COVID continues to whiplash tri-county region as Maine hospitals are inundated with patients

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Sep. 25—Androscoggin, Franklin and Oxford counties round out a second week of dizzying swings in COVID-19 case trends, as statewide numbers show signs that new cases may soon reach a plateau.

State health officials Friday reported 714 new cases of COVID-19 in Maine, including 80 in Androscoggin County, nine in Franklin County and 43 in Oxford County. There were no additional deaths.

Earlier this week, Franklin County's seven-day average of new daily cases tumbled by more than a third compared to the day prior, and continued to decline Friday.

Epidemiologists use a seven- or 14-day rolling average of new daily cases to smooth out the daily blips and dips in new cases to provide a more accurate snapshot of case trends. The rolling average per capita is the best metric to compare trends across areas with varying population size.

Franklin County reported an average of 2.15 new cases per 10,000 residents for the week ending Friday, which was almost two-and-a-half times less than where it stood midweek.

One week ago, on Sept. 17, the seven-day average was 5.97 cases per 10,000 residents, which nearly broke the all-time high set during the winter surge. That, too, was a steep swing from a few days prior, though in the opposite direction.

Meanwhile, Androscoggin and Oxford counties' case trends are once again on the rise after a brief reprieve this week.

As of Friday, the seven-day average of new daily cases was 2.8 per 10,000 residents in Androscoggin County and 3.37 cases per 10,000 residents in Oxford County. Statewide, the seven-day average was 3.48 per 10,000 residents.

Community transmission is considered to be at a high level for every county in the state now. The Maine Center for Disease Control and Prevention recommends that all individuals, regardless of vaccination status, wear a mask in indoor, public settings when community transmission is at substantial or high levels.

The latest wave in cases continues to slam Maine hospitals. There were 225 individuals hospitalized with COVID-19 on Friday, 77 of whom were in critical care and 36 of whom were on a ventilator.

"It feels as though when patients come in and they require critical care, whichever variant, which is probably the delta that's affecting most of the admissions, it feels as though this is more severe than prior waves," Dr. Al Teng, chief of critical care at Central Maine Medical Center in Lewiston, said Thursday.

"They come in with not only respiratory failure from COVID, but they also have the acute multiorgan dysfunction presentation," Teng said. "They have other organs that don't function in addition to the lungs, especially the kidneys. They require dialysis earlier and more frequent when they come in."

The statewide single-day records for total hospitalizations, individuals in critical care and individuals on a ventilator were all shattered this month.

"Usually when you have prognostic markers in critical care, the more that you have organs dysfunctional, such as multiorgan disfunction, the less likely you'll do well," Teng said. "And so, these patients with COVID coming are doing exactly that; they're presenting with different organs that are dysfunctional and therefore may not do as well."

Providers at CMMC were caring for an average of about 13 patients per day for the week ending Wednesday, according to the hospital. That's on par with average hospitalizations during the spring wave that hit Androscoggin County particularly hard. Patients then were younger and sicker than ever before.

Teng said patients continue to be younger — in their 30s, 40s, 50s — but being young and relatively healthy no longer seems to make a difference in how someone will fare against COVID, which he says is likely because the delta variant appears to be "more lethal anecdotally."

"It's a big gamble," he said.

"We have just seen people who otherwise do not have many medical comorbidities or conditions that cause immunosuppression and we're seeing young individuals like that present so sick," Teng said.

"You can't rely on your age, your young age, and you can't rely on the fact that you've always been healthy anymore," with the delta variant, he said.

The widely available and free COVID vaccines are highly protective against severe illness, health experts say.

"This is a crisis that is preventable," Gov. Janet Mills said at a media briefing Wednesday. "I remember and you'll remember a year ago, we were working hard to contain the virus. We had some tools. We had testing, we had masking and distancing and protocols. But we prayed for a vaccine."

"Today, we have three vaccines and they are safe. They are free, and they save lives," Mills said.

Breakthrough cases — instances in which a fully vaccinated individual contracts COVID — account for about 5.3% of all new cases in Maine recorded since the first date Mainers could be fully vaccinated.

About 5% of individuals with a breakthrough case are hospitalized due to COVID and about two-thirds to three-fourths of all hospitalized people are unvaccinated, according to state health officials. In Maine intensive care units, 90% of COVID patients are unvaccinated.

And even when a vaccinated person requires critical care, they tend to fare much better than unvaccinated individuals, Teng said.

"Please, I urge you if you haven't gotten vaccinated, if you have doubts or questions, just talk to your doctors and then roll up your sleeve today," Mills said.

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