Hospitalizations for COVID-19 continue to surge across Maine, breaking records both for simultaneous statewide hospitalizations and for patients in intensive care, with much of the burden occurring at medical centers serving central, western and eastern Maine.

The total number of confirmed COVID-19 inpatients statewide hit 90 on Friday, according to the Maine Center for Disease Control and Prevention, 50 percent higher than the worst day of the spring surge. Worryingly, the majority of these inpatients were in intensive care – 49 statewide, the highest level since the pandemic began and far above the spring surge peak of 27.

“The concern is that we’re approaching half of our capacity for ICU beds and that we appear to be early in the surge curve and we’ve got a major holiday coming up, which could result in many thousands of small super-spreader events,” said Dr. Dora Anne Mills, chief health improvement officer at MaineHealth and a former Maine CDC director. “I’m worried about two to three weeks from now when we’re a week to two weeks past Thanksgiving.”

Eastern Maine Medical Center in Bangor is bearing the biggest burden of any hospital in the state, with an average of 14.3 confirmed COVID-19 inpatients treated each day for the week ending Thursday. That figure represented a pandemic high for the hospital, the tertiary care center providing specialists and advanced treatment for much of eastern and northern Maine, and was well above the average of 8.9 for the previous week and 4.7 the week before. By comparison, EMMC had gone the entire month of September without admitting a single such patient and had only a handful in August and the first half of October.

“We are handling the current volume without trouble,” said Dr. James Clarke, senior executive physician at EMMC, who noted all the months they had to learn about the coronavirus and prepare for a surge. “But we’ve seen across the country where the numbers can get high enough that local resources can get overwhelmed, and we’re not exempt from that. We’re nowhere near that now, but it would be foolish for anybody to believe that it couldn’t happen here.”

“We’re asking for the public’s help,” Clarke added. “To wear a mask, to practice social distancing, to avoid gatherings, including at Thanksgiving.”

MaineGeneral broke its record for confirmed COVID-19 inpatients for the third week running with an average of 12.1 treated each day for the week ending Thursday, up from 9.9 the previous week. During the summer months, there were many weeks when Augusta hospital had no COVID-19 inpatients at all.

For most of the pandemic, Maine Medical Center in Portland has treated about half of the state’s COVID-19 inpatients, as it serves as the tertiary care hub for the populous southwestern third of state. But in the new surge, the hospital has not seen as sharp a rise as its counterparts further up Interstate 95. MaineMed’s COVID-19 inpatient burden of 9.4 a day was actually down from last week, when it stood at 9.9, though higher than the 3.6 the week before. It is also far below the peak levels of the spring surge when it was treating more than 30 COVID-19 inpatients at a given time.

Over the past week, as forecasting models predicted the hospitalization surge would continue for weeks, officials at all three hospitals and at Central Maine Medical Center in Lewiston told the Press Herald that they would be able to meet the demand by shifting staff and beds from elective surgeries if necessary. But they also expressed concern about their own staffs getting exposed while off-duty, which would create ripple effects in a state that had shortages of nurses and respiratory technicians even before the pandemic struck.

Maine CDC Director Dr. Nirav Shah said Friday that hospitals are better positioned now than in the spring, but that “the system has fragility” as it depends on having enough healthy staff members to take care of patients. As of Friday, 1,457 Maine health care workers had tested positive for COVID-19 during the pandemic, an increase of 21 since the day before.

Both of Lewiston’s hospitals also broke COVID-19 hospitalization records this week. These more than doubled at CMMC, going from 2.9 per day last week to 6.6 this week. It had 1.7 two weeks ago and 0.9 the week before that. The city’s other hospital, St. Mary’s, had its busiest week ever with an average of 4.3 COVID-19 inpatients a day, up from 1.6 the previous period.

For those acutely affected by the disease, hospitalizations typically trail initial exposure to the disease by one to three weeks, suggesting that the trend will get worse given the rapid ongoing surge in newly diagnosed cases. Over the past three weeks, Maine has repeatedly broken its daily record for new COVID-19 cases, suggesting the hospitalization surge will continue to grow.

Hospitalizations rose at both of York County’s hospitals. Southern Maine Health Care Medical Center in Biddeford, which had an average of 4.4 daily COVID-19 inpatients this week, up from 3.1 the week before. York Hospital in York, a much smaller facility, set an all-pandemic record of 4.1 per day, up sharply from 1.4 the week before, with an all-time high of six such patients treated Wednesday and Thursday.

Mercy Hospital in Portland remained quiet with an average of 3.0 patients a day, up from 1.7 last week. Brunswick’s Mid Coast Hospital averaged 1.9 per day this week, down from 3.6 last week.

During the spring and summer, it was typical to have one or two of Maine’s smaller hospitals report having a pandemic inpatient or two for a few days and then go weeks or even months without one. But for the past month many of these smaller hospitals have had inpatients at the same time. In the week ending Thursday, these included Franklin Memorial in Farmington, Waldo General in Belfast, Sebasticook Valley in Pittsfield, PenBay Medical Center in Rockport, Inland Hospital in Waterville, Blue Hill Hospital, A.R. Gould in Presque Isle, Maine Coast Hospital in Ellsworth and Mayo Regional in Dover-Foxcroft, which had COVID-19 inpatients for the first time, including three on Wednesday alone.

Hospitalizations are a lagging indicator in that they typically occur one to three weeks after a person is exposed to the disease, but unlike other metrics, it is not dependent on who and how many people were tested. They can end in three ways: recovery, death, or transfer to another facility.

The Press Herald’s survey is for the seven days ending Thursday. It compiles data directly from the hospitals and hospital networks. The data do not include outpatients or inpatients who were suspected of having the virus but never tested. It includes most of the state’s hospitals and accounts for the vast majority of the statewide hospitalizations reported each week by the Maine CDC.