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 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.
Also 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 non-essential and non-urgent scheduled procedures, and 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.”
The Department of Public Health on Tuesday issued an updated mask advisory that recommends, but does not require, all residents cover their faces in indoor public spaces even if they are fully vaccinated against COVID-19. The mask advisory takes effect immediately.
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.”
“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 combating 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.”
The governor’s plan, and specifically his decision to stop short of a full mask mandate, landed with a thud among some public health experts who have been pressing for the administration to take more dramatic action.
Julia Raifman, a Boston University School of Public Health professor and researcher, said an advisory alone is “not sufficient to achieve everyone in an indoor space wearing masks all at once.” Data indicate that full mandates increase mask-wearing rates “far above the levels that we see in Massachusetts,” she said.
“That is a policy that begins reducing spread today,” Raifman told reporters. “It’s one of the most important things we can do most quickly.”
She also suggested the Baker administration consider reviving capacity limits for some indoor venues where patrons tend to gather in close proximity without masks, such as bars and restaurants, because of the “very dangerous situation” the state is in.
In the latest data from DPH, Massachusetts recorded an average of 4,244 new COVID-19 cases per day over the past week, more than three times as high as the 1,155 seven-day confirmed case average reported on Nov. 1. The number of patients hospitalized for COVID-19 has been rising, too, from 522 on Nov. 1 to 1,513 in DPH’s Monday report.
The death rate also has been rising, nearly doubling from a seven-day average of 12 on Nov. 1 to 22 on Dec. 17. Even after that increase, the rate remains well below its level from this time last year – the seven-day average was 53 on Dec. 21, 2020 – thanks in large part to widespread vaccination.
Sen. Becca Rausch, who hosted Raifman and other medical experts and community leaders for a virtual press conference, touted a “COVID-19 Action Plan” she unveiled last week as a better option to slow the spread of the virus and avoid excessive strain on Bay State Hospitals.
Her plan calls for an indoor mask mandate based on local transmission risks as well as expanded mobile vaccination clinics in hard-hit communities, greater housing protections, new workplace safety standards, a stricter public school masking requirement, and several other steps.
The Needham Democrat called Baker’s proposal to deploy National Guard personnel to hospitals “important, but entirely reactionary to COVID transmission.”
“It is as if the governor has completely forgotten what flattening the curve means, even though our hospitals are at capacity,” Rausch said, later adding, “We need action and leadership now, and for the entire state, not just the cities with mayors willing to step up and lead the charge against COVID without meaningful preventive measures from the state.”
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 combating 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 that 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.
“We must act aggressively to mitigate the impact and spread of the new COVID-19 Omicron variant across Massachusetts and prioritize protecting our most vulnerable residents, workers, and communities disparately impacted by the pandemic,” Spilka said in a statement. “To do this, I believe it’s necessary to go beyond advisories and recommendations and apply a uniform, consistent approach to stopping the spread and saving lives. While I thank the Governor for his actions to date, today, I am calling on the Administration to reinstitute a statewide indoor public mask mandate, increase efforts to achieve vaccine equity and require proof of vaccination for most public indoor social venues.”
“Additionally, when it comes to school safety, our COVID-19 pool testing practices should be provided on an opt-out, rather than opt-in, basis to better protect our students, teachers and staff,” Spilka added. “Many communities, businesses and school districts have already instituted these measures to help save lives and they should be applauded. However, time is of the essence and a patchwork strategy will not lead to a healthier, faster recovery for Massachusetts.”
Congresswoman Ayanna Pressley is also among those who want Baker to take additional action, writing in a letter to the governor on Tuesday that is “critical that any comprehensive statewide plan include the reinstatement of a statewide universal indoor mask policy.”
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