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Doctors uneasy about uptick in state coronavirus cases

Lesley Galdamez administered a COVID-19 test in Charlestown.
Lesley Galdamez administered a COVID-19 test in Charlestown.Jessica Rinaldi/Globe Staff

The reported rate of positive COVID-19 cases in Massachusetts has crept up over the past week, heightening an uneasiness among some doctors who fear that they might be seeing a return of the virus that has spread so quickly around the nation this summer.

In e-mails, phone conversations, and on social media, the doctors say they’re seeing emergency rooms getting busier with feverish patients and more imaging tests coming back with distinctive signs of coronavirus infection.

It’s too soon to say whether their anecdotal observations, along with the recent uptick in state data, are the tip of an emerging iceberg or simply a temporary blip. But the head of the Massachusetts Medical Society said Monday that the state should seriously reconsider allowing gyms, indoor dining, and casinos to remain open — if the state wants to keep infection rates low as it reopens schools in the fall.

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“I would rather act too early than act too late,” said Dr. David Rosman, the society’s president and associate chair of radiology at Massachusetts General Hospital. “Our priority should be kids, school, and health. That’s where we should be focusing.”

Rosman, the father of two children, aged 8 and 10, said he realizes closing down certain industries again would significantly and adversely affect a lot of people’s livelihoods.

“We need to decide, as a community, how much we value being able to reopen schools,” Rosman said. “If that is a high priority, as I think it should be, we need to make sacrifices around that. Ultimately, this is about our patients, our neighbors, and our families.”

Over the past week, the rate of positive COVID-19 tests has climbed from 1.7 percent to 1.9 percent, after trending downward earlier this month and then holding relatively stable. Authorities reported increases of more than 200 cases four of the past five days.

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On Monday, the number of cases climbed by 182, bringing the total to 108,562. The death toll from confirmed cases rose by seven to 8,317.

“Obviously, we would prefer to see zero new cases of COVID, but we know that’s just not going to be the case until we have a medical breakthrough like a vaccine,” Governor Charlie Baker said during a press briefing.

Baker said officials are closely analyzing data for trends and are aware of some small clusters associated with gatherings, including a private party in Chatham and recent information regarding an employee at Baystate Health. The governor said the employee traveled to a hot-spot state and was “lax” about mask wearing.

He said the summer months present unique challenges in the fight against the virus.

“We can also assume there’s simply a lot more mobility out there, some of that as a result of the economic activity associated with opening up some of our commonwealth’s businesses and employers,” he said. “But also some of it is just people being out and about — it’s warm out, and people generally speaking are in more contact with people now than they were in the months of April, May, and even June.”

When asked to comment on Rosman’s suggestion that the state should reverse course on reopening, Baker said that individuals flouting health guidelines — not reopening policies — were largely to blame for clusters in cases.

“The public health data is going to drive our decision-making, but so far, most of the data we see about where the clusters have come from have had a lot more to do with people just sort of letting down their guard more than anything else,” he said.

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Baker: Coronavirus cases in Mass. rising
Governor Baker said that new coronavirus cases in Massachusetts have recently ticked up, and urged state residents to continue observing safety protocols (Photo: Sam Doran/Pool, Video: Handout)

Baker cited large private parties and failure to wear masks as examples of behaviors that ignored health guidance and led to more cases.

But Helen Jenkins, an assistant professor of biostatistics at Boston University’s School of Public Health, said the state’s latest data give her pause.

“I think the uptick is concerning and shows how little reopening can start to drive up numbers,” Jenkins said. “My hope is that Governor Baker is keeping a close eye on this, and I hope that he prioritizes schools in his decision-making and considers reversing other things such as casinos, gyms, and indoor dining so that schools have even a chance of reopening in the fall.”

At the same time, Dr. Helen Boucher, chief of the Division of Geographic Medicine and Infectious Diseases at Tufts Medical Center, is taking a more wait-and-see approach. Boucher noted that the rate of COVID-19 cases ticked up to 1.9 percent for a few days early this month before trending downward.

She said she would grow concerned if the number of infections, or the rate of positive cases, continued to climb.

“I am a mom of two daughters and nobody wants success for getting our students back to school safely more than I do. We have to be very focused on the data,” Boucher said. “But one thing I have learned from the pandemic is humility and how much we don’t know.”

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One open question is the impact of delays in processing coronavirus tests. People in Massachusetts and across the country often wait up to a week or more to learn the results of their COVID-19 tests, making it challenging for leaders to stay ahead of percolating cases and control future outbreaks.

The delays are largely being driven by a backlog at some of the nation’s largest laboratories, which process many of the tests from Massachusetts community health centers and businesses. The labs are struggling to keep up with demand caused by surging coronavirus cases in Southern and Western states.

The state Health Department said last week that the current statewide average for turnaround times in Massachusetts in July is 2.2 days and that the state is monitoring the situation. There can be significant variation, though, because it includes both the generally faster facilities that have internal testing capacity and those that rely on backed-up national diagnostic companies.

“We know that the data we are getting through no fault of [the state Health Department] is delayed because of the delay in processing the tests,” said Rosman, of the state medical association. “We need to be vigilant to small changes in the data.”

Travis Andersen and Jaclyn Reiss of the Globe staff contributed to this report.





Kay Lazar can be reached at kay.lazar@globe.com Follow her on Twitter @GlobeKayLazar. Dasia Moore can be reached at dasia.moore@globe.com. Follow her on Twitter @daijmoore