Hospitals officials are concerned that staffing shortages caused by COVID-19 could become acute as the pandemic deepens in Maine.

The state reported seven more deaths and 405 new cases Wednesday, bringing the cumulative number of cases to 14,454. Hospitals had 173 inpatients with COVID-19, including 42 in critical care beds and 15 on ventilators, according to the Maine Center for Disease Control and Prevention.

Dr. Nirav Shah, director of the Maine CDC, said at a media briefing on Wednesday that “staffing is probably our primary bottleneck.”

“In recent weeks, what is new and deeply concerning and alarming is that many facilities are running into challenges in regards to staff,” he said.

Shah said Maine had 84 staffed intensive care unit beds available across the state, but hospitalization numbers have been growing. From July through the beginning of October, Maine typically had fewer than 20 hospitalized patients per day, so hospitalizations have increased nearly tenfold since then.

A man carries a mask while walking on Congress Street in Portland on Monday. Derek Davis/Staff Photographer  Buy this Photo

Hospitalizations and deaths increase in the wake of higher case counts.

In some states, the influx of COVID-19 patients has overwhelmed hospitals. For instance, in South Dakota, where the pandemic is much worse than in Maine, some COVID-19 patients are being transferred to out-of-state hospitals.

The staffing problem varies among Maine hospitals.

Maine Medical Center is rescheduling a “small percentage” of its elective surgeries to free up hospital beds, said John Porter, spokesman for MaineHealth, the parent company of Maine Med. Across MaineHealth’s system of hospitals in Maine and New Hampshire, “we have not had any staffing shortages that we have not been able to deal with and work through,” he said.

Health officials couldn’t immediately put a number on the volume of staff shortages but said the issue is real. According to Maine’s plan submitted to the federal government for vaccine distribution, about 5,400 people work in intensive care or emergency departments in hospitals across Maine.

Jeff Austin, vice president of government affairs for the Maine Hospital Association, said the staffing shortage is “absolutely true,” although he couldn’t quantify the problem on Wednesday.

“It’s real and is as much the limiting factor for the number of beds available as the actual beds themselves,” Austin said.

Leaders of three of Maine’s larger health care systems – Northern Light Health, Central Maine Healthcare and MaineGeneral Health – held a joint news conference Wednesday to call attention to the rising case and hospitalization numbers.

Dr. James Jarvis, senior physician executive at Northern Light Health, said there are no widespread shortages among his system’s staff, but added that “it is a concern of ours that we need to monitor on a regular basis.”

“We all face staffing challenges,” Jarvis said. “Health care workers are just like everyone else. We all still need to go out into the community to do essential things like get groceries, buy gasoline and the like, and so we have felt the effects of COVID-19 amongst our staff.”

Dr. Steve Diaz, chief medical officer at MaineGeneral Health, said all hospitals have staff absences, either because of COVID-19 infections or quarantines due to potential exposure, including from family members. He said child care also has been an issue for many health care workers, as many schools continue to use virtual or hybrid learning models.

“I do think staffing at all levels is tight,” Diaz said. “Given the fact that our numbers are increasing and that we are so tight on staffing with little residual capacity, we need people to do their part, the community at large, in making good decisions about how to continue to protect themselves and their families and us as well.”

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A healthcare worker wears personal protective equipment as she speaks with a patient at a mobile testing location for COVID-19 on Tuesday in Auburn. Maine health officials are concerned about the drain on hospital staffing as COVID-19 cases increase. Robert F. Bukaty/Associated Press

The hospitals’ media briefing was part of a new public messaging campaign aimed at urging Mainers to follow basic guidelines for reducing transmission: wear a mask, keep a safe distance from others, stay home if sick and avoid gatherings with anyone outside your immediate household, particularly during the holidays.

All Mainers “have the power to slow the spread, reduce hospitalizations and prevent more deaths from COVID-19” by following these basic principles, Jarvis said.

“We are monitoring this and basically going on a day-to-day basis,” Jarvis said, noting that some hospitals are beginning to implement surge plans that were developed months ago. “There are some dire predictions that come Christmastime, we will be overwhelmed in hospitals. We don’t want to see that and that’s the reason why we are getting this message out today.”

He said 41 COVID-19 patients were hospitalized or receiving home/hospice care at Northern Light facilities as of Wednesday.

Diaz warned that Maine hospitals are “at a tipping point as far as the increases that we are seeing.”

He said public health officials know the best way to prevent spread is to wear face masks. Yet he said it is still relatively common to see people in public without face masks.

Realizing that behavioral changes are among the hardest in medicine, the three leaders were hoping to send a collective message that there is no dispute about what needs to happen to slow spread of the virus: physical distancing, wearing masks and avoiding gatherings.

“We are saying this is what we have to do,” Diaz said. “There isn’t an Option B. Option A, of all of these things, is the only thing that is going to help.”

The pandemic has created a staffing demand not just for nurses to work with patients in hospitals, but also to fill jobs in the rapidly expanding field of telemedicine.

Ed McKersie, founder and president of the Portland-based recruiting firm ProSearch, has been hired by several providers he would not identify to find registered nurses willing to work telemedicine shifts. McKersie said the providers are targeting both retired nurses and those who are currently working part-time – potentially because of their own child care or family issues during the pandemic – or who are looking for additional shifts.

“What we are trying to do is tap that pool of people,” he said. “The message to them is you don’t have to worry about going on-site. This is work that can be done remotely. So we are telling them these are part-time positions and full-time positions.”

McKersie said his firm has only been working with clients for a few weeks, but said they were looking to fill “definitely dozens” of positions. To date, the focus has been on nurses in Maine, but he envisioned potentially expanding that net to New Hampshire, Massachusetts or other New England states if there is sufficient demand.

“We are testing if this is doable: are there people out there willing to do this?” he said. “And so far, so good.”

The state shattered its one-day record for new infections on Monday, with 427 additional cases. Since the pandemic began, there have been 14,454 cases of COVID-19, and 246 deaths. The seven-day average of daily new cases stood at 321.9 on Wednesday, compared to 169.4 a week ago and 158.6 a month ago. Cumberland County reported 99 new cases, York County logged 84 new cases, while Penobscot County added 46 new cases and Androscoggin County had 39 additional cases.

The seven deaths on Wednesday included a man in his 100s from Androscoggin County, two men in their 80s from Cumberland County, a woman in her 90s from Hancock County, a man in his 80s from Hancock County, a man in his 80s from Androscoggin County and a man in his 50s from York County.

Maine continues to fare better than most states, but only because the virus spread is getting much worse everywhere. Maine had the second-lowest virus prevalence in the country on Tuesday, according to the Harvard Global Health Institute, at 19.3 virus cases per 100,000 residents on a seven-day rolling average. Only Hawaii was lower with a rate of 6.9. Twenty-six states had rates at least five times higher than Maine’s, and Alaska’s rate, the worst in the nation, was 196.7 cases per 100,000 residents on Tuesday.

On Monday, in light of the increasing cases in Maine, the Maine CDC scaled back contact tracing, cutting tracing of close contacts for those who have COVID-19 roughly in half. Everyone who tests positive will still receive an initial phone call from the health agency, but those who don’t fall into certain high-risk groups – such as those age 65 or older or 18 and younger and other vulnerable or prioritized groups – will be asked to notify close contacts on their own.

Maine Gov. Janet Mills also recently extended a 9 p.m. curfew for some businesses, including movie theaters and restaurants that offer indoor dining, through the end of the year in an attempt to curb transmission.

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