Preparations for second surge of coronavirus underway

Boston Herald – August 26, 2020

Alexa B. Kimball, MD, MPH (President & CEO, Harvard Medical Faculty Physicians at BIDMC) discusses how hospitals are preparing for a potential second surge of COVID-19, and why colder months present more of a challenge in terms of social distancing. 

Health experts say Massachusetts is likely to experience a second coronavirus surge in the fall — how prepared the state is to handle it depends on who you ask.

“We know what works and we weren’t prepared on the last round, and we should be, and we are not ready for the next surge,” said Donna Kelly-Williams, president of the Massachusetts Nurses Association.

Massachusetts Health & Hospital Association President Steve Walsh, however said health care facilities around the state are ready, they just don’t know yet the scope of the second wave.

“There is a strong likelihood, I mean this is coming back, we just don’t know quite when or whether it will be low numbers over a long period of time or whether it will surge like it did in March and April and May,” Walsh said.

Kelly-Williams highlighted several shortfalls such as continued lack of personal protective equipment, staffing, reliable testing and strict standardized protocols from the state on treatment, monitoring and procedures.

“Are we going to go through the same ‘just in time’ deployment and fast training when we’ve had all this time to have a better plan in place? It’s shameful,” said Kelly-Williams, putting blame on the state for lack of action.

The flu season and return of students to schools and colleges could all be factors contributing to the anticipated second surge of COVID cases, Walsh said.

Like Kelly-Williams, he said testing is a “moving target” and PPE will be a challenge for “quite awhile.”

But, he said Massachusetts hospitals are ready.

“We are really prepared, I think we are certainly more prepared than the first time because now we have one thing we didn’t have before and that is experience,” Walsh said.

Another challenge that the colder months present will be adequate social distancing. Spending time outdoors will diminish as people seek warmth inside, said Alexa Kimball, CEO of Harvard Medical Faculty Physicians at Beth Israel Medical Center.

“Being able to keep people more distant will become harder,” Kimball said. “That dynamic of how we keep enough space will be important to watch.”

Kimball said hospitals prepare by monitoring thresholds and dashboards that trigger different activity such as ramping up bed space or tightening restrictions.

“It is a continuum so it’s really watching for that and making sure you don’t miss any signals that are important,” Kimball said.

Kevin Whitney, chief nursing officer at Newton-Wellesley Hospital, said, “We have the capacity to immediately surge back up for both the general level care and the ICU level care.”

The five field hospital sites set up by the Massachusetts COVID-19 Command Center have been demobilized, according to the department, but the state has procured enough PPE for a five-month emergency supply and ventilators to manage a second surge.

The commonwealth also has plans to stand up alternative medical care sites, isolation hotels and to add post-hospital discharge options and support hospital surge capacity implementation if needed, according to the Command Center.