COVID Numbers ‘steadied’ somewhat at Baystate Health, but staffing and care challenges remain
The COVID-19 surge, fueled by the omicron variant, continues to fill up hospitals and stretch medical resources. That's the case for Baystate Health, which operates several hospitals in western Massachusetts, including its flagship in Springfield.
Baystate President and CEO Dr. Mark Keroack said capacity issues continue.
Dr. Mark Keroack, Baystate Health: We got to a high of 325 COVID patients across the whole health system, and these would nearly all be this new omicron variant. Things have steadied, I think, a bit. And [Thursday] morning, we had our first day in a week below 300 — 297 across the whole health system.
In addition to the COVID patients, we've been operating at 5 to 10% above our licensed bed capacity for the last two months. So that's between 1000 and 1100 patients, even though we're licensed for only 980, meaning that a number of patients are holding and waiting in the emergency room who have non-COVID conditions.
Adam Frenier, NEPM: You've mentioned in the past staffing shortages have also been a problem during the recent COVID-19 surge. I imagine that's still the case, and perhaps even more so now. What are you doing to address that?
Baystate Health employs 13,000, and before this latest wave, we had 1800 open positions. These were mostly people who chose to take early retirement or else resigned. Now, with omicron being so contagious and able to cause even disease in vaccinated individuals, [Wednesday] we had 880 people out, either isolating, waiting for a COVID test, or known to be COVID positive and having to wait that five days before they could come back.
And what are you trying to do to bolster your staffing numbers?
Well, we've been hiring like crazy. We're bringing on between 100 and 150 new people each and every week through a number of different job fairs and hiring bonuses and incentives. We also have ... 250 contract nurses that we have contracted with from national organizations.
Also you said last month, because of capacity and staffing, it might become necessary to ration care. Have you seen any evidence of that taking place?
Well, we have been postponing and curtailing care. When we took a look at elective procedures, elective surgeries like joint replacement or obesity surgery, we've largely stopped those.
It's something we haven't yet had to do, but there are some scarce technologies that only Baystate offers that I do worry about, given how high the numbers are and the fact that it's not yet clear that we're at the top of the curve. One of them is called extracorporeal membrane oxygenation, or ECMO for short. That's heart-lung bypass, where you circulate the blood outside the body to exchange oxygen and carbon dioxide when the lungs stop working. Because the COVID case cases this time around are nearly 80% unvaccinated individuals, they tend to be somewhat younger and they can get pretty sick. And we do try to do whatever we can to pull them through, including these sort of heroic measures like ECMO.
And finally, Boston is about to require proof of vaccination to enter into our businesses like bars and restaurants this weekend, and Northampton's Board of Health is discussing a similar measure. Is this a good idea or a step too far?
From a public health and medical standpoint, it would limit the spread of infection. I think that then you get into the whole political question about freedom of choice and the ability to do what you want to do. I certainly could say that it would make medical and public health sense. Whether or not it would jive with American politics, I think, is a whole other story.