Gov. Janet Mills activated the Maine National Guard on Wednesday to help hospitals straining to care for a flood of mostly unvaccinated COVID-19 patients.

“To address the increasing strain on hospitals and to maintain access to inpatient health care services, the governor today signed a directive activating up to 75 additional members of the Maine National Guard who will be used in non-clinical support roles to expand capacity at health care facilities,” Mills’ office said in a news release. Some Guard members already had been deployed to help with vaccination and testing efforts.

The Guard is expected to be deployed at least until the end of January.

The state’s largest hospital networks also announced new steps Wednesday as they scramble to maintain capacity amid record numbers of patients.

At Maine Medical Center in Portland, hospital officials are closing six general surgery operating rooms to free them up for COVID-19 patients, and all joint replacement surgeries are now being postponed. The hospital, which already had delayed some elective surgeries, ran out of critical care beds at some points this week and had to divert patients away from its emergency department.

“We’re running out of straws,” said Dr. Andrew Mueller, CEO of MaineHealth, the parent entity of Maine Med. “There’s not a lot of great options left.”

The announcements came after the state reported a record 1,275 new cases and eight additional deaths Wednesday. And hospitalizations continue to break records, with a record 379 people hospitalized for COVID-19 on Wednesday, including 117 in intensive care and 60 on ventilators.

The National Guard will be used in non-clinical roles to provide support for nursing homes and other facilities where patients are discharged from hospitals. One of the bottlenecks in the system is that staffing shortages at nursing and rehabilitation facilities cause delays in hospital discharges, further straining hospital capacity.

Another mission for the National Guard will be to support staff at clinics that administer monoclonal antibodies to patients who have early stage COVID-19. The infusion of antibodies can help prevent hospitalization. By having the National Guard help with non-medical duties, health care workers can be redeployed in other areas of the health care system, relieving pressure on hospitals.

Jeanne Lambrew, Maine’s health and human services commissioner, said the dynamic nature of the health care system makes it difficult to predict to what extent the Guard deployment will improve capacity, but it will free up “dozens of beds” for patients statewide.

Maine Army National Guard Sgt. Nicholas Whitmore prepares a dose of a COVID-19 vaccine Wednesday during the mass vaccination clinic at the Augusta Armory. The free walk-in clinic is expected to be open through at least the end of 2021. The Guard is also being called upon to help hospitals cope with surging numbers of COVID-19 patients, Gov. Janet Mills announced Wednesday. Joe Phelan/Kennebec Journal

Maine also is requesting federal help from the Biden administration. If approved, the federal government will send “surge response” teams of doctors, nurses and certified nursing assistants to help staff at Maine Med and at Central Maine Medical Center in Lewiston.

“Taken all together these actions we hope will alleviate the strain on our health care system,” Mills said during a media briefing Wednesday.

VACCINATIONS STILL KEY

Mills urged Mainers who haven’t yet been vaccinated to get their shots, which public health experts say is the best way to avoid hospitalization.

“Maine people must all step up to this challenge, too,” Mills said. “Get vaccinated, please.”

But Mills, when pressed about imposing new restrictions to curb the virus, such as mask mandates and vaccination requirements to enter indoor public areas, said those measures are not under consideration. She said vaccines have been available for months, and she cast the issue of getting vaccinated as a personal responsibility, not only for individuals but also for their families, friends and neighbors.

“People have to take it upon themselves to keep themselves safe,” Mills said.

Hospitals, meanwhile, are bracing for the situation to get worse before it gets better.

Mueller said they have “great concerns” about the pandemic this winter, and expect to see more surges related to holiday gatherings.

“We don’t think we’ve seen the full brunt of this surge, and probably won’t for two to three weeks,” he said.

Dr. Joel Botler, chief medical officer at Maine Med, said postponements have grown from 30 percent of elective surgeries – about 1,500 surgeries delayed – several weeks ago to currently about 50 percent, or 2,000 surgeries postponed, as unvaccinated COVID-19 patients overwhelm hospitals.

Botler said that although the surgeries may be classified as “elective” and can be delayed temporarily, they are surgeries that are needed.

“These surgeries are joint replacements, like hip and knee replacements, spinal surgery,” Botler said. “These are all patients in a lot of pain. These are people who need surgeries done, so they can do their work and activities of daily living.”

‘UNPRECEDENTED TIMES’

By delaying surgeries and closing operating rooms for COVID-19 patients, Botler said Maine Med can increase its capacity by eight to 12 intensive care patients, depending on that day’s staffing levels. Botler said the hospital cared for 50 COVID-19 patients on Monday, including 16 in intensive care, and the hospital reached capacity for that day. The six closed operating rooms are on top of six that were previously closed to make room for COVID-19 patients.

Dr. Christine Hein, a Maine Med emergency department physician, said patients are waiting in hallways and waiting rooms for beds to open up.

“This is absolutely unprecedented times we are experiencing right now,” Hein said.

MaineHealth officials pleaded with those who are still unvaccinated to get their shots, which will help alleviate conditions at the hospital, and protect yourself, family and friends.

Mueller said that while some vaccinated patients are hospitalized, it’s those who are unvaccinated who are “very sick, here for an enormous amount of time” and take up a “tremendous amount of resources.”

“When we step back and look at those patients, 90 plus percent (of ICU patients) are unvaccinated,” Mueller said. “Those who are vaccinated have significantly less risk of severe disease.”

Dr. Ryan Knapp, chief medical officer at Stephens Memorial Hospital in Norway and an active emergency medicine physician, said the 25-bed rural hospital is often full, and the only reason two beds were available on Wednesday is because two patients died. He declined to say whether they were COVID-19 patients, citing patient privacy.

“Now what we’re seeing is there is a significant burden in the rural counties like Oxford County – where our hospital is – that have very low vaccination rates and, therefore, we’re seeing very high COVID infection rates,” Knapp said.

BIGGER ROLE FOR RURAL HOSPITALS

Rural hospitals are taking on a larger role to care for COVID-19 patients. While such patients were previously diverted to Maine Med or other large hospitals, smaller hospitals such as Stephens Memorial are now caring for COVID-19 patients.

“What you see in the statistics, we feel every day when we come to work,” Knapp said.

Hein, the Maine Med emergency room doctor, said it’s difficult to see patients with severe COVID-19 – even if they don’t die they could suffer from lifelong complications – knowing that it could have been prevented by a vaccine.

Northern Light Health, the state’s second largest hospital network has begun delaying some medical procedures on a case-by-case basis because of the statewide strain on the health system.

Starting Friday, Eastern Maine Medical Center in Bangor will postpone some surgical procedures that could involve hospitalization, such as spinal surgeries or joint replacements, said Dr. James Jarvis, Northern Light Health’s physician incident commander. The network could be forced to delay more procedures if cases climb much more, he said.

“The current situation is more critical than it has been at any point in the pandemic,” he said.

Since the pandemic began, Maine has reported 125,373 cases of COVID-19, and 1,356 deaths. The high numbers on Wednesday are partly a reflection of the Maine CDC “catching up” from cases from previous days, as often there’s a lag in tallying cases from the weekend, when the agency does not report new numbers. For instance, Tuesday’s reported three-day total of about 325 cases per day was significantly lower than the daily numbers reported last week, when the Maine CDC was reporting about 800 to 900 cases per day.

“There are now more positive test results coming in than we can process on a single day,” Dr. Nirav Shah, the Maine CDC director, said during Wednesday’s media briefing. “The pandemic is at its peak and we expect the numbers to stay at current levels and likely increase in the coming days.”

RECORD PEDIATRIC PATIENTS

As of Wednesday, Maine hospitals were caring for a record seven COVID-19 pediatric patients, including three in intensive care, Shah said.

Meanwhile, scientists are studying a new coronavirus variant, omicron, that may be more contagious than the delta variant, which is currently the most widespread in the United States. But it’s unknown whether omicron causes more- or less-severe cases, on average, than delta. So far, no omicron cases have been detected in Maine, but it has been detected in at least 19 states.

Early indications are that omicron might cause milder cases than the delta variant, Dr. Anthony Fauci, the White House’s chief medical officer, said in a media briefing Tuesday.

“It might be, and I underscore might be, less severe as shown by the ratio of hospitalizations per number of new cases,” Fauci said.

Scientists also are examining the effectiveness of the current vaccines against the omicron variant. All people 18 and older are advised to get a booster shot of the COVID-19 vaccine if they received the two-dose Pfizer or Moderna vaccine series at least six months ago or they received the single-dose Johnson & Johnson vaccine at least two months ago.

To meet increasing demand, especially for booster shots, the Mills administration has opened a new COVID-19 drop-in vaccination clinic at the Augusta Armory, 170 Western Ave. The clinic, operated by the Maine CDC, Maine Emergency Management Agency and the Maine National Guard, is offering free Pfizer, Moderna and Johnson & Johnson vaccines for anyone 5 and older.

“Vaccination remains the best and most effective way to protect your health and that of your loved ones,” Mills said in a statement. “I encourage all Maine people to take advantage of this new drop in clinic in Augusta, which will be open after typical work hours, to get their free vaccine today.”

The clinic will initially be open from 9 a.m. to 4 p.m. on Wednesday, noon to 7 p.m. on Thursday and 9 a.m. to 4 p.m. on Saturday. The clinic is expected to be open through at least the end of 2021, although hours and days that it is open may vary in the coming weeks.

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