‘Nobody knows just which way this is going to go’: MA hospitals ready for 2nd COVID-19 surge, but a virus mutation could upend plans

BOSTON — Healthcare systems across the Commonwealth are readying their COVID-19 surge plans ahead of an anticipated second wave of the virus. Experts predict COVID-19 could once again overwhelm the state next month.

But staying ahead of a virus that is known to mutate won’t be easy for hospitals, as they must be prepared for whatever comes their way.

“This is the calm before the second storm. But nobody knows just which way this is going to go and where it’s going to end up,” said Dr. Eric Dickson, president and CEO of UMass Memorial Health Care.

Ironically, says Dickson, a second surge that looks similar to what unfolded in the spring would be the best case scenario for his hospital.

“We’re ready for what happened before. But there are other things that could happen,” he said.

Things like a mutation of the virus, which has already happened. If the virus mutates into something more virulent, Dickson says that could reverse the progress the nation has made in the areas of testing and vaccination.

“If the virus mutates in just the right spot, our test will become ineffective,” said Dickson. “So if we lost the test as it exists today, that would be a big problem for us."

Not only would it derail testing, but a virus mutation would also reduce the effectiveness of the vaccine, added Dickson.

Despite the many unknowns, he’s confident UMass, with its team of “world-class problem solvers,” will stay ahead of the evolving virus. He says his people are capable of executing plans quickly under unprecedented circumstances, pointing to last spring’s construction of the Worcester field hospital in just over a week as an example.

In March, when the novel coronavirus was surging in the state, UMass, like most hospitals, faced a severe shortage of N95 masks, surgical gowns, eye protection and disinfection supplies. They faced an around the clock battle to keep adequate supplies flowing. Now, UMass is stockpiling a minimum of three months' worth of personal protective equipment (PPE) to avoid the scramble they faced in the early days of the pandemic.

“So we’re in much better shape for dealing with what happened in the end of winter into the early spring, but things could change rapidly. This thing is far from over,” said Dickson.

The state’s positive test rate remains low – at below 1%. Nonetheless, hospitals remain on high alert, particularly as the hospitalization rate has started climbing in recent days.

In a statement to 25 Investigates, the Massachusetts Health and Hospital Association said:

“Our hospitals stand ready and prepared for a second wave of COVID-19, armed with the many lessons learned from the initial surge last spring. Healthcare providers have been collaborating with each other and state leaders to stockpile personal protective equipment, increase testing capacity, and prepare for every scenario this virus may present us in the months ahead. We are confident that this tireless work will put us in the best possible position to continue treating patients safely and effectively.”

“Looking ahead for us means that we have to assume there’s going to be COVID around for many months, if not next years,” said Dr. Paul Biddinger, chief of the Division of Emergency Preparedness at Massachusetts General Hospital in Boston. He says the hospital is in prepared and in good shape for a second wave.

“We went into this pandemic with a cache that was big enough to cover our needs at the peak two weeks of a wave. Now we’re making a cache big enough to accommodate four months of a wave,” he added.

Biddinger says Mass General is also better prepared to care for COVID-19 patients without shutting down non-essential care. In the spring, lack of experience with COVID and insufficient PPE forced hospital to stop elective procedures.

“Knowing what we know, we don’t think that should be necessary the second time," said Biddinger. “We know how to deliver safe care to patients in the primary care setting, procedural inpatient care, and we know there are consequences to deferring so much care.”

Even with the best laid plans in place, hospital must be nimble and prepare for whatever coronavirus throws their way this fall.

“Historically, pandemics have had second surges, but those have mostly been influenza. So we don’t know what that means for COVID,” Biddinger said. “So all our hospitals in the system have actually planned for surges that are milder than what we went through in the first wave, the same as or even worse than, even though thankfully, we think that’s the least likely scenario.”

Already European countries and Canada are seeing a steep rise in cases. As the cooler weather forces people indoors, the U.S. may soon follow.

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