ER providers are ‘overwhelmed’ as schools grapple with reopening amid Omicron surge

A man helped a woman navigate past cars in front of Boston Medical Center, as lines of people waited to get COVID-19 tests. The BMC is urging people not to come to the Emergency Department for COVID testing.Stan Grossfeld/Globe Staff

With Massachusetts approaching the somber mark of 20,000 COVID-19 deaths and emergency room providers warning they’re “overwhelmed” by the virus following the holiday-fueled Omicron surge, most school districts cautiously returned to in-person learning Monday.

The dire warning on emergency rooms came in a joint statement from the Massachusetts College of Emergency Physicians and Massachusetts Emergency Nurses Association. The groups urged members of the public to avoid using ERs for routine COVID-19 exposure tests or even for “mild symptoms.”

“We are overwhelmed,” the statement said. “Our Emergency Departments are at critical capacity and things will get worse.”

Separately in Boston Monday, Mayor Michelle Wu said the city will do everything it can to keep schools open as Omicron bears down on the region, but warned that keeping classrooms open may not be possible.

Asked by reporters about the prospect of Boston students returning to remote learning, Wu said that conversation is ongoing with the state. In-person learning is better for students, she said, before adding that the district needs to be realistic about staffing challenges.

“It becomes unmanageable at a certain point to keep classrooms staffed,” she said during a City Hall media scrum following the swearing-in of Boston city councilors.

She said Boston would do everything it could to keep schools open. City workers who can work remotely will do so for the next two weeks.

“If we can keep community transmission rates low, that means that schools have a better chance,” said Wu.

She said the district has activated substitute teachers and will continue to monitor the situation, noting that 155 Boston Public Schools staff members tested positive for COVID-19 over the weekend.

Boston Public Schools are set to open for students on Tuesday. Earlier Monday, Wu personally helped Superintendent Brenda Cassellius prepare test kits for distribution to the state’s largest school district.

The system employs 4,500 teachers, spokesman Jonathan Palumbo wrote in an e-mail.

Monday’s statement from the ER physicians and nurses groups, meanwhile, alluded to the fact that Massachusetts is currently down hundreds of hospital beds statewide and said that hospitals expect more staffers to get infected with the virus in the coming days and weeks and be forced to isolate, further straining ERs.

The provider groups listed a number of steps the public can take to help hospitals, in addition to avoiding ERs for routine COVID tests and mild symptoms.

Those additional steps, the statement said, include getting vaccinated and boostered against COVID-19; isolating when sick, per CDC guidelines; getting tested at a designated COVID-19 test site or with an at-home test; wearing a mask around others; and socially distancing amid the Omicron surge, regardless of vaccination status.

“Let us be clear,” the statement said. “We do not want you to ignore your symptoms or avoid emergency care when needed. You will be safely cared for despite the growing volume of patients with COVID-19.”

The alarming plea from the health providers and the grim data notwithstanding, an upbeat Governor Charlie Baker appeared Monday morning at a press event in Salem touting the fact that most school districts had opted for in-person learning, while also nodding to the testing resources his administration has made available to schools.

“The vast majority of the school districts and schools in Massachusetts are opening today,” Baker told reporters. “Which I think is incredibly important and a terrifically positive sign about the hard work that so many people around the Commonwealth are doing every single day to make sure kids get the education that they’re entitled to and that they deserve.”

Baker’s early-morning appearance came as a state effort to provide COVID-19 tests for public school employees stumbled, with fewer arriving, forcing some districts to decide whether to issue a pair of tests, or provide just one per employee, the Globe reported. The tests did not arrive as expected last Friday, but this past weekend.

“I think roughly 2,200 schools participate one way or another in many of our testing programs,” Baker said Monday, adding that “we’ve managed to save roughly 450,000 school days this year with our test-to-stay program, and some of the parents that we spoke with out on the courtyard on their way in with their kids this morning said that that test-to-stay program has been invaluable to them.”

But Massachusetts Teachers Association President Merrie Najimy and her union continued to fault Baker and his administration, saying reopening schools without knowing the test results unnecessarily jeopardizes the safety of teachers, students, and their families.

The proper public health policy, she said, would have been to close schools Monday so the results of COVID testing among staffers could be known — and districts could then respond with state help to the changed situation they face.

“The governor’s stubborn position on not closing schools puts us in jeopardy … We don’t have the data yet to see how many staff or students are going to be testing positive,” she said. “We are nowhere near in the clear. And kids are in school.”

Najimy said the MTA agrees with Baker — the best place for children is in schools. “Our Number 1 is to keep our schools open, safe,” she said.

Najimy also questioned the quality of face masks distributed by the Baker administration to school districts. She said teachers have reported the state-supplied masks do not meet quality standards to qualify as medical-quality N95 masks.

“A lot of our educators don’t have confidence in these masks that they’ve been given. That’s not the way to manage a public health crisis,” she said. “It’s just more of the incompetency of the Baker administration.”

In a statement Monday afternoon, the state Department of Elementary and Secondary Education, or DESE, said that earlier in the pandemic, the state “coordinated testing of their supplies of KN95 masks at an MIT laboratory, including the brand of masks that were distributed by DESE this week. According to the MIT testing, these masks, the Fujian Pageone KN95 mask, had a filtration efficiency of 87.5%.”

This information, DESE said, “can be found on MEMA’s website, under the PPE guidance section. Within this guidance page, you can find the KN95 Respirator Test Results link under the section entitled “Information regarding use of N95 and KN95 masks.”

The agency said it’s also consulted “with DPH on the use of these masks. KN95 masks, when worn properly per CDC and DPH guidance are considered to be highly effective. The CDC has outlined considerations for effective mask use and important factors include having two or more layers, a snug fit against the sides of your face without gaps, and a nose wire to prevent air from exiting the top of the mask.

The DESE agency also noted that “the use of the KN95 masks is voluntary and staff should be aware that their choice of masks is ultimately a personal decision.”

A DESE spokesperson said via email Monday afternoon that the agency “received 227,166 tests that were supplied to school districts this weekend. MEMA, State Police, and the National Guard helped DESE distribute the tests to schools who picked them up at a MEMA facility in Franklin, a distribution site in Pittsfield, and there was another on the Cape. Each teacher and staff member in the Commonwealth received one test.”

At least eight school districts — Lawrence, Brookline, Lexington, Burlington, Ipswich, Randolph, Wareham, and Sharon — canceled Monday classes, while Cambridge delayed the start of school for two days. Shawsheen Valley Technical High School in Billerica announced it would be open to staff only on Monday.

Northampton announced a staggered return from the winter break. Northampton High School and JFK Middle School will be open Monday with pool testing being conducted. The city’s four elementary schools will reopen Tuesday to conduct pool testing.

Thank you @MayorWu for joining us this morning and helping the @BostonSchools team get our tests out to our amazing educators. 🙌🏽🙌🏽 #AllHandsOnDeck https://t.co/WIf6ECVFs2

— Brenda Cassellius (@BCassellius) January 3, 2022

Wu ordered some City Hall workers to work remotely for the next two weeks to reduce the number of personnel inside city buildings as the highly contagious Omicron variant sweeps across the city, state, and nation, generating record numbers of infections.

Some districts have opted to shorten school days at the start of the week. Arlington Public Schools, for instance, will have early release Monday and Tuesday, said Superintendent Elizabeth Homan in a note to families, and focus those days on virus testing of staff and students who have given their consent.

Meanwhile, the levels of coronavirus detected in Boston-area waste water have reached new highs, with seven-day averages that shatter previous record-breaking levels.

On Dec. 30, the seven-day average of virus traces in the waste water in the southern section of the Massachusetts Water Resources Authority’s territory was 9,136 RNA copies/mL. That’s up from 2,574 RNA copies/mL on Dec. 23.

In the northern section, which includes the Boston area, the seven-day average was 6,987 RNA copies/mL on Dec. 30, up from 2,411 RNA copies/mL on Dec. 23.

Waste-water testing serves as an early warning sign for a COVID-19 surge. Cambridge-based Biobot Analytics, which tests the waste water coming into MWRA’s Deer Island treatment plant, has said it has found the amount of virus in the waste water is correlated with newly diagnosed coronavirus cases four to 10 days later.

Martin Finucane, Travis Andersen, Gal Tziperman Lotan, Taylor Dolven, and Mike Bello of the Globe Staff contributed to this report, and material from prior Globe stories was used.