Hospitalizations set record in Maine and omicron creates new hot spots for infections

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Jan. 7—Hospitalizations from COVID-19 rose to their highest total of the pandemic on Friday, testing the capacity of Maine's health care system even as hospitals report large numbers of sidelined staff members.

The number of patients in critical care has leveled off, however, a sign perhaps that the omicron variant might be leading to fewer cases of the most life-threatening illnesses.

Meanwhile, omicron is creating new infection hotspots in Maine.

Shifting infection rates among Maine counties show the new variant has spread first in coastal and more populous counties, driving up infection rates where they had been relatively low just three weeks ago. Experts predict cases will soon spike in every county, however, as omicron takes hold in rural areas, too.

Also Friday, Gov. Janet Mills announced that her administration has purchased 250,000 rapid COVID-19 tests from Abbott Labs and plans to soon distribute them to "Walgreens pharmacies, health care sites, schools, and congregate care settings," to help meet the high demand for tests.

"Widely available, accessible, and affordable COVID-19 testing is crucial to detecting COVID-19 and reducing its spread," Mills said in a statement.

There are now 391 COVID-19 patients in Maine hospitals, which eclipses the previous high of 387 set on Dec. 21. Hospitalizations had dipped as low as 327 on Dec. 26 but have been climbing since. The Maine Center for Disease Control and Prevention has said that 70 percent of all people hospitalized with COVID-19 are not fully vaccinated.

Of those currently hospitalized, 110 are in critical care and 59 are on ventilators. Unlike overall hospitalizations, those totals have actually remained steady and have even declined in recent weeks as omicron has spread throughout the state. The number of critical care patients climbed as high as 133 on Dec. 19 and the number of patients needing a ventilator reached a pandemic high of 68 three times last month, most recently on Dec. 23.

Dr. Nirav Shah, director of the Maine CDC, said this week that his team is keeping a close eye on hospitalizations during the latest surge — more so than new cases — and he made note of the fact that demand for intensive care beds hasn't increased.

The CDC also reported 1,328 new cases of COVID-19 on Friday and seven more deaths, adding to an already high level of omicron-fueled virus transmission here and across the country. Since the pandemic began, there have been 152,173 confirmed or probable cases of COVID-19 and 1,599 deaths. Both remain among the lowest per capita of any state.

Many of the new cases reported this week, however, have been from positive tests dating back a week or more. Because state officials are dealing with so many tests, and because many people are taking at-home tests and not always reporting the results to the state, the daily case counts from the Maine Center for Disease Control and Prevention don't necessarily capture the whole picture, or the most current picture.

Shah acknowledged as much this week but said the state should be prepared for a continued increase in cases, much like what other states are seeing. The unknown, he said, is whether it will be a sudden, sharp increase followed by a similar sharp decline, or a more sustained wave of transmission.

Dr. Robert Horsburgh, an epidemiologist at Boston University, agreed that the ease with which omicron is spreading is "really shocking."

"They said it was more infectious, but this is several orders of magnitude more infectious," he said. "I think people who are immune compromised or unvaccinated need to be super careful now. It may not make people as sick, but people are still getting sick."

The highly infectious nature of omicron is creating new hot spots as the virus spread deeper into the state.

Prior to the omicron surge, cases were spreading most rapidly in Maine's rural inland counties, which also were the state's least vaccinated counties. That is not the case now as omicron spreads first through more populated parts of the state.

Over the last seven days, York County has seen the highest number of new cases per capita, 549 per 100,000 people but has the 6th highest vaccination rate. Lincoln County, which has the third highest rate of cases over the last week, has the third highest vaccination rate.

Even Cumberland County, which has by far the highest vaccination rate of any county, is seeing significant spread, 443 cases per 100,000 people over the last seven days.

Counties that had been hotspots during the delta variant surge, including Oxford, Androscoggin and Frankin counties, are seeing lower transmission in the past week.

The hots spots are expected to continue shifting as omicron spreads. But it will eventually reach all counties, Horsburgh said.

"It's going to start in urban areas where people are close together and spread out from there," he said. "I wouldn't say other counties are going to escape omicron. I'm sure it's going to be spreading their way, perhaps as other counties are starting to recover."

He said he's encouraged that the omicron variant, based on what South Africa and other countries have seen, appears to move quickly through populations.

"If every wave of the virus is less bad, that will eventually lead us to better place," he said. "But I'm not going to bet the ranch on that just yet."

Health officials have said the omicron variant is almost certain to infect many people who are fully vaccinated, and even those who are boosted, but their risk of being hospitalized or dying from the virus is exponentially lower. And even if high vaccinated places, there remain large pockets of unvaccinated people, including children.

Cases have spiked dramatically across the country following the holiday season and are at their highest levels of the pandemic, according to the U.S. CDC. The seven-day average of 586,391 cases — which is skewed somewhat from some states reporting backlogs all at once in recent days — has more than tripled just in the last two weeks. Hospitalizations are rising sharply across the U.S. as well, although many states are seeing similar trends as Maine, with fewer needing critical care.

Vaccinations, which had picked up before the holiday in Maine, have come back down to about 4,800 doses per day on average, about half the doses that were being administered the middle of last month. Overall, 948,184 Maine residents, or 70.5 percent, are fully vaccinated, according to the CDC, and 509,583 people have gotten booster shots.

Horsburgh said vaccines have proven over and over again to be the best tool for avoiding serious illness from the virus, and that's true of omicron as well.

"It's like using sunblock," he said. "You don't have to, but your chances of getting burned are going to be greater if you don't."

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