Kayla Mitchell, a critical care nurse in the COVID-19 unit at Portland’s Maine Medical Center, made history in December 2020 when she became the first Maine resident to get vaccinated against the virus.

It was the first sign of hope after months of uncertainty.

Yet more than a year later – thanks to a pair of stubborn coronavirus variants – the pandemic remains out of control, and it’s putting more strain than ever on health care workers like Mitchell.

“I would say as a whole, it’s pretty discouraging to still be in the thick of it after (nearly) two years,” said Mitchell, 32, of Scarborough. “But my faith in the vaccine has not wavered. I see it every day. Since the vaccine rollout, the vast majority of patients in my ICU are unvaccinated. The vaccines and boosters are working to keep people out of here.”

Unfortunately, the virus is working just as hard. The latest variant, omicron, has proven to be even more transmissible than anything seen so far, and it has driven cases to their highest levels by far both in Maine and across the country.

Some research has suggested that it might be a milder strain, but because of the sheer volume of new virus transmission, many individuals are still ending up in the hospital. And even though Maine has a higher vaccination rate than most states, there are still tens of thousands of individuals across the state who have not gotten any shots.

This week, there were more than 400 COVID-19 patients in the hospital for the first time during the pandemic. The number dropped to 395 on Tuesday, but hospitalizations have been at a sustained high level for months. An estimated 70 percent of all people hospitalized with COVID-19 are unvaccinated and the percentage is even higher for those in critical care.

The omicron surge, which is leading to more breakthrough cases among the fully vaccinated, has created another problem as well: More and more health care workers are being forced to call out sick after being infected or exposed.

“We are the busiest we’ve ever been in the two years during the entire pandemic,” said Britney Meunier, 28, who also works in Maine Med’s COVID-19 critical care unit and lately has been picking up overtime shifts to help out during staff shortages. “We are seeing the sickest patients in the entire state, and it’s way more physically and emotionally challenging.”

Shannon Calvert, left, and Britney Meunier take a break from a shift as nurses in Maine Medical Center’s COVID-19 ICU unit. They say the COVID-19 unit is the busiest it’s been since the beginning of the pandemic nearly two years ago.

Shannon Calvert, 49, who has worked at Maine Med for 25 years, said the wave of patients is draining, but “we are holding our own.”

“We are seeing sicker and younger patients,” she said. “We are being highly impacted by people who are not getting vaccinated. We just wish people would get vaccinated, and we encourage people to get vaccinated so we can take on more patients who are not COVID patients.”

STAFF OUTAGES SURGE

At both MaineHealth and Northern Light Health – the state’s two biggest hospital systems – staff outages are at their highest levels of the pandemic. Northern Light had an estimated 500 workers out earlier this week, more than 4 percent of its staff. On Monday, 125 staff members at MaineGeneral in Augusta were out sick, about 3 percent of its workforce.

To help address hospital shortages and alleviate capacity constraints, Gov. Janet Mills announced Tuesday that she was sending an additional 169 Maine National Guard members to hospitals.

“I wish we did not have to take this step,” she said in a statement.

The governor also announced that the Federal Emergency Management Agency has approved a request for COVID-19 Surge Response Teams for MaineHeath in Portland and Central Maine Healthcare in Lewiston. The two teams, consisting of a total of seven nurses and pharmacists, began arriving Monday and are scheduled to stay through Jan. 27. They will administer vaccines to free up hospital staff to carry out other duties.

“We are in the midst of the most difficult time of the entire pandemic for hospitals. We are stretched to our bed capacity limits, all the while more and more of our employees are out due to COVID exposures. The stress on our caregivers can’t be overstated,” said Steven Michaud, president of the Maine Hospital Association.

Paul Bolin, senior vice president of human resources for Northern Light Health, said the current challenges are enormous, but he also praised the staff for doing their part.

“We’ve really been focusing on flexibility of workforce lately,” he said. “We’ve reassigned people to jobs that might be different from their regular job, and even administrators and support staff doing patient screening and delivering food trays. We’re trying to make sure we’re as nimble as possible.”

CROSS-TRAINING TO STAY NIMBLE

Mitchell said that’s been true at Maine Medical Center as well.

“I would say that Maine Med and the critical care units have done a great job of maintaining safe staffing ratios,” she said. “I’m not being asked to do more than I can handle.”

Maine Med nurse Kayla Mitchell receives the first COVID-19 vaccine in Maine from Dr. Christina DeMatteo on Dec. 15, 2020. Derek Davis/Staff Photographer

Kate Dickens, a charge nurse in the medical/surgical unit at Northern Light Maine Coast Hospital in Ellsworth, said the current surge comes at a time when everyone in health care is tired.

“We’ve fought the hard fight for a long time,” she said in a series of videos shared by Northern Light staff. “And it seems like from here on out, it’s going to be an uphill battle.”

Dickens said she and many of her colleagues know patients who end up in the hospital with COVID, which makes the work doubly difficult.

“We lean on one another as health care workers to try to get through the day,” she said.

Even before the recent staff outages, Dickens said she’s seen co-workers leave “due to stress, burnout, or to pursue other opportunities.” Some chose to leave because of the statewide vaccine mandate for health care workers, she said.

Some health care providers across the U.S. are taking the extraordinary step of allowing nurses and other workers infected with the coronavirus to stay on the job if they have mild symptoms or none at all, even though there is risk of spreading the virus further.

That hasn’t been widespread in Maine, although St. Mary’s in Lewiston said this week that it has allowed some COVID-positive workers to come in and work with infected patients.

Calvert said working shifts at Maine Med is “constantly emotionally taxing and physically taxing.” To go into a COVID-19 room, nurses and doctors have to gear up with hot and uncomfortable personal protective equipment and keep it on for four hours while caring for some patients.

“For people to think the pandemic is over, that is so far from the truth,” added Meunier, the COVID-19 critical care unit nurse at Maine Med.

NURSES VERBALLY ABUSED

The stress isn’t just related to patient care, either. Calvert said one or two times per week, a health care worker on the COVID-19 unit will get verbally abused by a patient or a family member of a patient.

“We are called liars and murderers and that we’re making things up and that we are ‘killing’ these patients with these treatments we are giving them and that they agreed to take. And yet they won’t get vaccinated,” she said. “We are being verbally abused frequently. It’s brutal, like nothing I have ever experienced.”

Mitchell said most of the patients under her care are on “full life support,” and need assistance breathing.

“While they are here, it’s maximum therapy,” she said. “We’re providing them with everything.”

Sadly, many die, and those who survive are often there many, many weeks.

“If there is one thing I could say it’s that: Every person who gets vaccinated is helping us because that’s almost certainly someone who won’t end up in the ICU.”

Asked whether any patients have expressed regret about not getting vaccinated, Mitchell said it hasn’t happened to her, but only because by the time she sees them, they are often intubated and can’t speak.

Staff Writer Joe Lawlor contributed to this story