The number of people requiring intensive care for COVID-19 statewide this week hit levels approaching the worst periods of the winter surge, a problem driven by unvaccinated people coming down with severe cases of the disease.
Major medical centers across the state report a dramatic change in the proportion of acutely affected people requiring intensive care even as patient ages have plummeted. More contagious variants of the coronavirus that have become dominant in the United States are presumed to be at least partly to blame.
Dr. Joan Boomsma, chief medical officer for MaineHealth, the state’s largest hospital network and parent of Maine Medical Center in Portland, said that during the winter surge about 3 in 10 of its patients hospitalized with COVID-19 required intensive care, but that now the proportion is at least 6 in 10.
“The good news is that we are seeing vaccinations work in the older populations that have been vaccinated – they’re not in the hospital or becoming critically ill,” Boomsma said. “But there does seem to be a higher percentage of younger age groups that are getting very sick, and that could be because the new variants are more virulent.”
Northern Light Health, the state’s second largest hospital network, has seen a similar shift, said Dr. James Jarvis, the network’s physician incident commander, with nearly half of all patients admitted to Eastern Maine Medical Center in Bangor requiring ventilators.
“The number of COVID inpatients is smaller, but they are significantly sicker,” he said. “We’re not talking about people in their 70s or 80s anymore, but individuals who are under the age of 50, and that’s concerning.”
The ratio is especially extreme at Central Maine Medical Center in Lewiston, which – unique among the state’s major hospitals – has been experiencing its heaviest COVID-19 inpatient burden in recent weeks and set a single-day record of 21 such patients Wednesday. Sixteen of those patients, or more than three-quarters, were in the ICU.
“It’s a frightening shift – it’s not even subtle,” said Dr. Al Teng, chief of critical care at CMMC’s parent, Central Maine Healthcare. “Patients who were critically ill in previous COVID waves were in their 60s, 70s and 80s, but now we’re seeing them in their 20s. It’s quite a stark progression.”
The average age of hospitalized COVID-19 patients at MaineHealth’s member hospitals had stood in the mid-60s in January, Boomsma said, but fell to 58 for the month of March and 50 for April. Now it’s about 45.
None of those in the ICUs of the 25 member hospitals of the three networks had been fully vaccinated, and senior doctors from the three networks were unaware of any having been admitted to their hospitals at all, though a handful of partially vaccinated people had.
“A lot of people are getting their first dose of the Pfizer or Moderna vaccine and then are not coming back for the second one,” Teng said. “I can tell you with certainty that one dose of either will not be nearly as protective against severe illness as for those who complete their vaccinations.”
Statewide there were 49 confirmed COVID-19 patients in Maine ICUs Thursday and 80 inpatients in non-intensive care. During the worst of the winter surge in late December and early January there were 40 to 70 ICU patients a day, but that was at a time when there were typically 130 to 140 non-ICU patients across the state.
Hospitalizations for COVID-19 have been creeping steadily upward for the past month statewide, a trend reflected in the numbers reported by Maine Med, EMMC, MaineGeneral in Augusta and other hospitals. But CMMC continues to break its records for the number of confirmed COVID-19 inpatients it has been treating, and eight have died from the disease there since April 20 compared to three in all of March, four in February and three in January.
The three doctors said their hospital systems were prepared for the burden and were not scaling back elective procedures and other forms of care, although Jarvis said EMMC had hit full occupancy on several days recently, requiring new patients to be sent elsewhere for admission. “That’s nothing new in the state of Maine, but it usually happens later in the summer, when our population swells,” he said. “That’s another word of caution.”
Boomsma urged people to continue to take the pandemic seriously, especially those who are not yet fully vaccinated.
“Young people who think they can’t get sick or in the ICUs are being transported to our ICUs from all over the state,” she said.
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