LEWISTON — State health officials signaled Wednesday that they do not plan to ease the state requirement that all health care workers at designated facilities must get vaccinated against COVID-19 by the end of the month, but said they will continue to help Central Maine Medical Center work through its staffing issues in any way they can.
At a media briefing Wednesday with Maine Center for Disease Control and Prevention Director Dr. Nirav Shah, Maine Department of Health and Human Services Commissioner Jeanne Lambrew said that throughout the pandemic her department, as well as the governor’s office, have had regular calls with leadership from Maine hospitals to discuss the challenges the hospitals are facing and how to help them.
“It is this wear that we’ve seen on our health care system during the pandemic, but also before the pandemic. We’ve had health care shortage issues in Maine for too many years,” Lambrew said, referring to CMMC’s staffing issues.
On Tuesday afternoon, CMMC’s parent organization, Central Maine Healthcare, confirmed that it is temporarily suspending all pediatric and trauma admissions to CMMC, citing “acute nursing staffing shortages.” Cardiac admissions were also halted Monday but resumed Tuesday morning.
Later this month, CMMC will also close its neonatal intensive care unit due to loss of critical specialty staff.
In a letter to Maine’s top lawmakers and Gov. Janet Mills on Tuesday, Sen. Jeff Timberlake, R-Turner, and Rep. Kathleen Dillingham, R-Oxford, urged the Legislature to reconvene “to amend the governor’s mandate to allow for a testing exemption” to vaccinations.
“We recently attended a meeting with members of the leadership team at Central Maine Healthcare and members of the Androscoggin delegation, at which it was presented to us that unless there is a testing exemption to Gov. Mills’ mandate, their health care system will be forced to ration care due to lack of staffing. Central Maine Healthcare is not alone among Maine health systems facing this Nov. 1 crisis,” the letter said.
The requirement is not a mandate, but rather a condition of employment laid out in a DHHS rule on health care worker immunizations that was passed nearly two decades ago. COVID-19 vaccinations were added to the list that includes influenza, measles, mumps and other diseases preventable via vaccination.
CMH’s president and CEO, Steve Littleson, did not respond to detailed questions on the reduced capacity at CMMC, staffing shortages and the hospital’s “contingency plan” should staffing issues continue through Oct. 29, when the state will begin to enforce the vaccine requirement.
According to a Maine DHHS dashboard on health care worker vaccination rates that was updated Wednesday, 85% of staff at CMMC were fully vaccinated as of Sept. 30. There were 378 staff who were unvaccinated.
About two-thirds of CMMC’s unvaccinated staff are nurses, according to Littleson, but other representatives of the hospital have declined to provide a breakdown or estimate of vaccination status by position type.
In response to Timberlake and Dillingham’s letter Tuesday evening, Mills rebuffed the suggestion that weekly testing must be offered as an alternative and that Maine’s other major health care systems agree with CMH’s proposal.
“Regular testing is not nearly as effective at protecting peoples’ health as vaccination, which is why it is not a part of our policy, and it is not a part of the forthcoming federal policy requiring all health care workers to be vaccinated,” Mills said in a prepared statement.
“It is also not supported by the Maine Hospital Association, MaineHealth, Northern Light Health and MaineGeneral Health,” she said.
This was not the first time Mills rejected the idea of a testing alternative.
At a media briefing on Sept. 22, Mills said the state had considered a testing option.
“But the fact is you could have COVID-19 and be at work and be spreading it before you get tested on that Friday or whatever day of the week it is you choose to get tested,” she said. “And you could be spreading it in dangerous situations, transmitting it to patients who are very vulnerable people in your care. That’s the highest risk, and that’s the danger we’re trying to address.”
At Wednesday’s briefing, Lambrew repeated that vaccinations are the “best protection against COVID-19 for (health care workers) as well as their patients.”
She referenced “dozens of outbreaks” at health care facilities throughout the pandemic, as well as the 6,516 health care workers in Maine who have tested positive for the disease.
“We should just recognize it is possible to fully vaccinate health care workers against a communicable disease and not have critical shortages,” adding that the state does not anticipate widespread disruptions to health care services across the state.
“All that said, we will always work with a facility that is struggling with staff because our obligation here at the department, here in the state of Maine, is to help sustain services for Maine people.”
Asked if residents should be concerned that they might not get the care they need at CMMC or elsewhere, Lambrew and Shah reiterated that they are working with the hospital to bring resources to them, but also pointed to St. Mary’s Regional Medical Center, which said in a statement Tuesday that it was prepared to accept patients.
Shah said people should not delay seeking health care, however routine, and called St. Mary’s statement “really critical.”
Meanwhile, the Maine CDC reported Wednesday there were 893 new cases of COVID-19 over a four-day period. The Maine CDC no longer reports case counts on weekends or holidays. Monday was Indigenous Peoples’ Day.
Of the new cases, 91 were in Androscoggin County, 41 in Franklin County and 43 in Oxford County.
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There were seven additional deaths reported on Wednesday. There was an additional death of an Androscoggin County resident reported Saturday.
As of Wednesday, 168 individuals were hospitalized due to COVID, 60 of whom were in critical care and 29 of whom were on a ventilator.
Providers at CMMC have been caring for an average of 16 patients each day for the week ending Tuesday. As of Tuesday, there were 17 inpatients there, eight of whom were in the intensive care unit and five were on ventilators. Wednesday’s hospitalization data was not available.
There were 42 critical care beds available out of 339 total in the state Wednesday, meaning that only 12% of critical care beds were available.
Each county in the state continues to have a high level of community transmission, meaning there have been at least 100 new cases per 100,000 residents of a county reported over the seven-day period ending Wednesday.
The U.S. and Maine CDCs recommend that all people, regardless of vaccination status, wear a mask in indoor, public settings when community transmission is at a high or substantial level.
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