One of Maine’s largest hospital systems is seeing a growing number of patients admitted for reasons other than COVID-19, then test positive for the disease.
While the patients aren’t at the hospital primarily because of COVID, they’re still counted among the state’s COVID-19 hospitalizations, which have set records in recent weeks due to the rapid spread of the omicron variant.
Some public health specialists have said that knowing how many people are hospitalized because of COVID-19, as opposed to being hospitalized with it but for another reason, is crucial to understanding the gravity of the ongoing virus surge from the omicron variant.
Nearby Massachusetts has started tracking so-called incidental hospitalizations, and reported that about half of that state’s COVID-19 hospital patients as of a week ago were hospitalized primarily for another reason.
But it changes little on the hospital’s end, as such patients often wouldn’t end up in the hospital if COVID-19 didn’t complicate their primary conditions, according to Maine hospital officials. And having more COVID-positive patients means that hospitals need to isolate them, and nurses and doctors need to use more PPE to treat them.
The Maine Center for Disease Control and Prevention does not require that hospitals report data like Massachusetts does, agency spokesperson Robert Long said. Patients who test positive for COVID-19 are counted in the agency’s hospitalization count regardless of symptoms and their primary reason for being hospitalized.
“The impact on the hospital is equivalent in many respects,” Maine CDC Director Nirav Shah said earlier this month. “They have to treat the patient, whether [hospitalized] for COVID or with COVID, with the same degree of care.”
COVID-19 patients who tested positive but weren’t being treated for COVID accounted for about a third, or 63 of 194, of the coronavirus patients in the MaineHealth hospital system on Monday.
At Maine Medical Center in Portland, nearly 40 percent of the hospital’s COVID patients were asymptomatic, with most of them fully vaccinated.
However, it would be wrong to say that those patients don’t see consequences from their COVID-19 infections, said Dr. Dora Mills, chief health improvement officer for MaineHealth, which has hospitals in southern, western and coastal Maine.
The difference between such patients and those who more clearly require treatment for the coronavirus is a “very blurry line,” she said.
In a number of cases, people have reported to the hospital for ailments other than COVID-19 but would not have been hospitalized if they hadn’t contracted COVID. Those cases include people with diabetes who had lived with the disease for decades without requiring hospital treatment.
“They don’t obviously have COVID,” Mills said. “But the underlying disease is suddenly worse and causing them to go to the hospital.”
It’s rare to see someone report to the hospital for an entirely unrelated condition, such as a broken bone, then test positive for COVID-19, she said.
Incidental cases of COVID-19 have been relatively uncommon in Northern Light Health’s 10 hospitals that stretch from Portland to Presque Isle, spokesperson Suzanne Spruce said.
“They do occur, but often their infection is a likely contributor to their reason for admission, such as causing hypoxia, which triggers a heart attack,” said Spruce, who said the system’s hospitals take precautions with COVID patients regardless of symptoms.
The presence of the coronavirus can exacerbate the effects of a number of illnesses, including heart disease, emphysema, cancer and neurological diseases, Mills said. Some asymptomatic patients end up deteriorating and requiring more significant treatments for COVID such as oxygen, she said.
Apart from the effects on the patients themselves, even an asymptomatic COVID patient will require more resources from Maine hospitals that are already being pushed to the brink.
“We end up having to put them in a separate room with negative pressure and put on a lot of PPE to help them,” Mills said. “It’s quite a bit of work that it entails.”
Augusta-based MaineGeneral Health and Lewiston-based Central Maine Healthcare do not track such information on COVID-19 hospitalizations.
“Each patient’s health needs are individual,” MaineGeneral spokesperson Joy McKenna said. “So, we cannot characterize a patient based on how and when they came into the hospital with COVID-19.”