In virus battle, health providers charge into harm’s way

Baker relaxes licensing rules to allow for reinforcements

GOV. CHARLIE BAKER announced emergency orders on Tuesday that will loosen some licensing requirements for health care providers, moves that could increase the supply of physicians, nurses, and other frontline health care workers in the state to deal with coronavirus crisis.

Baker’s orders will allow physicians who retired within the last year, with no complaints pending, to have their license reinstated. Physicians and nurses who are licensed in good standing in other states will be able to obtain emergency licenses to practice in Massachusetts. Nurses, pharmacists, and physician assistants whose licenses are set to expire may have them extended until 90 days after the end of the public health emergency declaration.

The governor also ordered an adjustment of minimum requirements for ambulance staffing personnel to ensure adequate EMS capacity.

“This is all about helping to expand our health care delivery capacity,” Baker said at a State House briefing on the crisis.

The president of Massachusetts General Hospital said on Sunday that the health care system needs to adopt a “war-like stance” in the effort to combat the coronavirus pandemic.

As in any battle, it’s imperative to plan for how to maintain the fight even when the army’s ranks are depleted by fallen soldiers. As grim as that military metaphor may be, it could be an apt description of the situation many hospitals may soon face — one that a hospital in western Massachusetts has already had to contend with.

At Berkshire Medical Center in Pittsfield, the Berkshire Eagle reported on Monday, more than 160 employees have been furloughed because of potential exposure to the novel coronavirus, a situation that led the hospital’s parent company, Berkshire Health Systems, to bring on 54 nurses through a temporary staffing agency.

“We do have a number of employees that were furloughed based on their potential exposure” to the coronavirus, Michael Leary, director of communications at Berkshire Health Systems, said in an interview Tuesday evening.

Berkshire County is the first area in Massachusetts to report cases of COVID-19 resulting from community transmission — patients with the virus who had neither traveled to a high-risk country where the disease was already prevalent nor had known contact with someone who was infected.

Leary said several patients were treated at Berkshire Medical Center with flu-like symptoms but did not qualify for coronavirus testing under the stricter testing guidelines originally put in place. They later tested positive for the virus.

As of Tuesday, Berkshire County had 14 of the state’s 218 confirmed cases, the fourth most after highly populated Middlesex, Norfolk, and Suffolk counties in eastern Massachusetts.

Leary said the 302-bed hospital has been able to maintain care for patients with the temporary nurses that were brought on. “We were pretty fortunate,” he said.

“The only upside I can give you to being the first community transmission area of coronavirus in the state of Massachusetts is we were able to reach out to that organization early,” Leary said of the temporary nurse staffing firm, which he declined to name. “We have been told since then that it’s getting far, far more difficult to hire travel nurses, not just in Massachusetts, but across the United States.”

How extensively the coronavirus will affect frontline care providers in the US and how badly that could strain the health care delivery system is one of the many unknowns as the country braces for an expected surge in cases in the coming several weeks.

The president of the Massachusetts Hospital Association, Steve Walsh, welcomed Baker’s move to loosen licensing requirements for health care professionals. “Hospitals are doing everything they can to ensure safe patient care and strong caregiver protections, but additional support is necessary,” Walsh said in a statement. “Removing barriers from licensing and credentialing will help ensure qualified caregivers are available quickly when needed.”

None of the Berkshire Medical providers have tested positive for coronavirus, and Leary said all of those who were furloughed are expected to be back on the job by sometime next week.

Health care workers have not been as lucky in China or Italy, where the virus has claimed the lives of frontline providers, including the director of a hospital in Wuhan, China, where the outbreak started.

In Bergamo, a city in northern Italy where the epidemic there is concentrated, many ambulance staff, who weren’t properly trained on dealing with infected patients, have become sick. The Wall Street Journal reported on Tuesday that an ambulance dispatcher in his 40s with no prior illness — and no direct contact with patients — died on Saturday after contracting the virus.

“We need to think about this in an almost war-like stance,” Dr. Peter Slavin, the president of Mass. General Hospital, said on Sunday on NBC’s “Meet the Press.”

“My concern is that we have millions of health care workers around this country who are prepared to do battle against this virus, but I’m concerned that there are at least a couple of areas of supplies that they need in order to fight that virus as effectively as possible,” Slavin said.

Meet the Author

Michael Jonas

Executive Editor, CommonWealth

About Michael Jonas

Michael Jonas has worked in journalism in Massachusetts since the early 1980s. Before joining the CommonWealth staff in early 2001, he was a contributing writer for the magazine for two years. His cover story in CommonWealth's Fall 1999 issue on Boston youth outreach workers was selected for a PASS (Prevention for a Safer Society) Award from the National Council on Crime and Delinquency.

Michael got his start in journalism at the Dorchester Community News, a community newspaper serving Boston's largest neighborhood, where he covered a range of urban issues. Since the late 1980s, he has been a regular contributor to the Boston Globe. For 15 years he wrote a weekly column on local politics for the Boston Sunday Globe's City Weekly section.

Michael has also worked in broadcast journalism. In 1989, he was a co-producer for "The AIDS Quarterly," a national PBS series produced by WGBH-TV in Boston, and in the early 1990s, he worked as a producer for "Our Times," a weekly magazine program on WHDH-TV (Ch. 7) in Boston.

Michael lives in Dorchester with his wife and their two daughters.

About Michael Jonas

Michael Jonas has worked in journalism in Massachusetts since the early 1980s. Before joining the CommonWealth staff in early 2001, he was a contributing writer for the magazine for two years. His cover story in CommonWealth's Fall 1999 issue on Boston youth outreach workers was selected for a PASS (Prevention for a Safer Society) Award from the National Council on Crime and Delinquency.

Michael got his start in journalism at the Dorchester Community News, a community newspaper serving Boston's largest neighborhood, where he covered a range of urban issues. Since the late 1980s, he has been a regular contributor to the Boston Globe. For 15 years he wrote a weekly column on local politics for the Boston Sunday Globe's City Weekly section.

Michael has also worked in broadcast journalism. In 1989, he was a co-producer for "The AIDS Quarterly," a national PBS series produced by WGBH-TV in Boston, and in the early 1990s, he worked as a producer for "Our Times," a weekly magazine program on WHDH-TV (Ch. 7) in Boston.

Michael lives in Dorchester with his wife and their two daughters.

He cited expansion of testing capacity as one imperative along with greater availability of “personal protective equipment” — an issue at the heart of the quest to keep health care providers from becoming infected. Slavin said those supplies were running low at Mass. General and other hospitals.

“We need the federal government to engage in a Manhattan Project to get industry to create surgical masks, eye protection devices, gowns, so that our health care workers can engage in this battle,” Slavin said. “We wouldn’t want to send soldiers into war without helmets and armor. We don’t want to do the same with our health care workers.”