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April 15, 2020

Baker: "We are in the surge"

Photo | SHNS Gov. Charlie Baker

Two and a half months after the first confirmed case in Massachusetts, and as the total number of COVID-19 cases passes 28,000 and the number of deaths from the virus approaches 1,000, Gov. Charlie Baker said Wednesday the surge of COVID-19 patients Massachusetts has been preparing for has arrived.

"I would say at this point in time, based on the conversations we're having every day with our colleagues in the hospital community, that we are in the surge, yes," the governor said in response to a question at his daily coronavirus press conference Wednesday.

The state has been working with the health care sector since at least February to be as prepared as possible for the influx that is expected to put hospitals, health care workers and emergency medical providers under tremendous stress. Hospitals have added to their bed capacity, beds that typically would be occupied by people who had elective procedures have been kept open, and the state has established field hospitals in a convention center and arena in case traditional hospitals become overwhelmed.

"I would say at this point in time I believe, with the addition of some of the other stuff that's coming online over the course of the next five to seven days, we are pretty well positioned to deal with this," Baker said.

As of Tuesday afternoon, the state had 28,163 confirmed cases of COVID-19 and 957 people had lost their lives to the new and highly-contagious virus. More than 9,000 more Massachusetts residents are under active quarantine or monitoring because of a possible exposure to the virus. Baker has said that the state's modeling estimates that the total number of COVID-19 cases in Massachusetts "will range somewhere between 47,000 and 172,000 cases during the course of the pandemic."

As of Monday - the most recent hospital capacity report from state officials - Massachusetts had 17,600 beds capable of treating COVID-19 and the governor said roughly half of those beds remained open. He said Wednesday that just under 6,000 of the beds are acute care beds, just more than 2,500 are intensive care unit beds and another roughly 750 beds are available at the field hospitals that have been set up at the DCU Center in Worcester and the Boston Convention and Exhibition Center.

The number of field hospital beds will continue to grow over the next week or so, Baker said, alluding to field hospitals expected to open at Joint Base Cape Cod, and in Lowell and Dartmouth.

"Right now the number of patients that the two sites that are open is relatively low, just a handful. But these sites are being built to augment existing hospital capacity and we hope this surge in cases is not significant enough that we'll need to rely heavily on those beds," he said. "But we think it's important that they be there and that we have them because all along the goal has been to plan for the worst, and that's exactly what we've been doing."

The state's COVID-19 Command Center, led by Health and Human Services Secretary Marylou Sudders, has also been working to ensure doctors, nurses and other health care workers are prepared with critical protective gear. Baker said Wednesday that the state has distributed more than 3.7 million pieces of personal protective gear to hospitals, nursing homes, public safety offices and others.

"This includes over 2 million gloves, over 820,000 masks -- over 370,000 masks from the AirKraft delivery -- and over 170,000 gowns," he said, adding that another portion of the "AirKraft" delivery -- a shipment of PPE from China secured and delivered with the help of New England Patriots owner Robert Kraft -- arrived in Massachusetts.

The governor said the federal government informed his administration Wednesday morning that it is providing the state with 1 million more pieces of PPE, including 650,000 masks and 260,000 Tyvek suits. But Baker said the command center continues to work around the clock to obtain more and more of the critical gear.

"I will never be satisfied that Massachusetts has what it needs with respect to to gear generally because one of the biggest lessons I hope that we and others have learned through this whole experience is you have enough gear until you don't," he said. "And then once you don't, finding it and acquiring it becomes enormously difficult. ... We're gonna keep chasing all elements of that stuff because I'm honestly never going to be comfortable that we have enough."

Long-term care facilities like nursing homes and assisted living centers have emerged as an important front in the battle against the virus, which can be particularly lethal to the elderly and people with underlying medical conditions. Baker and Sudders on Wednesday outlined many of the steps the administration is taking to support those facilities -- including $130 million in new funding, expanded testing, and PPE allocation.

"In early April, we announced an across the board 10 percent MassHealth rate increase, which is worth about $50 million, for all nursing facilities effective April 1 as part of that first out-of-the box, early stabilization package. Additionally, facilities that create dedicated COVID-19 wings or units, and who follow necessary safety protocols, will be eligible for an additional 15 percent rate increase ... that's worth approximately $50 million," Sudders said, adding that the administration assumes two-thirds of the 398 long-term care facilities in the state will set up dedicated units.

The remaining $30 million, Sudders said, will be used to continue to establish skilled nursing facilities dedicated to COVID-19, like the state has done at Beaumont Rehab and Skilled Nursing Center in Worcester. Baker said COVID-19 dedicated facilities in Brewster, Falmouth, New Bedford, East Longmeadow and Great Barrington will open within 10 days and that there are "several others in the planning stages."

There are 383 nursing homes, 255 assisted living residences and 93 rest homes in Massachusetts, the governor said. Approximately 38,000 people live in nursing homes, 16,500 in assisted living facilities and 3,000 residents in rest homes. As of Tuesday, 214 long-term care facilities had reported at least one case of COVID-19 and 3,907 residents or staff members had tested positive.

The state's mobile testing program collected more than 4,500 tests from 264 facilities as of Tuesday and 77 facilities had requested more than 8,600 test kits, the governor said. Since the start of March, almost 1.3 million masks, nearly 200,000 gowns and more than 2 million gloves have been distributed by the state to long-term care facilities.

The governor also said Wednesday that the state has contracted an unnamed firm that specializes in nursing home crisis management to provide long-term care centers with on-site management and operational support, and assistance with staffing, vendors, and implementing infection control measures.

The governor ended his prepared remarks Wednesday by noting that it was the seven-year anniversary of the Boston Marathon bombings that killed three people and left hundreds injured, including more than a dozen who lost a limb due to the blasts on Boylston Street.

"There was a lot of sadness that day, but there was also bravery, compassion and strength. First responders, health care workers and bystanders rushed in to help, putting their lives on the line in the process. Neighbors, friends and strangers held each other up with acts of kindness. The city and the commonwealth rallied, rose to the occasion, and turn tragedy into strength," Baker said.

"Now, as we all endure a worldwide pandemic, we are rising to the task to meet it again. Every day, nurses, doctors, public safety personnel and countless other essential workers in the public and private sectors are rushing to the frontlines. Millions of Massachusetts residents are sacrificing, upending their lives to protect one another from further spread. There's no doubt we have tremendous challenges ahead. But the one thing I am absolutely sure about and that is never in doubt is the remarkable people of Massachusetts. We will get through this. We will get through it together, just like we have so many times before."

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