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As the fiercely contagious Delta strain of the virus spreads infections at a frightening rate, hospital officials are worried about what could happen around the corner. And they’re frustrated with the number of unvaccinated COVID patients now ending up in hospital beds – a situation they describe as largely preventable if more people get vaccinated.
“It’s more sadness than anything else,” said Dr. Armando Paez, director of the infectious disease program at Baystate Medical Center in Springfield. “Look at someone breathless and you know it could have been avoided by getting the vaccine. “
Massachusetts was reporting 197 people hospitalized with COVID on Thursday, up from 80 the week of July 4, when the state’s seven-day average hit its lowest pandemic level. The spike in hospitals closely follows the increase in the number of people testing positive for COVID that began after the July 4 vacation.
The numbers are still well below last year’s peak, with more than 3,000 people were hospitalized on several days in April and May. But the trend is worrying, and some of the state’s largest hospitals are reporting the hospitalization rate is starting to accelerate.
Mass General Brigham, the state’s largest healthcare system, said the number of its COVID-19 hospital patients more than tripled this month, from 12 on July 1 to 38 on Wednesday. At UMass Memorial Medical Center in Worcester, cases also more than tripled, from 10 earlier this month to 33 on Wednesday. Baystate Medical Center in Springfield was reporting 17 midweek, up from a handful of COVID patients a week earlier. And Beth Israel Lahey Health said her COVID-19 patients went from 19 July 1 to 27 Thursday.
“It’s baffling,” said Dr Richard Ellison, infectious disease specialist at UMass. “None of our staff wants to go through what we went through last year or last winter.”
Dr Tom Sequist, a primary care physician who helped lead General Brigham’s COVID-19 response, said he and his colleagues were seeing an increase in the number of COVID hospital patients in their system.
“I am worried about the length of the current wave and its height,” he said.
Governor Charlie Baker pointed out that the second highest vaccination rate in the state – 69% of residents have received at least one dose – allowed Massachusetts residents extraordinary protection against the virus. Massachusetts still had Friday, the third-lowest COVID hospitalization rate in the country, behind Vermont and New Hampshire, according to the New York Times COVID tracker.
“Massachusetts is in a much better position than the vast majority of states in this country when it comes to how we deal with and how we are prepared to deal with COVID,” Baker said Wednesday after the Centers for Disease Control and Prevention have recommended a return to indoor masks in many counties across the country, including five in eastern Massachusetts, due to increased infections and hospitalizations.
Of course, vaccinations do not offer complete protection against COVID, as the July outbreak in Provincetown demonstrates. Nearly three-quarters of the 882 people who tested positive on Thursday have been vaccinated, prompting the Centers for Disease Control to reassess the ease with which the Delta variant spreads among those vaccinated. The agency reported on Friday that the rate of spread is extraordinary and that those who had been vaccinated appeared to carry the same level of virus as the unvaccinated – findings that were “pivotal” in prompting updated guidelines from the CDC.
But only seven of those infected in Provincetown were sick enough to be hospitalized, according to chief executive Alex Morse, and at least four of the those had been vaccinated, according to the CDC. Additionally, there has been at least one reported death of a vaccinated person on Cape Cod, Anna Silvi, 98, who lived in a West Yarmouth nursing home.
This year, about 97% of people hospitalized with COVID-19 in Massachusetts were not fully vaccinated, a figure that reflects the trend nationwide, in part because far fewer people were vaccinated earlier this year . But as of July, that number fell to 80% in Massachusetts, according to Globe analysis of state data. This is likely due to the increase in the new Delta strain and unusually high vaccination rates in the state, which means fewer unvaccinated people are contracting the virus.
Over the past month, analysis shows the risk of hospitalization from COVID was about eight times higher for those who were not fully vaccinated compared to those who were vaccinated, a number that has declined as more more people get vaccinated, but still important.
The Baker administration did not include vaccination rates among patients hospitalized with COVID in its regular public posts, but an administration spokeswoman said it was working with hospitals on this data and that it would be soon reported.
A Globe survey of Massachusetts hospitals shows officials are more concerned about unvaccinated people, both because there are so many of them and because their illnesses are so preventable.
More than 99% of COVID patients admitted to Tufts Medical Center since January have not been vaccinated, according to hospital records. More than 98% of Southcoast Health’s current COVID patients had not received their injections, said Dr Dani Hackner, clinical director of the system, which has hospitals in Fall River, New Bedford and Wareham.
“We are seeing COVID patients admitted with few risk factors and it’s tragic,” Hackner said. “We have had [COVID patients] ask for a vaccine after admission ”, when it is too late to help them.
Dr. Simone Wildes, an infectious disease physician at South Shore Health, has said almost every day that she meets COVID-free patients in hospital who are not yet vaccinated and could easily obtain this protection. Most of those who resist, she said, are in their 20s, 30s and 40s.
Wildes said she was offering a shot there, on the spot. Yet many are declining.
“You would think that being in the hospital would pique their interest a bit,” she said. “But they still don’t want to be vaccinated. They are still waiting to see how it affects others.
Dr. Kari Roberts, an intensive care doctor at Tufts Medical Center, said almost all of the COVID-19 patients she saw were not vaccinated. She said those who were not shot were largely in their 40s and 50s. But she has seen people in their 20s and 30s die from COVID throughout the pandemic, with and without other underlying health issues.
“It’s not 70-year-old diabetics with hypertension who smoke,” she said. “These are 30-year-olds with jobs, college or high school, families or dogs or plants.”
The increase in cases, she said, makes it harder to believe the pandemic will ever subside completely.
“I don’t know how we keep doing this over and over again,” she said. “We will, I guess. But I don’t feel like any of us have had a chance to catch our breath.
As the virus reappears, health and social justice advocates say it is essential for the state to publicly report not only on the immunization status of patients, but also on the demographics of COVID-19 hospitalizations , which he stopped doing on July 1.
They said inequalities during the pandemic, including the inability to work remotely and a heavy reliance on public transportation, fueled higher infection rates in low-income neighborhoods and communities of color. Demographics, before publication stopped, showed the consequences of these inequalities: significantly higher COVID hospitalization rates in black and brown communities, even after vaccines became more widely available.
“In order to address inequalities, we need to be able to measure them,” a coalition of more than a dozen advocacy groups called Vaccine Equity Now !, said in a July 28 letter to the Baker administration urging officials to resume monitoring and reporting.
A spokeswoman for the Baker administration said demographics were reported to the state by hospitals and tended to be incomplete or underreported. He said the state decided to remove all data because it lacked complete figures on the race and ethnicity of hospitalized COVID patients.
Leaders of hospitals outside the coalition also spoke of the need for the state to better address racial disparities and the severe consequences of more COVID-related hospitalizations and deaths if such risk factors are left unanswered.
“If we don’t take care of the really vulnerable people, and if we don’t do things right from an equity standpoint, it’s not just those vulnerable people who are going to suffer,” said Dr Alister Martin, emergency doctor in Mass. General hospital. “It’s all of us.
Kay Lazar can be reached at [email protected] Follow her on Twitter @GlobeKayLazar. Ivy Scott can be contacted at [email protected]. Follow her on Twitter @itsivyscott.
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