In the early days of the rollout of COVID vaccines, Hampden County in Western Massachusetts lagged.
Now many months later, as the highly contagious Omicron variant storms across the state, Hampden — home to Springfield, Chicopee, and Holyoke — remains the least vaccinated county in Massachusetts. Here, 65 percent of residents eligible for COVID shots are fully vaccinated, compared with 81 percent in most of Eastern Massachusetts.
There is a price to be paid for that.
The combination of a less protected population and the extremely transmissible Omicron variant means this part of the state is being battered especially hard by the current surge of infections.
Hospitals across the region are overwhelmed. Baystate Health was treating more than 300 COVID patients across its four hospitals during the past week. Its largest site, Baystate Medical Center in Springfield, routinely has more patients hospitalized with COVID than any other hospital in the state.
The rate of people testing positive for COVID in Hampden County over the last two weeks was 26 percent, the highest rate in Massachusetts.
“It’s just exploded, and it’s not clear that it’s hit the peak yet,” said Dr. Mark Keroack, chief executive of Baystate Health, which has about 1,000 patient beds.
About one-third of the patients hospitalized at Baystate have COVID — an extraordinary number to have the same diagnosis, Keroack said. The vast majority are being treated primarily for COVID.
In fact, COVID hospitalizations at Baystate have skyrocketed to levels not previously seen during the pandemic. Across Massachusetts, 3,223 people with COVID were hospitalized by mid-week, still shy of the April 2020 record of 3,965.
Keroack sees a clear pattern in the high rate of illness. “Seventy-five percent of the admissions we see are among unvaccinated individuals,” he said.
Forecasters project that Massachusetts could be nearing the peak of the Omicron wave, though case numbers and hospitalizations are expected to remain elevated into February.
“It’s going to be a hellish two or three weeks,” Keroack said. “Then I think by the end of February, early March, it’s going to be much less.”
The Baystate hospitals are treating the sickest COVID patients in Western Massachusetts. To make space for the influx of COVID patients, Baystate halted all elective surgeries, and it is accepting fewer patient transfers.
It is discharging some COVID patients early and treating them with high-flow oxygen at home. For those who must be in the hospital, engineers have been busy adjusting airflow throughout the buildings to control the spread of infection.
Keroack worries about running out of treatments such as heart-lung machines for the most critical patients. Baystate also has been scrambling to find workers from staffing agencies as more than 600 of its staff are out with COVID.
No one predicted just how fiercely this Omicron wave would hit. But in Western Massachusetts, the warning signs were there.
Since the beginning, the pandemic has taken an uneven toll on low-income communities, people of color, and people with underlying health conditions like diabetes that can exacerbate COVID-19 — all groups who represent a significant share of the population in this region.
The median household income in Springfield is less than $45,000, just about half the statewide median. Nearly one-quarter of the city’s population lives in poverty. About 43 percent of residents speak a language other than English at home.
“Western Mass., even in the best of times before COVID, was disadvantaged,” said state Senator Eric Lesser, a Longmeadow Democrat. “We don’t have the same access to health care, we had large shortages of health care providers even before COVID, and COVID has poured gasoline on all those underlying issues.”
Lesser faulted the Baker administration for the sluggish launch of vaccinations in the region, including the problematic opening of a site at the Eastfield Mall last winter where seniors were forced to wait outside in the cold for their shots.
“They were slow, and there’s been a game of catch-up ever since then,” Lesser said. “We lost precious months during that initial rollout period where the Baker administration didn’t think through a strategy for Western Massachusetts, in particular the metro Springfield area.”
Administration officials said they’ve worked to boost vaccination rates in the region, including with $3.5 million to support vaccine equity in Springfield and Holyoke. There are more than 135 vaccination sites across Western Massachusetts, they said, and the number of people getting first doses in Springfield and Holyoke has increased about 7 percent over the past two months.
This part of the state is home to rural communities populated in part by white conservatives wary of the COVID vaccines, as well as dense urban neighborhoods with Black and Hispanic residents, many of whom feel cut off from the health care system, or don’t trust it.
In Hampden County, just 59 percent of Black residents and 50 percent of Hispanic residents have received at least one dose of the vaccine — compared with 70 percent of Black and Hispanic residents statewide.
A coalition of community activists has been working to inform Black and brown residents of the benefits of vaccination, and they have made progress, but many people remain unswayed because of deep-seated distrust of the health care system.
“We just have the trust factor,” said Representative Bud Williams, a Springfield Democrat who helped launch the Black Springfield COVID-19 Coalition. “It’s a historic reluctance to deal with health care because we’ve been treated like third-class citizens.”
“It’s brick by brick, house by house,” Williams said. “We’re going to continue our work, we’re going to keep pushing. Hopefully, we’ll be in a better place a year from now.”
Health care providers are working to vaccinate and boost as many people as possible, but staffing shortages are making the job more difficult.
Caring Health Center in Springfield is giving as many as 100 doses of vaccine a day, but it reduced hours at its vaccination clinic because of a shortage of staff — many of whom are out sick with COVID themselves. The health center is partnering with another company for staffing help.
“Right now, it is almost impossible for us to man that vaccine site,” said Tania Barber, chief executive of Caring Health Center. “Our staff, they’re testing positive as well, although they’re fully vaccinated and most boosted.”
Among patients of the health center coming in for COVID tests, nearly one-third are testing positive.
The rapid rise of Omicron has become personal for many people. As more become infected or see loved ones get sick, some residents — after holding off for months — are finally opting to take the vaccine.
“A good number of patients who were on the fence to get vaccinated prior to Omicron, now with the significant increase in cases, they’re coming to our doors asking to be vaccinated,” said Dr. Alejandro Esparza-Perez, chief medical officer at Holyoke Health Center.
The staff in Holyoke is also working to test and treat as many COVID patients as possible so that they don’t have to seek care in jam-packed hospitals, he added. This past week, the health center received its first shipment of newly approved pills to treat COVID infection, Pfizer’s Paxlovid and Merck’s molnupiravir, which could help some patients avoid severe illness.
“We sent a blast text reminding everybody that the hospitals are overwhelmed,” Esparza-Perez said. “If they have upper respiratory symptoms or abdominal pain or headaches, they should be coming to us.”
Hospital leaders are meeting daily to manage the crush of patients during this unprecedented time of crisis.
“There’s just nowhere to go to hide from this thing,” Keroack said. “Even people who are trying to be careful are going to be breathing in some Omicron before long. Many people have no symptoms.
“If you’re not protected with vaccine,” he said, “you really ought to think twice.”