Dr. Melisa Lai-Becker, the medical director for the emergency department at Cambridge Health Alliance’s Everett Hospital, spent much of Monday afternoon urgently calling hospitals all over the state.
“I was searching for an ICU [intensive care unit] bed for one of our patients, and every single facility is full,” she said. “They are at full capacity. They have no ICU beds left.”
She even started looking up hospitals she could call in neighboring states, but they’re in the same predicament.
Before the holidays, public health experts warned that the combination of gatherings and the highly contagious omicron variant of the coronavirus could fuel a dramatic surge of cases and put further strain on hospitals already burdened with staffing shortages and increased patient needs due to delayed care. Those fears appear to have been realized. The state reported more than 31,000 new COVID-19 cases on Monday, January 3, 2022, which includes tests taken over the long holiday weekend. On Tuesday, the state added nearly 17,000 more confirmed cases to that tally. Last winter, the seven-day average of new confirmed cases peaked at about 6,000.
Experts say although the now-dominant omicron variant appears to result in less severe illness than earlier variants, the sheer number of new cases is overwhelming the capacity of the state’s hospitals.
“It’s really a math issue,” Lai-Becker said. “It’s the sheer volume, that so many more people have been infected with COVID.”
Even if only a small percentage of people who have COVID-19 require hospitalization for their symptoms, overall case numbers are so high that even that small percentage is enough to pack emergency rooms, she explained.
“The big concern right now is if we’re at a much, much higher number of cases — even if the severity is lower — the total hospitalizations may turn out to be the same as we saw last winter, or even higher,” said Andrew Lover, an assistant professor of epidemiology at UMass Amherst.
“Last year, there was a large spike all the way through mid-January. And I certainly expect to see the same this year,” he said. “And we’re already starting in a much higher level of reported infections so we could see an extremely high plateau.”
Just how bad it’s going to get isn’t clear yet, said Dr. Paul Biddinger, chief preparedness and continuity officer for Mass General Brigham and a member of Gov. Charlie Baker’s medical advisory committee for COVID-19.
“We’re very well aware of what happened in South Africa, where the numbers shot up astronomically, but then fell pretty quickly,” Biddinger said. “That’s obviously what we’re hoping here, is that the numbers start falling quickly. But I don’t think yet we have a sense for when the peak is going to come.”
More than 2,300 people in the state were hospitalized with COVID-19 as of Monday. That’s still significantly fewer than the nearly 4,000 people who were hospitalized at one point during the first COVID-19 surge in spring 2020. But back then, Biddinger said, hospitals in the state dramatically scaled back operations to focus on the pandemic, canceling everything but the most essential admissions and procedures.
“What we have seen … is actually the consequences of a lot of that canceled care where people come back sicker because they missed a procedure, missed an intervention,” he said. “And really, ever since the first wave, those chickens have been coming home to roost in terms of overall patient demand.”
That left hospitals packed before the current wave of COVID-19 patients. And on top of that, Biddinger said, many exhausted staff left the healthcare field during the last two years. And now, hospitals are seeing significant numbers of staff members unable to come to work because of their own coronavirus infections or exposures.
At UMass Memorial Medical Center in Worcester, hospital epidemiologist Dr. Richard Ellison said he’s hoping staffing issues don’t get bad enough to require reductions in crucial care.
“Nurses who give chemotherapy for cancer patients get special training, and we can’t train our entire hospital workforce nursing staff to give cancer chemotherapy,” he said.
If too many of those nurses are out, Ellison said, the hospital may not be able to provide that care.
“So we have great concern that we could actually impact our ability to provide care for some patient populations,” he said.
The demand for emergency room beds is so high at UMass Memorial Medical Center, Ellison said, that some patients are being cared for in hallways, with privacy barriers put up between beds.
“There is no bed capacity right now in the UMass system,” he said. “As soon as someone gets discharged, the bed is being filled immediately.”
Back at Everett Hospital, Dr. Lai-Becker said reports of besieged medical facilities in other states now feel familiar.
“Everything we heard about earlier during different surges, about other areas of the country, that has come to Massachusetts,” she said. “That’s where we are. That’s how bad this particular surge is.”