State’s 2d surge is not the same as 1st

Cases rising faster, but deaths, hospitalizations growing more slowly

THE STATE’S SECOND SURGE is continuing to build in intensity, with the number of cases starting to accelerate well beyond levels experienced during the first surge. But the outcomes of those cases, in terms of deaths and hospitalizations, are so far much less severe.

The number of cases hit a new daily high on Thursday of 6,477, which topped the previous high on Wednesday of 4,613. Baker administration officials said the Thursday number was inflated because of a software glitch that delayed a lab’s reporting of 680 positive cases. Yet even with those cases removed, the Thursday number was far and away the highest ever.

The number of communities at high-risk for COVID also kept rising, hitting 97 on Thursday, up from 81 last week and 62 the week before that. The so-called high-risk, or red, communities and the number of moderate risk, or yellow communities, now account for 67 percent of all municipalities in Massachusetts.

Lawrence was the community with the worst numbers – 107.3 cases per 100,000 people over the previous two weeks and a positive test rate (positive tests divided by total tests) of 14.7 percent. Those numbers were actually down slightly from a week earlier. The state’s numbers as a whole also continued their upward trajectory, rising to 35.7 cases per 100,000 people over the previous two weeks and a positive test rate of 3.73 percent.

While the state’s situation looks very grim on the case front, the second surge is very different from the first in several key respects.

First, the number of deaths, while growing, is rising at a much slower pace than it did in the first surge. In April, for example, the state reported a total of 55,584 cases of COVID-19 and 3,473 deaths.  In November, the case levels topped the record levels of April, rising nearly 15 percent to 63, 808. But the number of deaths from COVID-19 was down nearly 79 percent, falling to 746.

The COVID-19 report released Thursday showed a steady increase in both cases and deaths. From November 15 through November 28, the number of cases totaled 36,911, up 2 percent from the previous two-week period – November 8-21. Deaths hit 408 in the most recent two-week period, up 14 percent from the previous two-week period.

COVID-19 hospitalizations are also rising, but more slowly than in the first surge and much more slowly in hospital intensive care units. Eric Dickson, the president and CEO of UMass Memorial Health Care, said at a press conference in Worcester on Thursday that the last surge was heavily focused inside ICUs, largely because hospital system had fewer tools to fight the coronavirus then.

Dickson said new therapies, including remdesevir, monoclonal antibodies, convalescent plasma, and high-flow oxygen have made a tremendous difference in keeping patients out of intensive care.

Hospitals may also be benefiting from a changing patient mix. In the first surge, people over 70 accounted for 20 to 30 percent of positive cases and a very high percentage of the deaths. During the second surge, people over 70 still account for the bulk of deaths, but their case levels have dropped off to the 8-9 percent range. Over the last two weeks, people 39 and under accounted for 53 percent of cases.

Meet the Author

Bruce Mohl

Editor, CommonWealth

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

“That has a real impact on both the nature of who gets sick, how they get sick, and how they get treated,” said Gov. Charlie Baker at the Worcester press conference.

That may explain why, despite rising case levels, the Baker administration is not scrambling to open field hospitals the way it did during the first surge. A Worcester field hospital opens this Sunday with a relatively low number of beds. The state is also looking to stand up a field hospital in Lowell and another in southeast Massachusetts, but has no current plans to open a field hospital in Boston this time around.