About 1,500 people are waiting for elective surgeries at Maine Medical Center in Portland because of the continued fall surge of COVID-19 patients, hospital officials said Tuesday.

And hospital staff are struggling with the emotional toll of caring for sick and dying patients who could have been spared severe illness but opted not to get vaccinated, officials said.

Leaders of Maine’s largest hospital system held a news conference Tuesday and pleaded with the public to get vaccinated as hospitals and intensive care units fill with COVID-19 patients.

“We’re still battling, just a really hot pandemic. We’re seeing the largest numbers of hospitalized patients since the pandemic began, right now,” said Dr. Andrew Mueller, MaineHealth CEO. The MaineHealth network is Maine’s largest and includes Maine Medical Center in Portland.

The fall surge in COVID-19 patients combined with health care workforce shortages is straining Maine’s hospital systems. Elective surgeries, from joint replacements to some cancer-related surgeries, continue to be delayed so that hospitals can care for COVID-19 patients, most of whom are unvaccinated.

Workforce struggles at MaineHealth have been worsening throughout the pandemic and are not the result of the vaccine mandate imposed by Gov. Janet Mills, Mueller said. The mandate is instead helping keep staff from missing shifts because of exposure to the virus, he said.

“It’s very clear to us that the vaccine mandate really helps to protect and preserve our workforce,” Mueller said.

All health care workers in the state must be fully vaccinated by Friday to keep working. Mueller anticipates that about 1.5 to 2 percent of MaineHealth’s workforce of 23,000 – about 350 to 450 employees – will resign or be fired because of the mandate. But a fully vaccinated workforce means there will be far fewer employees who will be absent from work because they fell ill with COVID-19.

Maine Medical Center in Portland, photographed in June, now has 1,500 people waiting for elective surgeries because of the continued surge of COVID-19 patients, hospital officials say. Derek Davis/Staff Photographer

Absences among MaineHealth employees peaked in November 2020 – before vaccines were available – at about 450 and have declined to about 200 currently, just days before the mandate will be enforced. Since the mandate was announced in August, absences have dropped by about one-third, according to data provided by the health care system.

While worker absences are down as employees get their shots, unvaccinated patients are filling the hospitals.

COVID-19 patients are crowding out services for other patients, including elective surgeries, such as for knee and hip replacements, back, abdominal, head and neck surgeries, and cancer surgeries that can be safely delayed a few months. About one-third of all elective surgeries at Maine Medical Center are being delayed, hospital officials said, and there’s a backlog of 1,500 surgical procedures.

“It will get worse in terms of some of those delays,” said Dr. Joan Boomsma, chief medical officer at MaineHealth, the parent company of Maine Med and seven other hospitals in the state. Maine Med has been postponing elective surgeries since this summer. “There’s not an easy solution, or easy end in sight.”

Boomsma said they have worked on ways to increase capacity, such as getting people in-home care after surgery instead of sending them to a rehabilitation facility. But every solution comes with an additional challenge. For instance, nursing homes and assisted-living centers are dealing with staffing shortages, making hospital discharges to those facilities difficult. That results in patients staying in hospitals longer than they should, officials said.

EXTENDED STAYS

Pat Hinckley, 64, of Pittston, said he has heart failure and is on the transplant list and had to go to Maine Med for internal bleeding related to medications he’s taking.

Hinckley said what would have been a one-week stay at the Portland hospital in early September turned into a 15-day stay because there were so many COVID-19 patients competing for the medical staff’s services. He’s discouraged that so many people won’t take the vaccines, because it affects others.

Hinckley said during his stay, he had to pass on a transplant because he was in the hospital for internal bleeding. That was during the first week of his stay at Maine Med, so the delays related to COVID-19 patients didn’t affect his ability to receive a transplant. Nevertheless, Hinckley said he’s upset that others won’t do a “simple” thing like getting a shot.

“People are pig-headed, it’s just them saying, ‘Nope, you won’t tell me what to do,'” Hinckley said.

Northern Light Health, a network that includes Eastern Maine Medical Center in Bangor and Mercy Hospital in Portland, also is selectively postponing some elective surgeries.

“We are making adjustments on a case-by-case basis,” said Andrew Soucier, spokesman for Northern Light. “Clinical experts are reviewing patients who are both likely to need inpatient care after a procedure and can safely adjust the timing of their service. Providers are carefully considering each patient who might meet these criteria and having discussions about the timeline for their care.”

Central Maine Healthcare officials have recently said that some elective surgeries at Central Maine Medical Center in Lewiston are being postponed.

Unlike at other major health care systems, Central Maine Healthcare officials have asked the Mills administration for a testing option in place of the vaccine mandate so that they can hold onto more employees. Mills has refused to change the mandate, but has offered to help CMMC with staffing issues, and the National Guard could potentially help.

EMOTIONAL TOLL ON HEALTH WORKERS

The increase in COVID-19 hospitalized patients at Maine Medical Center and other MaineHealth hospitals also is taking an emotional toll on health care workers, officials said.

“They’re caring for patients, particularly in the ICU, who are as sick as any patients we take care of in the ICU,” said Dr. Joel Botler, chief medical officer at Maine Med. “They have to look at these patients, look at their families knowing that if the (COVID-19 patients) had been vaccinated, this would not be the outcome. For our care team members, it is very, very difficult.”

Maine Med is currently caring for 32 COVID-19 patients, with six additional patients suspected of having the disease. Botler said the total patient count at Maine Med was 643 on Tuesday, straining the hospital’s capabilities.

Maine reported 215 patients hospitalized with COVID-19 on Tuesday, down from 223 on Monday, but more than the 201 reported on Sunday. Hospitalizations peaked at 235 patients on Sept. 25, declined to 152 by Oct. 7, but have increased again during the past two weeks.

The overwhelming majority of those hospitalized have either been unvaccinated or are fully vaccinated but older with other serious health conditions, health officials have said.

Maine added 882 new cases of COVID-19 and 25 additional deaths for the three-day period that ended Monday, the Maine Center for Disease Control and Prevention reported on Tuesday. The agency, which no longer reports cases on weekends, periodically reviews death certificates, and 19 of the 25 deaths were attributed to a records review.

The seven-day average of daily new cases stood at 464 on Tuesday, compared to 527.9 a week ago and 520.7 a month ago.

Since the pandemic began, Maine has reported 101,849 cases of COVID-19, and 1,147 deaths.

67.7% OF STATE NOW VACCINATED

On the vaccination front, 909,948 Maine people are fully vaccinated against COVID-19, representing 67.7 percent of the state’s 1.3 million residents. The vaccination numbers have been on a slow but steady climb since the summer, but will likely see a significant bump soon if the Pfizer vaccine is approved for schoolchildren.

A panel of U.S. health advisers on Tuesday endorsed kid-size doses of Pfizer’s COVID-19 vaccine, moving the U.S. closer to beginning vaccinations in children ages 5 to 11.

That means the vaccine rollout for elementary-aged children could begin as soon as next week. About 100,000 schoolchildren would become eligible in Maine, setting the stage for a 5-7 point increase in the percentage of the state population that is immunized.

The higher the overall vaccination rate, the stronger likelihood that reductions in COVID-19 transmission will be long-lasting, public health experts have said. Also, school children, because they interact with large numbers of children and adults at school, can be vectors of the disease.

Maine is expected to offer the vaccine to newly eligible schoolchildren at school-based clinics, pediatrician’s offices and drugstores, among other places.