Mount Auburn Hospital, where flags were at half-staff Wednesday for a mass shootings at a Texas elementary school, saw a surge in Covid patients in May. (Photo: Marc Levy)

City officials have issued what they call a stronger advisory urging residents to wear masks indoors in public spaces, get vaccinated and get tested as new daily Covid-19 cases remain at a high level. Chief public health officer Derrick Neal told city councillors Monday that there are worries on numerous fronts: increasing case rates in schools and among residents over 65; rising levels of the virus in wastewater; and more people being hospitalized.

Besides those concerns, unreported results from home Covid-19 tests mean “these [case] numbers are likely to be an undercount of actual cases in the community, which means that we’re at a higher level than what we’re even able to report to you,” Neal said.

Reinforcing the news about hospitalizations, one of the city’s hospitals, Mount Auburn, has admitted increasing numbers of Covid-19 patients this month, according to state figures, and a federal report of hospital capacity showed that only 16 beds of 204 – about 8 percent – were not occupied during the week of May 12, the most recent data. A spokesperson strongly denied any implication that Mount Auburn is short of beds, saying the hospital is licensed for 217 beds and although the number of occupied beds has fluctuated, “we have not had a shortage of inpatient beds or any recent capacity issues due to Covid.” (A hospital’s licensed bed count may be higher than the number of beds it can staff; the federal data counts staffed beds).

There were four patients with Covid at Mount Auburn on May 3, including one in the intensive care unit, according to Covid hospital census numbers published by the state Department of Public Health. That rose to 12, including one in the ICU, on May 10, then higher to 24 patients with Covid on Friday. The census declined to 20 patients, including one intensive-care patient, on Tuesday.

Cambridge Health Alliance facilities had less inpatient capacity issues, according to a board member finance committee discussion Tuesday. A “mini-surge” in Covid seemed to be keeping some patients away, keeping volume lower than expected.

Seniors and students

Besides rising hospitalizations, case rates in residents over 65 have risen starting in late April – the rates in all age groups have increased except for people from 18 to 22, which plunged, Neal said. The public health department believes that’s because college students have left Cambridge for the summer, he said. Bearing him out, the percentage of infections in residents affiliated with higher education has dropped sharply according to a graph in Neal’s Covid-19 update to the council. But as vice mayor Alanna Mallon pointed out, the city’s major universities, Harvard and MIT, are testing fewer people because they made testing optional in April and May.

Many more Cambridge public school students and a smaller number of employees have come down with Covid-19 in the past month, although Cambridge Public Schools says only a few were infected in school. The number of new cases among all in-person attendees reached 164 in the week of May 9-15, almost as many as the 168 cases during the peak week of the coronavirus omicron variant, Jan. 3-9.

As for the new advisory, the city is preparing signs that businesses can post at their doors saying masks are “strongly encouraged,” City Manager Louis A. DePasquale said. “I think the advisory is really a much stronger statement than we have [made] in the past … this language is stepped up to really make people be aware of it,” he said.

No mask mandate

Despite the stepped-up language, the city administration’s response provoked familiar wrangling over the lack of a mask mandate. “I do appreciate everything that the city is doing,” councillor Quinton Zondervan said. “But as I said before, it’s not enough. We’ve lost over a million people in the United States to Covid-19. It’s been more than two years and we’ve had several waves, ups and downs in case counts. And I would hope that by now we would begin to learn that we need to be more vigilant and more proactive about protecting people.”

“We don’t believe a mandate is the way to go right now,” DePasquale said. The city had an indoor mask mandate from Oct. 2 to March 14 for non-government buildings and until March 27 for city buildings. DePasquale also rebuffed Zondervan when the councillor asked what situation would trigger a mask requirement. City and health leaders will monitor conditions and decide what to do, he said.

“We’re not going to publicly say if X becomes Y we are going to do it,” DePasquale said. “ I don’t think that’s the way to go. We’ve never done it that way. And I don’t think now’s the time to change it.”

Testing options on the way

Councillor Patty Nolan asked how the city would protect its employees, noting that one-third of library staff had been infected with Covid-19, with half of the cases occurring after the city dropped the requirement to be masked inside public buildings. DePasquale replied that employees could wear masks if they want, and the city provides staff with home tests and time off if they’re infected.

“I mean, we can’t stop government and we’re doing the best we can. So we will continue to evaluate these risks,” DePasquale said.

Responding to Nolan’s suggestion that the city provide masks at the entrances to public buildings, he said they are available and “we certainly can try to look at a way we could make people aware that masks are available if they want them.”

Other measures the city is taking to respond to high Covid transmission include opening a second walk-in free testing site on Saturdays in June at the St. Paul AME Christian Life Center, 85 Bishop Allen Drive, in The Port near Central Square. The city now offers walk-in tests Wednesdays at St. John the Evangelist Church, 2254 Massachusetts Ave., North Cambridge. Tests by appointment are available seven days a week at CIC Health in Kendall Square.

The health department will also mail reminders to residents who are overdue for boosters, and the city plans to conduct pop-up vaccination clinics at events during the summer. For people who test positive, case investigators will try to contact all those over 70 and families of children under 5 “to provide guidance,” Neal said.