PORTLAND — Maine Medical Center Wednesday announced the closure of six more operating rooms to free up staff and make additional space for intensive care units needed, due to the surge in COVID-19 patients.

“We’ve continued to see an upward climb in the number of COVID-19 patients, which has put significant additional pressure on our health care system, making it difficult to provide the care you need for the entire community,” MaineHealth Chief Executive Officer Andrew Mueller, M.D., said during a virtual news conference. “It appears to be a fairly steady trend as a result of the Thanksgiving holiday. We don’t think we have seen the full brunt and probably won’t for another two to three weeks, (but I) fear this will lead into what will ultimately become a post-Christmas/New Year’s surge, as well.”

This is largely a pandemic of the unvaccinated, he noted. The vast majority of patients are not vaccinated for COVID-19, especially those with the virus in critical care who are very sick and hospitalized for a long time, he said. More than 90% of COVID-19 patients are not vaccinated and on a typical day, upwards of 75-85% of non-COVID patients are not vaccinated, he added.

“Vaccination, including getting a booster is critically important to achieve our vision of working together, so our communities are the healthiest in America,” Mueller said. The vaccinated have significantly less risk of severe disease, he noted.

A behavior mental health pandemic has occurred as result of all that society has faced during the pandemic, Mueller said. Unprecedented needs far outweigh the capacity to care for those with mental health issues, he noted.

Facilities in the MaineHealth system are at or near capacity. Joel Botler, M.D., Maine Medical Center chief medical officer, provided numbers from Monday to describe the situation: There were 50 patients with COVID-19 and 10 being investigated for the virus. Sixteen were in the intensive care unit (ICU), 15 were on ventilators, and 13 others were critically ill but not in ICU.

“We had no capacity to take more ICU patients with COVID,” he said. The situation with non-COVID patients wasn’t much different with 35 patients in ICU on ventilators, he noted. “Fifty patients were on ventilators. In the past, we might have three on ventilators. That’s a really dramatic change.”

The rest of Maine Med was also at capacity as were all other hospitals in the system, Botler said. Reasons include lots of COVID-19 patients, the labor shortage, patients at Maine Med who don’t have a place to go from there, and the number of health care workers with or being investigated for COVID-19, he noted. “We might have 150 employees out with COVID-19 on any given day.”

Closing six more operating rooms will provide staff and space to open up eight to 12 more ICU beds, Botler said. It would mean the postponement of 20 non-emergency surgeries per day, he noted.

Surgeries being postponed include hip or knee replacements and some spinal surgeries, not cosmetic ones, Mueller said. “These are all patients in a lot of pain, it’s impacting their ability to work … function at home.”

“I can paint a different but related picture,” Ryan Knapp, M.D., Stephens Memorial Hospital chief medical officer and emergency department physician said about the current Maine Med situation. “As a health care system, we work closely together. As a small hospital, we rely on the resources Maine Med has for their expertise, specialty care and many advanced procedures we can’t offer. When Maine Medical Center is challenged, that really affects us as well.”

At Stephens Memorial in Norway on Monday, the emergency department had three patients waiting for transfer to other hospitals for higher levels of care but there was no space for them, Knapp said, adding, the 25-bed hospital has been running near or over capacity for several weeks. Wednesday there were eight COVID-19 cases, all four ICU beds had COVID-19 patients, and two beds were available but only because those patients had died overnight, he noted.

“We are running out of options,” Mueller said. It’s not just Maine. It’s New England, across the country. “Vaccination is the best strategy we have not only to protect oneself, but more importantly, to protect others in the community, preserve capacity.”

“At the beginning of the pandemic, many cases were coming from more urban communities where there was a higher density of population,” Knapp said. “Now we’re seeing a significant burden in rural counties that have very low vaccination rates and therefore seeing high COVID infection rates. Our test positivity rate has been as high as 21% the last couple of weeks, far outstripping anything we’ve seen previously.”

As a result of the pandemic, patients are spending longer in emergency rooms waiting for inpatient beds, Christine Hein, M.D., Maine Medical Center emergency department physician said. That means more patients are being seen in waiting rooms or hallways where the same level of care can’t be provided, she said.

“The sooner we can see patients the better they will do,” she noted. “We’ve been managing this pandemic for almost two years. It’s coming to a point where we are going to be making some of those difficult decisions we were concerned about at the beginning.”

Health care workers are tired, they’ve worked so hard, are continuing to hang in there despite the workforce shortage, Mueller said. “I can’t tell you how big their hearts are. It is especially heartbreaking when so many people  who understandably are stressed, frustrated, choose not to get vaccinated and are equally frustrated that many are asking them to be vaccinated.”

Team members have received verbal threats, a lack of civility and even physical violence while trying to do their jobs, he said. It’s not helping, is making the health care workforce crisis worse, he noted.

“Kindness matters,” Mueller said. “These heroes are doing so much for all of us. Please do your part. Respect them and know that they are doing their best to provide care.”


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