Exactly one week after Thanksgiving, Maine set a record with 346 new cases of COVID-19, a sign that the post-holiday pandemic surge health officials predicted has likely arrived.

Thursday was the first time daily cases have gone over 300 and the eighth time in the last 10 days that cases have eclipsed 200, according to data from the Maine Center for Disease Control and Prevention. The only days with less than 200 cases were Thanksgiving, when the state lab was closed, and the day after, when there were fewer tests to process.

The new record exceeds the previous high set last month by 91 cases.

Dr. Cathleen London, a family medicine physician in Washington County, said there is no question Thursday’s spike is connected to the holiday. She said she’s increasingly frustrated that people are still not taking this seriously.

“How do you make people care about everyone else?” she said. “We live in a society, we don’t live on an island. I think that’s the most frustrating part.”

Pedestrians walk up Congress Street in downtown Portland last week. Brianna Soukup/Staff Photographer

Since the pandemic reached Maine in March, the CDC has tracked 12,554 confirmed or probable cases and 220 COVID-related deaths, including two additional deaths that were reported Thursday, a man in his 50s from Penobscot County and a man in his 60s from Hancock County.

So far in December, seven people have died from COVID-19. Last month, 67 deaths were recorded, the highest of any month yet and more than June, July, August, September and October combined.

Many of the recent deaths have been residents of long-term care facilities. Rick Erb, president of the Maine Health Care Association, which represents nursing homes, said the current surge has been far worse on elder facilities than the spring.

“This is really rough,” he said. “All the predictions about when the surge would happen have been correct. And it’s more likely to get worse.”

Erb said one of the biggest challenges now is staffing. The number of workers who either test positive or have to quarantine because of possible exposure is growing. He said his members are working with the state on implementing training for replacement staff, but said nursing homes are “not the first place people are looking to work.”

“This is a very hard time for staff,” Erb said. “It’s both the emotional impact and just the fatigue. This has been going on for 10 months and it’s really showing on people.”

The seven-day average of new daily cases stood at 186 on Thursday, down from 220 a week ago. But the last seven days have included days of zero cases on Thanksgiving and 22 the day after. The seven-day average this time last month was 101 cases. Two months ago, it was 31 cases.

The number of active cases Thursday, 2,601, is 175 more than Wednesday and has more than doubled in a month. New cases were reported in every county except Knox. Cumberland County led the state with 60 cases, followed by York with 58, Penobscot with 53 and Oxford with 52.

As of this week, every county in Maine except Aroostook was seeing high or substantial community transmission, which is defined as a new case rate greater than or equal to 16 per 10,000 people over the last 28 days. This time last month, there were five counties with high transmission.

The highest rate of transmission is in Androscoggin County, 55 people per 10,000, followed closely by Somerset, with 52 people per 10,000. Aroostook County’s rate of 10 people per 10,000 is defined as moderate community transmission.

The Maine CDC this week updated case counts for individual zip codes. There are now 23 zip codes with at least 100 cases, including all of Portland’s zip codes, as well as cities like Lewiston, Biddeford and Sanford and smaller communities like Alfred and Cape Elizabeth.

One month ago, on Election Day, Maine set what was then a single-day record of 127 new cases. That number has been eclipsed 27 times in the last 30 days.

There were 144 people hospitalized with COVID-19 in Maine on Thursday, six more than a day earlier, including 43 in critical care and 19 on ventilators. One month ago, there were 31 people in the hospital.

Maine hospitals have been preparing for the expected surge and many have converted beds to critical care. Some are considering suspending elective surgeries again. And like staff in nursing homes, hospital employees are feeling the weight, too.

“Our health care teams are really starting to wear down,” Dr. Joan Boomsma, MaineHealth’s chief medical officer, told the Press Herald this week. “People are exhausted, and at the rate things are going we are going to need everybody’s help in containing this thing.”

Maine Medical Center added further restrictions on visitation, effective Friday, in response to the surge in cases. The updated policy spells out limits on the number of visitors for different types of inpatients and outlines procedures for dropping off and picking up outpatients. COVID-19 patients are not allowed visitors except at end of life.

On Wednesday, the number of individuals hospitalized across the country went over the 100,000 mark for the first time, according to the COVID Tracking Project. Additionally, the U.S. recorded 3,157 deaths on Wednesday, according to Johns Hopkins University, easily beating the record of 2,603 set on April 15.

The surge in new cases, hospitalizations and deaths comes as pharmaceutical companies and the federal government prepare to authorize the distribution of vaccines. Maine, like other states, has been preparing for shipments of a COVID-19 vaccine, perhaps as soon as this month. On Wednesday, Gov. Janet Mills said the state learned that it would be getting about 12,000 doses of Pfizer’s vaccine, about one-third of what it was expecting.

“This is far less than what is needed for Maine and proportionally for other states as well,” Mills said at a news conference.