The state’s largest health care system, Mass General Brigham, starting Monday, will be slashing thousands of surgeries it performs each week as it strains to stay ahead of the tsunami of patients pouring into its hospitals.
And on Thursday, UMass Memorial Medical Center, the largest health system in Central Massachusetts, suspended all surgeries and medical procedures for conditions not considered life-threatening until further notice.
The situation is so bad that it’s forcing hospital administrators to make heartbreaking choices to limit all but the most urgent surgeries and procedures. This extends even to some cancer surgeries, forcing doctors to weigh which tumors are growing faster and which slow enough to postpone care.
Dr. Ron Walls, Mass General Brigham’s chief operating officer, said hospitals are now fielding calls from patients “begging” to be put back on the list for surgery.
“This is really, really hard for patients,” he said.
These latest actions are on top of the cutbacks in service ordered by the state last month. While there may be signs that the surge of new infections from the Omicron strain could soon peak, the deluge on hospitals is not expected to ease for another two weeks at least. Additionally, the flood of patients with chronic health conditions who delayed care and are now acutely ill shows no signs of relenting, hospital administrators say.
“Starting Monday, we will postpone 2,200 [surgeries] a week to make the best possible use of the staff we have,” Walls said. That translates to roughly 40 percent of the system’s total surgical procedures.
“The human side of this now has become a really big thing,” Walls said. “People do a huge amount of preparation and then we just say, ‘Sorry we can’t do that.’”
In an effort to help medical operators struggling with absent workers, the Baker administration late Friday announced several emergency actions. The health care system is facing a critical staffing shortage, fueled by many resignations from burnout during the pandemic, and resulting in the loss of approximately 700 medical/surgical and intensive care hospital beds since the beginning of 2021, the administration said.
Among the new changes, physician assistants will be allowed to practice independently without physician supervision, creating less paperwork and freeing supervisors to care for more patients. Additionally, it allows dialysis centers to relax staffing requirements while still maintaining sufficient direct care staff.
Several hospital administrators said in interviews that they started cutting back procedures last month above and beyond what was ordered by the Baker administration early in the Omicron surge. Now, with so many health care workers themselves out with COVID, even more far-reaching cutbacks are needed, the administrators said.
“We had roughly 1,000 people out over the last 10 days who tested positive. That’s approximately 100 more out every day,” said Dr. Sunil Eappen, chief medical officer at Brigham and Women’s Hospital.
“It’s a double whammy,” he said, on top of the already large number of workers who have resigned from burnout.
The new round of suspensions is broader than previous cutbacks.
At Boston Medical Center, surgeries for thyroid cancer, which generally has a slow growth rate, are being delayed, as are colon cancer operations unless there is imminent obstruction or bleeding, the hospital said.
But surgeries for cancers that are faster growing and threaten “imminent harm” are continuing, such as tumors in a patient’s airways and some gynecological tumors as well as operations for breast cancer.
Earlier this month, BMC started postponing all inpatient operations that could be safely delayed, and they will continue to be put off two to four weeks until the surge ends and more inpatient beds become available, the hospital said.
“A multi-disciplinary adjudication panel led by the chairs of surgery and anesthesiology and nursing leadership reviews each case and considers the urgency of the situation and the hazards of delaying,” the hospital said.
“We consider the growth rate of tumors and closely monitor patients,” it said. “We have continued performing all urgent and emergency operations.”
Among the Mass General Brigham patients who were notified of a canceled surgery is Sharon Desbecker, a 55-year-old Concord resident who was supposed to have a procedure on her spine earlier this week at Brigham and Women’s.
She was diagnosed three years ago with spinal stenosis, a narrowing of the spaces within the spine, creating pressure on the nerves that travel through the spine and down the legs. Desbecker, who struggles to walk more than the length of a football field without excruciating pain, lives on the third floor of a building that has no elevator.
“After I was diagnosed, I couldn’t wrap my head around the fact that surgery was how I had to handle this. I was kind of in shock for years. So I didn’t rush into surgery,” she said.
But as the pain became unbearable, Desbecker relented, and the surgery was scheduled. Then came the call that it was suspended.
“I was finally ready,” she said.
Hospital administrators say COVID-19 has proved so unpredictable over the past two years they are unable to pinpoint for patients when their surgeries might be rescheduled, and instead are offering general timeframes.
“The situation remains very fluid and we are evaluating it on a day-to-day basis through our Command Center structure,” Justin Precourt, chief nursing officer and senior vice president of patient care services at UMass Medical, said in a statement.
Mass General Brigham is telling patients they aim to begin rescheduling procedures after Feb. 4.
Tufts Medical Center said it continues to postpone all inpatient procedures that can safely be postponed and in addition, is continuing to postpone many outpatient procedures, such as colonoscopies, to redeploy staff to inpatient and emergency care.
Dr. Maren Batalden, chief quality officer at Cambridge Health Alliance, said her system suspended all nonurgent inpatient surgeries earlier this month, in addition to other postponements.
But she said they are starting to see a glimmer of hope.
“We are encouraged to see the number of staff out for acute COVID infection coming down,” she said. “We are not anticipating any new reductions in services and are working to resume normal operations across the institution as soon as we can safely do so.”