Cumberland County and the midcoast region were reclassified as high risk for COVID-19 on Thursday as the statewide number of hospitalized patients with the virus spiked to 193, the highest level since late February.

Maine’s patient count rose by 24 individuals, or 14 percent, over the previous 24 hours after gradually increasing during the past few weeks from about 100 to 169. Of the patients hospitalized Thursday morning, 33 were in critical care and three were on ventilators.

The Maine Center for Disease Control and Prevention also reported 699 new cases Thursday and eight additional deaths.

The U.S. Centers for Disease Control and Prevention reclassified Cumberland County, as well as six other Maine counties, as being at “high” risk based on the number of new infections reported in the last seven days, new COVID-19 hospital admissions and the percent of staffed inpatient beds in use by COVID-19 patients. The other high-risk counties classified as such Thursday are Lincoln, Knox, Sagadahoc, Hancock, Penobscot and Piscataquis. Aroostook County was already considered high risk before Thursday’s update.

Every other county is considered “medium” risk with the exception of Androscoggin, which remains “low” risk. The CDC says people in high-risk communities should wear masks indoors in public places.

A sharp increase in new cases over the past three weeks – including more than 1,000 on Tuesday and Wednesday – resulted in Maine having the highest infection rate among all states, according to the U.S. CDC.

As of Wednesday, Maine had reported 372 new cases per 100,000 residents over the previous seven days, nearly three times higher than the national average of 130 cases, according to the U.S. CDC. Maine is followed closely by Rhode Island, Vermont and New York.

Infections have spiked over the past few weeks in Maine and other Northeast states as new and more contagious versions of the virus spread across the region. The omicron BA.2 subvariant and two closely related subvariants – BA.2.12 and BA.2.12.1 – now account for 80 percent of the new infections in Maine, according to data released by the state.

The surge in Maine’s COVID cases is consistent around the state, and there is no specific region showing a significantly higher rate of COVID than any other, according to MaineHealth, the parent organization of Maine Medical Center in Portland and seven other Maine hospitals.

With exceptions, there are two major groups of people admitted to hospitals specifically because of COVID, said Dr. Dora Anne Mills, chief health improvement officer for the MaineHealth and former state CDC director. Those are older, vaccinated people and younger, unvaccinated people.

Although the number of patients hospitalized in the MaineHealth network with COVID has rapidly increased, about two-thirds of those people are now hospitalized because of the virus and the other one-third are in the hospital for other reasons but tested positive. Maine’s CDC reports only the number of patients with COVID and does not separate out those who are hospitalized for other reasons.

MaineHealth has found 1 in every 25, or 4 percent, of people admitted to the hospital for non-COVID conditions happen to have the virus, according Mills. That is significantly lower than the percent of people admitted to the hospital who coincidentally had COVID during the January omicron wave, when around 1 in 10, or 10 percent, of hospital patients were coincidentally positive.

The percentage of COVID patients in critical care was also higher in January, said Mills. Out of all of the state’s patients currently hospitalized with COVID, around 17 percent are in critical care. In January, about 25 percent of all patients statewide were in intensive care.

People are generally moved to critical care when they are experiencing a life-threatening condition. “People can be quite sick before moving into critical care,” Mills said.

MaineHealth is also seeing patients who have had COVID multiple times, including some who were sick with omicron in January and then caught a new subvariant of the virus. One study that has not yet been peer-reviewed said some people have gotten BA.2 shortly after getting BA.1 but that those occurrences are rare.

Although the number of COVID patients in critical care remains low, hospitals are still strained, just for other reasons, said Mills.

Strokes, mental health conditions, addiction and diabetes were just some of the conditions patients are coming to the hospital with in higher than pre-pandemic numbers, said Mills. She pointed to a few reasons for this, including stressors from the last few years, a bottleneck caused by people who delayed care during the pandemic and the COVID infection itself, which has been showed to increase the risk of certain health conditions.

Public health officials including Mills continue to encourage Maine residents to protect themselves from contracting COVID by masking, getting vaccinated and boosted, choosing to gather outdoors when possible and testing regularly.

Unvaccinated people have made up 67 percent of COVID hospitalizations since vaccines became readily available last year. More recently there have been a higher number of vaccinated COVID patients compared to unvaccinated COVID patients.

Mills said around 40 percent of MaineHealth’s patients with COVID are unvaccinated. “That compares with less than 10 percent of the general population (who are unvaccinated), showing how much more risk there is for severe infection if one is unvaccinated,” she said.

Public health officials say the increased percentage of vaccinated patients does not mean vaccines are any less effective, but that the pool of Mainers without any COVID immunity – those without a vaccine who also have not previously been infected – has shrunk. Mills said vaccinations continue to protect against serious illness and contracting the virus.

The situation is similar at the Northern Light Health network facilities, which include Mercy Hospital in Portland and Eastern Maine Medical Center in Bangor.

Northern Light officials said they have a mix of COVID patients who were admitted for COVID and patients who were admitted for other reasons but happen to have COVID. Over the past few weeks, the network has seen a spike in patients admitted for COVID.

Out of 44 patients with COVID early Thursday afternoon, five were in critical care, according to Patricia King, associate vice president of marketing and communications at Northern Light Health. Although the severity of the virus for the other COVID patients is varied, officials noted that a person must be “quite sick” to be hospitalized for the virus.

Although the network has seen some repeat cases of the virus, they are not common. King said that most of the repeat cases recently encountered were from people positive in the fall, when delta was the prevalent variant.

About 75 percent of Maine residents and 90 percent of people 60 years or older – the age group most likely to be hospitalized due to COVID – are vaccinated. Since the pandemic began, Maine has recorded 248,798 cases and 2,304 deaths.

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