Unlike last 2 falls, COVID infections decline in Maine

Nov. 24—The number of Maine hospital patients infected with COVID has dropped dramatically in recent weeks, a sharp contrast to the surge of hospitalizations experienced the past two autumns.

It's a welcome trend that health officials hope will continue as Maine faces a combination of respiratory illnesses that could strain the health care system. The state's hospitals are currently packed with pediatric respiratory syncytial virus (RSV) cases and bracing for a potentially severe influenza season this winter.

COVID-19 hospitalizations stood at 98 on Tuesday, with 14 people in intensive care. That's the lowest patient count since May and a significant drop from 155 hospitalizations two weeks ago and 234 on Oct. 17.

In the past two Novembers, Maine experienced some of the worst surges of the pandemic.

In 2020, the number of hospital patients with COVID rose from 28 at the beginning of November to 139 at the end of the month.

In 2021, as a delta variant spike was followed by the omicron surge, COVID-19 hospitalizations spiked from 212 to 330 in November and kept rising until peaking at 436 on Jan. 13, 2022.

Nationally, COVID-19 hospitalizations also are down, a reduction of 4.4% compared to last week, and the general trend in the U.S. this fall is flat.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said that the declining COVID-19 hospitalizations are a welcome "bit of good news" at a time when hospitals are "packed" with RSV patients.

"What is having an outsize role in generating the downturn is our extremely high vaccination rate," Shah said. "It makes it harder for the virus to jump from person to person."

Maine has among the highest vaccination rates in the nation, including the new omicron-targeting booster shot.

Maine has the second-highest rate of vaccination for the omicron booster, with 21.2% of those ages 5 and older getting the shot, compared to 11.3% nationally, according to the U.S. Centers for Disease Control and Prevention. Many states across the South have omicron booster rates of 5% or less. Vermont has the best omicron booster vaccination rate in the country at 23.2%.

Shah said that even though omicron booster rates of just over 20% may not sound like a lot, it may be enough to help tamp down increases when combined with immunity from previous vaccinations and immunity from those who have contracted COVID-19.

"Even that 20% has a significant immunological impact, compared to states that have 3% to 4% with the bivalent (omicron) booster," Shah said.

Maine also is a leader in the original vaccination series, first rolled out in spring 2021, with about 82% of the state's 1.3 million people fully vaccinated, according to the U.S. CDC.

Wastewater testing, which is an early warning system that can project higher levels of virus circulating in the community, also shows a decline in virus prevalence this fall in many Maine cities and towns, including Portland, Westbrook, Bangor, Lewiston-Auburn and Augusta.

Dr. Dora Anne Mills, chief health improvement officer for MaineHealth, the parent organization of Maine Medical Center in Portland and seven other Maine hospitals, said one reason hospitalizations aren't climbing could be that compared to a year ago, or two years ago, immunity levels are high.

"We have a much bigger wall of immunity than we had last year," Mills said.

Another possible factor is that often there won't be two respiratory viruses circulating in great numbers at the same time, she said.

"It is unusual for two or three respiratory viruses to be at high levels at same time," Mills said. "It's not understood exactly why, but they tend to elbow each other out."

That may bode well for concerns this winter about a "tri-demic," or levels of RSV, COVID-19 and influenza spiking at the same time. But Mills said she isn't making any projections about the winter because viruses are unpredictable.

RSV is a pediatric respiratory disease most dangerous to infants, while influenza tends to be most deadly to seniors. Maine is so far experiencing low levels of influenza, but the virus is now hitting much of the East Coast, including high levels as far north as New York and Connecticut, according to the U.S. CDC.

"I look at the winter with some caution, but we really don't have a good barometer of what these viruses are going to do," Mills said.

Further mutations of the omicron variant — BQ.1 and BQ.1.1 — are adding more layers of complexity, but Shah said he is so far seeing relatively good news about the variants. The variants do not appear to cause more severe COVID-19, which is promising, Shah said. And while they have shown some ability to evade immunity in laboratory tests, the human immune system is much more complex and robust.

"These variants are doing a really good job of outfoxing the immune system in a petri dish, but in the real world, it doesn't necessarily translate into more infections in humans," Shah said.

SURGE COULD BE COMING

But scientists, including Shah, are not claiming victory over COVID-19, and there still may be a winter surge.

"The question is whether this increase is going to be nationwide and whether the size of the increase and the surge will be something like what we experienced with delta and omicron, or much smaller," Samuel Scarpino, vice president of Pathogen Surveillance for the Rockefeller Foundation, said in a Nov. 11 interview with NPR.

Meanwhile, public health experts say to practice good hygiene, including frequent hand-washing, wear a mask indoors in crowded and unventilated spaces, and stay home when sick. And public health officials are urging Maine people who haven't gotten a flu shot or omicron booster to do so as soon as possible.

In addition, Mills said parents with children under 6 months of age should limit the infant's contact with other people — particularly at family gatherings where the children might be kissed or passed around — to reduce the chances of RSV, which mimics the common cold in adults.

"If you have a very young infant, I wouldn't pass the baby around and have everyone kiss the baby," Mills said.