MaineGeneral Medical Center in Augusta is pictured on Nov. 6, 2013. Credit: Troy R. Bennett / BDN

Staffing shortages are limiting the ability of Maine hospitals to adapt to a surge of critically ill patients as officials consider contingency plans that were not needed earlier in the pandemic.

The sudden rise in virus cases is hitting hospitals on two fronts: COVID-19 hospitalizations here have risen 62 percent in the past week and the number of patients requiring critical care surged to 71 on Friday, tying the highest single-day total, while community transmission is leading health care workers to test positive or have to quarantine due to possible virus exposure.

Hospitals are now reconsidering backup plans from the early pandemic, when Maine maintained capacity by postponing elective procedures and did not have to use temporary hospitals like other states did. But staff shortages limit their options as Gov. Janet Mills’ controversial vaccine mandate for health workers is set to go into effect Oct. 1, though its effect on staffing is murky.

“We’re very close to being swamped,” Steve Michaud, the executive director of the Maine Hospital Association, said Friday. “I mean, that’s just the reality.”

Although the vaccine mandate for health care workers raised concerns that some would leave the profession, hospital leaders say the biggest challenge right now is workers who are missing time because they contracted the highly contagious virus or were exposed to someone who did.

Across Brewer-based Northern Light Health’s system, which includes 10 hospitals, about 400 employees missed time in the month of August due to exposure to the virus or a positive test. At MaineGeneral Medical Center in Augusta, 51 employees were out of work as of Friday because they had tested positive for COVID-19 or were exposed in the community, according to a spokesperson. That figure was up from 34 last week and 29 two weeks ago.

MaineGeneral also had to reschedule all radiation oncology appointments Thursday after five radiation therapists called out of work, the same day as an Augusta protest against the vaccine mandate for health care workers. A hospital spokesperson said the employees had not cited the mandate as a reason for their absence, adding that the hospital expects employees to “never put patients’ health at risk by denying them care.”

About 80 percent of hospital employees were fully vaccinated at the end of July, before the vaccine mandate was announced, according to state data. More than 80 percent of eligible Mainers have received at least one dose, according to federal data, but roughly 417,000 remain unvaccinated, including about 160,000 children who are not eligible for the vaccine yet. 

Hospital leaders raised alarms about a potential shortage of critical care beds in a rare joint news conference on Thursday, citing the rise in cases, high summer patient counts and staffing shortages that made it difficult for them to add beds to accommodate the recent surge.

The number of available beds increased slightly to 39 on Friday, according to Maine Center for Disease Control and Prevention Director Nirav Shah. The number of ICU beds in the state is not fixed, as hospitals can convert some depending on need, but their ability to do that also depends on staffing.

Fifteen of the 16 intensive care unit beds at MaineGeneral are currently occupied, while about 90 percent of ICU beds across Northern Light’s system are currently in use. Facilities within the Northern Light system hit hard by the virus are considering reducing non-essential procedures, such as surgeries, that could result in hospitalizations in order to take some temporary stress off the system, a spokesperson said.

Other options that may be under consideration in the coming week include shifting patients from urban to rural hospitals if the latter group has fewer patients, said Michaud of the hospital association. A Maine Department of Health and Human Services did not address a Friday question on surge plans.

When the virus first arrived in the spring of 2020, Maine made plans for temporary treatment centers in Bangor and Portland in anticipation of rising cases, though the state never ended up using them as caseloads stayed below dramatic projections. When infections surged again heading into the winter, hospitals across the state again restricted elective surgeries.  

While Maine’s largest hospitals have been dealing with a surge in cases, smaller facilities in Bridgton, Rumford, Calais and Machias did not have any COVID-19 patients as of Thursday. Those hospitals also do not have intensive care beds, however.

“We talked about those things a year ago, but we didn’t think we’d be back here,” Michaud said. 

BDN writer Michael Shepherd contributed to this report.

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