Massachusetts is standing up a command center in Boston and easing restrictions to accelerate coronavirus testing, officials announced Saturday, marking the latest steps in the evolving fight against the outbreak.
Health and Human Services Secretary Marylou Sudders will step aside from her regular duties and focus solely on leading planning and response to a virus that has so far infected 123 Massachusetts residents.
Gov. Charlie Baker said the center will serve as a focal point for the state government's response to the COVID-19 illness and will have "complete authority and discretion to tap whatever state funds are necessary," including a $15 million aid package the Legislature fast-tracked on Thursday.
"Our priorities will include expanding the capacity and distribution of testing, the allocation of personal protective equipment, surge hospital crisis capacity, scenario modeling and contingency planning and supply chain vulnerabilities," Sudders said.
Medicaid Director and Assistant Secretary Dan Tsai will assume day-to-day responsibilities at the top of the Executive Office of Health and Human Services.
Baker was joined at the press conference by members of his cabinet and the governor made the point that the state's response to the pandemic will span across state government.
The announcement came alongside a slate of changes to the state's clinical and health care infrastructure that officials say will accelerate COVID-19 testing well beyond the 475 tests conducted as of Friday and ensure greater public access to necessary treatment.
Clinicians will no longer need to receive approval from the state public health laboratory before submitting samples for patients within a broad range of criteria, allowing for greater and more rapid testing. They can also submit a single nasal swab rather than both a nasal and throat swab, which Sudders said would "allow us to test more individuals in the day."
Citing Boston-area doctors, the Boston Globe reported Friday that the changes could prompt a three- to ten-times increase in how many patients can be tested.
Other services will be expanded under MassHealth, the public health insurance program that covers 1.8 million qualifying Bay State residents.
New state guidance calls for MassHealth to cover the costs of both video- and telephone-based telehealth conferences between patients and doctors. Sudders said the inclusion of telephone care is "unprecedented."
Everyone on MassHealth will be able to acquire 90-day prescriptions and early refills, Sudders said, and the state will also expand hospital presumptive eligibility to any low-income patient that a provider suspects may have COVID-19.
"If they meet verbally the MassHealth income standard, they'll be automatically enrolled in MassHealth and we will do the paperwork after the fact," Sudders said.
A third commercial laboratory in Massachusetts, Thermo Fischer, received approval from the federal Food and Drug Administration to conduct coronavirus testing Saturday, adding to the two — LabCorp and Quest Diagnostics — that Sudders announced Friday.
Those facilities do not rely on the supply of test kits from the Centers for Disease Control and can use their own FDA-approved tests, further expanding the state's capacity to screen its residents for the virus.
The Department of Public Health will post weekly figures every Wednesday on total tests conducted, starting next week alongside numbers on total quarantines in Massachusetts.
After refusing to provide an estimate Friday, Sudders said Saturday that 475 people as of Friday had been tested, about 75 more than the last update on Tuesday. The state public health laboratory has capacity to test about 200 people per day currently and will have capacity for up to 400 by early next week.
Baker said the reason for the slow increase in total tests conducted was the "narrowness" of federal guidelines on which patients qualify. He reiterated concerns about "the lack of a response from Washington" to empower states more broadly, although he noted some improvement at the federal level.
"The guidelines we were using, which were recommended by the CDC, were such that if in fact you got tested based on those guidelines, it was highly likely you had it and that turned out to be the case," Baker said.
The governor said drive-through testing, which some states are deploying to expand access to screening options, is something Massachusetts health officials will "bake into the process" of planning next steps, but he said he got "kind of a mixed response" from fellow governors about the practice.
Saturday's announcement was the latest step the Baker administration took amid the outbreak. After cutting short his family ski vacation to Utah, Baker returned to Massachusetts this week and declared a state of emergency on Tuesday to free up additional resources. On Friday, he unilaterally banned most gatherings of 250 people or more.
However, schools were exempt from that emergency order. Baker said again Saturday that he is not recommending a blanket closure policy at this time and believes districts should make decisions based on their local circumstances.
"I do think it's important to remember this all comes with the phrase 'at this time,'" he said. "It's an evolving issue, and as the issue evolves and facts change, decisions change. That's what I expect will continue to be the case."
Saying there are no signs that the coronavirus spread is slowing down and predicting it could become more aggressive, Boston Mayor Martin Walsh held a 7 p.m. press conference Friday at Boston City Hall to announce city schools are closing effective Tuesday, March 17.
The mayor said the intention is to reopen the schools during the week of April 27.
"Now is the time to take bold action and slow the spread of this virus," Walsh said, noting 25 COVID-19 cases in the city.
Further details about dealing with impacts of the massive closures, which will upend the lives of scores of families, will be released on Sunday and Monday.
"We're going to make sure that our employees are compensated," Walsh said.
The Boston City Council will be closed to the public beginning Monday and remain closed until further notice, according to council president Kim Janey. The council president said staff will be operating remotely after March 18 and "carrying on the everyday business of the Council as per usual."
The city council plans to meet Wednesday at Boston City Hall but Janey said attendance at that meeting will be limited to councilors and staff. "Our first priority continues to be the health and well-being of the general public, as well as the staff that work in the Boston City Council," according to Janey's office, which cited an emergency order signed Thursday by Gov. Baker modifying open meeting law requirements.
A Janey aide told the News Service that Wednesday's noon council meeting can be viewed remotely by anyone.