Dr. Michael Melia, emergency medicine physician at Northern Light Eastern Maine Medical Center, says rising COVID-19 cases adds to stress for frontline health care workers in Maine. Credit: Linda Coan O'Kresik / BDN

Maine health care workers knew what they had to do when rising coronavirus cases began pushing more Mainers back into the hospital. But the routines made commonplace over the course of the pandemic are something most hoped they would not have to repeat.

The number of patients hospitalized with COVID-19 in Maine has soared in the past few weeks with the spread of the highly contagious delta variant across the state. As of Friday, 69 Mainers were hospitalized with the virus, nearly tripling from just 25 three weeks ago. More than half were in intensive care units and 15 were on ventilators.

Since mid-January, less than 5 percent of people hospitalized with COVID-19 here have been fully vaccinated, according to Maine Center for Disease Control and Prevention data. Maine’s high vaccination rate — more than 80 percent of adults here have received at least one dose — is one of the reasons the virus situation has not deteriorated as much as some southern states, where hospitals have begun to run out of critical care beds. Maine’s hospitalization numbers are lower than in the winter.

But the rising cases and hospitalizations still add to the stress of health care workers who have been on the front lines fighting COVID-19 for nearly a year and a half. After a brief period of optimism as cases dropped earlier this summer, they have been forced to resume full pandemic protocols to prevent the further spread of the disease while continuing to work to convince unvaccinated patients with only mixed success to eventually get lifesaving vaccines.

“We’re used to having to deal with that immediate trauma: something bad happened and you’ve got to deal with it,” said Dr. Michael Melia, an emergency room physician at Northern Light Eastern Maine Medical Center in Bangor. “This, like everywhere in the country, has been going on for almost two years now and so people get tired.”

Dr. Michael Melia, emergency medicine physician at Northern Light Eastern Maine Medical Center, says rising COVID-19 cases adds to stress for frontline health care workers in Maine. Credit: Linda Coan O’Kresik / BDN

Unlike when COVID-19 first arrived in Maine, the playbook for health care workers to respond is well-known. Rising cases mean extra protective equipment. Visitation restrictions have returned at hospitals. Employees are once again tasked with ensuring patients maintain physical distance in emergency department waiting rooms.

But the virus precautions, though necessary, also hit workers differently given the availability of the COVID-19 vaccines, which have proven highly effective in preventing severe illness, hospitalization and death. In Lewiston, Dr. John Alexander, the chief medical officer at Central Maine Medical Center, linked the rise in cases in Lewiston to Androscoggin County’s vaccination rate, which is about seven percentage points lower than the state average.

“The increase in cases is concerning to our team members who have been working hard throughout the pandemic to serve our communities,” Alexander said. “We continue to strongly encourage people to get vaccinated and to speak to their doctor if they have questions.”

More than 230,000 Maine adults remain unvaccinated, according to the latest federal data, with reluctance to the vaccine having surpassed accessibility issues in terms of barriers to getting the vaccine, a recent Census survey found. Health providers are one of the entities tasked with relaying facts about vaccines to patients.

Reasons for declining the vaccine vary. A common one is patients who have already been infected with the virus thinking they do not need the vaccine, said Melia, the EMMC physician, although studies have shown the vaccine makes COVID-19 survivors less likely to contract the virus a second time. Other patients do not like shots or worry about side effects.

“The harder one to challenge is when people say, ‘Yeah, I’m just not going to let you tell me what to do.’ And so that is a much more difficult conversation,” Melia said.

Health care workers emphasized that convincing patients to get the vaccine is a matter of listening and building trust with people who might be skeptical. Many have valid concerns that can be addressed by explaining the science behind vaccines, said Cathy Bean, a manager for Northern Light Home Care and Hospice in southern Maine who has worked on vaccine outreach. But patients ultimately have to make the choice themselves.

The home care division also works to supply care to COVID-19 patients recently released from the hospital. In the last few months, several patients who have recovered from severe cases of the disease have said they looked forward to getting the vaccine once they are healthy enough, Bean recalled.

There are fewer COVID-19 patients for her division to work with now as the average age of people hospitalized with the virus has trended younger, and those released from the hospital are more likely to have relatives to attend to them. But Bean and her colleagues still have to wear more protective equipment to interact with patients after they were briefly able to lighten up when the pandemic seemed to be waning. That change left her “pretty down in the dumps.”

“I felt like we were nearing a post-pandemic world and clearly we’re not there yet,” Bean said, “so it makes it really difficult for us to continue on when it doesn’t seem to have an end in sight.”