COVID-19 hospitalizations in Maine continued an upward climb on Monday with 130 people hospitalized, the most since March 9. While hospitalization increases are concerning, public health experts are not projecting a return to the winter surges the omicron wave caused in Maine and the U.S.

The number of hospitalized patients increased from 116 on Sunday, the Maine Center for Disease Control and Prevention said. The number of patients in critical care remained relatively steady, increasing by one patient to 25 on Monday. Three patients were on ventilators, up from two on Sunday.

Maine’s COVID-19 hospitalizations had remained nearly flat since March 18, hovering between 90 and 100 patients before spiking by 26 patients – a 25 percent increase – during the past two days. The long plateau occurred after a steady drop from a peak of 436 hospitalizations on Jan. 13.

Unvaccinated people represent roughly 67 percent of the COVID-19 patients treated in Maine hospitals since vaccines became readily available through April 15, according to the Maine CDC website.

Dr. Dora Anne Mills, chief health improvement officer for MaineHealth, the largest health care provider in the state and the parent organization of Maine Medical Center, said it’s “unlikely” that Maine will see a return to winter hospitalization levels despite the recent increases.

“We have a very high immunity wall to protect against hospitalizations,” Mills said, explaining that vaccination and prior infections to omicron offer protection against the omicron BA.2 subvariant. There also is increasing access to COVID-19 treatments, such as the oral medication Paxlovid, which wasn’t readily available in January.

Mills said increasing awareness of Paxlovid among patients and health care providers is a key to keeping hospitalizations down. While not everyone who contracts COVID-19 is eligible for Paxlovid, Mills said there are many common risk factors that would make people eligible. They include obesity, a sedentary lifestyle, high blood pressure, diabetes and asthma. The Biden administration also is expected to broaden eligibility criteria to Paxlovid later this week, according to news reports.

When taken within five to seven days of the onset of symptoms, Paxlovid can reduce hospitalizations by up to 90 percent.

Another factor working in favor of the public health effort is research indicating that people who were infected with BA.1 omicron still have immunity against the BA.2 variant, Mills said.

Maine’s high vaccination rate – about 75 percent of the total population – also will help blunt hospitalization increases, Mills said.

Breakthrough cases of COVID-19 are possible for people who are vaccinated, but they are less likely to lead to severe disease and require hospitalization.

Recent U.S. Food and Drug Administration approval of a second booster shot also will help reduce hospitalizations. The Biden administration recently made everyone 50 and older eligible for a second booster shot, with a strong recommendation to do so for seniors and those with high-risk health conditions.

Maine CDC Director Dr. Nirav Shah tweeted Monday encouraging Maine residents to get their vaccinations:

“In discussions with hospitals, the increases are all across the state. And the majority are hospitalized *for* COVID, not with COVID. At one hospital system, 80+% of the inpatients were admitted *for* COVID treatment.”

‘A HILL, NOT A MOUNTAIN’

Case counts also have been increasing in Maine, from a seven-day daily average of about 200 in recent weeks to 278 on Monday. The Maine CDC does not update case counts over the weekend, so the next release of case count data will be Tuesday, representing cases from Saturday, Sunday and Monday.

Dr. Laura Blaisdell, a South Portland pediatrician and infectious disease expert, said she is “relatively reassured” that the health care system will not be overwhelmed this spring despite the recent increase in hospitalizations.

“We should not be shocked that we are seeing an increase in cases and hospitalizations,” Blaisdell said, pointing to relaxed public health measures such as the suspension of mask mandates.

But Blaisdell agreed with Mills that vaccination levels and prior infection should help keep any surges to a “hill, not a mountain.”

“Cases are going up, but they are not going up with that same velocity that we saw with delta and omicron,” Blaisdell said.

Nationally, hospital admissions are up 6.6 percent on a seven-day average, and up 6.5 percent in the Northeast. Cases are up about 20 percent during the past week across the United States.

WASTEWATER SHOWS MIXED RESULTS

Meanwhile, COVID-19 wastewater testing from the past week is showing mixed results, but many sewer districts in Maine are reporting decreases in virus prevalence. Bangor, which had experienced a recent surge in virus levels in its wastewater, dropped to about 220,000 copies of the virus per liter of wastewater, a decline of about 80 percent compared with recent weeks.

Lewiston-Auburn also saw steep declines in virus prevalence in its wastewater. The Portland Water District’s wastewater plants in Westbrook and in the East End have seen upticks but remain at relatively low levels.

Brunswick, Belfast, York, Calais and Fort Kent are reporting substantial drops in virus prevalence in wastewater, but Houlton recorded a sharp increase. Augusta’s numbers are relatively the same and remain at an elevated level.

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