborhoods — the planning meetings and the real estate development permitting meetings that occur in our neighborhoods have been suspended. No surprise there. But a lot of the more detailed work can continue to be done remotely. And our planners and our project managers on the, the development permitting front continue to work on the details, continue to engage civic activists, developers, a whole range of stakeholders in our processes remotely. But there are also people who are responding to the crisis. For instance, there is a team that was stood up. It has urban planners, and it has some of our development review folks and some other professionals involved that are refining the city's food access plan. Right now, you have a lot of vulnerable people who need to get food, who have difficulty getting the food. It might be elderly people. It might be folks with disabilities. It might be school-age children who are used to getting their breakfast and lunch at the Boston, through the Boston Public School system. So we are knitting together all of the public agencies and the nonprofit agencies, making sure we identify the gaps in access to food and making sure we have a mechanism to get food to the people who need it. So that is a function that this agency has taken on. Again, very unusual given what we normally do for a living here. But it's an essential task, and because we are a planning agency, not necessarily a pandemic-response planning agency, but we are being called upon and happy to respond to that specific need. My, my role and the role of some others in the agency has been to work with the McChrystal Group in part on this whole-of-government approach. Every 24 hours, there's a whole lot of action items that come out of that 8 a.m. call that are worked throughout the day and then updated later in the day or the following morning on the 8 a.m. call. So there is that — a huge variety of issues that need to be worked there. Some of us are dealing with that. We just stood up a major field hospital in Boston at our convention center. Five hundred hospital beds and five hundred beds for the unsheltered population in the city that is COVID positive but has no place to go. They don't have a home to go to. They can't go back to the shelter that was their temporary home, because we can't have COVID positive people infecting people who are not COVID positive. Pretty basic stuff. So we have a thousand bed facility at the convention center that just started operating a couple days ago. So that effort was worked on and continues to be worked on by a variety of professionals in the agency. One of our staff came from New York a couple years ago, worked in the Bloomberg administration on Hurricane Sandy recovery efforts. That person came [laughs] here to work on climate change and resiliency. He's got his old hat back on and is doing emergency response, is playing a pivotal role in networking the city, the state, and the federal government on addressing logistical needs, primarily as it relates to this new field hospital, but also in a variety of other ways. So people are being tasked with things that they never really dreamt at all possible or likely, and we're all happy to play a role. So that's the immediate need that the agency is, is addressing. And that's just a few of the things I think might be worth noting. Longer term, you can bet the world is going to change in the way we do business. I, I've got to believe that most municipalities in America are going to do things differently when it comes to approaches to thinking about and preparing for a pandemic. Back in, back in the early 2000s in the wake of the terrorist attack in New York City and, you know, constant discussions about the fear of nuclear, biologic, and chemical warfare — the so-called NBC weapons of mass destruction. There was a lot of concern about whether or not a pandemic could occur either naturally, organically, or induced by bad actors. But with the the economic catastrophe at the time, of 2008, 2009, attention shifted elsewhere to deal with the more immediate crisis. And I think now, while lots of municipalities and states and the federal government had emergency preparedness planning that had occurred, was it as robust, was it as detailed, was it exercised? Were there sufficient drills for the different scenarios occurring year after year for the past 19 years? My bet is no, that everybody is going to be doing a whole lot more detailed planning, and identifying resources and roles to support those plans, and then exercising them so that we all develop muscle memory as government agencies in responding to the next big crisis. So I think you will see that. I don't think this is a surprise or there'd be much objection, I think, to my characterization that most municipalities in America will be looking at this far more seriously than they have been in recent years.

[00:18:20.020] RR: And it's my understanding — you mentioned a little bit that the McChrystal Group is part of this daily briefing that you're having, and there are McChrystal Group staff members who are embedded within the city government — I believe for the next two months. Can you talk a little bit more about what you're learning from having their ongoing presence as part of those meetings, and what can other communities take away from that that maybe they're not thinking of right now in how it would be beneficial?

[00:18:47.450] BG: Again, the McChrystal Group has created and continues to oversee a structure that allows for the free flow of information so that we can constantly define the new reality and respond to it. So the most important thing, I think for Boston as well as any other municipality, is to create a disciplined structure that allows the major stakeholders and decision makers in government and operators in government to understand reality and to make decisions. This, this is a decision-making structure and an information-sharing structure that has been established for us. And again, we think it's really important, at least as the point of departure, the past couple weeks working with the McChrystal Group, that we had an objective external set of eyes. Because every individual has their biases and their self-interest. They may think they're looking at things objectively, but we all have selfish interests, both as individuals and as organizations. So to get some outside thing — doesn't have to be the McChrystal Group, could be an academic, it could be another government body. But help you think critically about what your own capacity is, the decisions you're making to prepare and whether they're sound? And to have honest, critical thinking and critical commentary on your activities — that is absolutely essential for everybody. So we felt great about the fact this established, respected entity came in and we could all listen to them without worrying about — I'm not saying there's turf issues, but you don't have to worry about one agency criticizing another agency or one senior staff or criticizing another or a subordinate agency. We have an external party with really serious credibility looking at what we're doing and recommending and helping us — not just recommend but helping us to create a structure that responds to the crisis. Everybody can benefit from something like that. Now who that entity is that offers the critique could be a wide range of actors, but we thought it was essential to sort of hold a mirror up to us, ourselves, and say, "Man, where are the, where are the flaws here? Where are the gaps? How do we fill them?" And we were obviously doing it. This is the quintessential "fixing an airplane engine while the plane's in flight." That, that's tough. So better to be doing a whole — better to be doing that than not doing it, but also better to be preparing well in advance and just constantly testing it, constantly critiquing. So we, I'd like to think, have now got that in our bones. We have developed muscle memory to do that on our own without the external consultant.

[00:21:58.490] RR: Can you talk to us a little bit about some opportunities for planners kind of in helping to develop this communications infrastructure you mentioned? Planners, you know, are very good at communicating and making sure all ideas and groups are brought together. How can the profession benefit from this and move forward?

[00:22:18.820] BG: So that thought process has already begun. Again, we're dealing with a very serious crisis and we're plugging in as many people as we believe will provide value to the response. And that's occurring daily here. One of the, one of the things I instituted the first week after we essentially shut down business in city hall, as far as the, the full complement of Boston Planning and Development Agency staff coming to work — there are literally maybe two or three people here a day out of the 250 who do work here — but every Thursday, this will be my fourth tomorrow, we do an all-staff conversation with everybody in the agency. I share what I know about the response to COVID. Again, give people a feel for the whole-of-government, integrated approach that has been adopted and continues to be refined every week, some of the major activities — I always focus on the particular role that the agency is playing in the crisis response with the notion that as time goes by the agency will begin to understand how we played a role and, just as importantly, how we can continue to play a broader role week to week in this crisis, as well as prepare for the next. I think for years to come, from now on, you will see the planning division within this agency, which is the biggest piece of the agency — it is the largest division within the BPDA. You will see more of those professionals identify opportunities in our neighborhood, in our downtown planning efforts, to, to begin to prepare for the next major public health and/or other crisis. For instance, you know, we're already talking about what are the things — we adopted a citywide plan, the first done in 50 years was adopted in 2017. What were some things — if we were to go back and look at that document just a couple years ago, it was adopted — what would we do differently? For instance, the hospitals. The hospitals are a big part of life in Boston. We're a major, you know, medical behemoth. There are ten major medical centers. What should we, what should we have done, what should we do going forward to address the need through institutional master plans, for instance, which every hospital has? What should we be doing to identify means by which they could prepare for a surge? Right now Boston is, has been operating under the assumption [that] we need to create about 50 percent more hospital beds generally than we have in the medical centers. Not clear whether that number is what we will ultimately need, but we have been acting with that as an informative goal to our behavior. So could we have done something that really began to think about that through either our macro planning or through the IMPs, the institutional master plans, that every hospital has? I think you can, you can take it to the bank that going forward, we'll be thinking about how to deal with the needs of vulnerable populations, whether it's school children who have to stay home and need to access food, whether it's the city's homeless population that might be particularly vulnerable. The elderly, the city's elderly commission is, is really doing a significant amount of activity, staying in touch with our seniors and making sure that they are accessing the health care, and food and other needs are being addressed. But again, you look at more broadly, where, where would you find facilities to house people who could not go home as the city confronts a pandemic? I think all of those things are now front and center in demanding our attention and a meaningful response in all of our planning activities. Again, whether it's the citywide general plan, the neighborhood planning that's going on, or the institutional planning that's going on, there is something about the pandemic that will inform our decision making and our activities in all of those areas going forward.

[00:27:11.390] RR: And Brian, you've hit on a couple of times already, as we've been talking, kind of lessons learned about, you know, a centralized infrastructure, having someone come in and kind of bring the community together. What other kind of lessons from this emergency response and COVID-19 planning can you recommend for other communities to consider beyond what we've already talked about? Anything else that's like, this is what you should be thinking about — and maybe it's for a community that their peak might be coming down the way a little bit with COVID or, heaven forbid, another pandemic hits us.

[00:27:47.600] BG: Sure. I think, first and foremost, everybody needs to be about the business of creating a communications infrastructure and integration of all city agencies, making sure that everybody is moved out of their silos and is talking to each other about needs and the, the availability of the means to address those needs. That is the most crucial thing. We're — our peak is almost upon us. The peak and weeks of surge. ... Our medical system's capacity will be strained and probably exceeded. That's why we've created a major new field hospital and we're seeing other facilities being brought online to deal with the demands that the surge will place on our system. But you — every, every municipality that is confronting this needs to make sure that they are talking to each other within their, within — agency to agency, interdepartmentally, but also with their state. We've learned an awful lot about how to seek both support in the form of professionals, personnel, as well as supplies and equipment through the State Emergency Management Agency, which then goes up to the Federal Emergency Management Agency, FEMA. So we are far smarter today in our ability to communicate with each other and take action collectively at the city level. But we're also far smarter in our ability to get significant supplies, personnel, and equipment vertically from the state and from the federal government. So I would say begin, if you haven't already, if your peak looks like it's May as opposed to April or beyond, make sure you understand the processes by which you will requisition and obtain support from upper echelons, higher echelons of government. That is what needs to happen. And if you have — look, we're a significant-sized city. We have eighteen thousand employees and there are planning functions embedded everywhere. We're the land use planning agency, and we did the citywide comprehensive general plan. But there are planners in the transportation division and public works. Obviously where do I begin when I talk about the Boston Public Health Commission, our city's public health department? Making sure that they are all integrated, that needs are understood, and if we can't satisfy those needs at the city level, that we're getting them higher up or through the private sector. And I think this really gets to the point you're getting at, preparing above and beyond this, this whole-of-government approach. If — we went through a very painful process of literally brainstorming and then rank-order prioritizing, where would we put large populations who couldn't go home because they were COVID positive and we needed to, to mitigate the potential for community spread? So looking at government buildings — city, state, federal. Looking at private-sector facilities and reaching out and talking to private landlords of major facilities that we might need to house our homeless population or house the overflow at the major Boston medical centers and metropolitan medical centers. So a whole lot of that work was done on the fly, and there's no good reason why going forward we can't be having those conversations well in advance if we needed a major facility to house people or to treat people for medical needs associated with a pandemic. Where would those facilities be? Have we got plans to flick the switch and turn them on? That can all be done now. If you haven't done it already, you should be doing it. And we should all be doing it well into the future and just constantly refining availability of facilities and personnel and resources, supplies, equipment. That's going to be work that we do as well as our other colleagues in government, whether they are planners or not.

[00:32:36.460] RR: Wonderful. Brian, I want to thank you so much for taking the time — I know you're very busy — to kind of talk with us a little bit today and to also share some really wise information for other communities to consider as we're all facing the pandemic together.

[00:32:53.750] BG: No, I'm — it was a great pleasure to be with you. And I think it's really important that municipalities talk to each other and learn from experience. In our case, we think we had some really serious, substantive infrastructure in place, but there was also significant room for improvement. And I'm really pleased to be able to offer you a candid assessment of where we were and, and how other municipalities in the country might benefit from our experience. So thank you.

[00:33:30.280] RR: Thanks, Brian.

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