Emergency department physician Brandon Giberson steps into the ambulance bay at Mid Coast Hospital in Brunswick for a photo on Monday. Giberson was half way through his shift. Credit: Troy R. Bennett / BDN

When the coronavirus first flared up across Maine last spring, many of the state’s frontline health care workers were scared by how little they knew about it.

Would they have enough face masks and gowns? Would they bring the virus home to their loved ones? Would they die from it?

And how quickly would the strange new infection storm across a rural state whose large elderly population was particularly threatened by it?

The answers to all of those questions have become clearer over the last eight months, as the virus initially surged from March through June before petering out in early July, causing slightly more than 100 deaths. From there, the state went almost three months with daily COVID-19 hospitalizations remaining below 20.

But now, health care workers are again scared as the virus resurges in Maine, bringing record high numbers of hospitalizations and deaths across a much wider area. Their fears are similar this time around, but more rooted in the lessons they’ve learned about the virus since last spring — and just as important, the lessons that others seem to have missed.

“People were scared in the spring, but it was fear of the unknown,” said Sarah Bockian, a 39-year-old intensive care nurse at Maine Medical Center in Portland, who has treated COVID-19 patients. “Now it’s fear of the known. This time, we know what we’re getting into, and that’s scary enough.”

The workers know that hospitals are safe places when adequate protective gear is used, for example, and that there are various treatments and therapies to help sick coronavirus patients, such as rolling them on their stomachs.

They also know that community transmission of the virus can be drastically reduced if people take simple precautions such as wearing face masks, social distancing and avoiding indoor gatherings. Last spring, Maine’s hospitals were not overwhelmed by COVID-19 cases in part because so many residents “flattened the curve” of new infections by staying home and following those other guidelines when they had to go out.

But the unprecedented new surge seems to be at least partly driven by Mainers who now seem to be ignoring those same precautions despite a drumbeat of guidance and restrictions from state and federal officials, perhaps out of some mixture of pandemic skepticism and fatigue.

Jill Bouchard, a 58-year-old homecare and hospice nurse with Community Health and Counseling Services, has encountered some of those attitudes during her visits to patients in their homes around northern Penobscot County. Her protocol is to ask them to wear masks when she enters their homes, but some of them can’t because of their health problems, while others argue about it.

“They don’t believe the science,” Bouchard said.

If things stay on the current trajectory, the state’s hospitals could be swamped by additional waves of sick patients in the coming weeks. Like all Mainers, health care workers will be at greater risk of catching the virus themselves, just from running errands or dropping their children off at daycare. That could cause more personal stress for the workers while making it harder for hospitals to staff their emergency departments, inpatient areas and ICUs as sick employees quarantine at home.

“The outbreak is reaching our families and our communities more,” said Bockian, whose job often involves monitoring patients who are hooked up to ventilators. “A lot of people I work with are really stressed and scared.” She added that she’s “infuriated” and “baffled” that some “people can be so resistant to such a small thing” as wearing masks and avoiding gatherings.

At least 1,507 Maine health care workers have become infected with the coronavirus since the start of the pandemic, although the state does not keep track of how many are thought to have caught it inside or outside the workplace. In general, there does not appear to be great evidence the virus is circulating within hospitals or clinics.

One of the infected Maine workers, an employee at Northern Light Eastern Maine Medical Center in Bangor, just died after catching the virus out in the community, according to Suzanne Spruce, a spokesperson for its parent organization. “The greatest thing we can do right now to honor the memory of those lives lost to the pandemic is to work hard to keep one another safe,” Spruce said in a written statement.

Many other health care workers are pleading with Mainers to take preventive steps now that could lessen the number of people who end up in the hospital in the coming weeks, such as canceling large holiday celebrations this year.

“The people that go around saying, ‘I don’t have to wear a mask,’ if they had family that works in a hospital, that take care of COVID patients, they might feel differently,” said Cokie Giles, a nurse at EMMC who is president of the Maine State Nurses Association, a union representing almost 2,000 health care workers. “They might have to consider if they have a heart attack and they have to go to the hospital and find out there are no beds because there are COVID-19 patients. They need to stretch their imaginations a little bit.”

Dr. Brandon Giberson, a 33-year-old emergency room physician who primarily works at Mid Coast Hospital in Brunswick, said that he initially worried about catching the coronavirus while treating patients. That’s partly because his twin brother Tyler, who also is an ER doctor, became very sick with COVID-19 last May while finishing his medical residency at a hospital in Georgia. He suffered 31 straight days of fever and briefly had to be hospitalized, but has since recovered.

As an ER doctor, Giberson is typically responsible for intubating the sickest COVID-19 patients, a risky process that requires sticking breathing tubes down their throats, which can cause viral droplets to spray around the room. He must also ensure that more stable patients can be safely sent home.

Giberson — who is employed by a Brunswick-based physician staffing company called BlueWater Health and has also done shifts at hospitals in Houlton and Augusta — said that he now feels well protected by the respirator masks, face shields, gowns, gloves and other protective equipment he must wear in the hospital, and that he is more concerned about the risks of running into maskless people at the grocery store.

He noted several other challenges that he’s encountered throughout the pandemic, including the additional time it takes to don and doff protective equipment and the difficulty of forming a bond with patients while he’s suited up like someone who “walked off a sci-fi movie set.” A growing number of patients are also returning to the ER for more routine health problems after avoiding it last spring, which has added to the challenge of handling the new surge of coronavirus cases.

Giberson is now concerned that many Mainers will visit relatives over the holidays despite the fact that the virus is now circulating across many communities. If the daily transmission of the virus keeps growing, especially among more vulnerable populations such as the elderly, it could mean longer wait times for those who are brought to the ER and need to be admitted to the hospital, Giberson warned.

“There could be a time when we become overwhelmed, and I think that will largely depend on how sick this wave of patients is,” he said.

Watch more: