As cases surge, Gov. Baker calls up National Guard to help stretched hospitals

Amid the twin crises of an omicron-fueled COVID-19 surge and a health care staffing shortage, Gov. Charlie Baker will activate hundreds of Massachusetts National Guard personnel and require hospitals to postpone or cancel non-essential elective procedures.

The moves, which Baker and Health and Human Services Secretary Marylou Sudders announced Tuesday alongside an updated mask advisory, aim to relieve pressure on the state's overstretched health care system as the variant and holiday gatherings drive spread of the virus.

"There's no question the next few weeks will be enormously difficult for our health care community," Baker said at a State House press conference. "There are staff shortages, sicker patients and fewer step-down beds available, again, because of those staff shortages. The steps we're announcing today are designed to support them so that they can continue to care for patients."

Baker's plan quickly drew criticism from some elected Democrats and public health experts, who warned that the rapid spread of the omicron variant demands more dramatic action, including a full mask mandate for indoor public spaces.

The Department of Public Health's updated mask advisory recommends, but does not require, all residents cover their faces in indoor public spaces even if they are fully vaccinated against COVID-19. The advisory takes effect immediately.

The governor will activate up to 500 National Guard personnel to help staff health care facilities in need. Up to 300 members will begin training this week to support 55 acute care hospitals and 12 ambulance service providers.

They will be deployed starting Monday, Dec. 27 to roles including non-emergency transport between facilities, observation of patients at risk of harming themselves, security, food service, and transporting patients inside hospitals.

Another 80 to 85 personnel covered by the latest order are already in action assisting with school testing, Sudders said, and roughly 50 more will "manage logistics." The remaining 60 to 70 Guard members in the latest activation will be available if necessary.

Starting Dec. 27, hospitals must cancel or reschedule any "non-essential, non-urgent scheduled procedure" likely to result in inpatient admission, excluding individual specialty hospitals and facilities that maintain at least 15% availability in their medical-surgical and intensive care unit beds.

Massachusetts hospitals are operating at more than 90% of inpatient capacity despite previous steps to reduce certain non-urgent medical procedures. The state has 500 fewer acute care beds available, when compared to January, because of "unprecedented staffing shortages," Bureau of Health Care Safety and Quality Director Elizabeth Kelley wrote in a memo to hospital CEOs.

Sudders said staffing shortages and site availability pose a challenge for field hospitals around the country, implying the state may have the resources available to pursue that option again.

Baker said the "vast majority" of hospitalizations for COVID-19 in Massachusetts involve patients who have not received vaccines, which he said offer "tremendous protection from illness."

Massachusetts had varying forms of a mask mandate in place for much of the first year during the pandemic. DPH replaced it with an advisory in May, about a month before Baker ended the COVID-19 state of emergency.

Asked Tuesday if he would need to declare another state of emergency to have the power to order another mandate, Baker replied that he has "no interest in putting a mandate on this issue given all the tools that are available on a statewide basis."

"We issued a mask mandate last fall because we had no other options available to us. At this point in time, we have vaccines, we have rapid tests, we have our testing sites, and people know a lot more about what works and what doesn't with respect to combatting the virus. If people wish to add an extra layer of protection by wearing a mask in indoor settings, we would urge them to do so..."

Gov. Charlie Baker

"If locals wish to pursue alternative options, they can do so," Baker said. "We issued a mask mandate last fall because we had no other options available to us. At this point in time, we have vaccines, we have rapid tests, we have our testing sites, and people know a lot more about what works and what doesn't with respect to combatting the virus. If people wish to add an extra layer of protection by wearing a mask in indoor settings, we would urge them to do so, especially when we have cases rising across the commonwealth."

State Sen. Becca Rausch was among Democrats who called for the governor to make indoor mask-wearing mandatory.

"The governor's persistent refusal to follow the CDC guidance on mask wearing and failure to provide a data-driven blueprint to keep our residents safe puts all of us —families and businesses alike — at risk," Rausch said at a press conference Tuesday with public health experts.

Many of those who spoke at that presser called for the state to implement what they called a new "COVID-19 action plan" that would impose a statewide indoor mask mandate, take steps to improve vaccination rates, establish workplace safety standards and impose policies to reduce in-school transmission.

"Masking even temporarily during this highest surge can protect kids and allow them to avoid losing their parents forever, and it can protect all of us," said Dr. Julia Raifman, with the Boston University School of Public Health.

Rausch added that omicron has already spread rapidly in Massachusetts. This week, it surpassed delta to become the dominant strain of the virus in the state, and in the U.S.

"[Omicron's] potential severity is still unknown, and while vaccination is the best tool in our COVID-fighting toolbox, data indicate that a COVID vaccine without a booster may be only 30% effective against this variant," Rausch said. "People will get this strain of COVID without multi-pronged mitigation measures from the governor — a lot of people. And our hospitals are already at capacity."

Julia Koehler, a physician in the Division of Infectious Diseases at Boston Children's Hospital and a pediatrics professor at Harvard Medical School, said the state's messaging should make clearer the importance of booster shots in combatting the omicron variant.

She cited a blog post from National Institutes of Health Director Francis Collins reporting that a third dose of the Pfizer vaccine offered 25 times more protection against omicron than just the standard two-shot series.

"I would end with one question to the governor: if there is something you can do to save one life, if there's something that you can do to save one child from losing their father, losing their mother or losing their grandmother, why would you not do it?" Koehler said. "And if you can protect 1,000 lives, why would you not do it?"

Democrats wield veto-proof majorities in both branches, but legislative leaders so far have shown virtually no interest in imposing stricter COVID-19 requirements via legislation. The Legislature also has two weeks remaining on its winter recess, a period marked by light, informal sessions.

Senate President Karen Spilka said Tuesday she wants Baker to strengthen his mask advisory into an indoor mask mandate, require proof of vaccination in most indoor social venues, and convert pooled testing in Massachusetts schools to an opt-out system rather than an opt-in. Spilka did not say whether the Legislature would move to require mask-wearing or other additional mitigation measures if Baker does not act on her request.

Congresswoman Ayanna Pressley is also among those who want Baker to take additional action, writing in a letter to the governor on Tuesday that it is "critical that any comprehensive statewide plan include the reinstatement of a statewide universal indoor mask policy."

The new masking advisory will not affect existing mandates requiring face coverings in settings such as health care facilities and public transit, and it also will not affect policies in the state's public schools.

With additional reporting from WBUR's Deborah Becker. The audio atop this post brings reporting from WBUR's Gabrielle Emanuel.