With hospitals juggling staffing problems and an increase in patients, state officials on Friday issued a public health emergency order that they say will provide staff flexibility, ensure sufficient acute care capacity, and enable facilities to reopen inpatient capacity in spaces not currently being utilized.
The Department of Public Health also updated its Nov. 23 guidance intended to reduce non-essential, elective services at hospitals. Under the update, such services may be reduced by 50%, effective Dec. 15, compared to the 30% reduction envisioned in initial guidance.
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In making the announcements, the state Executive Office of Health and Human Services said the state's health care system is "facing a critical staffing shortage which has contributed to the loss of approximately 500 medical/surgical and ICU hospital beds" and that hospitals are also "seeing a high level of patients, mostly due to non-COVID related reasons."
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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.
"The Commonwealth's hospitals continue to face significant challenges due to staffing shortages," said Secretary Marylou Sudders. "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."
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.
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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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."
State House News Service contributed to this report.
