The changing nature of COVID hospitalizations

Also: Why the Tulsa shooting stirs fear and memories for Mass. hospital staff [View in browser](    [❤️]( June 7, 2022 Hello CommonHealth reader, I've been thinking a lot about two terms as I examine the latest [Massachusetts data on the coronavirus]( with COVID and for COVID. Daily case counts increased across Massachusetts for much of the spring before peaking in mid-May. COVID hospitalizations increased, too, before they recently began dropping. But not every COVID hospitalization is the same. Right now, just a third of people hospitalized were admitted primarily for a COVID-related illness, such as pneumonia. The other two-thirds were admitted to the hospital for some other reason. It might have been a broken bone, a heart problem, or cancer — but they tested positive after arriving at the hospital. These are the people hospitalized with COVID, not for COVID. This trend has become more distinct compared with the previous — and much larger — wave of the pandemic in January. At that time, about half of the people hospitalized with a COVID diagnosis were being treated for the disease, with a steroid called dexamethasone, while the other half were in the hospital primarily for some other reason. So what does this mean? The unfortunate fact is that a lot of people are still getting COVID. But the good news is a declining share of people need hospital-level treatment. [The doctors I interviewed]( attributed this to several factors, including the state’s relatively high vaccination rates and the availability of new drugs that help to prevent severe COVID illness. Hospitalizations are one key measure the CDC considers when [making local recommendations]( for masking and other precautions. Based on the current data, the CDC says almost [every Massachusetts county]( has high or medium levels of COVID. But those levels probably would look different if the CDC considered that most COVID hospitalizations in Massachusetts are not for COVID, Tufts Medical Center epidemiologist Dr. Shira Doron told me. Doron said she expects the percentage of people hospitalized for COVID-related illness could continue to shrink in the future. “To me,” she said, “the best-case scenario is that more and more of our hospitalizations are incidental, and not due to COVID.” That said, there’s always a big caveat when attempting to predict the future of COVID. A new variant could emerge and behave differently than past strains of the virus. “As someone once said to me… this is the virus that can leap tall buildings,” said Dr. Richard Nesto, chief medical officer at Beth Israel Lahey Health. “This thing can change at a moment's notice with very little warning. And suddenly, COVID can be a different disease.” There are so many unknowns with this virus, and medical experts are not suggesting we drop precautions. But for now, we can take a little comfort in the fact that COVID is less dangerous for most people than it once was. Priyanka Dayal McCluskey Senior Health Reporter [Follow]( Support the news  This Week's Must Reads [Tulsa shooting stirs fears and memories for staff in Mass. hospitals]( The deaths are bringing up especially painful memories at Brigham and Women’s Hospital, where a man shot and killed a cardiac surgeon in 2015. [Read more.]( [Tulsa shooting stirs fears and memories for staff in Mass. hospitals]( The deaths are bringing up especially painful memories at Brigham and Women’s Hospital, where a man shot and killed a cardiac surgeon in 2015. [Read more.]( [Monkeypox can look different than what doctors thought. Here's what they're learning]( Symptoms that doctors were taught about in medical school are not necessarily indicative of the cases of 2022. It can be much more subtle — and look a lot like other diseases. [Read more.]( [Monkeypox can look different than what doctors thought. Here's what they're learning]( Symptoms that doctors were taught about in medical school are not necessarily indicative of the cases of 2022. It can be much more subtle — and look a lot like other diseases. [Read more.]( [Hotel-based homeless shelters changed lives in pandemic. Some want them to be a model moving forward]( Some say this “non-congregate” form of shelter should become the standard, while others say the focus should be on creating permanent supportive housing. [Read more.]( [Hotel-based homeless shelters changed lives in pandemic. Some want them to be a model moving forward]( Some say this “non-congregate” form of shelter should become the standard, while others say the focus should be on creating permanent supportive housing. [Read more.]( [Why this wave of COVID hospitalizations in Mass. is different]( For much of the past two months, COVID hospitalizations in Massachusetts have been rising again. But this COVID "creep" is not quite the same as prior surges. [Read more.]( [Why this wave of COVID hospitalizations in Mass. is different]( For much of the past two months, COVID hospitalizations in Massachusetts have been rising again. But this COVID "creep" is not quite the same as prior surges. [Read more.]( [Novavax's COVID vaccine nears the finish line]( The Novavax vaccine appears to be about 90% effective at preventing mild, moderate and severe COVID-19, Food and Drug Administration scientists say in an analysis of the company's data. [Read more.]( [Novavax's COVID vaccine nears the finish line]( The Novavax vaccine appears to be about 90% effective at preventing mild, moderate and severe COVID-19, Food and Drug Administration scientists say in an analysis of the company's data. [Read more.]( What We're Reading 📚 Since 2020, there have been five suspected homicides inside a federal prison in Thomson, Illinois in a program known as the Special Management Unit. The deaths are generally cases of one prisoner killing another prisoner. [And a new investigation by]( Christie Thompson from The Marshall Project and Joseph Shapiro from NPR casts a harsh light on the prison, and how our justice system deals with people who have violent tendencies.  The shackles prisoners are put into at the Thomson prison often leave scars on their wrists, ankles and abdomen, which have apparently been dubbed "Thomson tattoos." The investigation also includes an account of guards in riot gear blasting incarcerated men with pepper spray while they are shackled. On the surface, the investigation is not a health story. But at each turn, I found links between the abuses at prisons like Thomson and the challenges of mental health care in the United States. “If [the prisoners] refuse to be celled with a person who they think could kill them...they get pulled out of the cell and put into restraints as a punishment," said Jacqueline Kutnik-Bauder, deputy legal director of the Washington Lawyers' Committee for Civil Rights and Urban Affairs, a legal nonprofit that had [previously sued]( the prison where the Special Management Unit used to be housed over a lack of mental health care. Reports like this make me wonder how better mental health services for incarcerated people — and more mental health training for the staff — could improve the environment in America’s prisons. "There was kind of this grand pivot to really starting to look at this differently," — Joyce Tavon, of the Massachusetts Housing & Shelter Alliance, about how the pandemic helped create a[new approach to housing and homelessness]( ICYMI [After historic nurses' strike, a new dispute roils Saint Vincent Hospital]( The union says the hospital is forcing nurses to work longer shifts, just months after signing a new labor contract. They worry longer work days could drive away experienced nurses. [Read more.]( [After historic nurses' strike, a new dispute roils Saint Vincent Hospital]( The union says the hospital is forcing nurses to work longer shifts, just months after signing a new labor contract. They worry longer work days could drive away experienced nurses. [Read more.]( Did you know...that [stingrays can add and subtract]( That's one take away from [Joe Queenan's piece in the Wall Street Journal]( on the nuttiest scientific discoveries this year. 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