Maine is preparing for a possible surge in demand for key health care personnel as the number of coronavirus cases in the state continues to grow.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said Friday that while all medical providers are considered essential, three core groups of health care professionals will be crucial to the state’s response to the pandemic: emergency medical technicians who respond to people’s homes and transport them to hospitals, intake workers such as emergency room doctors, and critical care providers such as anesthesiologists and respiratory therapists skilled in using ventilators.

Earlier in the week, the state launched a call for volunteers to assist in the event of an emergency, with a particular emphasis on health care workers. Robert Long, a spokesman for the Maine CDC, said Friday that the state doesn’t have a target for the number of people it is looking to recruit, but 300 people registered within the first 48 hours.

“We know based on models in other states that the situation will continue to get worse,” Shah said at a news briefing in Augusta. “We are continuing to plan our response and part of that is activating as many health care providers as possible.”

Mallory LeBlanc, a former certified nursing assistant from Auburn, said she was among those who have signed up to volunteer on maineresponds.org but has not heard back yet on whether she will be needed. LeBlanc said her license expired about five or six years ago and she is currently on disability due to a car accident.

She also has diabetes and asthma, which she worries would put her at further at risk if she were to contract coronavirus, but said she did want to let that prevent her from volunteering.

“Even though I have a high risk factor for getting sick, I see it this way: If I get sick at least I know I tried to help others,” LeBlanc said. “… I have a feeling before this is over with everything going on they are going to need extra assistance and will probably end up using us, even if I end up being retrained.”

Whether Maine is prepared with the staffing levels needed to respond to the virus will vary in different parts of the state, said Amy Madden, president of the Maine Medical Association.

“In terms of emergency room clinicians and physicians and ICU folks that do critical care medicine, it really depends on your hospital, how many beds you have and what services you provide,” Madden said.

“The most important thing is whatever our capabilities are in terms of EMS and the doctors we have on the front lines, all of them and the ability we have to serve is dependent on having the appropriate (personal protective equipment) and the ability to keep them from getting ill.”

Madden said Maine is well-staffed for the levels of medical care the state typically sees, but a pandemic will mean hospitals will have to look for other opportunities like telehealth to provide back-up to physicians who are consumed with treating seriously ill patients.

In an executive order Wednesday, Gov. Janet Mills also announced relaxed licensing requirements for physicians, physician assistants and nurses, including the ability to receive an emergency license with no application fee; the ability to see patients through telehealth without a Maine license if the worker is already serving patients in another state; and the ability for those who are retired to reactivate their licenses immediately with no application fee.

“In general, the issues we’re running into aren’t really staff based,” Madden said. “It’s not that we don’t have enough doctors or nurses. It’s more that we don’t have the testing that we need and we don’t have the personal protective equipment. That’s where the bottlenecks are.”

J. Sam Hurley, director of Maine EMS, a division of the Maine Department of Public Safety, said the group has been working to provide guidance to its 276 member agencies around the state on how to reduce the risk of exposure and properly acquire and use personal protective equipment.

The number of COVID-19 patients who have required transport by ambulance to date was not available Friday from the Maine CDC. Maine EMS is not aware of any emergency clinicians who have been exposed to the virus and become symptomatic, although a small number have been removed from service as a precautionary measure, Hurley said.

In recent years, Maine’s emergency response system has been strained, especially in rural areas staffed by volunteers, and it can be difficult to recruit and retain clinicians.

“There has been some stress on our EMS system,” Hurley said. “We are wholly supportive and excited about our volunteer services that are providing incredible resources and services to communities. However, sometimes it is hard in the current climate to recruit volunteers. … We want to make sure we build a sustainable system that has the number of providers and responders that can respond to our emergencies on a daily basis, no matter whether it’s a pandemic or responding to the local car wreck that happened.”

While the month isn’t over yet, Hurley said so far there has been a “dramatic decrease” in calls for service among Maine EMS providers, but he expects that to change in the coming weeks.

“We’ve heard Dr. Shah refer to the lull before the storm and we’re preparing for that as well,” Hurley said.

At the South Portland Fire Department, Deputy Chief Phil Selberg said he also has noticed a similar trend in reduced calls for service, likely due to orders for people to stay home and avoid gathering in large groups.

First responders have been taking additional precautions by wearing personal protective equipment, adding additional screening questions to 911 calls and doing “doorway surveys” by asking people if they are experiencing symptoms before entering a home.

“For most of us the approach we’re taking is pretty much a first,” Selberg said. “I would liken it to a hazmat call, which is something we’re all sort of familiar and comfortable with, but it seems like every EMS call we go on now is a mini-hazmat call … what typically would have been a short 30- or 40-minute event turns into an hour or hour and a half.”

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