The number of COVID-19 patients in Maine hospitals has spiked again, climbing back over 200 less than two weeks after falling as low as 152.

Officials said the increase in hospitalizations is especially difficult because hospitals face challenges discharging patients who need to be moved to nursing homes or other long-term care facilities that don’t have adequate staffing.

As of Monday, 201 people were in Maine hospitals, including 68 in critical care and 31 on ventilators, according to data from the Maine Center for Disease Control and Prevention. That’s an increase of 32 hospitalizations just since Saturday.

The number of hospitalizations reached 235 in late September – the highest number since the pandemic began. By Oct. 7, the number had fallen to its lowest total since the peak of the delta variant surge, but it has been rising steadily since and spiked again in the past two days.

Since the pandemic reached Maine in March 2020, 2,655 individuals have been hospitalized at some point with COVID-19, and 1,095 people have died with the virus.

Most of the people hospitalized in Maine, and especially those in critical care, have been unvaccinated. Vaccinated patients who contract breakthrough cases of the virus and end up hospitalized often have an underlying condition that made them vulnerable to more severe illness.

Within the MaineHealth system, there were 64 people hospitalized on Monday, including 30 in critical care and 15 on ventilators. Among those in critical care, all but five were unvaccinated. Similarly, in Northern Light Health’s system, 17 of 22 patients in the ICU with COVID-19 were unvaccinated.

Steven Michaud, president of the Maine Hospital Association, said hospitals have been dealing with more than just an influx of COVID-19 patients.

“Much of our problem is throughput,” he said. “In other words, moving patients to their most appropriate care setting once they no longer need hospitalization.”

The ongoing workforce shortage in nursing homes and other long-term care facilities has led to many of them halting new admissions. Several nursing homes also have closed in recent weeks because of the staffing crisis, further reducing bed capacity around the state. That means patients preparing to be discharged from the hospital don’t always have an immediate place to go.

“So as nursing homes cut back it has a direct impact on us so we not only have a COVID surge to contend with but we are as busy as we’ve ever been with non-COVID patients and we have these backups,” Michaud said. “It’s a toxic soup.”

John Porter, spokesman for MaineHealth, said officials there are still trying to determine if recent hospitalizations are a sign of increased virus spread or if there are other factors at play, including whether there are difficulties with discharging patients.

Similarly, Karen Cashman, spokeswoman for Northern Light Health, said hospitals in their network are having a hard time with that.

“This is because of the decreasing number of those beds available in Maine due to a variety of reasons – including facility closure,” she said. “The result is some patients stay longer in hospitals than they need to simply because there is no skilled nursing bed to send them to. When appropriate and when it is safe to do so, we are also transitioning some patients back home with home-care physical therapy and occupational therapy support.”

The sudden increase in hospitalizations comes after new cases had fallen in recent weeks. The Maine CDC no longer releases new COVID-19 case data on Mondays, but, as of Saturday, the seven-day daily case average stood at 402. That’s down from 607 cases on average two weeks earlier, although caseloads ticked up late last week, Maine’s positivity rate also has been increasing. Two weeks ago, the seven-day average percentage of tests that came back positive was 4.3 percent. On Monday, it stood at 5.4 percent.

Across the country, cases, hospitalizations and deaths from COVID-19 have been trending downward, but many areas still are seeing high levels of virus transmission. According to the U.S. CDC, hospitalizations are averaging 52,766 per day, which is down from more than 90,000 this time last month. The average number of new daily cases has been about 80,000, about half what it was in early September.

According to a tracker by the Washington Post, hospitalizations have declined nationwide by 8 percent in the last week, but 16 states saw increases. Maine and three other New England states are among the top five.

While Maine is among a minority of states seeing an increase over the past week, its rate of hospitalization – 14 per 100,000 people – remains lower than 34 other states and lower than the national rate of 18 per 100,000.

Vaccinations, meanwhile, have picked up in Maine in recent weeks, a trend largely attributable to additional doses of the Pfizer vaccine for older individuals.

As of Monday, Maine has administered 894,984 final doses of either Pfizer or Moderna vaccine, or the one-shot Johnson & Johnson vaccine. That represents 66.6 percent of all Mainers and 75.6 percent of those 12 and older who are eligible.

The state also has now administered 61,546 third doses.

Federal officials are expected to rule soon on approving the Pfizer vaccine for children between 5-11. Additionally, boosters for the Moderna and Johnson & Johnson vaccines are under review.

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