MaineHealth Providers Stretched to the Limit by Surging COVID-19 Hospitalizations

As the Delta variant spreads through the ranks of the unvaccinated, the region’s largest health care system says its hospitals are full, and patients can expect long waits for inpatient care and even clinic-based services.

PORTLAND, Maine – Leaders from across MaineHealth, northern New England’s largest integrated health care network, said today that an unprecedented surge in COVID-19 hospitalizations among the unvaccinated is pushing their network to the brink.

As a result, Maine Medical Center in Portland, the region’s leading tertiary care center, has at times this week run out of critical care beds and has had to divert patients away

from its emergency department. Across the MaineHealth system, other hospitals are seeing an unprecedented surge in cases. The result is that many non-emergent procedures have had to be rescheduled, and patients are experiencing long waits for care in both hospitals and medical practices.

Andrew Mueller, MD, chief executive officer of MaineHealth, said hospitalizations for COVID-19 are at an all-time high across the system, which serves 1.1 million people in 11 counties in Maine and Carroll County, NH.

“As much as we hoped we were wrong, this appears to be a fairly steady trend as a result of the Thanksgiving holiday. So we don’t think we’ve seen the full breadth of this surge and probably won’t for another two to three weeks, and then of course we fear that will lead into what will ultimately become a post-Christmas and New Year’s surge,” said Mueller, who along with other leaders from across MaineHealth appeared at a media conference held via Zoom.

The impact on MaineHealth operations has been significant. Joel Botler, MD, chief medical officer at Maine Medical Center, said at times this week MMC has had no critical care beds available. Its Emergency Department, meanwhile, has been overflowing with patients and has been on frequent “diversion,” meaning only the most critical cases are accepted.

To deal with the surge, many non-emergent procedures – those that can be postponed without significant harm to the patient – have been rescheduled. Botler said MMC has had to close an additional six operating rooms, in addition to six that were already closed, in order to free up staff to care for patients suffering from COVID-19 and other critical illnesses. He said about 50 percent of surgeries at MMC are now being rescheduled. The operating room closures not only free up care team members to work in other areas but they also create additional bed space for limited use.

The capacity challenges are not limited to the region’s leading tertiary care center. Ryan Knapp, MD, chief medical officer at Stephens Memorial Hospital in Norway and an active emergency medicine physician, said his small, Critical Access hospital is also full.

“Now what we’re seeing is there is a significant burden in the rural counties like Oxford County, where our hospital is, that have very low vaccination rates and, therefore, we’re seeing very high COVID infection rates,” said Knapp.

The demand for staffing resources to deal with COVID at MaineHealth’s hospitals, as well as increased volume due to people delaying care earlier in the pandemic and the ongoing labor shortage in health care nationally, have all had an impact on outpatient care across the region as well. Patients can expect long-wait times for all kinds of care, including laboratory services and visits to primary and specialty care providers.

During the media conference, Mueller noted that state and local officials have been good partners throughout the pandemic. For instance, the Maine Department of Health and Human services was recently able to deploy some public health nurses to help administer monoclonal antibody therapies, which have been shown to greatly reduce the chance of hospitalization for those at risk of severe COVID. Still, he said there is little that can be done in the face of a national shortage of health care workers. The problem, he and others said, is not finding space to treat patients, but staffing.

On Wednesday, MaineHealth had 116 patients in hospitals across its system being treated for COVID-19, 82 of whom where unvaccinated. The proportion of unvaccinated patients in an intensive care unit was higher, with 39 out of 48 not having been immunized. Of the 20 patients on a ventilator, all but three were unvaccinated.

Both Christine Hein, MD, an emergency room physician at MMC, and Christopher Bowe, MD, chief medical officer at Mid Coast - Parkview Health in Brunswick and also an emergency medicine physician, said they are seeing much younger people with severe illness now than earlier in the pandemic. Ryan observed that this is a function of younger people having lower vaccination rates at a time when COVID is surging.

All the participants urged, over and over, for people to get vaccinated or get a booster if eligible.

“While this is not easy for everyone to hear, this really largely is a pandemic of the unvaccinated,” said Mueller. “So vaccination, including getting a booster, is critically important to all of us, and really, working with us to achieve our vision of, ‘Working together so our communities are the healthiest in America.”

Mueller also asked that people continue to support and show appreciation for MaineHealth care team members. He noted that frustrations among patients have started to spill over in some instances where care team members have been abused verbally and sometimes even physically.

“Part of our message today is to really implore our community, in a heartfelt way: Kindness matters. These are great heroes who are doing so much for all of us. Please do your part to be kind to them and respect them,” said Mueller.