Maine hospitals are holding their own as the number of COVID-19 inpatients has soared to its highest levels since the pandemic began, with more critical care beds available across the state than a month ago, before the surge reached their doors.
On Tuesday the number of COVID-19 inpatients statewide hit 138, up from 105 a week before and 17 on Nov. 1. But despite 46 of those patients being in critical care – the industry’s new term for intensive care – the number of staffed and available critical care beds has decreased only by nine over the past month, from 108 to 99, even as most hospitals continue to conduct non-emergency surgeries and procedures that use those resources.
The state’s larger hospitals have done this by increasing the number of critical care beds, taking advantage of newer facilities that were designed with the ability to shift rooms from ordinary medical-surgical duties to critical care, including the care of COVID-19 patients requiring intubation or other intensive interventions.
Forecasting models predict new daily hospitalizations will sharply increase over the next two weeks. Maine is averaging about eight a day now, and the COVID-19 Simulator run by Harvard Medical School, Massachusetts General Hospital, Georgia Tech and Boston Medical Center predicts a jump to 19 per day by Dec. 14, up from about 8 currently, while the Columbia Mailman School of Public Health model pegs the figure at 10.
Northern Light Health’s Eastern Maine Medical Center in Bangor – one of the hospitals hardest hit in recent weeks – has used these “swing beds” in its newest tower to increase critical care capacity from 62 to 75 to meet the added demand, said Dr. James Jarvis, physician incident commander for Northern Light.
“We have the capacity to flex on a regular basis, and a lot of it has to do with how we designed the floors,” Jarvis said. “Because we’re a rural state, we have to be a little more flexible than some of our urban colleagues to serve our communities.”
Jarvis said the Northern Light network – 10 hospitals including Mercy in Portland – hasn’t had to cancel or postpone any nonessential procedures because of the surge. “Are we at that panic mode right now? No,” he added. “But we are very lucky that we have had time to plan and have procedures in place so that if we do need to take more extreme measures to protect the number of hospital beds we can do that.”
It’s a similar story at another hard-hit hospital, MaineGeneral in Augusta, which was at 87 percent critical care capacity on Tuesday, with only two of 16 beds being occupied by COVID-19 patients. The hospital, which opened in 2013, was also able to increase capacity via the use of swing beds and hasn’t had to scale back other services.
“Based on our overall current census, we do not need to put our surge plan into place at this time,” MaineGeneral spokesperson Joy McKenna said via email. “We recognize that delaying needed health care can lead to worse outcomes for patients.”
“It is a balancing act, and we are pulsing our current environment daily, and we will make changes quickly as necessary.”
Maine Medical Center and the other hospitals of the MaineHealth network have also avoided scaling back elective surgeries, though tight capacity at Maine Med and Southern Maine Health Care have occasionally caused last-minute postponements, as sometimes happened before the pandemic. As of last Thursday, Maine Med had 16 confirmed COVID-19 inpatients, up from 8 a week earlier, though it was not known how many were in critical care.
“Where we’re feeling it right now in terms of capacity is really on the non-critical-care hospitalization side,” said Dr. Joan Boomsma, MaineHealth’s chief medical officer. “I would say we are at a point where needing to potentially dial back elective surgeries is not far off the horizon. We’re seeing a lot of hospital beds being taken up by COVID-infected patients, and it’s stretching our capacity and our staffing.”
“Our health care teams are really starting to wear down,” she added. “People are exhausted, and at the rate things are going we are going to need everybody’s help in containing this thing.”
Central Maine Medical Center in Lewiston had an average of 9.3 COVID-19 inpatients being treated each day in the week ending Nov. 27 but reports having an ICU capacity of 20. “Thanks to the planning and hard work of our team members, CMMC is well-positioned to care for patients beyond that number if needed,” said the hospital’s president, Steven G. Littleson, who said they also had not had not yet had to defer other types of care.
York Hospital, a much smaller facility that had six COVID-19 inpatients for much of last week, also has not had to defer other care to make way for the surge. “We still have the staff and capacity to safely continue care as usual for our non-COVID patients, the hospital’s director of quality, Matthew Bennett, said in a statement. “We continue to closely monitor the situation, and at this time York Hospital is both available – and safely able – to continue with all elective procedures.”
Bennett also said York has set up a COVID-19 care clinic attached to its emergency department in expectation of a further surge in demand but hasn’t yet had to put it into operation. “Our ED staff has been able to effectively manage the current volume in the ED setting,” he said.
Jarvis at Northern Light urged Mainers to help protect the hospitals and their staff by observing public health advice.
“If you want us to be on the job we need your assistance in the community,” he said. “Avoid large gatherings. Remain 6 feet apart. Wear face coverings. Because you never know who is next to you, and it might be a health care worker.”