Hospitalizations for COVID-19 in Maine ticked up in the past week, with a geographic pattern that parallels the wider distribution in new cases as the state experiences a record surge of positive tests.

Bridgton Hospital is one of the small hospitals in Maine that had COVID-19 inpatients this week.

Throughout the pandemic, COVID-19 inpatient admissions have been concentrated at major hospitals in Maine’s three southernmost counties. But this week’s increases were primarily at hospitals in other parts of the state, with an unprecedented number of small hospitals having inpatients at the same time.

The total number of COVID-19 inpatients statewide is still low compared to other states. The count stood at 17 Friday, according to Maine Center for Disease Control and Prevention, well below the peak of 60 on May 26. But the agency Friday reported a record-breaking 103 new cases of the disease, which is spreading at twice the rate of a month ago.

“It’s a strong warning for all of us,” said Dr. Dora Anne Mills, chief health improvement officer at MaineHealth, the state’s largest hospital network and parent of Maine Medical Center. “I would not say we are in a surge, but that we have all the ingredients for a surge and it’s baking.”

“We knew we would probably have a surge in the winter,” she added, “but I am concerned that all the ingredients are there and it’s still fall.”

In a given week during the crisis, one or two of Maine’s smaller hospitals might have reported having a pandemic inpatient or two for a few days but would go weeks or even months without one. But this week many of these smaller hospitals had inpatients, including Franklin Memorial in Farmington, Waldo General in Belfast, York Hospital, Bridgton Hospital and A.R. Gould in Presque Isle.

PenBay Medical Center in Rockport and Rumford Hospital both had a higher average daily inpatient load than Maine Med this week, reporting 2 and 1.3 cases, respectively. In PenBay’s case, this week’s total of nightly COVID-19 inpatient counts – 14 – represented two-thirds of the hospital’s total tally for the entire pandemic.

York Hospital had its busiest week since late August with 1.1 patients a day. Erich Fogg, who oversees COVID-19 testing at the hospital and its drive-thru rapid testing locate on Route 1, said it has also seen a steady rise in the proportion of tests coming back positive, with Thursday’s total count of 80 being the largest daily figure yet. “We’re heading into a concerning trend line,” he said.

Eastern Maine Medical Center in Bangor had its busiest week since July, averaging 1.7 COVID-19 inpatients a day for the period, while MaineGeneral in Augusta had 2.4 a day, its busiest week since the late May surge.

By contrast, Portland’s hospitals were both unusually quiet for the week ending Thursday, with Maine Med reporting an average of only 0.9 patients per day, down from the low-to-mid 30s per day during the disease’s peak surges in early April and late May. Mercy Hospital hasn’t had a COVID-19 inpatient since Sept. 28.

The largest hospital in York County, Southern Maine Health Care Medical Center, also had 0.9 patients per day, while Mid Coast in Brunswick last had a COVID-19 inpatient on Oct. 2.

Androscoggin County’s major hospitals were quiet. Central Maine Medical Center in Lewiston had 0.9 inpatients a day, less than half its burden in late September and the first half of October. Lewiston’s other hospital, St. Mary’s, had no COVID-19 inpatients at all for the period, whereas it had at least one every day from Sept. 26 to Oct. 19.

“The window is getting narrower to get this under control, and it’s all in our hands,” said Mills, a former director of the Maine CDC and younger sister of Gov. Janet Mills. “It’s the ‘three W’s’: Watch your distance, wear a mask, and wash your hands.”

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 three ways: recovery, death or transfer to another facility.

The Press Herald’s survey is for the seven days ending Oct. 29. It compiles data received 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. The survey includes most of the state’s hospitals and accounts for the vast majority of the statewide hospitalizations reported each week by the Maine CDC.