COVID-19 hospitalizations in Maine fell to 191 on Thursday, the lowest number in more than four months, as pandemic conditions continue to improve.

At the same time, however, Maine’s pandemic death toll climbed above 2,000 on Thursday.

Maine reported 53 additional deaths from COVID-19 in an update posted Thursday, bringing the total number of lives lost to 2,024 since the pandemic reached the state nearly two years ago.

The large number of deaths reported Thursday did not all occur this week, but resulted from a review of death certificates dating back weeks. Forty-nine of 64 deaths reported Wednesday and Thursday occurred from Jan. 23-31.

There are wide geographic disparities when it comes to deaths per capita in Maine, with Oxford County experiencing 23 deaths per 10,000 residents since the pandemic began and Knox County experiencing just 6 per 10,000. The least vaccinated counties have experienced far higher death rates than those with high vaccination rates.

Since July 1, 2021, months after vaccines became widely available, highly-vaccinated counties such as Cumberland and Sagadahoc had COVID death rates of 4.4 and 4.2 per 10,000 residents respectively. Counties with much lower vaccination rates, such as Androscoggin, Somerset and Franklin, experienced death rates about 2.5 to 3 times higher – 13.6 per 10,000 in Androscoggin, 13.4 in Franklin and 12.7 per 10,000 in Somerset County.

The majority of COVID deaths in Maine have been among older residents. About 70 percent – 1,417 – were in their 70s or older. About 22 percent – 94 deaths – were people younger than 50, and three of those who died were under 20 years old.

Deaths are included in the count if COVID-19 is identified as the cause of death, a contributing factor or if death by natural causes occurs within a certain timeframe after a person tests positive. For most of the pandemic, that period was 14 days, but it has been 30 days since Jan. 2.

That definition is believed to identify most deaths for which COVID was the cause or a contributing factor, although it does not include deaths that could be linked to undiagnosed cases.

Meanwhile, hospitalizations stood at 191 on Wednesday, a 56 percent decline from a peak of 436 on Jan. 13. It is the first time in four months that the number of inpatients statewide has dropped below 200.

The number of patients in intensive care dropped to 42 on Thursday, the smallest number since mid-August, when the delta variant was taking hold in Maine. Statewide, 15 patients were on ventilators Thursday.

Maine Medical Center in Portland reported Wednesday that it had begun resuming some procedures – such as knee and hip replacements – that had been postponed during the most recent surge. By late January, the backlog of surgical procedures had swelled to about 2,000.

As pandemic conditions improve, mask requirements are going away, with South Portland and Brunswick this week joining Portland, Freeport and Bath in rescinding the mandates. Some school districts have set dates for making masks optional, including those in Lisbon, Hermon and Oakland. Other districts, such as Lewiston, are considering mask-optional policies.

Maine does not have a school mask mandate, but the Maine Center for Disease Control and Prevention currently recommends indoor masking in schools, and most districts follow those guidelines. However, Dr. Nirav Shah, Maine CDC director, said the masking recommendation will be re-evaluated next week after the February break.

Maine is now the only New England state that has not set a date to ease its recommendation that masks be worn indoors at schools. New Hampshire, Vermont, Connecticut, Rhode Island and Massachusetts all plan to end such mandates or recommendations this month or next.

The U.S. CDC is also considering changing its indoor masking recommendations for schools.

The Maine CDC added 1,123 confirmed cases of COVID-19 on Thursday as it works through the backlog of positive tests. Since the pandemic began, Maine has recorded 224,048 cases of COVID-19.

Maine has whittled down the backlog of unprocessed positive COVID-19 tests from nearly 60,000 at the peak of the omicron wave to about 6,000 on Wednesday.

The state’s shift to a partially automated process for screening tests, together with a dramatic drop in the number of new tests submitted each day, have allowed CDC staff to catch up on several weeks’ worth of cases that had not made it into the state’s official count.

“Barring a significant increase in the number of positive results reported in the coming days, the backlog will likely be eliminated by the end of this week,” said Robert Long, Maine CDC spokesman, in an email  Wednesday.

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