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AUGUSTA, Maine — Ventilators may be in short supply if the coronavirus outbreak continues to worsen in Maine, though the state is looking for ways to acquire new devices and retrain hospital staff in anticipation of more patients requiring critical care.
As of Tuesday, there were 118 confirmed cases of coronavirus in Maine, with 15 patients hospitalized, up from 32 cases and three hospitalizations a week ago. Nationally, more than 600 people have died from the virus, according to the COVID Tracking Project.
There have been no deaths from coronavirus in Maine, but half of the state’s adults are considered “high risk” for developing most serious illnesses of the virus due to age or pre-existing medical conditions. In severe cases, patients with coronavirus require a ventilator, a machine which delivers air to a patient’s lungs and requires special training to operate.
But public health officials in Maine and many other states have expressed concern about a shortage of the life-saving devices. A Bangor Daily News analysis of a model developed by researchers at the University of Pennsylvania Healthcare System suggests that, even if overall case numbers are kept below hospital capacity, Maine could still run out of ventilators and intensive care unit beds.
Even if Maine hospitals have enough beds for all coronavirus patients, the state might not have enough ventilators to provide necessary care. The Penn model suggests that without significant social distancing measures, more patients would require hospitalization in Maine than there are hospital beds. If Mainers were to reduce social contact by 55 percent, the number of coronavirus patients requiring hospitalization simultaneously would be within the capacity of the state’s hospitals.
Maine CDC Director Nirav Shah said on Tuesday that 77 intensive care unit beds and 248 ventilators are currently available in Maine. Shah said the state was hoping to acquire an additional 300 ventilators in order to meet anticipated future needs.
Data on how frequently coronavirus patients require a ventilator is scarce. One study of patients in Wuhan, China, found that 5 percent of individuals with coronavirus ended up in the ICU, while 2.3 percent needed a ventilator. If the rates in Maine were similar, there would not be enough ventilators and intensive care units in the scenario, even at 55 percent social distancing.
In this scenario with 55 percent social distancing, the number of patients simultaneously requiring a ventilator would peak at 421 at the height of the outbreak, which would take place about a year from now. That would be more than 100 more devices than the state has right now. To avoid that scenario, Maine would need to acquire more ventilators or further reduce overall cases through social distancing.
Maine is taking steps to increase capacity to care for critically ill patients, but it has to compete with other states, many of whom are experiencing similar shortages. Shah, the Maine CDC director, said on Tuesday that the agency was working with hospitals in several ways to increase capacity, first by finding beds that were not currently classified as intensive care units but could be “adjusted” to accommodate a patient with a ventilator.
Shah also said that the state was hoping to acquire an additional 300 ventilators and plans to train anesthesiologists, who might not be performing some of their normal duties because hospitals have postponed elective surgeries, to operate the devices.
Gov. Janet Mills said on Tuesday that Maine was also looking at adapting other types of respirators from outpatient facilities to be used to treat coronavirus patients, an idea she said was raised on a Monday phone call with governors and Vice President Mike Pence.
The potential ventilator shortage is a widespread problem, and Maine might find it difficult to acquire more machines as it competes with other states, some of which are facing more dire circumstances. Hospitals in New York, for example, are considering splitting ventilators between two patients, as the state’s governor predicted that the state will need 30,000 of the devices, but has only 7,000.
It is also not clear where additional ventilators will come from in the immediate future. The Center for Public Integrity reported on Tuesday that there are only 16,600 of the devices in the U.S. strategic stockpile. Production of new ventilators has been slowed by a lack of parts nationally, Bloomberg News reported.
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