A masked woman walks by Maine Medical Center's south entrance in Portland on Feb. 10, 2021. Credit: Troy R. Bennett / BDN

Maine Medical Center’s intensive care units were full on Tuesday as MaineHealth struggles with capacity issues across the state, causing some types of care to be delayed and threatening emergency care across a system that has 10 percent of total positions open.

The workforce challenges are the culmination of a steady departures since the early days of the pandemic. Although Maine Medical Center in Portland, the state’s largest hospital, is not diverting emergency patients, patients are being sent to other hospitals to keep its intensive care units open. As of Tuesday, every critical care unit at the hospital was full, with 643 patients altogether, 61 people in the emergency department and 32 COVID-19 patients.

As of Tuesday, every critical care unit at the hospital was full, with 643 patients altogether, 61 people in the emergency department and 32 COVID-19 patients. The state saw near-record COVID-19 hospitalizations on Monday at 223 cases, up by 22 in just one day after a brief reprieve in early October. The number of virus patients requiring critical care stood at 79, with 46 critical care beds available across the state.

The problems familiar to hospitals — understaffed units, a backlog of care, people needing to be discharged to strapped rehabilitation facilities and ongoing high COVID-19 cases — have reached a peak at many of the system’s hospitals, officials said during a Tuesday press conference. Although MaineHealth is not at a crisis yet, the ability to provide ongoing care could falter if more people do not get vaccinated and alleviate some pressure.

It creates a grim situation for health care in Maine as the coronavirus pandemic continues to stress systems. MaineHealth is the state’s biggest hospital system, with locations concentrated in southern Maine and up the coast. It could create additional strain as other regional hospitals, including Lewiston’s Central Maine Medical Center and York Hospital’s Wells campus — have shut down emergency services.

“There is no escaping the workforce shortage anywhere,” said Andrew Mueller, MaineHealth’s chief executive officer, “and that’s true of all our partner health systems.”

Officials stressed that Gov. Janet Mills’ requirement for health care workers to be vaccinated by a Friday enforcement deadline has little to do with the challenges MaineHealth is facing. It expects to lose between 1.5 percent and 2 percent of its staff due to the mandate, which will add onto the nearly 3,000 open positions it is currently seeing. The governor’s sister, Dr. Dora Mills, is a senior official at MaineHealth.

Those vacancies have required different measures at different facilities. The system is expanding its primary care, walk-in, urgent care and telehealth hours to reduce strain on emergency departments. Waldo County General Hospital in Belfast and Pen Bay Medical Center in Rockport have had to pause non-emergency procedures. At Maine Medical Center, operating room capacity has been diminished by 30 percent to ensure care in other sections. At Mid Coast Hospital in Brunswick, emergency room patients have been treated in hallways.

Treating people in hallways is not decreasing their level of care, said Lois Skillings, the president of the Brunswick hospital. But it might be something people have to get used to if capacity issues at the hospital do not let up.

“This is what is happening today because of health care systems meeting the needs of health care services on top of a staffing shortage on top of meeting the needs of day-to-day care that needs to be provided,” she said.