A LifeFlight of Maine helicopter at Northern Light Eastern Maine Medical Center in Bangor. Credit: Linda Coan O'Kresik / BDN

LifeFlight of Maine helicopters have transported COVID-19 patients in need of more acute care since the start of the pandemic. But now, the combined pressures of a stubborn pandemic that won’t subside and a stressed medical system that’s short on beds and staff are catching up with the emergency helicopter service that’s been around since 1998.

Just recently, LifeFlight saw one of its most serious days since the pandemic’s start. Over the weekend of Oct. 30-31, 11 of the 18 patients the service transported who had tested positive for COVID-19, were in respiratory failure or had COVID-19 symptoms. Worse, with hospitals’ capacity stretched, the organization’s helicopters have occasionally been prepared to take off with a patient in need only to find out that a hospital bed is no longer available.

As hospitalizations remain high and Maine continues to see hundreds of new coronavirus cases daily, LifeFlight’s leaders fear the situation is only going to get worse.

“We’re going to have to work hard over the next six months,” said Thomas Judge, LifeFlight’s executive director, “or we are going to see empty chairs at the table.”

Judge and Norman Dinerman, the organization’s medical director, are pleading with Maine residents to get vaccinated and wear masks at gatherings. Those pleas come as more Maine residents begin to gather inside maskless due to the cooling weather and as Thanksgiving and Christmas approach.

Judge and Dinerman have helmed LifeFlight, a non-profit jointly operated by Northern Light Health and Central Maine Healthcare, since the organization’s first flight in September 1998. The bulk of their work involves flying acute patients from rural hospitals to better equipped, more metropolitan medical centers. But the COVID-19 pandemic has made that a complicated endeavor.

A LifeFlight of Maine helicopter at Northern Light Eastern Maine Medical Center in Bangor. Credit: Linda Coan O’Kresik / BDN

“I’ve never seen anything like this in my life. I don’t think anyone in critical care medicine has,” Judge said. “I don’t think we’ve ever seen the pace of this.”

LifeFlight helicopters transport patients to hospitals throughout Maine as well as to hospitals out of state when even more specialized care is needed. Massachusetts is a common destination, but LifeFlight has brought patients as far as the Cleveland Clinic in the past. The farthest it had transported a COVID-19 patient was to New York, Dinerman said.

Besides being from rural areas, Judge said most of the patients with severe COVID-19 that LifeFlight has transported have one thing in common: they were unvaccinated. Many of the state’s least vaccinated communities are the rural areas LifeFlight most commonly serves.

Adding to the pandemic pressures, there is no central system that provides up-to-date availability of hospital beds across Maine, Dinerman said. This has put stress on physicians and nurses in Maine’s smaller hospitals during the pandemic, who are often forced to call other hospitals, anxiously asking if they have a bed available, he said.

Many smaller hospitals simply don’t have enough beds to treat all the patients that come to them, said Dr. James Jarvis, senior physician executive of Northern Light Health’s COVID-19 response. In addition, COVID-19 patients with severe cases require longer hospital stays and more staff attention than non-coronavirus patients, taking up valuable beds. And then a lack of available long-term care beds as nursing homes have struggled to retain staff has made it so hospitals have nowhere to discharge patients who no longer need hospital-level care.

While the situation is already dire, Judge believes it could get worse. He especially fears that there won’t be a concentrated enough effort for vaccines, masking and other health protocols to stop this winter from looking as bad as — or worse than — last year’s winter surge.

Maine still has more than 230,000 residents 12 and older who have not received a single COVID-19 vaccine dose, Maine CDC data show.

LifeFlight saw its first coronavirus case on March 17, 2020, just five days after Maine’s first documented case. Since then, 18 to 20 percent of LifeFlight patients have either had COVID-19 or had symptoms that made it a strong possibility they did, Judge said. Even more patients have tested positive after transport.

During the first months of the pandemic, LifeFlight saw some patients who had waited until the last moments to call 911 for non-COVID medical problems. People died because they had run out of time, Judge said.

“We saw some real tragedies,” Judge said. “People with an active heart attack that had waited hours until they just couldn’t bear it.”

A lot has changed since then. COVID-19 treatment and respiratory care have significantly improved in ways that will help people far beyond the end of the pandemic, Judge said. LifeFlight has also received new PPE, ventilator equipment and other items that have enhanced care.

And after a decision by the U.S. Centers for Disease Control and Prevention on Tuesday, everyone 5 and older is eligible for the COVID-19 vaccine.

Noting recent upticks in COVID-19 hospitalizations in colder regions across the western United States, including Alaska and Idaho where hospitals are now in crisis care mode and are prioritizing certain patients, Judge said he was hoping for the best in the coming months. But he and his staff are preparing for the worst.

“We’re worried it’s going to be a very tough winter,” Judge said.