Massachusetts, girding for coronavirus surge, joins coalition of eastern states to plan next chapter

Governor Charlie Baker spoke about the coronavirus on Monday.Nancy Lane

Governor Charlie Baker on Monday joined a coalition of governors from eastern states who will work together in planning the region’s return to normalcy from the COVID-19 pandemic, at once warning residents to prepare for more death and illness ahead while offering a hint at how they will lift the stringent controls on daily life.

Massachusetts’ participation in the seven-state council, which was initially announced Monday without Baker’s participation, came hours after the Republican governor cautioned against focusing too heavily on reopening parts of the economy while the state remains in the throes of the public health crisis.

Baker acknowledged his administration has had talks “about what life might look like once we get past this,” and later said he was in touch with the other states, all of whom are headed by Democrats.

But he sketched a series of milestones it will take to get there — including getting past the peak of cases — none of which appeared on the immediate horizon as the state’s death toll grew by another 88 people Monday, with 844 lives now lost to the virus. Confirmed cases jumped by nearly 1,400 to 26,867 total.

“I don’t think anybody thinks you can just flip the switch at any point in the not-too-distant future,” Baker said Monday at the State House, emphasizing he’s trying to steady Massachusetts through a surge in illness ahead that threatens to overwhelm the health care system.

“I really don’t want people to start to think today that this is over,” he said. “That was pretty much why we did all the stuff we did to put the commonwealth and much of the rest of the country in sort of a self-induced coma.”

The shift in public discussion from erecting immediate safeguards to COVID-19 to clawing back a semblance of normal daily life has largely come from President Trump, who has, at different points, floated Easter and then May 1, as target dates to begin reopening the country’s everyday life.

Asked on Monday what authority he has to order the country reopened, Trump said, "I have the ultimate authority.”

Governors, who’ve imposed the most constrictive orders on residents, don’t necessarily see it that way. Similar to a group of governors on the West Coast, the council of seven eastern states said Monday it will examine how to begin lifting restrictions in a coordinated response.

That group encompasses governors from New York, New Jersey, Connecticut, Delaware, Pennsylvania, Rhode Island, and Massachusetts, who will each tap health and economic development experts and their respective chiefs of staff to build a framework to “gradually lift the states’ stay at home orders while minimizing the risk of increased spread of the virus,” according to a statement from the coalition.

“The reality is this virus doesn’t care about state borders, and our response shouldn’t either,” said Governor Gina Raimondo of Rhode Island.

The states announced Baker’s participation Monday evening, hours after they initially unveiled the coalition, and Baker’s office acknowledged afterward it “is in touch with other states in the region including New York.” But Terry MacCormack, a Baker spokesman, said the governor’s focus remains on expanding testing, hospital capacity, and the state’s supply of personal protective equipment.

At his new conference, Baker pointed to a variety of checkpoints the state would need to hit for a “soft opening,” which included getting past the initial peak in cases. He also pointed to significantly reducing the speed of the virus’s spread and creating a set of standards for how, and which, businesses could open.

He also cautioned that how the virus moves through states differs widely. Case in point: As Baker warned again of the coming surge of cases in Massachusetts, New York Governor Andrew Cuomo said he believes “the worst is over” in that state — “if we continue to be smart.”

“I want people to realize that today is the beginning of what we expect is going to be a very difficult period,” Baker said at his briefing.

Data the state released Monday showed that about half of 16,000 beds “suitable for COVID” patients are available. They are spread across more than 60 acute-care hospitals, as well those that recently came online at temporary field hospitals.

Mayor Martin J. Walsh said the city’s temporary facility at the Boston Convention and Exhibition Center, dubbed Boston Hope, had 45 patients as of Sunday night. (The facility has a 1,000-bed capacity, with 500 set aside for homeless patients.) Another 10 patients were at a facility set up at the DCU Center in Worcester, said Marylou Sudders, the state’s health and human services secretary.

But Sudders cautioned the available hospital beds “clearly” come with regional differences, meaning where cases surge — and what hospitals are available for patients there — could play a major role in the state’s ability to weather the influx of cases.

Those contrasts were evident in a chart released by the state Monday showing considerable variation, particularly in the availability of intensive-care beds. For example, while it showed about 2,000 ICU beds appear to be vacant for very sick COVID-19 patients, more than 800 were in Boston-area hospitals. The lowest availability was in the northeast part of the state, where hospitals there had fewer than 100 ICU beds available.

Since the pandemic began, state officials have not released figures showing total hospitalizations on a given day, which would provide a way to detect if the surge is peaking or flattening. It also has not publicized any COVID-19 admission numbers by individual hospitals.

Sudders suggested that even with the new data, it could drag behind reality. She said with thousands of new cases being confirmed in recent days, that state won’t know the full brunt of hospitalizations “until the next seven or 10 days.”

“This is just the eye of the storm,” she said.

The state also continues to chase fresh supplies of medical equipment, a frustrating and highly competitive exercise that last month included a carefully executed mission to get masks from China aboard the New England Patriots team plane.

The Globe reported that as well-intended as the highly publicized effort was, at least some and possibly many of the roughly one million masks brought over were not the time-tested, industry-standard N95 masks that medical workers wear when treating coronavirus patients.

Rather, some were a Chinese version known as a KN95 mask that some hospitals in Boston and beyond have so far declined to use and remain reluctant about deploying.

Baker on Monday defended the quality of the haul, though he did not specifically address how many of the masks were the Chinese version. “All those masks are FDA-approved,” Baker said. “All of them were inspected.”

His administration has released data showing 362,136 of the KN95 and N95 masks from the shipment have been distributed as of Sunday, with more than one-third of them going to nursing homes and 83,600 going to hospitals. The data did not break down which types of masks went where.

Dr. Peter L. Slavin, president of Massachusetts General Hospital, on Monday praised Baker’s efforts to bring the shipment to Massachusetts, saying that “infectious diseases leaders have confirmed that a well-made KN95” is as effective as an N95 mask.

“The purchase and delivery of these respirators to Massachusetts and New York were a godsend to front-line health care workers in hospitals and nursing homes,” Slavin said.

Jonathan Kraft, the oldest of Robert Kraft’s four children and president of the Patriots, is also the chair of the MGH board of trustees.

To produce more gear, the Baker administration has also launched a $10.6 million grant program for manufacturing companies who want to “pivot” to making personal protective equipment at their factories for front-line workers.

Nearly 400 companies, including 260 from Massachusetts, have contacted the state with offers to make everything from masks and gowns to swabs and shoe coverings, Baker said. The Lawrence-based company 99Degrees Custom will make one million gowns in the coming weeks, its founder Brenna Schneider said.

“I felt a responsibility to put our manufacturing model to work,” Schneider said alongside Baker and other state officials at the briefing.

Patricia Wen, Martin Finucane, Travis Andersen, Danny McDonald, Joshua Miller, ​Dan McGowan, and Jaclyn Reiss of the Globe staff contributed this report.