Baker halts non-essential hospital procedures, urges indoor mask wearing

GOV. CHARLIE BAKER is requiring Massachusetts hospitals nearing capacity to cancel all non-essential, elective, invasive procedures as of December 27 in order to preserve room for incoming patients amid an impending surge of COVID-19 cases. He is also activating the National Guard to help struggling hospitals. 

The Republican governor also updated the state’s mask rules to “recommend” people wear face coverings indoors, but he stopped short of imposing a new statewide mandate. 

The new order on hospitals, announced Tuesday, is stricter than orders issued earlier this month which required hospitals to limit only a percentage of non-essential procedures if the hospital were nearing capacity. 

The policy will require hospitals to postpone all non-essential procedures likely to result in an inpatient hospital stay. These are procedures like joint replacements, which require inpatient recuperation but can generally be postponed without medical harm to the patient. There will be some exceptions for specialty hospitals, and for hospitals that are able to maintain at least 15 percent of their total capacity. Hospitals will still be allowed to perform preventative care, pediatric care, abortions, outpatient procedures, and urgent procedures that would adversely affect patient health if they were delayed.  

“We’re committed to ensuring our health care system meets the acute care needs of our residents,” Secretary of Health and Human Services Marylou Sudders said at a press conference Tuesday morning.

Decisions in the spring of 2020 to defer medical care – both because the state required hospitals to defer non-urgent procedures and because people were slow to return to health care settings out of fear – are widely thought to have contributed to the capacity crunch today as people who deferred care are sicker and now require more care. But the state is facing a scenario now in which hospitals are already facing severe staffing shortages at the same time as the Delta and Omicron variants are sweeping the country and creating a surge in new cases. 

As of Sunday, there were 1,513 patients hospitalized with COVID-19 in Massachusetts, and 90.4 percent of hospital beds were occupied, including 83.7 percent of beds in intensive care units. 

The state has lost 500 inpatients beds over the course of the year, largely due to staffing challenges. 

Baker said Tuesday that he will authorize the deployment of up to 500 members of the National Guard to assist with the non-clinical needs of hospitals and ambulance services. Up to 300 of those Guard members will start training this week to begin work December 27, and they will be available for up to 90 days. They will be working at 55 hospitals and 12 ambulance providers. The Guard members will be able to: drive patients from one facility to another, for example when someone is discharged from a hospital to a long-term care facility; provide monitoring of a patient at risk of harming themselves; serve as security guards; transport patients via wheelchair or stretcher around the hospital; and deliver meals to patients in their rooms. Sudders said the 500 number also includes administrators and 85 Guard members who are already deployed helping with COVID testing in schools. 

The state did not announce plans to stand up any field hospitals, as officials did in 2020. Sudders said the challenge of creating field hospitals is the continuing staffing shortages as well as the need to find appropriate locations.

Despite calls from Democrats and public health experts, Baker did not impose a new statewide mask mandate. But the Department of Public Health did issue guidance recommending that individuals wear face coverings in all indoor public spaces, regardless of vaccination status. The department wrote in its advisory that it “particularly urges this recommendation” for individuals who are immunocompromised or otherwise high-risk for COVID-19.  

Asked why he is not imposing a statewide mask mandate, Baker said he imposed a mask mandate in 2020 because it was the only tool available. Now, people have widespread access to testing and vaccination, and vaccines are the best protection against COVID. “I have no interest in putting a mandate on this issue given all the tools that are available on a statewide basis on the people of Massachusetts,” Baker said. “People know more what works, what doesn’t, and if people wish to add an extra layer of protection by adding a mask in indoor settings, we’d urge them to do so.”

Baker added that if officials in individual communities choose to impose a local mask mandate, “they are free to do so.”

In response to a question, Baker also added that he has no intention of shutting down schools again. “My view on this one’s simple: kids need to be in school. It’s safe, it’s not only safe, it’s healthy,” Baker said. Baker said there is overwhelming evidence that keeping kids away from peers and trusted adults earlier in the pandemic caused terrible damage to children nationwide. “It’s not going to happen in Massachusetts,” he said.

A group of over 100 public health and medical experts and 36 community organizations, many representing immigrant and ethnic communities, led by Sen. Becca Rausch, a Needham Democrat, recently wrote a letter to Baker demanding more stringent public health measures to respond to the virus surge. They called for a mask mandate to be implemented by county based on levels of COVID transmission, the reimposition of statewide workplace safety requirements, universal masking and a remote learning option in schools, daily mobile vaccination clinics in hard-hit areas, and protections against foreclosures.

“We have grossly and inexplicably insufficient action from the governor to protect public health and ensure hospitals and emergency rooms remain accessible,” Rausch said on a press call Tuesday.

Dr. Julia Raifman, assistant professor of Health Law, Policy, and Management, at Boston University School of Public Health, said mask policies are the opposite of school closures and lockdowns, since they allow people to gather indoors by limiting the amount of COVID in the air. “Mask policies allow us to more safely share indoor spaces and air together,” Raifman said. She said mask policies prevent more stringent measures and save lives.

This is a breaking news story that has been updated.