Major hospitals in Boston are seeing a steep rise in the number of infected workers, a doubling to more than 160 in the past two days, which officials believe may be more attributable to community spread than contact with infected patients.
At Massachusetts General Hospital, 41 members of the staff have tested positive for COVID-19, a quadrupling from earlier in the week, and at Brigham and Women’s Hospital, 51 employees have been infected, up from 33 two days ago.
At Tufts Medical Center, the number of staff who have the virus has increased from 29 to 52 workers since Tuesday, and at Boston Medical Center, 22 have tested positive, more than tripling since earlier this week.
The staff infections raise alarms about the ability of the hospitals to meet the challenge of a potential deluge of patients. When a staff member is infected, it has a ripple effect on close colleagues, who must be quarantined, and could spread the virus to others within the institutions.
The escalation comes at a time when the state has seen an increase in the number of infected patients, both in and out of hospitals, and a death toll that climbed from 15 to 25 in the past day.
Just how strained the state’s existing hospitals are is not entirely clear. When asked by the Globe, not all hospitals have released data on their coronavirus-related admissions or staff infections.
For example, Beth Israel Lahey Health has not disclosed the number of employee infections at its 12 hospitals, which include Beth Israel Deaconess Medical Center in Boston. The system does release information about patient admissions: As of Thursday, it had 93 patients confirmed with coronavirus, including 26 in the intensive care unit. It also admitted 214 patients being investigated for possible infections.
Baystate Health in Springfield has consistently declined the Globe’s request for all information related to patient hospitalizations and staff infections.
Health care workers face increased risks because their jobs require them to be around sick people. Many health care workers fell ill in China and Italy, where the virus spread earlier, and the numbers of infected workers in Boston and across the United States are expected to rise.
Officials at Mass. General, the Brigham, and Tufts all said the workers infected at their hospitals did not work together in one area. In fact, some of them do not work directly with patients, which leads officials to believe their infections came from their ordinary lives, not work.
“There was definitely no clustering,” Tufts spokeswoman Rhonda Mann said. “This was across the hospital, and across job sites, and not just clinical people but people who worked in other parts of the hospital as well.”
Indeed, Tufts has five times the number of infected workers as it does patients admitted for coronavirus.
Similarly, Brigham spokeswoman Erin McDonough said worker infections are “quite spread out.”
“We haven’t seen any kind of pockets,” she said.
When they’re working with patients who may have coronavirus, hospital workers wear gowns, gloves, masks, and eye or face shields to protect themselves. This protective equipment is in short supply, and many hospitals are requiring doctors and nurses to extend use of masks that they would normally discard after one patient encounter. Mass. General is also studying whether N95 respirators — the masks that offer the fullest protection against contagious respiratory illnesses — can be sterilized and safely reused.
As long as health care workers are wearing protective gear, and remove the gear correctly, they should be safe from contagious patients, said Dr. David Hooper, chief of infection control at Mass. General.
“I think the risk in the hospital is probably overall a good deal less than in the community — at least before we started doing the social distancing,” he said.
Across the Partners HealthCare system, which includes Mass. General and the Brigham, employees are now required to wear masks at all times. It’s a policy meant to protect them — but also to prevent health care workers who may unknowingly be carrying the virus from infecting others.
UMass Memorial Health Care this week implemented a similar policy. At the Worcester-based hospital system, nine workers to date have tested positive for coronavirus.
Massachusetts health officials said they do not track the number of health care workers who contract the virus, and information about other states’ experiences is still scant. Ohio officials this week said that 16 percent of that state’s cases are among health care workers, according to cleveland.com.
While coronavirus spreads quickly in the community, the experience in Italy and China shows that front-line health care workers face a special threat. In China, where the virus started, more than 3,300 workers became infected. In Italy, where hospitals are now overwhelmed with coronavirus patients, about 9 percent of all cases were among health care workers.
In the early days of the virus’s spread in China, health care workers became infected before they started wearing full-body protection, said Dr. Ashish Jha, director of the Harvard Global Health Institute.
In Italy, Jha told reporters this week, a combination of inadequate personal protective equipment and severe fatigue led many health care workers to become infected: “People started getting tired and just ended up being less vigilant.”
“This is an issue I’m deeply worried about, because it creates a cascade,” he said, ”where once health care workers start getting sick, everybody else has to work more hours, which increases their risk, which gets us into a vicious cycle. And we’ve got to do whatever we can to avoid that vicious cycle, or it’s going to get very hard to take care of patients.”
Dr. Francesco Castelli, an infectious disease specialist at the University of Brescia and Brescia Spedali Civili General Hospital in Italy, said health care workers who contracted the virus in that country largely became sick in the early days of the epidemic, when it was difficult to identify COVID-19 patients and workers were not taking regular precautions to protect themselves.
“Other countries should be in a better position to address this issue because every country now knows that the epidemic may be arriving” and can protect workers appropriately, Castelli said by e-mail.
Many hospitals are already conserving or running low on personal protective equipment, leaving front-line workers worried for their safety.
“We are making do with what supply we have,” said David Schildmeier, a spokesman for the Massachusetts Nurses Association, a labor union. “It’s not safe for the nurses. They know they are putting themselves at risk, but they have no other choice.”
Governor Charlie Baker said Thursday that the state is trying to buy additional protective gear for hospital workers but continues to lose contract bids to the federal government. State officials also are seeking supplies from a national stockpile.
“My hope is that we’re going to have fewer health care workers infected in the US, at least than Italy," said Dr. Davidson Hamer, professor of global health at Boston University School of Public Health. "But if we run out of personal protective equipment, or reuse things . . . the risk will increase.”