A successful beginning

Thanks to all who have sacrificed their jobs and their social life and thanks also to our health care leaders and working professionals who have scrambled to build enormous new capacity to handle COVID-19 patients, we have avoided the social catastrophe we have seen in some places, an overwhelmed health care system with dying patients waiting for care.

Not that we can declare victory or diminish our efforts, but we should celebrate a successful beginning to a long struggle.

Mary Lou Sudders, the commander of the Governor’s COVID-19 response effort, reported a telling statistic in a recent call with legislators.  When public health workers traced contacts of an infected person back in March, they would on average identify about 10 close recent contacts per person.  Now the average is down to two.  That fivefold reduction is the result of the sacrifices we are all making. 

The virus has rampaged through our nursing homes and poverty neighborhoods where people cannot get away from each other.  But statewide, the reduction in contacts is having its intended effect.  The infection curve lies well below the exponential growth curve we were on in March.

Even with the sacrifices we have all made, COVID-19 patients needing intensive care would have over-taxed the system but for the efforts of hospital leaders and the Governor and his team to build hospital bed capacity to meet the surge.  In a recent briefing for Senators, the head of the Massachusetts Hospital Association stated that the current use of ICU beds stood at 113% of the capacity that existed before preparation for the surge.  

With the extra beds in place, the use is only at 68% of capacity — a decent margin of safety.  ICU beds are available in every region of the state.

As the patient count was on the upswing, we began difficult conversations about how to ration ICU care and the use of ventilators.  While ICU needs have gone beyond the pre-surge capacity, no hospital has had to close its doors to patients and no patient in need has been declined a ventilator.

Now, health care leaders are worried about the unmet needs of patients with serious conditions other than COVID-19.  The head of the hospital association reported a 40- 50% decline in emergency room visits, a 60-65% reduction in patients with stroke symptoms, a 37% decline in patients with heart attacks and a 14% decline in patients with appendicitis. 

While staying home might reduce some kinds of injuries that bring people to emergency rooms, these statistics suggest that some patients in need are not seeking care.  Health care leaders want people to know that the hospitals have the capacity right now to treat non-COVID-19 patients with urgent needs.  People with urgent needs should not wait.

In preparation for the COVID-19 surge, hospitals deferred all elective procedures and other care.  As a result of the loss of revenue from elective care and the extra expenses of building out to prepare for COVID-19, the state’s hospitals are collectively losing $1.4 billion per month, according to the hospital association.

While other hospitals in some other states have been authorized to return to elective care or are contemplating returning soon, they report that progress is slow.  Hospitals need more testing capacity and personal protective equipment for both patients and staff as they return to elective care.  They also have to maintain available capacity in case of a resurgence of COVID-19.

Massachusetts has a deep and collaborative health care leadership team.  They will take a careful step-by-step approach to reopening hospitals for elective care.  I’ve watched their efforts so far with great admiration and have confidence that they will do their part effectively in the months to come.

Published by Will Brownsberger

Will Brownsberger is State Senator from the Second Suffolk and Middlesex District.

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73 Comments

    1. NOTE: No sacrifices or jobs lost for the politicians and their staffs who caused this crap along with the leftist news people who scared the populous, in some cases, to death.
      First time in WORLD history healthy people have been quarantined. If there is a silver lining to all this, it is that the sheep-following, liberal populous might understand what living in a socialist dictatorship is like and remember it come election day.

        1. Jonathan, we’re learning that you like replies no longer than a few words.

          I guess that’s your idea of brilliance. No need to actually say anything substantive.

          You wouldn’t stoop so low as to do that.

          Must be nice to live in a world where everyone thinks alike.

            1. Jonathan, it’s nice to see people with overarching egos make themselves look silly in front of everyone.
              Thank you.

            2. I’m confused, Dee.

              You first seemed to criticize me for not having enough to say.

              Then you seemed to criticize me for having too much to say.

              I don’t quite know how to reconcile those two seemingly contradictory criticisms except perhaps to conclude that you are being disingenuous.

              Would you be able to suggest another interpretation that is consistent with what you’ve written?

              Thanks.

      1. Gordon,

        It’s a shame this site allows such stupid, thoughtless, ignorant, childish ravings as yours.

  1. This is lovely to hear. It’s really scary to think how we’d have blown past our capacity with just a few more days of unrestrained spread.

    By-the-way, I would willingly, happily pay higher income taxes to help keep the lights on and shield people from hardship, if we can find a way to do that which does not ding people making much less than the income I am now quite lucky to have. I realize that this properly ought to come from the federal government (that can borrow, that has a progressive income tax), but we have to be realistic in our expectations.

  2. Thank you for the update. Instead of soldiers defending us from this attack it is a true cross section of our society that are on the front lines. May we always appreciate and acknowledge all the people who do the jobs that keep us safe and healthy and allow us to live in the comfort that we have come to rely on. In this war these people are the heroes that deserve our gratitude.

  3. Lot’s of work still ahead – Sadly there will need to be something done in regard to rents and mortgages – many businesses ordered to close with little notice – not sure that current regulations put in place are sufficient to help.

    We have another issue brewing and that might be food shortages and price gouging. I have seen prices rise dramatically at the market along with the shortage of products.

    Lastly we really need to be strict with the operations of enclosed spaces such as stores to make sure everyone is wearing mouth coverings. For example I came across an employee at Wegmans in Burlington not properly wearing a mask – claimed it was all a hoax – Hoax or Not – it is my life and the life of others that he could be putting in jeopardy.

    1. For low- and moderate-income renters in Belmont who are in financial crisis due to the covid-19 pandemic, the Housing Trust is working on establishing an emergency temporary rental assistance fund for about three months’ rent, payable to landlord. This is a proposed additional use for the Trust’s $250K CPA funds awarded in 2018. Our June Town Meeting would need to approve this, then the earliest estimate that a lottery for the 3-months of support would be July. An early draft of the proposal is posted here: https://www.belmont-ma.gov/sites/belmontma/files/uploads/cpa_rental_assistance-cpc.pdf

  4. I agree that the response in MA healthcare has been admirable. However pressure for opening outpatients services needs to be very strategic. For example should health care workers who have been redeployed to covid units return to treat the outpatient population without testing or without a 14 day quarantine?
    Also much thought needs to go into social distancing while working in these environments.
    Often times clinicians and management have different ideas of what the protocol should be –

    1. Thanks, Gail.

      I appreciate this. The voices of those doing the work need to be heard. We can’t be so driven by the financial pressure that we go back to soon or without proper precautions.

      1. I am the co-chair of ambulatory recovery efforts at my hospital. This is incredibly complex and will certainly not be a “flip the switch and it’s back on situation.” Resources for the surge are still needed and must be preserved; workers are redeployed and furloughed; spaces repurposed; PPE being used. A huge issue will also be convincing patients these environments are safe to return to.

        Lots of work to go.

  5. Thank you for the continued updates.
    I never heard that in the US we had “an overwhelmed health care system with dying patients waiting for care”. Where did that information come from???
    I do agree that we in MA did a great job, our leadership did their jobs and MOST of the population followed.
    I am very concerned when leadership and hospitals made it so hard for those with serious health conditions to have face to face appointments with their doctors and lets be truthful in that using tele-conference in place of a face to face visit just does not work for those with serious health issues like heart, lung, etc. All that can be done is ask a question and get an answer and that does not cut it.

    1. I never heard that in the US we had “an overwhelmed health care system with dying patients waiting for care”. No. I haven’t either. That has happened in other countries. Notably Italy, where it was most visible.

  6. Thank you, Will. We’re deeply appreciative of the way you keep in touch with constituents; your articulate and informative updates are very valuable.

  7. Thank you Will. Grateful for your work as usual.
    Following up on David’s point, I wish we could have choose more than the .8% uptick for state tax. Maybe it is not too late to ammend it? we can alway refile, as I understand.
    Private effort like Andrew Yang funds, https://secure.actblue.com/donate/covid-ubi?refcode=banner, can help in the between, but it does not scale as well, nor can prioritize as well as our state infrastructure: requests need to be send by email and are vetted by volunteers. a stop gap…

  8. The following sentences about unmet health needs from your piece above have been the case fron nearly the commencment of the lockdowns weeks ago.
    You’re just NOW getting around to considering this?

    “Now, health care leaders are worried about the unmet needs of patients with serious conditions other than COVID-19. The head of the hospital association reported a 40- 50% decline in emergency room visits, a 60-65% reduction in patients with stroke symptoms, a 37% decline in patients with heart attacks and a 14% decline in patients with appendicitis.”

    And there is a lot more out there regarding this particular topic of unmet health needs (and fatalities).

    I have read several times that the fatality rate of Covid-19 may be approximately that of the seasonal flu, especially given that large numbers of people apparently have Covid-19 but have few or no symptoms.

    Doctors who disagree with the standard mainstream line on Covid-19 have been largely censored by mainstream media. Is this OK?

    Massachusetts is just now allowing golf courses to open. What was the logic in closing them in the first place?
    Gov. Baker closed gun shops for obvious political reasons.
    Now a Federal judge has just overruled Baker.
    Will, any misgivings about the ongoing violations of civil rights due to these lockdown? Apparently not.
    Is anything that the government rules under “emergency health rules” OK?
    Drive-in church services even with social distancing have resulted in cititations and arrests. Is that OK?

      1. To which we notice that you have no real answers, Jonathan.
        That’s not a surprise.
        Must be reassuring to live in a world of your own where everyone thinks alike, and contrary views are unwelcome. Must be why you like Will.

    1. Dee, health care leaders have been worried about this for many weeks now. Baker held a conference on it a few weeks ago. Will is just reporting on the continuation of their efforts to make people feel safe enough to come into the hospital for non-COVID-related illnesses. There are a lot of people working a lot of hours trying to nail down the difficult logistics and figure out how to get hospitals up and running again, while still keeping prepared for any surges. It is unbelievably complicated.

  9. Senator,
    Thank you for your updates which are much appreciated and informative. In your remarks you mentioned ” in case of a resurgence of Covid-19″. What are your thoughts of such an occurrence happening?

  10. You are very open in your communications and this is very appreciated.

    But I’ve been increasingly concerned that other kinds of communications have been lacking overall. Where are the PSAs urging people to wear masks? Where are the motivational advertisements telling people the progress that we’ve made (your 10 vs. 2 statistic should be more widely known)?

    There are plenty of underused advertising agencies in Boston who could be and should be tapped for pro bono work on this front. It really needs to happen.

    1. NOTE: No sacrifices or jobs lost for the politicians and their staffs who caused this crap along with the leftist news people who scared the populous, in some cases, to death.
      First time in WORLD history healthy people have been quarantined. If there is a silver lining to all this, it is that the sheep-following, liberal populous might understand what living in a socialist dictatorship is like and remember it come election day.

  11. Thank you for your clear and informative news-
    letters. The data about increase in icu capacity and current level of use are very important and have not, to my knowledge, appeared in the press.

    1. Susan, these things have appeared a lot in the press, but probably just not in the mainstream media that you and Will read.

      I knew about them 2 months ago.

      I think Will depends on the Boston Globe and New York Times.

      1. Dee, you have actually written here that the press you read let you know two months ago about present (NOW) icu use. Time travel or prophecy. Or just trolling by reflex with no regard for truth?

  12. “The virus has rampaged through our nursing homes and poverty neighborhoods where people cannot get away from each other.” What lessons can we learn from our state’s housing policies? As a city planner I have been following the professional dialogue about the role of density in the spread of disease. While density undoubtedly plays a role, not all density is created equal. Density of housing units is not the same as crowded housing units. Here in Massachusetts, we have a lot of crowded housing units because we have resisted density of housing units. The house next door to me in Watertown, built as a two-family residence with four bedrooms, has people living in the attic and basement. There are at least six cars in the driveway, all in all at least 12 people in the house, definitely more than two families. This is what happens when we cling to our outdated zoning rules that allow places like Watertown to have single-family neighborhood zoning in the middle of an urban area with a severe housing shortage. I’m sure in some neighborhoods of inner Boston, the crowding is even worse. If we were building enough housing to keep up with population growth, there would have been less spread of COVID-19. There is no doubt in my mind, and that is really sad.

    1. Keep in mind that the building “of enough housing to keep up with population growth” would of neccessity involve “building of enough schools to keep up with population growth.” However, in Watertown it has been graphically revealed that population growth, while not seasonal 🙂 expands and contracts. as does the need for classrooms, which has resulted in the sale and/or changed utilization of schools, which then results in the need for more schools but in limited, or no building space. Since our sexual appetites are not seasonal, there is no way that “keeping up with population growth” with housing, or schools, is logical. Thinking “outside the box” is absolutely necessary but I do not see that happening in Watertown. The town is besieged with new multi-story and multi-family housing units; occupants of these housisng units will eventually reproduce, and I doubt that the Town of Watertown will be equipped to accomodate with increased classroom availability, due to little or no space for new schools; do I foresee house-trailer classrooms? If so, where would they be “parked?” Just saying.

  13. My concerns are for those who have lost their jobs and the small businesses that have had to close. How are any of them going to recover? There needs to be massive help available through grants and yes, taxes may have to go up on those of us in the upper income brackets. I really worry about the health, both financial and physical, of our lower brackets. May we come out of this with greater concern for ALL our neighbors. Love thy neighbor as thyself. We can return to greatness.

  14. Great, but we need to continue the partial shutdown until the number of new cases per day falls to a level that permits testing and contact tracing to systematically keep the number of cases below that level indefinitely, as has been done in Norway, South Korea, New Zealand and several other countries. It is more difficult here because Massachusetts’ open borders with other states means we will always have imported cases, but that just means we’ll have to reach a somewhat lower level than we otherwise would. My understanding is Gov. Baker intends to hire 1000 contact tracers, and hopefully the requisite 10,000 or more tests per day will soon be available as well, with or without any help from DC. We’re currently at around 2000 new cases detected per day, although it’s probably actually several times that given that our testing capacity is still limited. So, even if we can get back to golfing a bit sooner, it’s going to take at least another month before we can really start opening up again. Meanwhile, hang in there one and all!

  15. Thank you Senator for your tireless dedication.
    As I have watched the unfolding of this health crisis around the world I have been struck with the differing responses from those in charge and thus the outcomes. These are all experiments in governing around the world. I have actually been grateful to live in a state with true leadership – those willing to make hard, unpopular decisions for the good of the many. I echo the praises of those who have posted before me and add one more:
    Governor Baker’s decision very early in this crisis to force health insurers to accept and reimburse telehealth services in MA has been essential. This has especially been true in the mental health field. I hope this shows the utility and importance of this service and thus allows for permanent adoption of this benefit.

  16. Regarding rationing of ventilators and beds, advocates for marginalized people like disabled people and people of color are demanding that the state again revise its Crisis Standards of Care, the rationing plan published on April 7 and revised on April 20 in response to criticism.
    That’s because the state did not drop its use in a crisis situation of estimated five-year survival rates. These estimates are mere educated guesses and will be informed by biases against our lives. Members of the disability community are used to laughably inaccurate predictions of our survivorship.
    On April 22, the Boston City Council Public Health Committee held a hearing on the rationing plan. Area doctors of color from the Massachusetts Coalition on Health Equity testified that rationing based on survival estimates would reinforce the structural racism that produces such comorbidities in the back population like diabetes, hypertension, and heart disease in the 1st place.
    Please see my expanded testimony for the hearing at the Not Dead Yet website: http://notdeadyet.org/2020/05/john-kelly-testimony-to-boston-city-council-opposing-triage-based-on-5-year-survival-predictions.html

  17. Will, thank you for your regular communications and thoughtful update.

    For those on this thread that are complaining about golf courses and gun shops not being opened earlier during a GLOBAL PANDEMIC where the death rate surpassed all other death rates in a given year, that without the extreme measures of social distancing, business closures, etc., would have overwhelmed hospitals, ICUs, access to ventilators, etc., what is wrong with you? Would you have been okay with a higher death rate? More infections? There are already over 73,000 deaths in the US alone – with still several thousand new deaths per day. And we are far from the end of this, so consider that number increasing ever day for many more days. MANY MORE DEATHS. The annual deaths by the flu are estimated at 12k-60k. (CDC)

    Honestly, it infuriates me to read the cavalier attitude about human life and the impact that selfishness has on others. Putting health care workers at risk, let alone all those working in service during this time, be grateful for them. Not ungrateful because you couldn’t buy a gun to take on your golfing trip. Also, it frightens me that you could be in my neighborhood – since we share the same district – who knows if you are adhering to social distancing and mitigation of the spread of this disease during, uh, a GLOBAL PANDEMIC. [Steps off soap box]

  18. Thanks Sen. Brownsberger for your clear communication in these times in which are society is afflicted by the other virus of distortion and obfuscation that afflict our social media and the federal government.

  19. Thanks for the information. It’s been 5 weeks since the Covid-19 contact tracing program was announced. Hundreds of people, maybe a thousand or more have been hired. Any information / statistics on how it is going.

  20. Dear Senator Brownsberger:
    I deeply appreciate your efforts to respond to this great tragedy. Frontline people also deserve all the support and compassion we can offer. However, I continue to be dismayed at the comparative statistics from the worldmeters.info site. In terms of total number of confirmed cases and total deaths, the Commonwealth ranks third behind NY/NJ. We rank 4th in the number of deaths per 1M population behind NY/NY/MI. I continue to believe that the Governor did not ring the alarm bells early, loudly, and strenuously enough when the virus began to spread. We need strong Democratic leadership in the Governor’s Office in my opinion.
    https://www.worldometers.info/coronavirus/country/us/

  21. Massachusetts has made a successful beginning. I’d like to know that someone was planning for a successful ending. I’d like to have some idea of what plans are being considered for bringing about a successful ending.

    1. That’s the thing: We can’t plan an end yet. No one knows where this will go in the medium term. Or even the long run — it may keep coming back like the flue. We are going to have to keep adapting.

  22. Thank you for this encouraging, news, Senator. There is still much to do, but at least medically, Massachusetts has risen to the occasion. I feel proud of my state, and am happy to live here.

  23. The epidemic has shut down the economy. The rate of unemployment is rising to levels not seen since 1932. The current government has been inept in dealing with the epidemic. It has threatened to fire competent professionals like Dr. Anthony Fauci. It has pushed important decisions down to the states. We are lucky to have smart and effective political leaders in Massachusetts. The citizens of Florida and Georgia are not so lucky. Like the early 1930s, we are seeing mass unemployment and the rise of authoritarian governments in the U.S., Hungary, and Israel. An important American value, Individualism, is in crisis. The age of small government is over for the time being. Will we become a dictatorship–or will we muddle through as FDR did during the New Deal? There are signs stating Hope around my neighborhood. I am tempted to put up one that says Despair.

  24. Info about capacity is exactly what I have been wondering about recently. Thanks for providing! Anyone know of a public source of hospital capacity we can check on? I’d like to see how this tracks over time and the same for PPE needs. I’ve been tracking infection rates on a personal website here: https://sites.google.com/view/covid-tracking-by-nate

  25. Thanks for the information. As strange as the federal response has been, it’s great that we’re doing reasonably well in Mass.

  26. We must remember, that the “emergency” declaration was intended to “flatten the curve” and prevent overburdening and outstripping the capacity of our ICU and extreme care health resources. That has been accomplished and does not appear by any reasonable projection to be a concern any longer.

    In fact, the overwhelming majority of health care facilities, especially outside of the high risk cities (there is life outside of 128 y’all know, right?) have nothing or little in the way of COVID patients. They are on the verge of bankruptcy and critical staff are being laid off in numbers. The emergency declaration must be rescinded and hospitals allowed to get back to more normal operations, where they are able and with reasonable safety precautions.

    The same is true for most other businesses. There are thousands of business that operate in towns that have negligible infection rates, and can operate with safety precautions that don’t come anywhere close to the risks posed by grocery stores. Again, the criteria for the “emergency” state is no longer valid, and we should not continue to destroy our economy, shatter families, and risk additional lives from non-COVID health issues because of media-hyped fear and bias.

    1. You do understand that all of the “reasonable projections” you claim show that sheltering in place is no longer necessary, assume that we continue to shelter in place, right?

    2. Mike, you make a lot of sense.
      You seem to be disagreeing with most of the comments here.
      You know that’s not allowed, don’t you? Not in this senatorial district. We vote in lockstep.
      What are you, some sort of “Republican”?
      Someone commented above that Massachusetts seems to be doing “fairly well.”
      Yes, assuming you are still employed and have a nice nestegg.
      A lot of people seem to assume that since they’re doing OK then everyone is.
      There are 30+ million unemployed in the US and growing every day. I would not say that is doing “fairly well.” There are many dissenters, including doctors, but their viewpoints are generally not being covered by mainstream media.

      Lots of issues are like that.

      1. As a mildly, self-proclaimed prepper I am one who remains aware of world impact events, such as potential epidemics and pandemics when they surface ever few years. They are actually fairly common. I was wearing a mask and gloves months before it was declared necessary. I was laughed at by family and friends for warning of what was coming and encouraging them to take precautions. I am no nouveau pandemic lemming.

        Stringent levels of separation are beneficial for those at high risk with pre-existing conditions. We need to provide extra protective measures for the elderly and those who are most susceptible to serious effects of the virus. The sad fact that we did not initially put that kind of focus on elder care facilities is tragic. However, the overwhelming majority need only practice safe “physical” distancing (not “social” distancing), wear a mask, gloves in high touch settings, and practice good hygiene to remain virus free.

        With the experience we have gained over the past months about safe personal and business practices there is no reason to remain shut down and quarantined. So much good information exists now about how this particular virus spreads and how to minimize its impact that simply were not known two months ago. The objective of the shutdown was met, and we now know how to live with it.

        We can’t continue to “shelter in place” now and with every new spike. The depression level consequences of doing so for our Commonwealth and Nation will be far, far worse than incorporating safe practices into our “new normal” daily lives. Negative possibilities are multiplying as we continue to procrastinate. There will be waves of higher and lower infection rates for a year or two. This new way of life is going to be with us until a focused viral treatment or vaccine is widely available, so let’s not destroy our Country in the process.

        And for the record, I am an Independent. I vote for the person, not the Party. 🙂

  27. Will, Thank you for your on-going communication on this and so many other issues. The transparency you provide is unique, both in terms of the information you share and your decision-making process. Keep up the great work!

  28. I don’t think anyone sacrificed their jobs. They were taken away, lost, or made obsolete by the so-called “non-essential’ business closures ordered by the Governor under his self-declared emergency powers. Furthermore, whole businesses, where people invested years of time, sweat, worry, and capital, have also been lost. I don’t think any of these people are happy about it and do not consider that they made a sacrifice for everyone’s health. Please do not try to portray this that they made a sacrifice.

    And now that we have avoided catastrophe, the state of emergency needs to end. It is no longer justified. The Legislature has had time to pass laws if we need them. Let’s get back to a 3-part government.

  29. Thanks for your information to Sen. Brownsberger. I can consider you a reliable source along with the government departments for updates. Your interface with constituents is also helpful. I like hearing about progress and pitfalls too.

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