The state doesn’t know how many people are hospitalized with COVID-19, as hospitals and the Maine Center for Disease Control and Prevention haven’t fully established timely reporting of critical data more than three weeks after the outbreak began here.
The daily update of the number of COVID-19 hospitalizations that the CDC has been providing is a cumulative figure that includes patients who have been released – not the number currently in hospitals. Maine CDC spokesman Robert Long said the latter information was not yet available to the agency from all hospitals.
“We are working with Maine hospitals to be able to provide information in this way,” Long said via email. “They are not there yet, but we hope they can be by the end of this week.”
The Portland Press Herald reported last week that the CDC lacked a precise picture of critical care resources because some hospitals have not been regularly providing key data, including the numbers of intensive care unit beds and ventilators they had and how many of them were available for use. Maine CDC Director Dr. Nirav Shah said this problem – which inhibited the agency’s ability to prepare – was now largely resolved and he thanked hospitals for their cooperation in filing complete daily reports.
But the number of patients hospitalized daily is still not being reported by all hospitals, although the CDC has been asking for it since March 31. It isn’t clear why the information has been more difficult to obtain than the number of cumulative hospitalizations.
Maine Hospital Association President Steve Michaud blamed the difficulties of reporting important data to the state on the shaking up of established processes when former Gov. Paul LePage dramatically changed the state’s emergency preparedness system in the final months of his administration. The system LePage replaced consisted of three regional centers based at hospitals in Portland, Lewiston and Bangor and, according to Michaud, served the state well. In its absence, hospitals have been communicating directly with the CDC, but it’s been a learning process, he said.
“It’s certainly not people sitting around not wanting to provide the data, because it’s critical data,” Michaud said. “The previous system got rapid, organized, quality bedcounts during the H1N1 situation in 2009, and the change to a new one was not helpful.”
“It’s taken a while for the state and the hospitals to get to the point of getting quality, timely data shared back and forth,” he added. “The good news is no damage has been done. There’s no hospital full of COVID patients. It’s just part of the growing pains here.”
Jeremy Youde, who studies the intersection of government and public health at the University of Minnesota Duluth, said having daily hospitalization data is essential for a statewide public health authority.
“When we are dealing with an outbreak like this, one of the most important things is to have these disease surveillance capabilities, because you want to be able to track how the disease is spreading and changing over time and to be able to identify trends, to see anomalies early, and be able to respond and prepare for those,” Youde said.
Suzanne Spruce, a spokeswoman for the state’s second largest hospital group, Brewer-based Northern Light Healthcare, said the onset of the pandemic forced the 10-hospital network to retool its administrative and information systems to properly capture and report various types of capacity information, a process that took a few days.
“We have now created all necessary internal processes to capture and report all required information to the various agencies requesting it,” she said via email. “We do not foresee any problems in providing this information going forward.” She said Northern Light has been reporting its daily COVID-19 hospitalization count for several weeks.
John Porter, a spokesman for the state’s largest hospital network, MaineHealth, which operates Maine Medical Center, was asked via email whether the hospital network had been asked for or has been reporting this information to the CDC, but he responded with a statement that did not answer the questions: “All MaineHealth organizations have complied fully with federal and state CDC reporting requirements,” he wrote. “We would refer any additional questions about CDC reporting to the CDC itself.”
Meanwhile, the CDC is still trying to secure additional supplies of personal protective equipment, such as masks and gowns, for front-line medical workers. In briefings over the past week, Shah has detailed his agency’s distribution of equipment to hospitals, assisted-living centers and other medical faculties.
Long confirmed that these items – including seven vanloads distributed last week and hundreds of “orders” received and dispersed Monday and Tuesday – had come almost entirely from a previously announced March 30 allotment from the federal Strategic National Stockpile.
Last Thursday, Shah said his agency had “just this morning” placed an order for an additional 300,000 N95 masks “from a vendor here in Maine with whom we work quite a bit.” Long said the order was not expected to be delivered until late April and that the agency would not reveal the supplier or the cost until then.
During his briefing Monday, Shah said that to his knowledge none of the supplies sent to Maine from the federal stockpile were spoiled by rot, as some other states’ shipments had been. Long said via email that the agency had also not had any of its orders from private suppliers intercepted by the federal government, as happened to Massachusetts and other states.
Maine hospitals do not yet have adequate supplies of personal protection equipment to weather a dramatic surge in patients, Michaud said, though they might if Mainers succeed in slowing the spread of the virus via ongoing physical distancing efforts.
“If we have any sort of a surge we have a big, big problem,” he said. “There’s no way to dress that up and I’m not going to.”
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