COVID

Massachusetts hospitals filling with COVID patients — but still have space for more

Statewide, 20 percent of medical beds and 38 percent of ICU beds are still available, according to state officials.

By Priyanka Dayal McCluskey, The Boston Globe

December 5, 2020

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The number of people hospitalized for COVID-19 in Massachusetts is accelerating as the pandemic reaches new heights, but hospitals in the state are still far from getting overwhelmed.

For now, local hospitals have been able to avoid the level of crisis seen in other states, including neighboring Rhode Island, where hospitals filled up this week.

“The surge is definitely here,” said Steve Walsh, president of the Massachusetts Health & Hospital Association. “The real difference this time is that every hospital now has a plan in place. They know how to quickly scale up beds if necessary. They know how to keep COVID treatment separate from non-COVID treatment. They’ve been learning about this now for months.”

Across Massachusetts, 1,394 people with the coronavirus were hospitalized as of Friday. That’s up from 986 patients on Thanksgiving, and 178 on Labor Day. Of those in hospitals, 278 were in intensive care, and 134 were using ventilators to breathe.

Within the rising numbers, there are hopeful signs. The share of hospital patients in ICUs is lower than in the spring, partly because the people getting sick skew younger and are less likely to need intensive care. Doctors also know how to better manage the course of COVID-19 and treat patients before they reach critical condition. So for now, they are not worried about running out of ventilators.

The current number of hospitalizations is far below the peak of nearly 3,965 COVID patients in April, at the height of the first surge.

Statewide, 20 percent of medical beds and 38 percent of ICU beds are still available, according to state officials.

But to alleviate pressure on the health care system, the state is opening a field hospital Sunday at the DCU Center in Worcester, with at least one more planned for Lowell.

And as Massachusetts hospitals fill with COVID-19 patients, more of them may have to postpone elective procedures as they did in the spring but are trying to avoid this time.

Meanwhile, hospitals in the Dakotas, Montana, Utah, and other states are getting swamped. California’s governor warned this week that an influx of COVID patients may force hospitals to turn people away by Christmas.

Overwhelmed hospitals could be forced to ration care, said Dr. Eric Toner, senior scholar at the Johns Hopkins Center for Health Security.

“In many parts of the country, we are imminently facing a problem in hospital capacity,” he said. “We are facing a very bleak time over the course of the next month.”

In Massachusetts, doctors and hospital officials believe the state is not at the same crisis point as others because many residents are adhering to state restrictions, wearing masks and limiting gatherings. And Massachusetts already was hit hard by the virus, providing lessons for hospitals here, while other states are struggling through it for the first time.

Massachusetts hospital leaders regularly discuss their patient numbers and are working together and with state officials to balance the load so that no one hospital is completely overwhelmed.

The severity of the situation varies from one hospital to the next, and some in communities hit especially hard by the virus already are feeling the strain. Baystate Medical Center in Springfield surpassed more than 100 patients with COVID-19 this week — more than any other hospital in Massachusetts, according to state data.

Nancy Shendell-Falik, president of Baystate, is preparing for the possibility the number could double in the coming weeks.

“I didn’t think we’d be this high this fast,” she said. “If it gets higher, we will have the beds [but] we will have to make decisions then about what [non-COVID care] gets postponed and deferred.”

Baystate, in a change from last spring, has started transferring some less acute patients from its Springfield hub to its community hospital campuses to maintain space for the sickest COVID patients. Baystate officials also plan to convert areas of the hospital typically used during the day into 24-hour COVID units, if needed.

Hospital leaders and state officials digest a slew of data about the state of the pandemic every day — including new cases and new hospitalizations — and try to predict what will happen next.

At Mass General Brigham, the state’s largest hospital system, internal models look two weeks into the future, said Dr. Peter Dunn, a vice president at Massachusetts General Hospital who works on capacity management. The models pull together data from local hospitals, other states, and around the globe.

It’s too early to see the full effects of Thanksgiving, and how much holiday gatherings and travel contributed to higher cases of COVID-19. But Mass General Brigham’s models still show a steady rise in hospitalizations that is not as steep as what happened in the spring, or as severe as what hospitals in other parts of the country are experiencing now.

“We have not seen us tracking in the same way as . . . other hard-hit areas in the United States at this point,” Dunn said.

Not every hospitalized patient with the virus represents the same strain on the health care system, Dunn noted. At Mass. General, for example, about 30 percent of COVID patients are at the hospital primarily for some other reason — but also happen to test positive for COVID. They are mostly asymptomatic.

Dr. Assaad Sayah, chief executive of Cambridge Health Alliance, which runs Cambridge Hospital, said it’s difficult to predict the severity of the second surge because models change constantly. The number of COVID-19 patients at his system is nowhere near the height of the spring, when Cambridge Health Alliance transferred patients to other hospitals, including Beth Israel Deaconess Medical Center, to manage capacity. It also ran a satellite unit in a college dorm for patients with less severe illness.

“In a week or two weeks, we got overwhelmed,” Sayah said. “Now, it’s been a few weeks and we’re still managing.”

Twenty-eight patients with the virus were in beds at Cambridge Hospital as of Friday.

“I think it’s going to get a bit worse before it gets better,” Sayah said. “I’m hoping that in a few weeks, we’re going to have a vaccine. I hope that’s going to make a big difference.”