2022
COVID-19

Pandemic Surges and Baystate Health Response

Few envisioned that some of the greatest challenges of the pandemic were yet to come. The coming of fall ushered in a new variant of the virus, Delta, which was able to cause breakthrough infections in vaccinated individuals and was every bit as virulent as previous strains for unvaccinated individuals. As Delta receded in December, a new variant emerged on the scene, Omicron, which was far more contagious than any prior strain. It too was able to elude the immune protections of prior infections or vaccination. Case levels across the BH system rose to record levels, cresting at 320 inpatients in January.

Containment measures used in the early days of the pandemic were brought back online, including a shutdown of elective procedures in January and February to keep beds open for COVID-19 admissions. Team members from areas that were suspended or curtailed were redeployed to areas of need. Surge spaces were reopened across the system, and screening areas for suspected cases set aside in our Emergency Departments (EDs). Monoclonal antibodies, the mainstay of treatment to keep high risk patients from developing severe disease, were found to be ineffective for Omicron (save for one product). Fortunately, a new oral antiviral, Paxlovid, which demonstrated good activity against Omicron, was released in December 2021. After some initial shortages, the medication was distributed to most BH outpatient practices, and soon providers were dispensing 100 courses a week in a program that was cited as a best practice by the Governor of Massachusetts.

The emergence of Omicron spurred new public interest in vaccination as well. The percentages of adults and teens in our service area who had received the initial series rose to over 80%, and testing among pediatric populations showed a high percentage of natural immunity. This translated into a lower severity phase of the pandemic as Omicron cases waned in March and yet another relative of Omicron (BA.5) took over as the predominant strain. As inpatient case numbers settled into the 70-90 range in the spring and summer, it was clear that far fewer patients (<5 most days) were requiring critical care, and over half of those admitted had minimal symptoms or no symptoms at all. As the fiscal year ended, vaccination was approved for younger children, and a bivalent vaccine active against omicron and its relatives was released. However, public attention to the pandemic had waned, so that uptake of the newer version vaccines has been slow so far. Massachusetts is one of the best vaccinated states in the country, and it currently shows no increase in deaths related to COVID-19.