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The surge in coronavirus cases long expected by public health officials could start to hit Massachusetts between April 7 and April 17, Gov. Charlie Baker said Monday, stressing the importance of taking steps to prepare additional health care capacity.
With the state's testing apparatus up to thousands of patients per day, confirmed COVID-19 cases have recently been increasing at a rapid pace. Massachusetts had 5,752 cases as of Monday and 56 deaths attributable to the disease.
That trend will likely continue, Baker forecast during his daily press briefing Monday, and according to at least some models could hit its apex in the next eight to 18 days.
"This isn't an exact science, but generally speaking, most of the calculations that are out there with respect to Massachusetts, both some of the ones we've done and some of the ones other people have done, suggest that the surge here is probably going to start somewhere between (April) 7th and the 17th," Baker said.
State officials continue to prepare to manage and mitigate the peak. Baker identified four key areas of focus: protective gear, hospital bed capacity, ventilators and staffing.
On Monday, Baker announced that the federal government — which he criticized last week as handcuffing states' efforts to acquire protective equipment — will send more than 1,000 ventilators to Massachusetts, which will make a "big difference" to the most critical patients. He said he expected the ventilators to arrive by week's end.
The state also received another shipment of personal protective equipment from the national strategic stockpile over the weekend, and local manufacturers have begun working with the administration to supplement supplies. Baker said New Balance will begin manufacturing face mask prototypes in its Lawrence factory and then ramp up production across New England.
In another new state effort, about 1,800 people have registered to volunteer their medical expertise in hospitals amid the outbreak since the administration launched a portal last week, Baker announced Monday. They will be brought on board on an accelerated basis under a Department of Public Health order.
The governor outlined plans in motion to designate nursing homes specifically — and only — for care of patients with COVID-19. Beaumont Rehabilitation and Skilled Nursing Center in Worcester will start the process with 150 beds ready to begin transfer by Thursday, Baker said, before ramping up to a maximum capacity of about 300.
Altogether, the administration is targeting establishment of at least 1,000 beds for coronavirus-afflicted older adults, hoping both to lessen the strain on hospitals ahead of the forthcoming surge and to avoid requiring that skilled nursing facilities receive patients from hospitals.
"We need to continue to create significant capacity so our most vulnerable population, should they get infected with COVID-19 and need acute care in a well-equipped and safe setting, will get it," Baker said. "We know this isn't an easy task, but without these designated sites, hospitals would have to discharge COVID-19 patients to any skilled facility with an open capacity, which could put the rest of the healthy residents and staff at those facilities at risk."
In a statement after Baker's announcement, Massachusetts Senior Care Association President Tara Gregorio said the push to open coronavirus-specific facilities is a "difficult, but right" decision.
"Massachusetts is acting boldly and responsibly, while other states are mandating that all nursing facilities admit COVID-19 positive patients," Gregorio said in a statement. "We believe based on clinical guidance that this approach unnecessarily introduces a highly contagious and deadly virus into nursing homes."
While he offered a projection about the surge, Baker declined to estimate specific numbers of cases or deaths due to the spread of COVID-19 after Dr. Anthony Fauci, a member of the White House's coronavirus task force, on Sunday said some models roughly predict 100,000 or more fatalities nationwide.
"A huge part of what we're trying to do, both through preparation around the surge and a lot of the other work we're doing is to make sure that everybody who can be saved is saved," Baker said. "I prefer to think about it that way than I do with respect to some really cold and impersonal number. I know a couple of people who have lost people as a result of the COVID-19 virus, and it's a way more personal item in my mind than any number you can put on it."
The administration has not offered any estimate about the statewide hospital capacity amid the outbreak. In January, the Center for Health Information and Analysis in a report identified 14,596 acute care hospital beds across the state.
Through Monday afternoon, the Department of Public Health confirmed 453 of the state's 5,752 COVID-19 cases required hospitalization. In the same figures, 1,603 patients did not need to be admitted, and the hospitalization status remained unknown for another 3,696.
Baker also asked those newly eligible for unemployment insurance under the new federal stimulus — gig workers, freelancers and those who previously didn't make enough money, among others — hold off on applying through the state system.
“These benefits are not available to be applied for today," he said.
The governor said Massachusetts is still waiting on guidance from the federal government on how to fold these applicants into the existing state system. Baker said those newly eligible workers who apply now will likely not be able to get through the system and create a backlog for others.
Health and Human Services Secretary Marylou Sudders said Monday she ordered the Massachusetts Health Connector, the state's health insurance marketplace, to delay many coverage terminations that would normally result from administrative issues such as lack of documentation.
The governor also issued an order Monday granting HHS flexibility to offer health providers financial relief, including rate adjustments and supplemental payments, to cope with skyrocketing demand or high volumes of vulnerable individuals during the outbreak.
Baker stressed the importance of social distancing as he has in almost every public appearance since the outbreak began, particularly after Public Health Commissioner Monica Bharel announced on Friday that she tested positive for COVID-19. Baker said Bharel is working from home and described her condition as "good."
The governor also forecast announcements to come, saying his administration would likely offer an update Tuesday on an order that non-essential businesses must close and would provide more information later this week on efforts to trace contacts of those who contracted the virus.
With reporting from the WBUR newsroom.
This article was originally published on March 30, 2020.
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