AUGUSTA, Maine — The sharp rise in serious COVID-19 cases over the past few weeks has forced Maine hospitals to think once again about capacity, highlighting the continued challenges the pandemic poses for health care providers as long as the virus is broadly circulating.
On July 23, there were just 25 patients hospitalized in Maine with COVID-19. Five weeks later, that figure had increased more than fivefold. Similar trends have played out in other highly vaccinated states — Vermont, which saw hospitalizations drop into the low single digits in June, was up to 34 patients hospitalized as of Monday, according to the state’s health department.
In both states, more than 70 percent of critical care beds were occupied as of last week, according to federal data, a trend that led Maine hospital leaders to call on residents to take precautions and get vaccinated to prevent additional spread of the disease.
It highlights how quickly the trajectory of COVID-19 can change, even in states with the lowest case rates and highest vaccination rates, and the challenges that poses for health care providers as they care for more virus patients while simultaneously continuing to offer regular services and address a backlog of care delayed by the pandemic.
The lifting of most COVID-19 restrictions combined with the spread of the more contagious delta variant created the conditions for rapid transmission of the virus, said Dr. Robert Horsburgh, an epidemiology professor at Boston University. While Maine’s vaccination rate is high compared with other states, that does not mean it is high enough to stop the spread of the virus, Horsburgh said, noting that immunization rates for childhood diseases typically exceed 90 percent.
Caseloads and hospitalizations in Maine and its neighbors remain significantly lower than the rest of the U.S. — New England states account for six of the seven states with the lowest hospitalization rates, according to The New York Times, even as rates are higher than they were a few weeks ago. The region also has the highest vaccination rates in the U.S., with more than 80 percent of Maine adults and 86 percent of Vermont adults having received at least one dose, according to federal data.
The situation in Maine and Vermont makes clear there are “two kinds of full” for hospitals — the critical care crunch that the low-case states have seen and the dire situations in states such as Alabama, Florida and Texas where hospitals are overwhelmed, said Dr. Timothy Lahey, an infectious disease physician at the University of Vermont Medical Center in Burlington.
“There’s full while you’re continuing to do non-urgent surgery and essentially staying open for business as usual and then there’s full when you’ve canceled elective surgeries and still you’re not quite sure where the next patient’s going to go,” he said.
In Maine, the 69 COVID-19 patients in critical care on Monday occupy only about a fifth of the state’s total intensive care units, according to data from the Maine Center for Disease Control and Prevention. But that still puts significant strain on hospitals, which anticipate having a certain number of beds available for surgery patients, accident victims and others.
In the early summer, Lahey said there were typically up to two patients daily at his 562-bed hospital with COVID-19. There are between 12 and 15 now. It’s a situation that many hospitals “would celebrate,” but it is difficult on top of higher patient loads in the late summer, he said.
On one hand, the problem facing Maine hospitals right now is a consequence of managing the pandemic relatively well, said Steven Michaud, the president of the Maine Hospital Association.
Across the country, health care providers canceled non-urgent procedures amid doomsday projections about cases, hospitalizations and deaths to conserve capacity. Those restrictions were lifted earlier in states like Maine with lower infection rates and some of those patients — now receiving needed care — are adding to current hospital loads.
At the same time, COVID-19 makes it harder for hospitals to surge staff to areas that need it most because of safety guidelines. Exposures to the virus and a worker shortage encompassing the health care sector — and virtually all others — makes even having enough staff the major issue. Nursing homes are also facing staffing problems, making it hard to discharge patients.
“What makes it … difficult to pivot is when you’re already kind of jammed to the gills and now you impose the COVID influx,” Michaud said.
Having to take care of more patients under pandemic conditions also poses challenges to hospital staff, who play a role in helping providers adapt while adhering to additional virus precautions in their day-to-day work.
“People are tired and they’re focused on the mission, but if we want to retain people, we’re really well aware of the fact we don’t want them working at 110 percent all the time,” said Lahey, the Vermont doctor. “The way we sprint right now affects what the marathon looks like later.”
Correction: An earlier version of this story misspelled Dr. Timothy Lahey’s last name.