They’ve been on the front lines of the pandemic for almost a year. They’ve battled under grueling conditions. They’ve saved lives and watched people die. And a staggering number have become sick themselves.
More than 14,000 health care workers at the state’s largest medical centers and hospital systems have been infected with COVID-19 since the start of the pandemic, according to data compiled by the Globe — a reflection of the toll of the pandemic on the essential health care workforce. The figure includes people who work in all parts of hospitals, from nurses and doctors to cleaning and cafeteria staff.
Like grocery store workers and other essential employees, their jobs cannot be done from home.
“As front-liners, we can do everything right but still be exposed because we’re exposed at work, which we simply can’t avoid,” said Dr. David Rosman, a radiologist at Massachusetts General Hospital and president of the Massachusetts Medical Society. “Being in health care at this time has meant placing yourself at risk of COVID.”
Rosman knows this first-hand. He felt symptoms in January — he was fatigued and couldn’t taste his food — after his wife, Dr. Samantha Rosman, an emergency medicine physician at Boston Children’s Hospital, became sick. The couple and their children, ages 8 and 10, all tested positive for COVID. None fell seriously ill.
They don’t know exactly how they were exposed.
“But since March, we haven’t been in a restaurant, we haven’t been in a grocery store, we haven’t been in any store,” said Rosman, 44. “Our existence is Instacart and home and work. The only point of potential contact for either of us is work.”
To assess how many hospital workers contracted COVID, the Globe surveyed the state’s largest hospital systems and academic medical centers, including Mass General Brigham, Beth Israel Lahey, UMass Memorial, Baystate, Wellforce, Boston Medical Center, and Boston Children’s Hospital. Steward Health Care did not respond.
Mass General Brigham said more than 5,000 of its workers, or 6.6 percent, tested positive for COVID from the beginning of the pandemic through early February, while Beth Israel Lahey said more than 3,000, or 8.5 percent, had COVID. At BMC, 11.8 percent of the workforce, or more than 1,000 people, tested positive for COVID in the same period.
Now, as more health care workers receive their vaccinations and community spread slows, the rate of new infections is dropping.
The state Department of Public Health doesn’t specifically report infections among the hospital workforce, but a 2020 law requires the department to track the occupations of people who test positive for COVID. This information was many months out of date until early February when, after inquiries from the Globe, state officials released new figures that shed light on what kinds of workers have been most affected.
State officials counted 4,275 nurses in Massachusetts who tested positive between March 10 and Dec. 31, 2020. During the same period, 3,178 nursing, psychiatric, and home health aides tested positive, as did 499 physicians and 921 medical assistants. The data don’t specify whether these medical professionals work in hospitals or other settings.
The number of deaths is harder to pinpoint, although a project from The Guardian and Kaiser Health News counts 74 Massachusetts health care workers who have died from COVID.
Nationally, the Centers for Disease Control and Prevention estimate that more than 408,000 health care workers have contracted COVID, and more than 1,400 have died.
“COVID is the first time I really had fear of going to work,” said Trish Powers, 58, a longtime nurse at Brigham and Women’s Hospital. For many months, Powers found herself pondering thoughts like “If I’m holding my patient’s hand, am I going to get sick?” and “Oh my god, did I touch my eye? Did I give myself COVID?”
Her fears were not unfounded. She tested positive for COVID in mid-December, an infection she suspects she picked up in a hospital break room where employees remove their masks to eat and drink. Hospitals including the Brigham have designed break spaces that allow employees to sit 6 feet apart when they unmask. But there is still the possibility of transmission.
Powers, who leads the nurses union at the Brigham and usually spends hours on her feet in an operating room each shift, has been out of work for two months, her recovery hampered by cardiac complications and lingering fatigue.
It seems unfair that she got sick despite trying to follow the rules — wearing a mask, washing her hands, avoiding gatherings — but she also knows how much worse it could have been. She will never forget the people she saw dying from COVID last spring, when she was deployed to the ICU. “You’re so lucky that you’re OK,” she tells herself.
Hospital workers who test positive for COVID must stay home for at least 10 days. But some, like Powers, could be out for weeks or months, depending on the severity of their illness. This has stretched an already stressed workforce.
During the surge in December and January, healthy employees worked extra shifts, skipped vacations, and redeployed to new departments to keep up with the demand from patients while so many of their colleagues were out sick with COVID. At Baystate Health, for example, about 450 people were out of work in mid-December because they were sick with COVID or had been exposed to it.
Despite the large numbers of hospital workers who have contracted COVID, hospital officials contend that most were infected through community exposures, not during their shifts.
When they take care of COVID patients, front-line workers wear masks, eye protection, gowns, and gloves — which are largely effective at preventing infection when worn properly. Even staff who don’t treat patients typically wear masks and eye protection while at work.
A growing body of evidence points to community spread of the virus and demographic factors such as race and ZIP code as greater risk factors than the fact that someone works in a hospital, said Dr. Erica S. Shenoy, associate chief of infection control at Massachusetts General Hospital, where more than 2,000 employees tested positive for COVID over the past 11 months.
The number of health care workers infected with COVID peaked in April and again around the winter holidays.
“We saw patterns that very much resembled what was happening in the community,” said Dr. Helen Boucher, chief of infectious diseases at Tufts Medical Center, where about 600 employees have tested positive for COVID. Boucher said contact tracing indicates that almost all acquired their infections outside the hospital.
“Clusters arise when small groups of people gather, often in people’s home, let their guard down, and transmission occurs. ... We’re all human, and colleagues at work have engaged in these gatherings,” she said.
But officials acknowledge that clusters of infection do occur in hospitals all the time — ranging from two or three people in one unit who test positive to much larger outbreaks. An outbreak at Brigham and Women’s Hospital in September infected 57 people.
Lori Pannozzo, a nurse who takes care of COVID patients in the intensive care unit at St. Vincent Hospital in Worcester, said she feels exposed because she must reuse masks at work. She believes she was infected from a COVID patient who needed to be intubated quickly, a process that releases respiratory droplets into the air.
Pannozzo was coughing on New Year’s Eve, hours before she was scheduled to work in the ICU; she tested positive for COVID that day. She began to feel short of breath and developed pneumonia. She spent her 48th birthday sick on the couch in the Monson home she shares with her husband and son.
Weeks after testing positive, Pannozzo remained out of work, struggling to breathe as she walked short distances.
“I never really had anxiety before,” she said. “I was kind of able to relate with my patients. Not being able to breathe is scary.”