In this March 2020 file photo, medical personnel discuss patients that had been admitted for testing for the coronavirus at the entrance Central Maine Medical Center in Lewiston, Maine. Credit: Robert F. Bukaty / BDN

Patients have been diverted from Maine hospitals or treated in hallways over the past few weeks as record COVID-19 hospitalizations continue to stress the health care system.

A record number of 225 people were hospitalized with COVID-19 on Tuesday, eclipsing a record set the day before. On Monday, 90 percent of those hospitalized were unvaccinated, continuing a trend with relatively few breakthrough cases occurring in the state. The state had 48 critical care beds available with 82 people in those units, which are increasingly becoming defined by the number of people available to staff them as a workforce shortage stretches further.

It is happening while some hospitals are taking stark measures to keep providing care to vulnerable patients. Rumford Hospital last Monday needed to move emergency department patients into hallways to provide them with better care, which spokesperson Ann Kim said happens only rarely when the hospital’s 10 emergency room beds are unavailable.

Others have limited elective surgeries and redirected patients to other facilities. The stress on space is lingering from the summer into the fall, and is compounded even further by  limited space in nursing homes and other care facilities after four recently closed, industry experts say.

“There isn’t any doubt that in the short term, we’re in for a bumpy ride,” said Steven Michaud, president of the Maine Hospital Association. “There’s no quick fix to any of this.”

Many hospitals have the beds to accommodate more patients, but are lacking the staff to fill them, Michaud said. There has been a recent push to staff up as Gov. Janet Mills’ vaccine requirement that health care workers get vaccinated by Oct. 29 at the latest, he said. In the interim, it is likely people will continue to see care delayed if cases do not decrease.

Eastern Maine Medical Center, Northern Light Health’s main hospital in Bangor, is preparing a fourth COVID-19 unit if needed, spokesperson Andrew Soucier said. Nearly three-quarters of the 30 people in its intensive care unit are COVID-19 patients. The system has about 13 percent of 12,500 positions open, a small number of which are related to vaccine requirements, he said.

Maine Medical Center also has flexible beds across two new floors, said MaineHealth spokesperson John Porter, but it needs the staff to use them efficiently. The system has had about 2,600 openings in its staff of 23,000 care team members over the last six months, which Porter attributed to longstanding labor shortages. It recorded 51 COVID-19 patients across the system, with 23 of them in intensive care units.

Some hospitals are stressed even without many COVID-19 patients. At Rumford Hospital, the decision to move some patients into the hallway was not spurred by high counts, Kim said, and the practice is never used for virus cases. The hospital had zero confirmed cases last Tuesday.

The state is not yet in a dire-enough place where it may have to ration care, a practice when hospitals mete out care based on who is likely to live rather than who is most sick, Dr. Gibson Parrish, a Yarmouth-based epidemiologist, said. But the effects of hospitals shutting down medically necessary procedures could lead to downstream health effects for Mainers.

“Vaccinations are really critical at this point to lowering the burden on the health care system,” he said.