In a first since the pandemic started, an ICU without COVID patients

This week, for the first time since the beginning of the pandemic, Tufts Medical Center had no COVID patients in any intensive care units. It lasted just one day, but the hospital said that hasn't happened in just over two years.

Tufts' first COVID patient was admitted to the ICU on March 23, 2020.

Across the state, the number of COVID patients in ICUs is dwindling. At UMass Memorial Health, the current number is just six. Both Mass General Hospital and Brigham and Women's Hospital have only three COVID patients in their ICUs.

“I am glad for whatever break this period gives us,” said Shira Doron, a hospital epidemiologist at Tufts Medical Center. “When we are in a period of low cases — and we are — it is actually the time to enjoy oneself.”

However, many experts — Doron included — are closely watching a slight uptick in case counts and positive rates in Massachusetts. State officials reported more than 1,000 new confirmed cases of COVID on both March 23 and 24, more than was typical in a single day over the two previous weeks.

In New England and the Boston metro area, the amount of COVID detected in wastewater samples has risen significantly for the first time since late December, according to Biobot Analytics, which conducts much of the local wastewater sampling.

Despite the increase, levels remain low overall and far below the omicron peak.

"There has been an increase recently, but it’s been small, and it could be part of a plateau rather than a 'wave,' " said Scott Olesen, an epidemiologist with Biobot Analytics.

Any increase is likely a result of a version of omicron known as BA.2 that appears to be even more contagious than the original and now accounts for the majority of COVID cases in Massachusetts.

Experts say it is still unclear whether Massachusetts, and the U.S. more broadly, will follow the path of South Africa, where BA.2 became dominant but did not lead to a surge in cases. There is concern the U.S. could instead chart a course that looks more like many European countries, where COVID case counts have increased rapidly in recent weeks.

“Those are the two extremes,” said Jacob Lemieux, an infectious disease doctor at MGH. “I don't think we know what's going to happen over the coming weeks to months.”

Even as Doron, at Tufts Medical Center, urged people who are vaccinated and boosted to enjoy the current lull, she said hospital staff won't get a break.

“The beds are still full, including in the ICU,” Doron said.

While these patients may not be sick from COVID, many are experiencing the ripple effects of the pandemic.

Doron said some patients have deferred medical care, so doctors may be catching their illnesses at a later and more acute stage. Other patients are suffering from mental health issues and stress-related illnesses brought on — or exacerbated — by the pandemic. Still others are dealing with chronic problems triggered by a COVID infection in the past two years.

And the increasing prevalence of omicron's subvariant BA.2 adds to the uncertainty of the moment.

"Although we are so happy that the cases are down, there always seems to be some dark cloud," said Doron.