Restrictions extended, ICUs afforded staffing flexibility
Photo | SHNS
Gov. Charlie Baker
The post-Christmas business restrictions put in place by Gov. Charlie Baker to prevent a worst-case holiday surge of COVID-19 will be extended at least an additional two weeks as the number of daily new cases of the virus in Massachusetts and the rise in hospitalizations continue to ring alarm bells.
Baker also said that hospitals constrained in their capacity to treat the volume of COVID-19 and other emergency patients coming through the door would be given flexibility to redeploy nurses to maximize bed space.
The administration said hospitals with less than 20 percent bed capacity across their system who have already suspended non-essential, elective invasive procedures can request a temporary exemption from mandated nurse-to-patient staffing ratios in intensive care units.
The move was cheered by hospitals, but one nurse union leader said it could put lives in danger.
"We remain committed to supporting our world class health care system and our incredible health care workers and we believe that these steps, among others, are crucial to ensuring that they can continue to provide the care to all the patients who need it as we battle this pandemic," Baker said at a State House press conference.
Beginning the day after Christmas, most businesses in Massachusetts were told that their capacity for customers must be reduced to 25 percent and that the limits on social gatherings would be lowered from 50 to 25 outdoors and 10 indoors, including events and public spaces.
Those restrictions were due to potentially lift at noon on Jan. 10, but Baker Thursday said he would be extending them until at least Jan. 24.
"We know that extending those restrictions for many businesses, especially small businesses, is a lot to ask. But we need to stay in this game a little longer, especially during this most crucial period to stop the spread of the virus and build the bridge to vaccines," the governor said.
Since Thanksgiving, the state has experienced a worrying surge in COVID-19 cases that has dimmed some of the hope that came with the arrival of vaccines.
Baker said that since Thanksgiving there has been a 91 percent jump in the average number of daily new COVID-19 cases detected, and a 145 percent increase in hospitalizations over the last six weeks.
"That puts a lot of pressure on our health care system and our hospitals," Baker said.
In November, Baker said that based on testing volumes at the time, tests were actually identifying probably one in four COVID-19 cases, "maybe higher depending upon the assumptions people make."
On Thanksgiving Day, 65 percent of medical and surgical beds and 50 percent of ICU beds were occupied across the state. Those occupancy numbers were up to 88.9 percent and 79 percent, as of Wednesday.
While Massachusetts has opened two field hospitals in Worcester and Lowell since November with a capacity to serve 225 patients, 57 of those beds are also occupied.
"As the health care system absorbs the magnitude of the impact of the holiday season, they need more relief," Baker said.
Health and Human Services Secretary Marylou Sudders said that because hospital capacity statewide has fallen below 20 percent all hospitals have been moved into Tier 4 of their preparedness planning, meaning there is "active and ongoing constraint warranting intervention."
All hospitals meet daily with one another within regions to discuss their load capacity and make plans if patients need to be transferred within systems or to other hospitals within the region with the capacity to provide the greatest care.
Sudders said once triaged and stabilized, COVID-19 positive patients may either be treated at hospitals or transferred to one of the two specialty field hospitals. Non-COVID patients may also be transferred without their consent, preferably within the region.
The secretary stressed that unlike in the spring the state has not closed outpatient services, but hospitals with less than 20 percent capacity who have suspended all non-essential invasive procedures may request a temporary reprieve from mandated nurse-to-patients staffing ratios.
"This is not an across the board exemption," Sudders said. "It's hospital or hospital system specific."
Massachusetts Health and Hospital Association CEO Steve Walsh said the pressures on hospitals were "growing more intense by the day."
"As COVID-19 admissions continue to rise, hospitals are doing everything in their power to create additional capacity and keep up with care demand. The measures announced by the Baker administration today will help ensure that they can maintain a fully flexible workforce, maintain beds for the sickest patients, and keep services open that are crucial to long-term health," Walsh said.
However, Katie Murphy, the president of the Massachusetts Nurses Assocation and an ICU nurse at Brigham and Women's Hospital, said hospitals should be hiring more nurses, instead.
"These patients are critically ill and to now spread the nurses even thinner could have fatal consequences. We're really against it," Murphy said.
Murphy said the reason nurses fought for changes in the law to ensure certain staffing ratios is because they have been shonw to improve health outcomes for patients.
"Some hospitals have not staffed up, have furloughed," Murphy said. "I don't think patients should be placed at risk because hospitals didn't plan for, wouldn't plan for or thought it would be more financially advantageous to not plan, but we all knew this was coming," she said.
Baker said he's not looking to open additional field hospitals at this time, noting that the 2,416 patients currently hospitalized with COVID-19 is still well below the spring peak of more than 4,000.
With health care workers already eligible for vaccination and first responders like police and firefighters poised to gain access next week, Baker said detailed data on the state's vaccination efforts would be released later Thursday, but to date 329,000 first and second doses of vaccine have been shipped to Massachusetts, and 154,132 doses had been reported as administered.
CVS and Walgreens has also administered vaccine at 280 of the state's 383 nursing homes, he said.
"We know these can't be administered fast enough," Baker said.
WBJ Web Partners
Most Recent
Most Recent
0 Comments