Second Coronavirus Surge Would Pose New Challenges: Experts
The COVID-19 pandemic that has shined a light on health inequalities and exposed parts of the health care system that are not working as intended also revealed strengths of the system in Massachusetts, Health and Human Services Secretary Marylou Sudders said Tuesday.
In particular, she said, those assets include the system's willingness to collaborate and the resilience of its workers.
"I have to tell you the strength of our health care system, our health care delivery system, has never been stronger than in April and May and June when the pandemic hit hard," Sudders, who has been running the state's COVID-19 command center, said during an annual Health Policy Commission hearing. "There were a couple of weekends where the system felt stretched but never overrun as has happened in other states."
Typically focused on trends in health care spending, the hearing this year delved into the effects of the pandemic and inequities in health care. Referred to by some industry watchers as the "Super Bowl of health care" in Massachusetts, the event was held virtually this year, and HPC executive director David Seltz quipped that, like this year's NFL season, the 2020 hearing was the "bubble version."
"I'm sure all of us will look forward to forgetting 2020 if we can, but in fact I hope that there are things from this pandemic that we take to heart and learn from going forward, and not see this as a moment in time, because I do think this kind of global pandemic, we will experience another, perhaps not as deadly as this one," Sudders said.
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Gov. Charlie Baker, in recorded remarks, revisited the topic of the speech he gave at last year's hearing — the health care reform bill he filed in October 2019. Baker said some of the emergency measures put in place to respond to the COVID-19 crisis underscore the importance of ideas proposed in that bill, like permanently integrating telehealth into the state's health care system. Telehealth legislation has been before a House-Senate conference committee since July 31, although the practice has gained traction in the industry.
At the height of the pandemic earlier this year, Baker said, 75 percent of mental health clinical visits occurred via telehealth.
"If the current trend of telehealth utilization continues beyond the pandemic, we can reduce cost for the health care system long term by shifting care out of higher-cost settings, and telehealth also reduces the potential for infections to spread," Baker, a former health insurance executive, said.
As the health care community reflected on the spring surge in COVID-19, many also looked ahead to the likelihood of another spike in virus activity this fall and winter, as flu season also hits and the colder weather means many activities that have been happening outdoors will move inside.
"Nobody wants to see another surge, nobody wants to think about being in March or April again, but I do think that people are trying to prepare for that possibility," Lawrence General Hospital President and CEO Deborah Wilson said.
At times earlier in the year, Wilson said, more than 70 percent of her hospital's patients were in with COVID-19, and securing necessary personal protective equipment was a "daily fight."
Lawrence General is now "in decent shape with PPE," she said, and a staff that was "fairly exhausted" in June was able to "take much-needed breaks" throughout the summer. Employee assistance programs are also in place to support workers dealing with after-effects of the surge, Wilson said.
"People were definitely traumatized by what they witnessed, with families not being able to see their loved ones if they were dying, and everything was very intense," she said.
Dr. Steven Strongwater, the president and CEO of Atrius Health, cautioned of a potential "brewing problem" — the availability of staff. He said some people have not been able to come back to work, either because they are dealing with chronic conditions that leave them reluctant to risk caring for COVID-19 patients or because, in a time of remote learning, they lack child care.
Strongwater said virtual care delivery and telehealth eases some challenges for such workers. Atrius Health, he said, "deployed overnight and trained hundreds of people to use telehealth."
Independent practices like Atrius are struggling "and will continue to struggle because we are under significant financial and operational stress," Strongwater said.
"Without the support of the state and federal government and flexibility from commercial payers, we predict practices will close or consolidate, leading to potentially higher health care costs in the commonwealth," he said.
Health care workers are poised "to carry a huge brunt and a huge burden" in the weeks ahead, said Health Policy Commission member Barbara Blakeney.
"All indications are indicating that we are going to get slammed over the next 12 weeks or so, that this winter is going to be extraordinarily difficult, and it will fall heavily across the board, but I think especially of our clinicians and our folks working in hospitals and care facilities at every level, and the care that they offer and the demand that it takes of them to do it," she said.
Blakeney, a registered nurse, said the pandemic's long-term impacts are still unknown.
"We don't really have a good clue what the prolonged effects of this pandemic will be, either, physically, emotionally, economically, psychically. We don't know," she said. "When this virus is done with us, it's not yet done with us."
Another commissioner, MetroWest Health Foundation President and CEO Martin Cohen, flagged behavioral health as an issue to watch.
"I think we also have, we currently have a behavioral health crisis — stress, anxiety, depression, drug and alcohol use, suicidal ideation — that is only going to get worse in the next several weeks and beyond, and I think that is something that we need to pay attention to," Cohen said.
Lynn Community Health Center CEO Dr. Kiame Mahaniah said he is concerned about how the COVID-19 crisis will affect non-COVID patients, saying the numbers of people he's seen seeking medical attention for presumed heart attacks, strokes and asthma emergencies have "plummeted."
"I'm worried about actually a pretty heavy increase in early mortality amongst our patients in their 50s and 60s," Mahaniah said. "I'm very worried about actually many more orphans, many more people losing their grandparents when they're young children, and that really severely cuts down on the support network that's going to be available for a lot of our patients."
Baker, state officials and health care industry leaders have repeatedly encouraged people to not let COVID-19 fears keep them from seeking other necessary care.
"Residents should not delay accessing care due to the pandemic," Baker said Tuesday. "Our health care facilities are safe and they continue to implement rigorous infection control measures."
This article originally appeared on the Boston Patch
