Hospital Exec Checks In On Care Landscape, Virus Fight
As originally appearing in State House News

By Katie Lannan

Two days after the first case of the new Omicron COVID-19 variant was officially confirmed in Massachusetts, the head of the state’s largest hospital system stressed the importance of vaccines and masks.

Mass General Brigham CEO Dr. Anne Klibanski joined the New England Council for a virtual conversation, where she discussed the future of health care — with a nod to her system’s proposed expansions in Woburn, Westborough and Westwood — and how the pandemic has affected care delivery.

“People want to have the best care delivered near where they live, at a lower cost,” Klibanski said. “So getting at community hospitals, getting that out into ambulatory and getting out into the home. The home is the final frontier.”

MGB has touted its planned ambulatory care expansion as a way to save patients in those suburban communities a drive to Boston and offer them services at a lower cost than its hospitals. The project is opposed by business and community groups that raise concerns that MGB is a higher-priced provider and could financially threaten community hospitals by drawing away their commercially insured patients.

“We are looking at the future of health care, and I would summarize it as follows — the future of health care is to provide the right services in the right places, so the movement of secondary care out of those highest-end hospitals for that tertiary, quaternary care, is going on around the country,” Klibanski said. “It has to be done.”

Klibanski said telehealth, which exploded in popularity and availability during the pandemic, has “revolutionized medicine.”
Asked by New England Council President Jim Brett what steps the federal government could take to support the health care system, Klibanski pointed to some actions involving telehealth.
“Without some congressional action, we’re going to see a decrease in Medicare coverage for telehealth services,” she said. “I think the other thing that’s really challenging is the geographic restrictions and licensure.”
She said it can be “incredibly disruptive for patient care” when providers cannot provide telehealth care to patients located outside of the state where they are licensed.

With the COVID-19 pandemic ongoing, Klibanski said it would be a “huge relief” if federal officials once again extend the current national public health emergency that allows for various flexibilities, including around telehealth services and hospital surge capacity.

State public health officials on Saturday announced the first case of the Omicron variant in Massachusetts identified through genetic sequencing, in a Middlesex County woman in her 20s who had traveled out of state. The woman, according to the Department of Public Health, was “fully vaccinated, has experienced mild disease, and did not require hospitalization.”
Klibanski said questions about the new variant — including what impact it will have on hospitalizations — remain unanswered, but the advice for the public remains the same.

“Stay masked, follow precautions, get vaccinated, get boosters,” she said. “That’s what you need to do, and I think if we follow those rules, we will be at the very best place in terms of protecting ourselves, protecting our families.”

She said there is a difference between transmissibility — how easily the virus spreads — and how pathogenic it is, or how likely it is that a person will get sick.
“We know that this particular variant is highly transmissible, i.e. it is highly contagious, so it will likely take over,” Klibanski said. “It will likely take over as the dominant variant at some period of time. We don’t know what that looks like, but we’ve seen that with other variants that have come forward. We certainly saw it with Delta. Here’s the critical question — is it more likely to cause symptomatic disease, illness that leads to hospitalizations?”

Masks have come off in many public settings but remain required in others, such as health care and public transportation. Winter’s arrival and the ongoing surge in infections is causing some to rethink mask-wearing.

In Boston, where a local mask mandate is still in place, Mayor Michelle Wu’s office said getting tested for COVID-19 remains important, especially during the holiday season, and said that community-based testing was down by 23 percent in the city in the last week.

The number of boosters administered was up over a one-week period — from 82,173 to 94,274 — while hospitalizations have increased by 28 percent during the last two weeks, Wu’s office said.

Wu on Monday announced that Boston Public Health Commission Executive Director Dr. Bisola Ojikutu will chair a COVID-19 Advisory Committee that will help with decision-making around the new variants and other elements of pandemic response.
“COVID-19 cases are surging here and across the country, making it a critically important time to get vaccines and boosters to as many people as possible, especially in communities where vaccine and booster rates are troublingly low,” Ojikutu said in a statement.
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