COVID and Frontline Health Care Workers

Please keep our health care workers in mind as you make decisions about what COVID risks to take over the coming weeks.

As of Tuesday, December 14, there were 1411 people hospitalized with COVID in Massachusetts, of which 326 were in the ICU and 176 were intubated. That is well below the level in the first April 2020 surge when hospitalizations peaked at almost 4,000, yet for a combination of reasons, the hospital system is feeling a lot of strain.

Steve Walsh, President of the Massachusetts Hospital Association testified at a hearing on December 16 about the state of the hospital system. He made the following points in his testimony:

  • Like many employers across the country, hospitals are having difficulty recruiting staff — nurses and behavioral health specialists are most in demand, but all hospital jobs are hard to fill.
  • Caregivers are exhausted and burnt out — many are leaving for other fields or retiring.
  • In the early days of COVID, it was possible to recruit travel nurses — acute surges were happening in only a few states. Now, travel nurses are in demand everywhere.
  • Although hospital leaders feel that, to protect patients, all hospital workers should be vaccinated, the loss of some employees due to vaccine mandates has added to the strain.
  • As COVID patients stream into the understaffed hospitals, they are competing with patients who have deferred other kinds of care, many of whom are also very sick.
  • COVID patients are also competing with behavioral health patients. The “epidemic within the pandemic” is mental illness. More are seeking psychiatric care than ever before.  People with behavioral healthcare needs appear in emergency rooms and there is no place to send them. These patients “board” in the emergency room — safe, but without access to the care they really need. These behavioral health boarders take up ER beds that could be used by other patients.
  • Statewide, roughly 500 are boarding in emergency rooms on any given day of which 150 to 200 may be children. Staffing shortages are currently preventing the use of several hundred behavioral health beds that already exist — we could solve half the boarding problem if we just could staff those beds.
  • Staffing shortages extend to patient transportation — some patients who would be ready to leave to rehabilitative care cannot access transportation and continue to take up hospital beds.
  • In each region of the state, hospital leaders confer every morning to discuss capacity issues and transfer patients as needed. As capacity tightens, they make decisions to defer optional hospitalizations. If there are patients in acute need and the region is out of capacity, they reach to other regions or out of state.
  • So far, collaboration has assured that all urgent needs are being met, but with “capacity stretched more than it has ever been,” the rising case load due to Delta and Omicron is a cause for real concern, said Mr. Walsh.

Mr. Walsh’s testimony was well-received. The legislature recognizes the health care workforce challenges. In our recent $4.5 billion ARPA spending bill, we devoted $1.15 billion to public health and health care, including substantial investments in building the behavioral health workforce. An additional broad bill dedicated to strengthening the behavioral health system is moving forward.

But nothing we do legislatively can immediately add staff to the system. That means we all have to continue to do what we can to prevent spread of the disease.

The legislature and the Governor are continuing heavy investment in vaccination and testing. The main discussion right now is whether we should strengthen statewide rules on social distancing, especially masking.

I personally favor a statewide indoor mask mandate, applicable to all public spaces. It would take pressure off the many local health agencies who are enforcing mask mandates.

In the absence of mandates, we each strike our own uneasy balance between social distancing and staying connected. The risks of indoor unmasked crowds remain very real and if we elect to take those risks, we may be adding to the burden on health care workers who have already endured too much.

Published by Will Brownsberger

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

Join the Conversation

51 Comments

  1. Thank you for taking in to consideration the nursing staff who are appalled this is still going on. Yes, masks are the least we can do.

    1. Just curious, were any nurses or doctors who have a stake in these issues, but whose points of view may not be sufficiently represented by Mr. Walsh (or they may have something to add to his testimony) invited to this hearing?

  2. Thank you for this. I do think there is a point that is missing. You say: “In our recent $4.5 billion ARPA spending bill, we devoted $1.15 billion to public health and health care, including substantial investments in building the behavioral health workforce. An additional broad bill dedicated to strengthening the behavioral health system is moving forward.”

    I have lived in other states, and I was shocked at the lack of infrastructure around mental health in MA. There are almost no inpatient treatment settings, settings for temporary shelter, and inpatient and outpatient mental health treatment that is not seriously scary. I had a partner with bipolar for a few years, and essentially, this gave me a “tour” of MA’s mental health system. You say you are adding workers and shoring it up – I would argue it’s not even there in the first place. I think there needs to be an acknowledgement that basic pieces of the mental health system are missing (unlike the rest of the healthcare system, which is just stressed). Until that happens, we’ll get Mass/Cass situations and similar in other cities as an ongoing situation that doesn’t go away.

    1. I’m really curious about this. I work in the mental health field (privately, low/no-fee) but all of my MA experience is in college counseling…what have you seen in which other states? Would be nice to know more as I can potentially begin to play a role in advancing MA care options.

      1. Our family has two children who have required both therapy and emergency mental health care in the Boston area. It has been an absolute nightmare getting them the care they need.
        There aren’t enough therapists qualified to treat adolescents. The majority of those who are don’t accept insurance because reimbursement rates—even for Blue Cross Blue Shield, which is one of the better insurance companies—are too low for them to live on.
        Blue Cross—and probably other insurance cos. as well—refuses to cover therapy from LCSWs even though they are authorized to provide therapy under supervision (and indeed that is the only way they can get the practicum hours required to become LICSWs), worsening the shortage of practitioners and making it harder for the number of providers to increase.
        The inpatient adolescent psych units at hospitals—when you can get a bed at all, which is a challenge—do little more than keep patients physically safe; they do not provide the treatment needed for patients to improve their condition.
        We could not find a single good adolescent mental health inpatient or outpatient program in the greater Boston area. And believe me, we looked. We experienced several bad programs firsthand.
        In contrast to all this, we’ve found that there are great adolescent programs in the Cleveland Ohio area, along with more capacity for therapy (though they’re crunched for capacity there as well).
        My theory is that the biggest reason why things are so bad in the Boston area is because the insurance companies don’t adjust their reimbursement rates to account for the cost of living, and it’s simply too expensive to live in the Boston area that therapists can’t afford to practice here.

  3. I agree with your suggestion. Many of those who do chose to mask avoid the unmasked for fear of infection, especially given the transmissibility of the Omicron variant. So in addition to endangering those who chose to wear a mask, unmasked crowds limit their freedom of action.

  4. I agree it is past time to institute a state-wide indoor mask mandate. It is ridiculous to see the patchwork pattern across the Commonwealth, let alone the nation, of towns that now have such a mandate, including Boston , and those that do not, as well as those with a mandate but in public buildings only. E pluribus unum has become E pluribus divisi (or E pluribus pieces). The prospect that hospitals will be overwhelmed by the confluence of Delta & Omicron Covid cases, other serious and often long delayed medical procedures, bad cases of the flu, and mental health issues is frightening.

  5. I second Monika’s comment that the Massachusetts’ mental health support system has been much less than the need for many years, long before this pandemic. But certainly the pandemic has made it much worse. More facilities are needed, and more staff, and probably to get sufficient staff the pay needs to be increased, at least for the direct-support staff at the bottom. In the current system untrained people in emergency rooms, public schools, police, jails, homeless shelters, and of course family members end up dealing with a large fraction of the mental health crises in the Commonwealth, because the official mental health system is so overloaded. Perhaps the current crises could lead to a consensus in the legislature for a bigger budget for the mental health system? Perhaps higher reimbursement rates are needed from insurers and MassHealth to provide higher staff salaries?

  6. We should look to states which are managing much better. I believe Florida has the lowest number of “cases” in the Country. They have accomplished this with limited mask mandates, social distancing, segregation policies, mass firings, etc. We should not continue down this insane path. Just look what’s going on in Europe, particularly Germany, Austria and Australia. Is that the direction you want for Massachusetts? I hope you will at least hold the line at internment camps and forced injections. These are all things that have failed miserably and are an affront to basic human dignity. I’m very surprised they are still being thought of as things that work by intelligent people. Something is very wrong here. Additionally, the abuse that is going on with children in schools is unforgivable. The vaccine and mask fanatics are doing incalculable damage, both physically and mentally, to children. There needs to be a deprogramming campaign of the people who are psychologically damaged. They are clearly sick.

    1. Thank you Mark. Well said. I would add that all hospital staff who worked tirelessly through the pandemic, only to lose their jobs for not getting the vaccine
      is unconscionable. Hire them back with full back pay.

    2. I agree with all the points you made. I think there is some strange collective psychosis — it looks to me like a media-induced PTSD, which has been fueling an exaggerated fear of death that interferes with people’s rational thinking. It’s overwhelming our society (here – though not in all US states — and in parts of Europe). It is being exploited by various special interests, and it has a disastrous effect – needlessly – on nearly all aspects of our lives. In combination with other factors, it will likely lead to a permanent demise of our political power in the world. For some reason, the powers that be enjoy frightening people – nobody bothers to explain that Omicron is actually good news – it’s a milder variant of the covid virus – no worse than a seasonal flu. People will not be dying from Omicron – and this variant is displacing Delta. The virus is and will continue to mutate. We cannot eradicate it — just like we cannot eradicate flu and colds. The so-called “vaccines” are not stopping the spread, only making Big Pharma very, very rich – and they will be using that wealth to continue to lobby government officials to force those products, effective or not, on people via government-imposed mandates, as long as they can get away with it, and it continues to make mega profits for them. I know people who are/were triple-vaccinated, and got covid. I also know people who were un-vaccinated, got covid, and recovered promptly without any need for hospitalization – but we never hear about them on the evening news, do we? Getting vaccinated is a personal choice. The government needs to switch the focus of their efforts from useless vaccine mandates to informing people about home covid tests and effective covid treatments (they exist), and ensuring they’re easily accessible as soon as someone starts feeling sick – because at some point everyone will get this or that covid variant. Why is it that in nearly all sources that seek to influence our thinking (incl. this well-meant report) the focus is always on the number of recently diagnosed/detected covid cases, plus the deaths (let’s be afraid, let’s be very afraid!) — but there is no mention of how many people had covid and promptly recovered (with and without any pharmaceuticals). Covid is dangerous only to immuno-compromised people and those who are old and weak. They should take extra precautions – everybody else, should be living normal lives. No mandates of any kind. Anyone who wishes to remain masked and socially distanced (and I do), it’s their choice.

    3. ” I believe Florida has the lowest number of “cases” in the Country. ”
      Since the start of the pandemic, 17% of Florida’s population has been infected, Massachusetts, less than 15%; California, less than 14%; Wyoming, greater than 19%.

      1. Infection rates are not the key metric – since about 99% of people who get infected with covid don’t die of it (and those who do usually have a serious underlying condition that is on its way to kill them). High infection rates and low mortality is an ideal state, since it leads to herd immunity, which is what we need. Even in the beginning of the pandemic Fauci et al were saying that we cannot stop the spread, we can only slow it down to prevent overwhelming the healthcare system. We’re now in the phase of “the herd” gradually acquiring natural immunity, and this is what naturally needs to happen. The jury is out on whether the mRNA “vaccines” are helping with that.

      1. The reason is obvious. You keep posting this link every time you see opinions that differ from yours.

  7. If hospital workers are in short supply – for whatever reason – the proper American response is, “Pay them more”. Maybe if our hospitals de-emphasized profits and share prices, at least for a few months, and emphasized their basic purpose – to provide healthcare – things might improve.

  8. Thank you Will for posting & supporting indoor masks state-wide! I have supported mandatory indoor mask wearing since
    Covid started. Having some people wear masks only in a few places is like a bandaid affect. Let us support all our Health care
    professionals & anyone working with the public. Loosing one more person to this Virus is one too many! Get fully vaccinated now & wear a mask indoors please.

  9. Thanks for the reminder.

    Don’t forget that “healthcare workers” includes everyone who works in healthcare settings: cleaning staff, security officers, etc. They’re all overworked!

  10. “Behavioral Health!” That sounds like something straight out a Chinese labor camp. This misplaced and ill-conceived notion reduces people to basic outwardly behaviors, while undermining genuine psychological and emotional suffering in people who happen to be complex multi-dimensional human beings.

    This so-called “mental health crisis” is nothing but the consequential evils born of a society where living is a daily struggle, individual liberty is oppressed by the state, and corporate raiders rule. Those who are so lucky as to have a job cannot take sick days or time off for family matters, for fear of losing their healthcare coverage, their ability to feed themselves and their families, and the roof over their heads.

    The hospital and healthcare systems are crumbling under the weight of their own multi-million dollar CEO salaries and benefits, and their dozens of top executives who would not get caught dead taking a call from a patient to assess concerns first-hand, or making the round of their own hospitals to evaluate the quality of the care that patients receive under their stewardship.

    The hospital bosses would be “well-received” before the legislature any day of the week, because those people circulate in the same black-tie affairs. Also, because the hospital and healthcare lobby is one of the biggest and most powerful, second only to the drug company lobby. There is a real crisis.

    Throwing billions at these problems will never fix them. It may make some people feel better about the absence of an honest approach to addressing societal problems in sound and sustainable ways. But the real crisis will remain the need to move away from the current mediocre-level thinking and the collective and hysterical pathologizing on the neverland path of least resistance.

    We need intellectuals with brain power, thinkers with integrity and strong ethics, and people outside the cottage industry who can see their way clear, to turn this ship around. Throwing more money at misidentified or drummed up problems will continue to amount to flushing money down the drain.

    1. Thank you for expressing what I was thinking as well. A representative for an industry group shows up and says whatever he needs to say to fulfill his mission — which is to get a hefty public subsidy. He’s saying they have staffing problems – when the hospitals themselves are responsible for that (due to underpaying people and the thoughtless mandates that deprive people of control over their own bodies). Will anyone on Beacon Hill will challenge them on that? Of course not. But they will gladly hand them a big pile of taxpayers money.

  11. Thank for bringing frontline and healthcare workers to mind as Delta is resurgent (+/- logarithmic climb inRNA in wastewater per MWRA Covid-19 monitoring. (https://www.mwra.com/biobot/biobotdata.htm) That should just be Delta right now. I guess it will be saw-toothed for a spell, but I d k) and Omicron is here. DPH reported 1 Omicron case, Boston 3 and NBC 10 Boston says 15 known cases are in the Bay State.
    Anticipating the term “community spread,” (of Omicron) from officialdom I imagine soon. Omicron will surely out compete Delta. Even if it is milder in our population (knock on wood if you’re superstitious that there’s little sequelae) the “fully vaccinated” 2 x Pfizer has only 3o% protection. Even the best case scenario of spiking Delta and changeover to Omicron our frontline and healthcare workers will know no rest.

    So, are we rolling the dice that Omicron is just a mild cold? But, basically, carry-on? I guess? Wear a mask of course. Get boosted of course. Unless yer under 16. Yeah we want to avoid saturating ERs with boarders and standing up expanded capacity, but what are infectious disease docs saying about what Omicron may do in the long run, especially the naïve? I’m not worried, just want to hear more; even about the unknowns.

  12. Also, when will we see a quantitative analysis of the morbidity and mortality of frontline and essential workers who had no choice but to march unto the breach -without a rousing speech mind you, no culpability.- and correlate that with economic activity imposition of restrictions and lifting of restrictions. Not saying it should have played out differently necessarily. Just want to see the analysis made public.

  13. As I have said during this pandemic, germ avoidance is job one. Masks are a must when social distancing is impossible. Better triage can make a difference.
    I think it’s disgraceful that health care workers are forced to take the vaccine or be fired. Last year treated like heroes, this year like outcasts.
    Our government is ungrateful and using military tactics turning the vaccinated against the unvaccinated. Our government is applying fascism.
    On Capitol Hill and Beacon Hill we need less BS and more positive actions.

    1. Healthcare workers who refuse to get vaccinated put already-sick and vulnerable people at real risk. They may have the right to refuse vaccination, but they don’t have a right to risk other people’s lives.

      1. That’s the point! They do NOT have to right to refuse vaccine! Since these hospital workers made it through the worst of the pandemic alive, maybe they know something that you don’t.

      2. If the vaccines are protective – supposedly – then the healthcare workers who refuse to be vaccinated should be able to work with people who are vaccinated, and with those who already had covid, and with those who are recovering, and therefore are no longer in danger of getting re-infected. That’s pretty much everyone.

  14. I recently was hospitalized in Boston. And talking with some of the Nurses, I found out that because of the burden of student loans too many Nurses could not afford to live in the city where they worked. And for the grossly underpaid patient care technicians, it was even worse. But while it would be great to have more dedicated workers like these, if we collectively deny them adequate recompense, we shall get our just desserts.

  15. I recently was hospitalized in Boston. And talking with some of the Nurses, I found out that because of the burden of student loans too many Nurses could not afford to live in the city where they worked. And for the grossly underpaid patient care technicians, it was even worse. But while it would be great to have more dedicated workers like these, if we collectively deny them adequate recompense, we shall get our just desserts.

  16. How many health care workers in Massachusetts and around the country this year have quit their job or been fired/suspended/laid off/warned of impending dismissal because they would not voluntarily adhere to Covid emergency requirements? (For example, by refusing to get vaccinated.) My impression is that the number is substantial. If this is indeed the case, it strikes me as bizarre that the folks who run those institutions would dare to wag admonitory fingers at the rest of us. It would seem more appropriate for them to put their own house in order first. And harangue us later. I happen to be fully vaccinated and I wear a mask in designated places. So I’m no anti-vaxxer or Covid denier. I’m just wondering why the CEOs and department heads of all those hospitals and clinics say one thing, while so many of the boots on the ground in those same hospitals and clinics say “No thanks, I’ll wait a bit.”

    1. Those health care workers survived two years working with sick people and covid patients. They probably know whether they need a vaccine or not. I don’t get why people are so obsessed with the vaccine. Experts have estimated anywhere from 30-50% of the general population has been infected, and is immune, to covid by now. I’m sure many of the health care workers would fall into that category. There’s zero reason to give a chemical immunization to someone who is already immune.

      And yes, my friend happens to be one of the ones who has to call HUNDREDS of nurses, she told me, to fire them this week for not getting the vaccine.
      Which is an absolutely insane and disastrous move for our hospitals right now.
      So hey, when we hear the “health care system is stretched thin,” we only have the CEOs and government to blame.

  17. Will definitely keep frontline healthcare workers in my thoughts and good wishes, so should I not have gone to a packed movie house last night where most people had their masks of munching popcorn?

    1. That is to say, it’s up to the wisdom of individuals to restrict our movements/mobility and contacts, or will those with assorted flavors of authority make clear and specific pronouncements and guidelines?

      The movie was good as far as Marvel live-action/cgi cartoon offerings go-the new Spider-Man middling quality for them.

      1. Honestly, I wouldn’t go to a packed theater right now and sit through a movie. Especially since I have good streaming options at home. All it takes is one person who doesn’t know that they are infectious or doesn’t care enough to stay home.

        1. Thank you for saying that Senator. Responsible voices (like yours) and actions are lagging commercial efforts it seems. We’re walking a fine line.

          Surprised to see it so full.

          2021-2022 ILINet is above the National Baseline and tracking 2017-18, 2018-19 and 2019-20 %visits. 2020-21 was below the Nat’l Baseline. Pediatric deaths in 2018-19 and 2019-20 was 144 and 199 respectively. 2020-21 =1.

        2. I agree. Is the Commonwealth’s lack of a mask mandate and other measures, and lack of guidance in light of a much more transmissible variant a de facto policy of encouraging immunity by allowing the virus to spread?

  18. The response to the healthcare system in this current climate can be addressed in so many other helpful ways than masks. My thoughts and prayers go out to those working in this current healthcare system. Health is a complex and very individualized issue involving a multitude of factors that come down to SELF-responsibility. I do not agree with any state wide mask mandate. It should always be voluntary. Getting enough sleep, being well-hydrated, managing stress, reducing stress, exercising and nutrition are health factors that need to be encouraged! This is what creates a robust and responsive immune system. A mask is a terrible long-term solution. The inability to hear people in a mask is very real and effects those who are heard of hearing. Many of the mental health issues such as anxiety, depression and are related to the fear-mongering of this virus. There has been no balance between preventative health measures versus generic widespread mandates that do not address the root issues. The virus does not effect everyone is the same way, so there needs to solutions and choices that address that.

    1. Well said. Their solution will be you giving up all freedoms and submit to the corporate government fascists. At this point of the fear based training they are conditioning people to accept Health passports, break families up, further destroy economy with mandates and just demoralize the population. They will soon be pivoting to climate control measures and a social credit system tied to an app/QR code. This will dictate every aspect of your life. Whether you can work, travel, buy food, etc. We are sleepwalking into a dystopian hell led by irrational fears and cowardice which is unnerving to witness.

      1. What you are saying is what many of us are thinking, but only some dare to articulate. Others, who don’t realize where this is going, are just behind in their understanding – and if they don’t wake up, will be enabling the destruction of our society and all necessary freedoms. I would like to know how to connect with more people, including you, who have the clear understanding of the dangers we are facing.

  19. As I told you during a Zoom call half a year ago, masks and vaccines were not used during the last pandemic, which was noticed and documented by the CDC in October 1968.

    Our Governors and Mayors followed the advice of the experts and allowed people to continue their normal lives. Super Bowl #3 was held, with a full stadium, three months after that pandemic began. The worldwide death total was only a million, compared to the Ebola disease, which was far more deadly.

    The Wuhan Flu is more contagious than the 1968 disease, which the public called the Hing Kong Flu, but during the course of this disease, the symptoms have been less and less serious. The Mortality Rate has never been above 1%. The Mortality Rate for children is even lower.

    Public health policy should always be driven by facts and figures instead of fears. The symptoms of the Omicron variant are indistinguishable from the annual flu. This variant is not affecting the public’s ability to work, shop, and travel any more than any flu strain does.

    There is little danger to the public from people who are unvaccinated and unmasked, so there is no good reason to require masks at any indoor event that the public has access to, including baseball games at Fenway Park, football games at Gillette Stadium, and basketball or hockey games at the Boston Garden. The Statehouse should also reopen to the public.

  20. I am vaccinated with a booster shot, wear a mask at indoor public places, and avoid large crowds. The reasons are to protect myself but also to protect family, friends and all of you. I think it is really that simple. We need to protect our hospitals from being overrun and to permit folks that need non-covid-19 care to have availability. Protect each other – it is the right thing to do.

    1. Thank you. You sound caring, rational, and since I’m all for personal responsibility, I appreciate that you do everything that you believe is helpful (I take some precautions too). But I believe that the longer we resist this virus (ie., prevent its natural spread), the longer it will be with us and continue to paralyze our lives and economy. The only way to make this virus inconsequential, like cold viruses, is to allow our immune systems to develop natural immunity. Everything else is just noise, as some interests seek to make money of the pandemic, while others are getting ruined (or are slowly getting there without realizing it).

      1. The reason that we are not speaking about polio is because the vaccine wiped it out rather than polio wiping us out.

        1. Big difference between the polio vaccines, and the mRNA “vaccines” (which aren’t true vaccines, and should not be called that way). The latter cannot wipe out covid the way the polio vaccine wiped out polio. We have people who got three doses of the mRNA vaccines and they still get sick and spread the virus.

  21. Ironically, mental health issues and physical health issues are going up because of the government’s authoritarian lock down, social distancing and masking mandates. This is not an exaggeration. Those severe isolating actions have a REAL EFFECT on people. And now we are seeing those effects reflected in an uptick in mental health issues as well as a general downward trend for people’s health, due to the aforementioned actions which have harmed and continue to harm long term natural immunity.
    We don’t gain immunity by hiding at home, isolating from people or constantly covering our faces. All of those actions actively harm our body’s immunity and ability to fight ANY disease! Hello, think about it, it’s common sense!
    So NO, there should not be a statewide mask mandate. Let people who are concerned about their own health take whatever precautions they think are necessary.
    Me, I’m going to keep exposing myself to germs and viruses, as WE ALWAYS HAVE, and I’m going to keep myself healthy by eating well, and exercising because MY health is MY responsibility. It is nobody else’s but my own.

Leave a comment

Leave a Reply to Fred Cancel reply

Your email address will not be published.