Hospitalizations for COVID-19 are rising sharply across Maine, with the largest hospitals in central and eastern Maine breaking their all-time peaks and the overall patient count statewide exceeding the worst days of the spring surge.
The total number of COVID-19 inpatients statewide Friday stood at 66, eclipsing the previous high of 60 on May 26, though the number of intensive care patients was lower: 18 as opposed to 21.
Dr. Dora Anne Mills, chief health improvement officer at MaineHealth, the hospital network that includes Maine Medical Center, said the trend is concerning.
“Statewide there’s additional hospital capacity, but we appear to be early on in this surge curve and yet hospitals around the state have beds filling up,” said Mills, a former director of the Maine Center for Disease Control and Prevention. “That tends to happen this time of year, but when you add COVID to it and then realize that we have a chronic statewide staffing shortage, it becomes an issue.”
The geographic distribution among hospitals is markedly different than in the prior surges, when cases were concentrated at the major hospitals of southern Maine. The new surge has been driving case counts at hospitals across the state simultaneously over the past three weeks, with sharp, record-breaking surges at MaineGeneral in Augusta and Eastern Maine Medical Center in Bangor. Acute COVID-19 patients from across much of central, eastern and northern Maine are typically transferred to these hospitals, which together with Maine Medical Center in Portland now carry the heaviest pandemic burden in the state.
MaineGeneral broke its record for confirmed COVID-19 inpatients for the second week running and continued to bear the largest burden in the state. For the week ending Thursday, it reported an average of 9.9 confirmed COVID-19 inpatients being treated each day; on Thursday it had had 13.
Eastern Maine Medical Center in Bangor had its busiest week of the pandemic, with an average of 8.9 confirmed inpatients a day, up from 4.7 the week before and 1.7 the week before that.
“This is the largest number of patients we’ve had throughout the whole COVID crisis, but we’ve spent months preparing for this, and the situation at the hospital is very different now than it was in the spring,” said surgeon Dr. James Clarke, EMMC’s senior physician executive. “In terms of capacity, we are well prepared to be three or four times as busy as we are now, and in addition we are not shutting down our elective urgent and emergency care.”
Maine Medical Center saw another sharp increase to an average of 9.9 confirmed COVID-19 inpatients each day, up from 3.6 the week before and 0.9 the week before that, but well below the peak levels of the low-to-mid 30s per day during the early April and late May hospital surges. On Thursday the Portland hospital, which has treated roughly half of the state’s COVID-19 inpatients, reported eight such patients.
For those acutely affected by the disease, hospitalizations typically trail initial exposure to the disease by one to three weeks, suggesting that the trend will get worse given the rapid ongoing surge in newly diagnosed cases. Over the past two weeks, Maine has repeatedly broken its daily record for new COVID-19 cases and now has the highest rate of spread of any state in the country.
“We are excited that there is a vaccine coming and maybe multiple vaccines, but in the meantime we have to protect ourselves and protect each other by wearing a mask and social distancing and hand hygiene,” Clarke said. “I know this is repetitive, but the election is over, and there’s no reason for any of us to be caught up in politics. Wear a mask. Protect the safety or yourselves, your family and your neighbors. Because the hospitals are going to fill up with people who weren’t wearing a mask.”
Brunswick’s Mid Coast Hospital, which had no COVID-19 inpatients from Oct. 3-29, averaged 3.6 per day this week, its busiest period since mid-April.
Patient counts also grew at York County’s largest hospital, Southern Maine Health Care Medical Center in Biddeford, which had an average of 3.1 daily COVID-19 inpatients this week, up from 0.9 the week before. York Hospital reported an average of 1.4 such patients a day, up from 0.7 the previous period.
Dr. Evangeline Thibodeau, infectious disease specialist at York Hospital, said York has admitted more COVID-19 hospital patients in the past month – five – then in the entire summer season, when it treated four individuals, while the positivity rate at its testing sites has nearly quadrupled from 1.3 to 4.2 percent over the past two weeks.
“What our communities should understand is that we need to look beyond the number of hospital beds and ventilators,” Thibodeau said via email. “For there are many other considerations affecting direct and indirect COVID care, such as staffing, testing supplies and PPE. We need to ensure that in addition to caring for our patients with COVID, that we still maintain enough resources to provide routine care for our patients who are here for other reasons.”
Central Maine Medical Center in Lewiston had 2.9 inpatients a day, up from 1.7 the week before, and 0.9 the week before that. Lewiston’s other hospital, St. Mary’s, had 1.6 per day, its highest level since mid-August.
During the spring and summer, it was typical for one or two of Maine’s smaller hospitals to have a pandemic inpatient or two for a few days and then go weeks or even months without one. But for the past three weeks, many of these smaller hospitals have had inpatients at the same time, and several of them with multiple patients. In the week ending Thursday, these included Franklin Memorial in Farmington (with 2.0 per day), Waldo General in Belfast, Sebasticook Valley in Pittsfield, PenBay Medical Center in Rockport (with 2.3 a day), Inland Hospital in Waterville, Blue Hill Hospital, and Maine Coast Hospital in Ellsworth (with 1.9 a day).
Mercy Hospital in Portland had 1.7 COVID-19 inpatients per day, up from 0.6 the week before.
Hospitalizations are a lagging indicator in that they typically occur one to three weeks after a person is exposed to the coronavirus, but unlike other metrics, it is not dependent on who and how many people were tested. They can end in three ways: recovery, death or transfer to another facility.
“Without question, everyone is experiencing COVID fatigue, but we must continue to be vigilant and follow all recommended public health measures,” Thibodeau said. “This means masking, maintaining social distancing and limiting exposures, as the situation is likely to worsen before we see any improvement.”
The Press Herald’s survey, for the seven days ending Nov. 12, compiles data directly from the hospitals. The data do not include outpatients or inpatients who were suspected of having the virus but never tested. It includes most of the state’s hospitals and accounts for the majority of the statewide hospitalizations reported each week by the Maine CDC.
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