Different views of Northern Light Eastern Maine Medical Center for file use. Credit: Linda Coan O'Kresik / BDN

Hospitals in Bangor and Augusta have seen the largest numbers of patients with COVID-19 over the past week as coronavirus cases continue to surge across the state.

That marks a change from the first part of the pandemic in the spring, when the bulk of COVID-19 cases, and thus hospitalizations, were concentrated in more populous areas of the state, particularly Cumberland, Androscoggin and York counties.

Over the last week, Nov. 13-19, Northern Light Eastern Maine Medical Center in Bangor recorded a daily average of about 14 admitted patients with COVID-19, according to data the BDN requested from some of the state’s largest health care groups.

During the first coronavirus surge last spring, EMMC never had more than seven coronavirus patients admitted at a time, and it went almost three months between late summer and early fall without admitting more than one at a time.

On Friday, the hospital announced that it will tighten its visitation policy next week given the virus’ new prevalence in the community. There are now at least 169 active cases in Penobscot County, as well as clusters of cases in all its neighboring counties.

In general, record numbers of Mainers have been hospitalized in this second wave of COVID-19, reaching a new high of 90 on Friday. Additionally, more than half of those patients — 49 — were in intensive care, an increase of 14 from just one day earlier.

Over the last week, the next most packed hospital was MaineGeneral Medical Center in Augusta, which had an average of 12 patients admitted with COVID-19 on each day.

It was followed by Maine Medical Center in Portland and Central Maine Medical Center in Lewiston, which averaged nine and six admitted coronavirus patients daily over the last week, respectively. The BDN’s data covered a majority of the state’s hospitals, which had admitted more than 80 percent of the state’s hospitalized COVID-19 patients as of Friday.

During the state’s initial coronavirus surge last spring, Maine Medical Center bore a much larger brunt of the state’s hospitalized patients. At the time, the state’s caseload was largely driven by outbreaks in nursing homes, factories and other institutions in Cumberland, York and Androscoggin counties.

But now, the coronavirus is spreading much more evenly across the state, reaching more rural communities as colder weather has driven many people indoors and individuals have spent more time in maskless gatherings with friends and relatives from outside their household.

Maine’s rate of hospitalized coronavirus patients now stands at 66 hospitalizations per 1 million people after going three months without climbing above 13, according to the COVID Tracking Project. That’s well below the current national rate of more than 200 hospitalizations per 1 million people, but state health officials are still expressing concern that hospitalizations could keep climbing in the coming weeks and months.

For now, health care organizations in the state say that they have enough beds and protective equipment to take on new patients after going months with few cases of COVID-19, although having enough staff could be a challenge if enough health care providers become sick or have to quarantine because they’ve been exposed to someone with the virus. The challenge is all the greater now that COVID-19 rates are spiking across the whole country, meaning it will be harder to recruit backup workers from other places.

“Staffing is going to be one of those things that has the potential of making us vulnerable,” said Dr. James Clarke, senior vice president and senior physician executive at EMMC. “When I say we’re well prepared for what might come, that’s sort of assuming our staffing stays strong. But if the staffing gets challenged by quarantine or by illness, that has a big impact on our ability to meet the demand.”

That danger recently became clear at Maine Medical Center in Portland, where 17 workers and one patient have tested positive for the coronavirus in an outbreak connected to the hospital’s cardiothoracic intensive care unit, according to spokesperson Caroline Cornish. She wasn’t able to answer questions about how many workers are now in quarantine or what caused the outbreak.

It’s important for Mainers to wear face masks, wash hands, social distance and avoid gatherings to limit the community spread of COVID-19, which contributes to health care workers becoming infected, said Clarke, of EMMC.

Hospitals have a few options for filling in staffing gaps, such as calling in volunteer workers, moving patients to facilities that still have available staff or delaying elective services so that the providers who would perform them can instead treat COVID-19 patients, according to Nirav Shah, director of the Maine Center for Disease Control and Prevention. But Shah cautioned that delaying some surgeries — as hospitals did for most of the spring — “is not a desirable step.”

In general, health care providers have learned enough about treating COVID-19 that smaller hospitals are able to handle some of the new cases in Maine, rather than transferring them to larger, better-equipped facilities along the Interstate 95 corridor, Shah said. Maine hospitals still had 98 critical care beds and 688 ventilators available on Friday.

“We have a significant amount of headroom,” Shah said. “So if additional people needed to be hospitalized and in the ICU, the system right now can accommodate them.”

But the state recently “dusted off” its plans for opening satellite hospitals in Portland and Bangor — a step the state prepared for but never had to take in the spring — in case the existing ones are inundated with new cases, Shah said. He said it would only take a few days to set up those centers and that the state would likely decide to do so if hospitals were on track to run out of beds, ICU space or ventilators within one or two weeks.

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