The latest state trends in COVID-19 cases and hospitalizations lead to cautious optimism among hospital chiefs and epidemiologists
For a state that is largely shut down, shut in, and starving for good news, this may be a start: Massachusetts appears to be descending from its coronavirus plateau.
Key statistics on COVID-19 infections and hospitalizations, by which experts measure progress in the battle to contain the disease, are showing improvement.
The trends are slow, agonizingly so, but going in the right direction.
“It certainly looks that way," said Samuel Scarpino, a mathematical epidemiologist at Northeastern University, in an interview Tuesday. "And it’s consistent with the model-based forecasts that have come out of multiple groups in the Boston area, and it’s consistent with the governor’s forecast.”
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Here are some of the brightening numbers:
- The percentage of people testing positive for coronavirus has been trending down. The seven-day rolling average was 15 percent Tuesday, down from 29 percent as recently as April 17.
- The total number of people with a positive test result has also been trending down, even as testing has increased. The seven-day rolling average on Tuesday was 1,709, down from a peak of 2,249 on April 24.
- The number of patients hospitalized with confirmed or suspected cases of coronavirus is generally shrinking, though along a jagged line, with slight ups and downs, day to day. After reaching a high point of 3,965 on April 21, the figure had ticked down to 3,539 by Sunday, and stood at 3,542 on Monday. That’s a fall of 10.6 percent.
From April 27 to Monday, Massachusetts General Hospital recorded a reduction in coronavirus-related hospitalizations from 477 to 371 — a significant 22 percent drop, according to the latest state data.
Boston Medical Center’s figures fell from 259 to 233; Brigham and Women’s from 192 to 163; and Baystate Medical Center’s from 120 to 95.
Experts are keenly interested in the decline in hospitalizations, which not only indicate progress against the pandemic but ease concerns the state hospital system could be overwhelmed with patients.
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- The number of COVID-19 patients in ICUs statewide was 914 on Monday, down 16 percent from a high of 1089 on April 26.
“Generally, across the state, we’re seeing downward trends in the numbers,” said Dr. Kevin Tabb, president and CEO of Beth Israel Lahey Health. “That’s true when we look at the day-over-day trends as well as the three- and seven-day rolling averages.”
The declines are not uniform and some geographic areas and hospitals are still experiencing numbers “at or near the high water mark,” he said.
The slogging progress against the disease so far supports predictions that the way out of the pandemic will be a lot slower than the way in.
“We saw a quick rise, we saw a lengthy plateau, and we're starting to see a slow decrease,” Tabb said.
Tabb and other experts go out of their way to stress that the numbers are going down because the state has been under social distancing guidelines and that it is too soon to stop.
“I would be concerned if there was a declaration of victory and everybody just sort of stopped social distancing,” Tabb said, “because the decline is still slow and tenuous and we need people to keep their foot on the gas, so to speak, around social distancing.”
Hospitals are beginning to see an increase in non-COVID patients who put off other types of medical care while the coronavirus outbreak was expanding and heading toward its peak.
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Dr. Paul Biddinger, chief of emergency preparedness at Massachusetts General Hospital, said, “It’s fair to say we are on the other side of the peak, that the numbers of COVID cases in the hospitals is declining, and that hospitals need to be considering how best to accommodate the deferred care that was necessary in order to make room for the critically ill COVID patients.
“None of us knows what future waves may look like,” Biddinger said. “So for the foreseeable future we’re watching our [emergency department] presentations and our hospital admissions very, very closely in case there is another wave. But we’re eager to be able to accommodate the care that’s still needed, and in fact are very concerned about the number of people that have deferred their care during this outbreak.”
While Greater Boston hospitals are generally seeing improvement, Dr. Eric Dickson, president and CEO of UMass Memorial Health Care, Worcester, said on Monday that it appears that Central Massachusetts is just now hitting its COVID-19 peak.
“We started [the outbreak] later and we’ll probably end later,” Dickson said. The theory, he said, is that Boston’s outbreak moved faster in the beginning through events such as the infamous Biogen conference in late February, which is blamed for spreading dozens of cases.
“So it's not really unexpected that we would be the last to peak,” he said. “We are at the peak right now. South Shore is a little bit in the same thing. There's some stuff going on in New Bedford and some of the fishing communities that started spreading some more cases. But yeah, we're definitely not on that downside that everybody else was seeing.”
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UMass COVID-19-related hospitalizations were at 169 on April 27 and 168 on Monday. And as a sign of the volatility of these figures, over the weekend the hospitalization figures at UMass went as high as 186, including 69 ICU admissions.
Central Massachusetts may have kept its overall number of cases down, though, by beginning social distancing practices at the same time as other, earlier-hit areas of the state, Dickson said. “Hopefully, that means that we blunted the peak. If we were at 5 percent more than the patients that we have today, we’d be having to ship some out to Springfield or Boston. We’re holding on. We’re just really right at our capabilities.”
State officials on Tuesday reported another 122 COVID-19 deaths, for a total of 4,212. Massachusetts has cumulatively 70,271 confirmed cases of the disease.
Governor Charlie Baker at his daily briefing Tuesday sounded hopeful notes about the decline in the percentage of positive tests and in hospitalizations.
“We’ve seen a pretty steady downward trend on the number of people hospitalized for COVID-19 for just about a week. That’s a really encouraging sign and a key piece of data,” Baker said.
“We are starting to see the positive downward trends in a number of those key indices that are so critical to our ability to actually pursue a phased-in reopening strategy here in Massachusetts. Now they need to continue to go in that direction for a while,” he said.
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“We’re still very much in the fight against the virus, but it’s encouraging, I think, for everybody to see progress, given how much hard work and how much sacrifice has been invested in this. As we come through the other side of this and start to determine next steps going forward, we need to see these numbers continue to fall.”
Patricia Wen and John Hilliard of the Globe staff contributed to this report.
Mark Arsenault can be reached at mark.arsenault@globe.com. Follow him on Twitter @bostonglobemark Martin finucane can be reached at martin.finucane@globe.com
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Are we now coming down from the coronavirus plateau? - The Boston Globe
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