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Baker order aims to preserve hospital capacity in Massachusetts

Massachusetts Governor Charlie Baker on January 21, 2021.
State House News Service
Massachusetts Governor Charlie Baker.

Updated at 4:52 p.m. 

As COVID-19 hospitalizations in Massachusetts climb and residents seek care that they might have put off over the last year and a half, the Baker administration will next week begin requiring hospitals to roll back non-essential and non-urgent scheduled procedures if the number of available beds at the facility is limited.

The new order from Acting Public Health Commissioner Margret Cooke was developed in tandem with the Massachusetts Health & Hospital Association, and is intended to ensure that hospitals maintain adequate capacity for immediate health care needs while they deal with "a critical staffing shortage" that has already fueled the loss of about 500 medical/surgical and ICU hospital beds across Massachusetts, the Baker administration said.

The order is effective Nov. 29.

"The current strain on hospital capacity is due to longer than average hospital stays and significant workforce shortages, separate and apart from the challenges brought on by COVID," Secretary of Health and Human Services Marylou Sudders said. "COVID hospitalizations in Massachusetts remain lower than almost every other state in the nation, but the challenges the healthcare system face remain, and this order will ensure hospitals can serve all residents, including those who require treatment for COVID-19."

The administration said that "the current high census level and annual increases in hospitalization commonly seen during the period post-Thanksgiving through January" also contributed to the decision.

As of Monday's update from DPH, there were 708 people hospitalized with COVID-19 in Massachusetts, more than any day since April, and the hospital system was averaging about 647 patients each day.

Last year, when vaccines were not available, COVID-19 hospitalizations exploded after Thanksgiving — jumping more than 135% from 986 patients on Thanksgiving to 2,323 patients on New Year's Eve.

"In terms of hospitalization, the numbers thankfully are much lower. We're in the 700-ish range. But I think to crest 1,000 patients in hospitals again ... does start to strain the health care resources of the commonwealth," Dr. Paul Biddinger, a Massachusetts General Hospital disaster medicine specialist who has advised the administration on COVID-19, said in April when COVID-19 hospitalizations were at roughly the same level.

Cooke's order said non-essential procedures will have to be limited at any hospital or system "that does not maintain or exceed the available staffed medical-surgical and intensive care unit bed capacity threshold" as set by DPH.

A spokesperson did not respond when asked what the DPH threshold has been set at. 

Baystate Health Systems, which operates several hospitals across western Massachusetts, said it was facing capacity challenges, in part but not wholly as a result of a rise in COVID cases.

"Baystate Health, in compliance with the Baker Administration guidance, is working with its physicians to reduce elective procedures at its hospitals and is currently reaching out to those patients whose prescheduled procedures need to be postponed," said Baystate Health president and CEO Dr. Mark Keroack. "Decisions about postponement of procedures is being done on an individual basis as our clinical teams evaluate medical needs of each patient."

Keroack acknowledged that postponing procedures is "difficult news" for impacted patients.

A spokesperson for Berkshire Medical Center in Pittsfield said the new order will not impact the hospital as it is "not close" to capacity.

At Cooley Dickinson Hospital in Northampton, a spokesperson said patient volume is higher than typical, but the facility is currently able to accommodate all scheduled procedures.

NEPM's Adam Frenier contributed to this report.

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