Massachusetts hospitals began to see a mounting number of suspected coronavirus patients Tuesday, an ominous indication that the pandemic may be spreading in the region at a clip that is more rapid than the official state numbers imply.
Massachusetts General Hospital officials said the number of patients suspected to have COVID-19 in their emergency room or in beds had quadrupled to 53 between Monday and Tuesday, in addition to three other confirmed cases in intensive care and three in regular beds.
“This is clearly escalating at a very rapid pace,” said Dr. Peter Slavin, president of Mass. General. “Up until last week, we were seeing a smattering of activity, but now it seems to be accelerating, which is what you expect in epidemics like this.”
Across the 12-hospital Beth Israel Lahey Health system, 210 patients had been admitted as of Tuesday, including three with confirmed coronavirus and the rest “highly suspected’’ and awaiting test results. And at Brigham and Women’s Hospital, two hospitalized patients have tested positive and another 16 were awaiting results Tuesday.
Boston Medical Center and Tufts Medical Center have also admitted patients related to suspected cases of COVID-19.
The numbers from individual hospitals suggest the official number released daily by the state is likely to increase significantly in the days ahead. The state said Tuesday that Massachusetts recorded 218 coronavirus cases, an increase of 21 from the day before.
This new data comes at a time when the exact trajectory of the highly contagious virus is unknown. The current numbers for Massachusetts are well within the capacity of the state’s hospitals, and come while these facilities have been quieter than usual as hundreds of non-urgent surgeries, such as joint replacements and weight-loss surgeries, have been canceled. Procedures have been as much as halved at some hospitals.
But the recent escalation of hospitalized patients combines with other troubling signs. Hospitals are scrambling to find enough protective equipment to help doctors and nurses guard against infection. Mass. General and others are requiring staff to reuse critical gear, including face masks, as long as they are not visibly soiled.
Some hospitals are running so low on equipment that they’re seeking donations from the public. Cambridge Health Alliance put out a plea for new and unused face masks and gowns — as well as used protective glasses and goggles.
A handful of health care workers in the state — including three at Mass. General and two at the Brigham — have tested positive for COVID-19, and scores of others have been sent home because of possible exposure to the virus. And the current trend of incoming patients is deeply concerning — though not unexpected — to many hospital officials.
“If it exceeds a certain level, it could overwhelm all the best planning in the world," Slavin said.
Dr. Kevin Tabb, president of Beth Israel Lahey Health, said a little less than a quarter of patients with confirmed and possible coronavirus require intensive care. “That’s a significant proportion," he said.
Like other hospitals in the state, he said, those in his system have empty beds both in their ICUs and on regular floors, in part because of aggressive cancellation of elective surgeries that began over the weekend.
“We have capacity, and people are working around the clock to get ready for what will without a doubt be a very large surge," Tabb said. "There is no question in the mind of any health care leaders I know [that] there we will be significant surge that will exceed the capacity of our hospital system and other hospital systems.’’
As hospitals braced for more patients, Governor Charlie Baker announced the immediate distribution of emergency funds to local boards of health in an effort to bring more doctors, health staff, and other resources to the front lines.
Baker and state health officials pledged to increase testing for the disease, which is believed to have infected far more than the number of officially recorded cases.
While Baker has instituted new limits on public interaction, he insisted he was not ready to issue a shelter-in-place order — a dramatic move that already has been taken in the San Francisco Bay area and might be implemented in New York City within days.
On Tuesday night, Mayor Martin J. Walsh of Boston asked residents to take action to help slow the spread of the coronavirus in a televised address, while seeking to reassure them that Bostonians won’t be required to restrict all movements — at least not yet.
Walsh reiterated Baker’s statement from earlier Tuesday that residents will not be asked to shelter in place at this time.
“We are not currently at that point, but we are monitoring the situation closely. It’s not a decision that should be made lightly or in isolation," Walsh said.
Walsh also said more than 500 donors have contributed a total of more than $10 million to the Boston Resiliency Fund launched Monday.
Tuesday marked the first day that Boston’s public schools were closed. The city handed out 1,360 meals to students at 16 locations amid confusion and logistical challenges. Restaurants and bars across the state began a three-week shutdown, limiting residents to takeout, deliveries, and store-bought food. Grocery stores and pharmacies remain open.
Gatherings of more than 25 people have been prohibited. Public transportation was restricted beginning Tuesday, with MBTA subways and buses resorting to less-frequent, weekend schedules.
Across the state, government buildings were closed. Public hearings ground to a halt at the State House. And municipal boards were moving to remote meetings — when they hold them at all.
The governor said he cannot predict exactly what lies ahead.
“It’s been hard to get a handle on what the ramp-up, the peak, and the drop looks like,” Baker said. “The bottom line: It’s going to come down to the work that everyone does collectively to practice social distancing.”
Among the data most watched by top officials are the hospitalization numbers, including when facilities could reach their maximum. At Brigham and Women’s, because of the cancellation of elective procedures, the hospital is about 70 percent full, far lower than its usual 93 percent occupied.
Boston Medical Center, like others, has canceled non-urgent surgeries and other appointments, while setting up a special area to screen patients with respiratory symptoms. Eighty-one patients showed up with symptoms on Monday, and five needed additional care in the emergency department, chief executive Kate Walsh said. The hospital also has admitted 32 people with possible coronavirus.
“Our hospital is no longer functioning as business as usual,” Walsh said.
Tufts Medical Center was investigating possible coronavirus in 14 patients who had been hospitalized as of Tuesday.
Smaller hospitals in other parts of the state are also bracing for patients, though so far things are relatively calm. As of noon Tuesday, there were no positive cases of COVID-19 at Martha’s Vineyard Hospital, according to spokeswoman Katrina Delgadillo. The same was true at Athol Hospital, which did not have a confirmed case, according to spokeswoman Dawn Casavant. Athol Hospital had screened 26 people and five tests had come back negative with the remainder pending, Casavant said.
However, Mass. General, the state’s largest hospital, is seeing close to 200 patients a day in a special area where staff evaluate them for acute respiratory illness, said Dr. Paul Biddinger, chief of emergency preparedness.
He said a small number are testing positive — but testing remains a concern. “We are still struggling to mobilize as much testing as possible," Biddinger said. “We don’t have the resources. We can’t test everyone. Those are by definition our somewhat milder patients.”
The hospital’s special pathogen unit with 18 beds contains both positive patients and patients for which they are awaiting results. That unit is nearly full, Biddinger said.
Mass. General has 150 ICU beds and is targeting to double that number to 300, each with a ventilator, either by using repurposed machines within the hospital or buying or renting additional ones. The hospital currently has 150 ventilators, the machines that help critically ill patients breathe.
Meanwhile, among front-line hospital workers, one of the biggest concerns is also having enough protective equipment to handle the inevitable influx of patients. “If you stopped 100 people walking out today and asked them what they are worried about, that is what you would hear,’’ said Brigham spokesperson Erin McDonough.
If you have tips related to patients who are in hospitals due to the coronavirus, please contact email@example.com or firstname.lastname@example.org. Tonya Alanez, Vernal Coleman, John R. Ellement, Martin Finucane, Naomi Martin, Andrew Ryan, Matt Stout, and Adam Vaccaro of the Globe staff and Globe correspondent Caroline Enos contributed to this report.
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