Henoc Ngoy of New Mainers Public Health Initiative gives instructions Wednesday on how to swab the nose during a COVID-19 test at the YMCA of Auburn-Lewiston’s Outdoor Learning & Education Center in Auburn on Feb. 2. Daryn Slover/Sun Journal
LEWISTON — Maine’s health care systems remain under significant stress, even as promising signs of omicron’s waning grip on the state have emerged over the past couple of weeks.
One of those signs: Maine appears to be on the other side of the omicron-fueled surge in COVID-19 hospitalizations.
As of Friday, there were 355 individuals hospitalized with COVID-19, 82 of whom were in critical care and 36 of whom were on a ventilator. That’s down from the all-time peak of 436 patients on Jan. 13. And earlier this week, patients in critical care and on a ventilator were at their lowest levels since November.
The recent decline has offered some relief to health care providers, Dr. Douglas Smith, chief medical officer for St. Mary’s Health System, said Friday.
St. Mary’s Health includes St. Mary’s Regional Medical Center and d’Youville Pavillion, both in Lewiston.
“While I think it’s definitely better and we’re maybe running less fast around all the time, there’s no doubt that COVID, along with all of the other stuff that we take care of, is still stretching (the system),” Smith said.
Providers there were caring for an average of about 14 patients per day over the seven-day period ending Friday. A few weeks ago, the seven-day moving average hit an all-time high of about 30 patients per day.
Smith said that unlike previous surges where there were more fluctuations from day-to-day, providers are seeing sustained highs over the course of several weeks.
At Lewiston’s other hospital, Central Maine Medical Center, the seven-day moving average was about 23 patients per day as of Thursday. In mid-January, as hospitalizations peaked statewide, the average number of patients at CMMC hit 35 per day.
“Interestingly, I think that the difference with omicron, you know, was that one, we did see a lot more positive tests. So, we had a lot more outpatients, if you will, who tested positive,” but fewer who ultimately required hospitalizations, Smith said.
But with omicron’s high transmissibility came high numbers of staff members who were exposed to or tested positive for COVID-19 and had to quarantine at home.
At one point last month, more than 70 staff members at St. Mary’s were out for COVID-related reasons.
Around the same time, there were nearly 200 staff systemwide at Central Maine Healthcare, CMMC’s parent company, who were out on a given day, CMH’s chief medical officer, Dr. John Alexander, said Friday.
Staffing challenges have eased somewhat — St. Mary’s is now down to about 30 employees on average who are out and CMH has about 100. For CMH, at least, that’s still incredibly high compared to other points in the pandemic.
“Prior to omicron, you know, I would say 100 would be probably a peak day for us, which is why that higher number of almost 200 out one week or two or three weeks ago was so significant,” Alexander said.
“But again, the good news with the omicron infection and what we see with our team members is they have very mild illness, so they’re able to recover much more quickly.”
Alexander said employees who test positive are being asked to isolate at home for at least 10 days. They can return to work before then, only if they are asymptomatic and test negative.
St. Mary’s briefly put in place a policy last month that followed U.S. Centers for Disease Control and Prevention guidelines that said COVID-positive staff who were asymptomatic could forgo the isolation period to work only with COVID patients.
Still, other challenges remain.
“One of the other challenges that we’ve had for the last several weeks is, you know, hospital capacity as a whole,” Smith said. On any given day, there may be up to 10 individuals, some with COVID and some without, in the emergency department waiting for a bed to open up on a medical floor.
There are usually even more patients on the medical floors who are waiting to be discharged but have to wait days and sometimes weeks for a bed at a skilled nursing facility to open.
CMMC has had the same issue, Alexander said. Declining COVID-19 hospitalizations have offered some reprieve, however.
“By having fewer patients with COVID occupying those beds we can get those patients out of our emergency department (and) into a hospital bed,” Alexander said.
And as more beds open at other facilities, it’s been easier to transfer patients who need a higher or different degree of care out to another hospital, such as Maine Medical Center in Portland.
Outside help is also making a difference. Members of the Maine National Guard working at both facilities have helped “ease the burden” on providers.
Guard members at CMMC have helped open up additional “swing” bed units, which provides on-site skilled nursing care and helps relieve some of the patient bottleneck.
Federal clinicians have also assisted CMMC with administering COVID-19 vaccines and more recently, 20 U.S. Air Force members arrived to help with direct patient care.
At St. Mary’s, the Guard members have assisted in a variety of roles, from patient transportation to nursing assistance and even housekeeping.
“I think there’s no doubt it’s been helpful and we’re very appreciative of having them here,” Smith said.
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