The state’s two-front war on COVID-19

Deaths keep rising, but most occur in long-term care facilities

THE NUMBER OF COVID-19 deaths in Massachusetts spiked on Wednesday, hitting the third-highest daily level since the pandemic began.

The state Department of Public Health reported that 208 people died of COVID-19 — 133 of them in long-term care facilities and 75 in hospitals and elsewhere across the state.

The numbers were another affirmation that the war against COVID-19 in Massachusetts is being played out on two fronts – one front is in nursing homes and the other is in hospitals and other medical facilities.

Since April 10, when the state Department of Public Health first started disclosing how many deaths were occurring in nursing homes, the two-front nature of the fight has become clear. Over that time span, the daily number of deaths in nursing homes averaged nearly 91 a day, while the average outside nursing homes was nearly 54.

Over the last week, the number of deaths outside long-term care facilities dropped to 26 on Monday and 30 on Tuesday before rising to 75 on Wednesday. Deaths at long-term care facilities also bounce around, but generally at a much higher level. Overall, COVID-19 deaths at long-term care facilities account for 60 percent of all COVID-19 deaths in the state.

The two-front nature of the death data can also cast a different light on other coronavirus information. For example, the state on Wednesday released a breakdown by municipality of COVID-19 cases. The top 10 municipalities remained roughly the same compared to last week in terms of cases on a per capita basis, although Lynn moved up from fourth to third (just behind Brockton) and Randolph dropped from fifth to six (behind Everett and Lawrence).

Chelsea remained the hardest hit community, with 2,244 cases in a city of 40,160 people. Chelsea has reported 110 COVID-19 deaths, which is a high number for a city its size. But it appears a large percentage of those deaths occurred at nursing facilities. The exact number is unclear because the state doesn’t report deaths by individual nursing home, and many nursing homes don’t disclose the information publicly. Still, the Chelsea Soldiers’ Home alone has had 27 COVID-19 deaths and the other nursing facilities in the community have also had a number of fatalities. It’s possible Chelsea as a whole is getting slammed by COVID-19 cases, but its nursing homes are where a large number of deaths are occurring,

The Baker administration doesn’t look at death data much when it tries to determine whether the state is on the downward side of the surge and prepared for reopening. At a midday press conference at Gillette Stadium after he swore in a new class of State Police cadets, the governor on Wednesday ticked off a number of positive signs – hospitalizations were trending down, the number of patients in intensive care units was stable, and new cases as a percent of tests administered were relatively low.

Baker also added a new indicator he hasn’t mentioned before. He said he wants to see a decline in reliance on temporary hospital facilities set up to cope with the influx of COVID-19 patients before starting to reopen the state.

“We’re still very much in this fight with COVID-19, but it is encouraging to see some positive progress. As we come through the other side of this and determine our next steps for a path forward, we need to see those numbers continue to drop,” Baker said. “Our goal, starting on May 18, is to begin re-opening certain types of businesses in a limited fashion where it can be done more safely than under normal operations. But this phased-in process can’t begin until we see sustained downward trends in many of the data elements that we talk about every day.”

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.

The state’s COVID-19 dashboard released later in the day indicated the state had fallen back on some of the indicators. Deaths were up. So were new cases as a percentage of new tests; the percentage was 28 percent on Wednesday, up from 13 percent the day before. Hospitalizations and ICU patients were up, but only slightly.

Baker said he hopes to begin reopening the economy on May 18, and indicated some information on how that will be done will be released before then. But he repeatedly stressed that nothing will happen until the data indicate it is safe.

“It’s very risky to make broad prognostications about what’s going on, where it’s going, how it’s going to get there,” Baker said. “So much of what we know about this virus has changed in the last 60 days. Some people might even say that everything we know about this virus has changed in the last 60 days. So when I say here that we have seen encouraging trends, that’s because I’m talking about the past.  I’m not going to speak to the future. The future is going to be what it’s going to be.”