A federal “surge response team” of doctors, nurses and paramedics is coming to Maine as soon as this weekend to help Maine Medical Center in Portland care for a record number of COVID-19 patients, Gov. Janet Mills said Thursday.
“I am grateful to the Biden administration for quickly recognizing the seriousness of the surge in Maine and for approving our request to send a team of skilled medical professionals to help,” Mills said in a written announcement.
On Wednesday, Mills said she was requesting the federal help along with activating the Maine Army National Guard to help hospitals statewide. The Federal Emergency Management Agency agreed to send 14 out-of-state clinicians who will arrive as soon as this weekend and stay through Dec. 23. A separate request on behalf of Central Maine Medical Center in Lewiston for federal assistance is pending.
Pressure on Maine hospitals continued to rise Thursday as Maine reported a record number of new infections and intensive care patients, and the state’s top public health official predicted the surge is going to get even worse in the coming days. Maine Medical Center ran out of critical care beds at least once this week and was forced to refer emergency patients to other hospitals.
The hospital announced Thursday that it was limiting visitation as part of its effort to control the surge. The restrictions begin Saturday and will affect all inpatient areas with exceptions for pediatrics and obstetrics, and parents of pediatric patients in the emergency room.
The state reported 1,460 new cases of COVID-19 on Thursday, the second straight day of 1,000-plus cases as the state deals with widespread transmission that likely accelerated during the Thanksgiving holiday. One additional death was reported as well, a man in his 40s from Kennebec County.
The rate of infections and deaths remains highest in parts of Maine with lower rates of vaccination, underscoring the appeals of state officials and hospital executives for more Mainers to get vaccinated and get booster shots to prevent hospitals from being overrun with unvaccinated patients.
The seven-day daily case average increased to 769, which also is a pandemic high. This time last month, the daily case average stood at 513, according to data from the Maine Center for Disease Control and Prevention.
Because the CDC has been flooded with more test results than it can process in a 24-hour period, some of the new cases reported Thursday were from tests received in the past two weeks. Maine’s testing volume has increased substantially since Thanksgiving, even as some testing sites have been unable to meet demand due to staffing shortages.
SHAH: IT’S GOING TO GET WORSE
Dr. Nirav Shah, director of the Maine CDC, said during an appearance Thursday on the Maine Public radio program “Maine Calling” that even though the state is setting new highs almost daily, all indications point to things getting worse as the holiday season approaches.
“In the next several days, if not the next several weeks, things will continue to get worse,” he said. “That puts a very real strain on people and their families, to say nothing of health care workers.”
Since the pandemic began, there have been 126,833 confirmed or probable cases of COVID-19 and 1,357 deaths.
Hospitalizations decreased slightly to 373 on Thursday, from a pandemic high of 379 on Wednesday. Of those hospitalized, 118 individuals are in critical care, which is the most to date. The daily average of people hospitalized increased by 73 percent in the last month.
In a week during which Maine saw its heaviest COVID-19 hospital burdens to date, many hospitals reported unprecedented numbers of inpatients with the disease. Those included the state’s largest hospital, Maine Medical Center, with an average of 45.9 such patients being cared for each day for the week ending Thursday, up from 40.7 last week. On Monday, the 615-bed hospital had the highest single day count of COVID-19 patients, with 50.
ICU nurses cares for a COVID-19 patient at Maine Medical Center in Portland in September. Screen image from Maine Medical Center video
The burden is driven largely by the unvaccinated. At hospitals run by the state’s two biggest health care systems – MaineHealth and Northern Light Health – there are 221 COVID-19 patients, 86 of whom are in critical care beds. Of those, 75 percent of all patients and 84 percent of critical care patients are unvaccinated, a fact that is even more stark when considering that the pool of fully vaccinated people in Maine is more than twice as big as the unvaccinated pool.
Vaccinations, meanwhile, are increasing slightly in Maine, although much of that is attributable to boosters. As of Thursday, Maine had administered 932,424 final doses of vaccine, which represents 69.4 percent of all residents. Additionally, 347,955 Mainers have gotten booster doses, which accounts for 25.9 percent of residents.
Recently, though, there have been reports that pharmacies have not been able to make good on booster vaccine appointments, a development Shah called “disappointing.” He stressed that it’s not a supply issue, but rather a staffing problem.
“If the pharmacies can’t get it done, the Maine CDC and its partners will,” he said.
Already, the CDC has partnered with the Maine Emergency Management Agency to establish a pop-up clinic at the Augusta Armory. In two days, more than 1,200 shots were administered. That site will be open all day Saturday as well, and will return next week. No appointments are necessary.
SPREADING AMONG UNVACCINATED
Although Maine’s overall rate of vaccination is among the highest of any state, there remain large pockets of people, in more rural counties generally, who are unvaccinated and that is where the virus is spreading most.
For many weeks, there has been a strong correlation between counties with high virus transmission also having lower vaccination rates.
According to CDC data, four of the five counties with the highest case rates over the last seven days – Piscataquis, Franklin, Androscoggin and Oxford – also are in the bottom five for vaccination rates, all below 62 percent.
Cumberland County, which has by far the highest vaccination rate at 79 percent, has the second lowest rate of transmission of any county over the last seven days. The coastal counties of Knox, Lincoln and Sagadahoc also have higher than average vaccination rates and lower-than-average virus spread.
There is also data that show counties with lower vaccination rates are seeing more COVID-19 deaths. For example, Franklin County, which has a vaccination rate of 58 percent, has experienced 6.62 deaths per 10,000 residents since June 1. That’s roughly four times the rate of death of Sagadahoc County, which has a vaccination rate of 73 percent.
In response to the strain on hospital capacity, Mills has directed as many as 75 Maine National Guard members to assist hospitals in non-clinical roles so medical staff can care for the record number of patients. The governors of New Hampshire and New York have done the same.
Mills said she is not considering any additional restrictive measures, such as universal mask mandates, but instead renewed her plea for people to get vaccinated.
“People have to take it upon themselves to keep themselves safe,” she said during a media briefing Wednesday.
Shah also was asked Thursday on “Maine Calling” why Maine isn’t going back to a mask mandate.
“Wearing a mask is critical, I cannot stress enough the importance of wearing a mask anytime you’re in an indoor public setting,” he said. “But a mandate as we remember from last year is a legal imposition,” and one that would require the governor to declare a new emergency and would force businesses to enforce.
PRIVATE GATHERINGS RISKY
Shah also said the evidence collected by his staff demonstrates that the recent spread of virus is not happening in public settings but private, indoor settings where mask mandates wouldn’t apply anyway.
Hospital leaders welcomed the prospect of more help from the National Guard, and from FEMA, but agreed with Shah that things are likely to get worse.
“We don’t think we’ve seen the full brunt of this surge, and probably won’t for two to three weeks,” Dr. Andrew Mueller, CEO of MaineHealth, said Wednesday.
There is also the unknown associated with the omicron variant, which has been detected in several states already and is likely to arrive in Maine soon, if it’s not here already. Some early research suggests the variant may be more transmissible than the delta variant but milder, although more study is needed.
Cases are rising again across the country after a steady decline for most of September and October. According to the U.S. CDC, the seven-day case average is now 117,488, which is the highest it’s been since late September and up 63 percent from 72,186 cases on average one month ago.
Maine’s rate of transmission over the last seven days – 355 cases per 100,000 people – ranks 21st among all states. New Hampshire ranks first, with 650 cases per 100,000, and Vermont, Rhode Island and Massachusetts are all in the top 10. Testing volume plays a role in some of the recent case trends. Many southern states that have reported low transmission recently have seen testing reduced dramatically.
COVID-19 hospitalizations across the United States have increased by 29 percent in the last month, from 40,683 to 52,605.
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