Baystate Health is withholding local statistics from cities and towns.
By SAMANTHA WOOD
FRANKLIN COUNTY – For several weeks, the local hospital company Baystate Health has released daily counts on the total number of people it has tested for COVID-19, the illness caused by the new coronavirus. These numbers include positive and negative test results for the entire chain, which includes four hospitals in Hampden County and one in Greenfield. Baystate has refused to release more detailed information about each hospital, and is not granting interviews.
In an interview this week, Franklin Regional Council of Governments public health nurse Lisa White explained asymptomatic spread has led to infection among people who don’t know they are spreading the virus. Some will never become ill, or will have such mild symptoms they won’t seek care.
“We should assume anyone we come in contact with may be carrying” the virus, White said.
Because testing is not widely available, positive test results cannot give an accurate picture of the presence of the virus in the community.
“It is popping,” White said. “People are getting sick.”
When residents experiencing symptoms reach out to a public health nurse or their own clinician, state and federal health authorities advise that they be instructed to stay home as long as possible. Only people who are very sick are advised to go to a hospital, and these are the people most likely to get tested. Then it takes days to get test results.
“The priority is for treating people with severe illness,” White said, “regardless of how they were diagnosed.”
As people are quarantined and isolated at home, tracking by public officials is haphazard at best. It appears that no public agency is tracking everyone who is sick with COVID-19 symptoms at home.
The state Department of Public Health tracks positive COVID-19 cases in a database known as the Massachusetts Virtual Epidemiologic Network (MAVEN), but several local officials we spoke with said the state is likely several days behind in updating that data. Meanwhile, the tests themselves may have a 30% false negative rate, according to a recent report in the New York Times, which cited research on the disease in China.
Beyond this tracking system, there is broad agreement that many more people are now sick with COVID-19 in Franklin County than are being tested. The numbers of those who seek treatment in hospitals may provide a broader view of the illness’s scope and spread than do positive test results alone.
A Communication Gap
Emergency management teams in Franklin County are collaborating across town lines to develop plans for adding bed capacity, ramping up staff, and working to find much-need personal protective equipment (PPE), which has been in short supply nationally.
Local leaders are working to pull together all of the data they can to understand what is happening in real time, and plan in anticipation of changing needs. Each community is different, and responses must take into account variations in demographics, level of need, medical risk factors, and geography.
When asked about emergency planning for an expected surge in COVID-19 illness in Franklin County in mid-to-late April, a source in local municipal government told the Montague Reporter that Baystate Health has not been forthcoming with necessary information for local towns. The source, who spoke on condition of anonymity, said emergency planners have sought details related to increasing treatment capacity and staffing at Baystate Franklin Medical Center, but have thus far received only a vague response from hospital administrators.
Without this information, the source said, municipal leaders cannot plan effectively in a public health crisis.
No “Hospital-Specific Data”
Baystate Health owns Baystate Franklin Medical Center in Greenfield, Baystate Medical Center and Baystate Children’s Hospital in Springfield, Baystate Noble Hospital in Westfield, and Baystate Wing Hospital in Palmer.
The Reporter reached out to the hospital company on Wednesday with questions about treatment capacity at the Greenfield hospital, and whether the company was coordinating with municipal emergency management teams. In response, Baystate’s media relations office sent a statement from Ronald Bryant, the president of Baystate Franklin Medical Center, saying: “Baystate Health has plans in place throughout the health system to accommodate a surge of patients as needed and we are prioritizing all available resources in support of our efforts to address the public health needs associated with COVID-19.”
Asked more detailed questions Thursday morning – including the number of COVID-19 patients currently being treated at the Greenfield hospital, the capacity that can be treated there, how many ventilators the hospital has, information regarding surge plans, and the number of employees out sick – another Baystate Health spokesperson replied in an email, “We do not have that information.”
On Friday the company issued its daily press release listing what have been the routine, system-wide totals: 1,889 people have been tested, 1,386 have come back negative, 387 have tested positive, and there are 116 pending results.
In addition, the release said, “Currently within BH, we are caring for 139 hospitalized patients with confirmed COVID-19 infection, 41 of whom are in our critical care units; we are also caring for 65 hospitalized patients who are under investigation for COVID-19 infection. We are not reporting hospital-specific data to ensure patient privacy is maintained, especially in our smaller facilities.”
The Health Insurance Portability and Accountability Act, also known as HIPAA, protects patient privacy by preventing hospitals from disclosing information that would individually identify a patient. It does not cover information that does not reveal an individual’s identity.
Greenfield Releasing Numbers
On Thursday, the office of Greenfield Mayor Roxann Wedegartner announced it would begin releasing its own daily updates of local numbers of positive tests on the city website. As of Friday, the city reports that 46 Greenfield residents have tested positive, up from 25 the day before.
The mayor’s office said that as of mid-day Thursday, five Greenfield residents had died of COVID-19. On Friday that count had risen to eight.
While up-to-date figures on countywide cases are not available, the state releases a daily report breaking down positive test results by county. Thursday’s report – which local officials say may be as many as three to five days behind – listed 85 confirmed cases in Franklin County as a whole.
Test results are just one piece of the puzzle as communities respond to the virus. Given the difficulty of getting tested for COVID-19 and the possibility of false negative results, these figures may be less immediately significant in the effort to get a sense of the virus’s community spread than the numbers, currently guarded by Baystate Health, of local people suffering and dying from its disease.