Massachusetts announced new measures on Friday to give hospitals dealing with “critical” staffing shortages and an influx of patients more flexibility to ensure sufficient acute care capacity.
The state Department of Public Health in conjunction with the Massachusetts Health & Hospital Association announced guidance to reduce certain nonessential, elective services and procedures by 50%, starting next Wednesday.
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Certain non-essential, elective services and procedures were already reduced by 30% last month.
The state has lost about 500 medical/surgical and ICU hospital beds and hospitals are seeing a high level of patients, mostly due to non-COVID-19 related reasons, the department said.
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In order to assure hospital inpatient capacity, the department issued an emergency order that provides ICU nursing staff ratio flexibility and that permits hospitals to create capacity in alternate spaces.
“Today’s actions will help alleviate pressures by providing hospitals with staffing flexibility in order to reopen inpatient capacity in licensed and alternate space not currently being utilized,” Health and Human Services Secretary Marylou Sudders said in a statement.
The state’s health care community is under “tremendous pressure, and these flexibilities will provide hospitals with additional tools to remain nimble and accessible as they navigate the weeks ahead,” hospital association President and CEO Steve Walsh said.
What does the emergency order mean, exactly?
The emergency order, issued by the Department of Public Health, governs intensive care unit nurse staffing ratios and permits hospitals to create additional capacity in alternate spaces. Staffing ratio flexibility will enable hospitals to redirect ICU nurses, although hospitals will be required to meet certain criteria to ensure patient safety and quality of care.
Under updated "alternate space" guidance, hospitals will be able to use licensed and unlicensed space for non-invasive outpatient care and to use alternate licensed inpatient spaces to care for medical/surgical and ICU adult patients through March 31, 2022 -- authorization for such uses would have otherwise expired on Dec. 31.
When will the COVID surge in Massachusetts end?
Massachusetts is currently seeing one of the worst spikes in coronavirus cases in the country. The delta variant has propelled a surge in COVID cases after Thanksgiving while the highly mutated omicron variant's impact remains to be seen as it gains a foothold in the Bay State.
Boston doctors say the situation in Massachusetts hospitals is unlikely to improve anytime soon.
"Our health care system is challenged," Dr. Jon Santiago of Boston Medical Center said. "It was challenging before COVID, but particularly in this pandemic and with this new surge.”
Santiago, a Massachusetts state representative and emergency room physician, blamed the overload on several issues including staff shortages, rising coronavirus cases and prolonged treatment that has compounded throughout the pandemic.
“We are in a crunch for beds at the smaller hospitals but at the larger hospitals as well," Santiago said. “You go to any emergency department across the Commonwealth, you will find beds in the ER, you will find people who are boarding -- that is waiting for a room to open up -- particularly in psychiatric cases."
Three other Boston doctors told NBC10 Boston that they're already feeling the impact of the surge during the weekly "COVID Q&A" series. Hospitals have seen a nearly 134% increase in COVID-19 admissions over the past month and about a 50% rise in just the past two weeks. About 93% of the state’s medical surgical beds are full and 87% of ICU beds are full.
Santiago said he expects the situation will only get worse.
"The concern is that going into the winter, with an uptick in the omicron variant and delta still very present, and an increase in flu and patients who are now attempting to get the care they should have gotten, or tried to get maybe months or years ago but for whatever reason didn’t, you have a problem," Santiago said. "That has only been worsening over the past couple of weeks and my guess is that it’s only going to get worse before it gets any better.”
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Other New England states also seeing spike in coronavirus cases
Massachusetts isn't the only state experiencing a surge in cases and hospitalizations, it's been happening across New England in recent weeks. The governors of Maine and New Hampshire announced earlier this week that they are activating the National Guard to help expand capacity at hospitals in their states.
Asked about those announcements Thursday, Baker said he is trying to determine if the Massachusetts National Guard could be called upon without causing more disruption among the health care workforce.
"I don't want to take people who are citizen soldiers, who are part of the guard, who currently work in many of these hospital positions," Baker said. "If there's a way that we can bring the Guard in and involve the Guard as an ancillary and supportive group to support what's going on in the health care system, we'll certainly pursue that and try and put it in place."
The Associated Press and State House News Service contributed to this report.
