COVID-19 hospitalizations continue to decline, led by drop in ICU patients

Jan. 27—The number of people hospitalized with COVID-19 across the state declined for the fourth straight day, dropping from 427 on Monday to 400 on Thursday as the omicron wave appears to be ebbing in Maine.

But at least some Maine hospitals are still struggling to care for the high numbers of patients and staffing shortages caused by the highly contagious variant. The Mills administration announced Thursday that a federal COVID-19 Surge Response Team will assist at Central Maine Medical Center in Lewiston.

Intensive care patients in all Maine hospitals decreased from 88 on Wednesday to 84 on Thursday. The number of COVID-19 ICU patients has declined 37 percent from a peak of 133 patients on Dec. 19, with a marked drop-off in the last week. The number of ICU patients hovered around 105 to 110 patients from early January through last week.

Overall hospitalizations have declined 8 percent statewide since the peak of 436 patients hospitalized for COVID-19 on Jan. 13. The experience is different at individual hospitals, however, with some seeing bigger declines while others have not seen any easing.

At Maine Medical Center in Portland, COVID-19 patients dropped from 97 on Jan. 21 to 65 on Thursday. It's a hopeful sign, but many challenges remain, said Dr. Joel Botler, chief medical officer at Maine Med.

"The trends are all pointing in the right direction," Botler said. "We are definitely in a better place than we were."

However, Botler said with 2,000 people waiting for elective surgery, such as knee and hip replacements, it is going to take awhile, even after omicron recedes, to get through the backlog of patients needing care. And there's still bottlenecks in discharging patients to nursing homes and rehabilitation facilities, leading patients to stay longer at the hospital. The average length-of-stay for a patient at Maine Med is currently 8.2 days, much higher than 5.5 days before the pandemic started in March 2020.

"The length-of-stay is messing up our operations and our ability to get new patients into the hospital to get the care they need," Botler said.

At CMMC in Lewiston, COVID-19 patients declined from 32 on Jan. 20 to 24 on Wednesday. At Northern Light Health, which includes Eastern Maine Medical Center in Bangor and Mercy Hospital in Portland, there were nearly the same number of COVID-19 patients on Wednesday (116), as the previous week (114). MaineGeneral Medical Center in Augusta on Thursday reported 27 COVID-19 patients, compared with 27 a week ago.

Steven Michaud, president of the Maine Hospital Association, said conditions are improving, but hospitals still have a long way to go to get back to operations close to pre-pandemic times. He said despite a lot of effort to discharge patients in a timely manner, bottlenecks caused by a lack of available beds for patients at long-term care facilities will persist for some time.

"But every day those COVID numbers go down is a better day than it was before," Michaud said.

The trends coincide with what other states and countries have experienced as omicron has spread around the globe. The latest variant tends to be less severe than the delta and earlier variants, requiring less ICU utilization, but the high transmissibility of omicron leads to skyrocketing hospitalizations before the wave crests and starts to recede.

Even with the recent decline, overall hospitalizations are still far higher than during previous pandemic surges and, combined with staff shortages because of infections and exposures, hospitals continue to rely on the support of federal medical teams and Maine Army National Guard members.

An additional 20-person U.S. Department of Defense military medical personnel crew — which will include doctors, nurses and respiratory technicians — will come to Maine to help staff at CMMC care for COVID-19 patients, the governor announced. The crew follows a team of four clinicians from the Federal Emergency Management Agency who had been helping to administer vaccines but are leaving on Thursday.

The new 20-person crew, approved for the Lewiston hospital by FEMA, will be there from Tuesday to March 2.

FEMA on Thursday also approved Gov. Janet Mills' request for a 30-day extension of federal ambulance crews, and an additional ambulance crew to be stationed at Cary Medical Center in Caribou that also will assist other hospitals in Aroostook County.

The ambulance crews that were extended for 30 days were scheduled to leave on Thursday, and include crews at Maine Medical Center in Portland, Southern Maine Health Care in Biddeford, Franklin Memorial Hospital in Farmington, Mid Coast Hospital in Brunswick, CMMC in Lewiston, MaineGeneral Medical Center in Augusta, Eastern Maine Medical Center in Bangor and St. Joseph Hospital in Bangor.

The ambulance teams "are assisting Maine emergency medical services crews with non-emergency transportation of patients among facilities to match patients with open beds and ensure they are treated in the facility that best meets their health care needs," Mills administration said in a news release.

Meanwhile, Maine reported 12 additional deaths from COVID-19 on Thursday and 1,526 new cases as the state deals with a massive backlog of positive tests that have yet to be processed, making the daily case counts an unreliable metric to track current pandemic conditions.

Since the pandemic began, Maine has reported 171,524 cases of COVID-19 and 1,728 deaths.

Maine has a backlog of 56,000 positive tests that have yet to be processed, which means checked for duplicates, vaccination and hospitalization status and other tasks. The state is moving to an automated system to relieve the backlog, although Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said on Wednesday that it will take some time to switch to the system. He didn't have an estimate of how long it would take.

People who test positive will continue to be notified about the test in the same way they have always been. That has not been affected by the backlog.

Shah said that because omicron is so easily transmissible — often before investigations can begin — the case investigations have become far less useful, leading the Maine CDC and many other states to conclude that a more automated system would be more suitable. The sheer volume of cases still left to process has overwhelmed the state's current capacity to process the tests in the same way they had during most of the last two years, he said.

The Mills administration also announced on Wednesday that they will be expanding wastewater testing for COVID-19 to 23 sites across the state, as Shah said wastewater testing is currently a superior way to assess current pandemic conditions than case counts.

"It's designed to show what's going on in my community, how is that changing and what does that mean going forward," Shah said.

Portland and Yarmouth are two communities in Maine that currently test for COVID-19 in their wastewater, and they have been tracking sharp declines in virus prevalence in their wastewater systems compared to early January.