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Hospitals are struggling to care for a record surge in COVID patients. In normal times, patients who arrive at community hospitals but need more specialized care are typically transferred to a larger teaching hospital. But with hospitals full or close to full all across Massachusetts now, these lifesaving transfers are much harder to arrange. As Martha Bebinger at WBUR in Boston explains, there are cases now of patients who die while waiting.
MARTHA BEBINGER, BYLINE: In the small town of Brimfield, school buses, fire engines, police cars and utility trucks rolled past Athens Pizza in December, paying tribute to pizza shop owner Tony Tsantinis. He died from complications related to COVID.
RONA TSANTINIS-ROY: My father was loved so much by the community. He was my children's, and mine, best friend.
BEBINGER: Rona Tsantinis-Roy is haunted by many moments during her father's 10-day battle with COVID at Harrington Hospital. Here's one of them.
TSANTINIS-ROY: When the doctor literally looked me in the eyes and said, this didn't have to happen.
BEBINGER: Tsantinis-Roy understood that to mean that her 68-year-old father might have survived if he'd been transferred to a larger hospital. On day four, Tsantinis-Roy was told her dad needed an intensive care bed. But Harrington's ICU was full.
TSANTINIS-ROY: And they said they called 17 hospitals, and nobody was able to take him.
BEBINGER: Tsantinis-Roy says an ICU bed did open at Harrington within a few days. But then her dad's kidneys started to fail, and the hospital was not able to provide dialysis. Hospitals say nurses who specialize in dialysis are in particularly short supply right now. Harrington, which is close to the Connecticut border in central Massachusetts, again tried to transfer Tony Tsantinis, but it was too late.
TSANTINIS-ROY: They said that Hartford Hospital accepted him on a waitlist, but he was too unstable at that point to transfer. That was at 2:30. He died at 4 o'clock.
BEBINGER: Harrington Hospital says it will not discuss the details of Tsantinis' case. The hospital is part of UMass Memorial Health, which declined specific questions as well. But the network's president and CEO, Dr. Eric Dickson, says there are problems at every level of care patients need right now.
ERIC DICKSON: And I think everybody wants to believe that the system is holding up just fine, but it isn't. It's breaking down. And when it breaks down, patients are harmed.
BEBINGER: There are daily regional calls among hospitals in Massachusetts to flag urgent cases and balance the patient load. Gov. Charlie Baker has also called on the National Guard to help staff health care facilities.
Some hospital employees say it's time to impose so-called crisis standards of care, where an ICU bed or dialysis, for example, would go to the patient most likely to survive, rather than the one who shows up first. But Dickson says asking hospital teams to decide who gets a bed and who doesn't would be extremely difficult.
DICKSON: I think we have to have a conversation amongst health care leaders in the state about what that would mean, how we would implement it. But at some level, care is already being rationed because we just don't have the beds we need to take care of the patients that are coming in with COVID right now.
BEBINGER: It's almost like a lottery for care. And Tony Tsantinis isn't the only possible victim. At hospitals north and south of Boston, doctors tell of patients who've died while waiting to be transferred for more specialized care. A gunshot victim and a man who needed heart surgery are among them. Dr. Kathleen Kerrigan, president of the Massachusetts College of Emergency Physicians, says it's become even harder to transfer patients since mid-December, when Tsantinis died.
KATHLEEN KERRIGAN: Dramatically, we're hearing stories of 30 phone calls trying to get patients even out of state to get the care that they need.
BEBINGER: ER doctors say it's now virtually impossible to transfer a patient into Boston. And some hospitals in neighboring states are so full they are not taking patients from Massachusetts either.
KERRIGAN: This was the pandemic we were afraid of when the governor shut down the state back in March of 2020.
BEBINGER: Which translates to fear that more families like Rona Tsantinis-Roy and her children will lose beloved parents and grandparents. Tony Tsantinis was able to call once from the hospital.
TSANTINIS-ROY: And he asked to talk to the kids. So I put the kids on speaker, and the kids were all excited. And he goes, I'm good. I'm great. I love you guys. He hung up with them and, obviously, they were over the moon.
BEBINGER: But to Tsantinis-Roy, her dad's optimism seemed too good to be true.
TSANTINIS-ROY: We never heard from him again after that. (Crying) It felt like a goodbye.
BEBINGER: Tsantinis-Roy is still struggling to understand how her dad's death could have happened in a state that prides itself on having health care that is supposed to be among the best in the world.
For NPR news, I'm Martha Bebinger in Boston.
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