As COVID-19 cases continue to rise exponentially across the state, those who don’t work in hospitals often view that wave of infections as just a line on a graph.
For the workers and patients inside local hospitals, however, that graph translates into real-world hardships that can be difficult for outsiders to imagine: overworked and burned-out nurses dealing with more patients than there are beds; staffing shortages as front-line workers fall ill; “elective procedures” canceled as health care workers are redeployed to overfilled intensive care units and emergency departments; National Guard troops aiding with non-clinical work; and mostly unvaccinated patients getting very sick and dying.
“There’s no certainty. You don’t know what it’s going to be like the next day you go in,” said Katie Bean, a nurse on a COVID-19 unit at Cooley Dickinson Hospital in Northampton. “It’s really stressful. You just don’t know how bad it’s going to get before it gets better again. Or when it’s going to get better again.”
Cooley Dickinson, which reported a record-high 25 COVID-19 inpatients on Tuesday and 24 on Wednesday, is not alone in facing those challenges. Baystate Health system has also seen its pandemic-era records broken daily, hitting an all-time high of 257 COVID-19 patients across its system on Wednesday, including 32 in its critical care unit.
And those numbers are only expected to grow.
“We are dealing with a staggering number of COVID cases,” said Dr. Armando Paez, chief of Baystate Health’s infectious disease division.
Noting that New Year’s Eve was only a few days ago, he said the impact of those celebrations would likely mean increased infections for the next 10 to 14 days.
“The trajectory is still moving up,” Paez said. “We don’t know where it’s going to peak.”
That means hospitals are “extremely busy,” said Cooley Dickinson CEO and President Lynnette Watkins. Making matters worse is the fact that hospital employees are also catching the coronavirus, leading to staffing shortages at this critical time, she said.
Challenges One of the most challenging aspects of the wave has been the fact that the patients who have become sick and ended up at Cooley Dickinson are largely unvaccinated — particularly in the intensive care units, Watkins said.
“Please get vaccinated, and if you have the vaccination but have not received the booster, please receive the booster,” Watkins urged. “It is definitely, definitely the way to prevent severe disease, hospitalization and death.”
As case counts climb, hospitals are doing what they can to limit the impacts on their abilities to care for patients. Both Paez and Watkins said their hospitals have not yet had to take the drastic step of rationing care. But they have had to cancel non-urgent procedures and redeploy nurses to keep up.
“We are staying nimble in order to address issues,” Paez said. “At this time we are meeting the demands … but of course it can change depending on how things go.”
Paez said Baystate is administering treatments like monoclonal antibodies to vulnerable patients to keep them healthy enough to stay at home. The hospital system has also received a limited supply of antiviral drugs that the federal government recently approved. Those pills are meant for particularly vulnerable patients, and can be quite effective at keeping them out of the hospital, Paez said.
That’s important for one key reason, Paez said: “The number of beds are finite.”
The problem with administering the small supply of those pills, however, is that patients need to begin taking them within five days of symptoms developing, Paez said. But with stores running out of rapid tests and state-run testing locations so crowded that it can take hours just to get to the front of the line, it can be difficult to ensure that patients begin taking that medicine on time.
Omicron Paez said the current wave of new cases is being driven by the highly contagious omicron variant. Although some studies have suggested the variant might cause less severe disease, Paez said the reality is that the variant is so contagious that it is still leading to higher numbers of hospitalized patients than previous waves.
That patient surge is being felt most acutely by front-line staff. Watkins said Cooley Dickinson employees are committed and hard-working, but they are suffering from “compassion fatigue,” burnout and “a bit of angst and concern that there is a way forward.”
“They feel like it’s deja vu,” Watkins said. “We’ve had colleagues who have just been very tired, we have colleagues who have been ill and we have colleagues who, because of burnout and fatigue, have chosen to go into other professions or take a pause and reflect.”
Cooley Dickinson nurse Peter Sohriakoff, who works in endoscopy and is a leader in the Massachusetts Nurses Association bargaining unit at the hospital, said the current moment is “very difficult” for hospital staff. Sohriakoff said that as patient numbers are “exploding” in the emergency department, patients are waiting for long periods of time to get a bed. Everything is “backed up and clogged.”
“Nurses who work … in the ICU, who work in the emergency departments, are being asked to do more work than they’ve ever done before, often without as many of their colleagues as they’re used to because so many nurses are out with COVID right now,” Sohriakoff explained.
If hospital systems like Massachusetts General Hospital, which Cooley Dickinson belongs to, had better staffed their hospitals prior to the pandemic, it might have alleviated some of the problems they are now facing, Sohriakoff added.
“I think if people can start social distancing again, wear their masks, get vaccinated and stay home, that’s just what we desperately need in the hospital right now,” said Bean, the Cooley Dickinson nurse on the COVID-19 unit. “We’re just exhausted and people who need to be in the hospital are getting stuck in the emergency room.”
Dusty Christensen can be reached at dchristensen@gazettenet.com.