Maine Medical Center in Portland is one of MaineHealth's hospitals specially designated to care for COVID-19 inpatients. With virus cases rising statewide, hospitals are preparing for another surge. (Portland Phoenix/Elizabeth Clemente)
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With cases of COVID-19 reaching new daily highs in Maine, hospitals are preparing for another surge in seriously ill patients.

According to the Maine Center for Disease Control and Prevention, the seven-day average for cases in Maine has increased by roughly six times since mid-October.

As of Nov. 16, the state had 9,117 cases of COVID-19 and 566 hospitalizations. The seven-day average number of cases was 179, compared to an average of only 30 cases per day a month earlier.

Cumberland County had the highest concentration of the state’s cases – 3,270 since the pandemic began in March. 

The number of Mainers hospitalized with the virus also continues to rise. On Nov. 15, Maine CDC Director Dr. Nirav Shah said 71 people were in hospitals with 24 in intensive care and seven on ventilators. These numbers nearly doubled in two weeks.

Since the beginning of the pandemic, COVID-19 has killed 165 Mainers and more than 246,000 Americans.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention. (Courtesy Maine CDC)

In one of his regular calls with the press earlier this month, Shah warned against the dangers of small gatherings, even though they “do not have the same stigma attached to them” as large gatherings. Because small gatherings are usually “longer in duration and in smaller locations,” he said the risk they pose can be “pronounced.”

He also said in addition to continuing with social distancing measures, people should get flu shots right now in an extra effort to stay healthy.

If a person is exposed to someone that has tested positive for COVID-19, Shah added, it is important for the exposed person to wait five to seven days after exposure to get tested. They should also quarantine for 14 days.

“If you go rush out and get a test right after you were in contact with somebody who had COVID-19, your test result will almost certainly be negative,” he said. “It won’t actually tell you anything about (whether you have COVID).”

Shah also said the CDC has been “in very regular contact with hospitals” in Maine throughout the pandemic, in terms of ensuring medical personnel have the proper personal protective equipment and other resources.

However, he said, a major change in COVID-19 care since the beginning of the pandemic has been the “geographic location” of patients. In March and April, Shah said, hospitalized patients with the virus were largely being moved for care to tertiary care centers in “major population centers.” 

Now, however, more patients are able to have care closer to home, at their local community hospitals. Shah said that’s because fewer patients must be ventilated, and medical providers now have more experience caring for those with COVID-19.

“But make no mistake, hospitals are feeling the strain of the increased number of cases,” he said. 

Dr. Dora Anne Mills, chief improvement officer for MaineHealth, which runs 11 hospitals throughout the state, said in a recent interview her organization completed a lot of surge planning at the end of the summer.

Dr. Dora Anne Mills, chief improvement officer at MaineHealth, compared the public’s responsibility to continue social distancing to civilians’ contributions to the World War II effort. (Courtesy MaineHealth)

Part of that surge planning, she said, included making sure the “right resources” existed in the “right places.” Mills said MaineHealth is trying to care for its COVID-19 patients mostly in hospitals, like Maine Medical Center in Portland, that have departments dedicated to the virus and teams of providers that specialize in treating virus patients.

She said while smaller hospitals without such dedicated wards, such as Stevens Memorial Hospital in Norway or Franklin Memorial Hospital in Farmington, are still capable of caring for COVID-19 patients, it makes more sense to care for them at larger facilities.

This is partly because caring for hospitalized COVID-19 patients, Mills said, takes “quite a few resources,” such as specialized PPE and “much larger” rooms with negative pressure capacity. COVID-19 patients also require the care of special personnel such as respiratory therapists, more commonly found in larger hospitals.

As part of the MaineHealth system, Mid Coast Hospital in Brunswick has been identified as one of the sites where inpatient care for COVID-19 patients is concentrated.

“Mid Coast continues to care for patients in separate treatment areas and has dedicated care teams for patients with symptoms of COVID-19,” hospital spokesperson Judy Kelsh said Monday. “This allows for non-COVID-19 inpatient care as well as routine and ongoing outpatient care to take place in non-COVID-19 areas.”

Kelsh echoed Mills and said identifying sites within the health system specifically for COVID-19 inpatient care allows MaineHealth to leverage “clinical experience” and most effectively use its specialists and resources.

On Monday, biotechnology company Moderna Therapeutics announced its COVID-19 vaccine appears to be 94.5 percent effective, judging by preliminary data from the company’s studyIt is the second encouraging piece of news that has emerged recently in regards to a potential COVID-19 vaccine.

Earlier this month, drugmaker Pfizer said its vaccine has shown to be more than 90 percent effective in its trials, which Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, called “extraordinarily good news.”

Mills echoed that sentiment prior to Pfizer’s announcement, and said while the prospect of a vaccine is “very exciting,” it will be “not a panacea but a critical layer of relief.” 

However, the vaccine, if successful, likely will not be available on a widespread basis for several months, meaning social distancing and wearing masks remains crucial for the foreseeable future. 

While more knowledge about the virus is helpful for medical providers, Mills said, it can be a double-edged sword. It means citizens also have more knowledge, which may trigger so-called pandemic fatigue, where they fail to take precautions.

Mills compared the public’s duty to continue social distancing and practicing virus safety to her parents’ generation’s support of the World War II effort.

“I remember my own parents (talking about) not being able to buy sugar or gasoline for years, and being worried about having enough food on the table,” she said. 

She said Americans facing the pandemic today need to “take some inspiration” from that generation. While a potential vaccine may be a light at the end of the tunnel, Mills said, now is “not the time to get fatigued,” especially with cases surging across the state and nation.

Though it may not seem like it, she said it is the responsibility of everyone to make sure Maine hospitals stay available and adequately staffed, by maintaining social distancing and mask-wearing.

“I know we’ve got that spirit in us,” Mills said.

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