UMass Memorial Medical Center has reopened its COVID-19 command center, establishing a structure to manage a recent increase in cases and plan for the possibility of even more.
The move by the Worcester hospital portends struggles that may lie ahead throughout the health care system, as the pandemic throws new curve balls at traumatized and exhausted providers.
“I was optimistic earlier this summer that we were close to putting COVID-19 behind us and that we could focus on our post-COVID vision for the Medical Center,” hospital president Michael Gustafson wrote in a memo to staff that was shared by Massachusetts Health & Hospital Association. “While that reality is still attainable, I must be honest and transparent with you about the significant challenges we are facing today.”
As of Sunday, there were 402 COVID-19 patients in hospitals across Massachusetts, according to data from the state Department of Public Health. That’s one-tenth of the number hospitalized in late April — but still five times more the number in early July.
UMass currently has 18 COVID-19 patients, six of whom are in intensive care. The hospital doesn’t know to what extent the numbers will continue to grow. But mindful of the highly transmissible Delta variant, it wants to be ready, said Justin Precourt, chief nursing officer and incident commander.
In addition to the rise in cases, UMass is picking up the slack from another Worcester hospital, St. Vincent, which shut down 100 beds in response to a monthslong nurses’ strike.
And most worrisome, UMass has an extraordinary staff shortage. Normally staffed with 8,600 employees, the hospital now has 400 vacancies, and 600 people are out on paid leave.
Precourt attributed both departures and leaves of absence to the stresses the pandemic forced on workers.
“There’s a level of fatigue and exhaustion. People left the workforce, retired earlier, or cut back hours,” he said.
The jobs hardest to fill are entry-level roles for technicians and patient care assistants to provide daily care for patients, Precourt said. Nurses and physicians are also getting harder to find, he said.
“We feel like we’re really in the eye of the storm and trying to navigate out,” Precourt said.
UMass has not reopened its field hospital. Rather, it has set up an organizational structure that establishes roles and lines of communication. Having a command center ensures that hospital employees, who might otherwise be focused solely on their day-to-day work, touch base twice a day to get the latest information and plan their response, Precourt said.
“Opening the command center gives us an opportunity to align everyone, and kind of focus on a singular goal,” Precourt said. “This gives us a chance to be prepared and not caught off guard.”
Michael Sroczynski, senior vice president and general counsel for the Massachusetts Health & Hospital Association, said that he does not know of another hospital that is close to reopening its command center. But all, he said, are paying close attention to a gradual climb in cases.
“Hospitals across the state have experienced renewed pressures over the past week,” Sroczynski said. “The COVID numbers are growing and the hospitals have never really had a chance to fully recover from the pandemic crisis.”
All are facing workforce shortages, and temporary nurses are expensive and hard to get, because they’re being called to other parts of the country with more severe outbreaks.
“We see what’s happening in states around the country,” Sroczynski said. Even though Massachusetts’ high vaccination rate puts it in a better position than many other states, “We’re also seeing the rate of transmission increasing here,” he said.
Adding to the pressures, hospitals are busy with patients who delayed care during the pandemic, said Patricia Noga, the association’s vice president for clinical affairs.
At a press briefing Monday, Governor Charlie Baker noted that the hospitalization rate in Massachusetts remains below the rest of the country.
“The fact that so many people in Massachusetts have been vaccinated — and that is a real tribute to the enthusiasm that the people of this Commonwealth showed to getting vaccinated — has put us in a dramatically different place than many other states across this country,” Baker said.
State officials pay close attention to data surrounding case counts, hospitalizations, and deaths from the virus in shaping policy on pandemic response, he said. Baker’s comments came in response to questions about why he does not plan to alter the state’s voluntary mask guidance, which recommends masks for certain vulnerable people but requires them only on public and private transportation, and in health care and congregate care facilities.
“I hope and pray that many other states move as aggressively as the people in Massachusetts have moved to get a vaccine,” Baker said. “Vaccinations are the pathway out of this pandemic, period.”
Travis Andersen and Felicia Gans of the Globe staff contributed to this report.