The number of COVID-19 patients in Maine hospitals declined from 427 on Monday to 416 on Tuesday, and patients in intensive care units  dropped below 100 for the first time in nearly two months.

There were 97 patients in critical care Tuesday, down from 100 on Monday, according to the Maine Center for Disease Control and Prevention. The last time Maine hospitals had fewer than 100 patients in critical care for COVID-19 was Dec. 1, when 99 were in ICU units. Maine peaked at 133 ICU patients on Dec. 19.

While the number of hospitalized patients overall remains near the pandemic peak, new hospital admissions have been plummeting, from a seven-day daily average of about 18 in early January to a seven-day daily average of eight on Tuesday.

The omicron variant, which has been driving infections in Maine for the past month, appears to be less severe than delta and earlier variants, although more contagious, leading to a spike in hospitalizations but flat or declining ICU utilization. There are signs that the omicron spike is now on the decline in parts of Maine, at least, based on the results of wastewater testing and on daily positive test numbers.

Dr. Dora Anne Mills, chief health improvement officer at MaineHealth, the parent organization of Maine Medical Center in Portland and seven other Maine hospitals, said in a Facebook update on Tuesday that there are some positive trends occurring with the pandemic and some optimistic projections suggest omicron may be the last big wave.

“Some are predicting omicron will be the last big wave here in the U.S., since between its high infection rate and our vaccination rates, we should have a resulting wall of immunity. I certainly hope they are right,” Mills wrote.

Even as positive signs emerge, however, Maine reported Tuesday there have been 16 additional deaths, bringing the number of Maine people who have died during the pandemic to 1,714.

The state’s count of new cases is still lagging and is not a good barometer of current conditions.

Maine reported 1,575 new cases of COVID-19 Tuesday, the first update in three days.  But the case counts continue to understate the actual infection rate as the state grapples with a massive backlog of unconfirmed positive tests.

The state received more than 2,000 positive tests each weekday from Jan. 3 through last week. However, because the number of confirmed case reports is limited by how many state workers can process each day, most tests are added to a backlog that totaled about 46,000 as of last week. State officials have refused to say how large the backlog is this week.

The backlog is skewing results, and the Maine CDC has been de-emphasizing case counts in recent weeks as a way to measure current pandemic conditions. That’s not only because of the backlog, but the proliferation of at-home tests, which are generally not reported to the state agency, and a lack of testing supplies also has made case counts less reliable.

The backlog also resulted in Maine receiving a smaller shipment of monoclonal antibodies than other states based on a federal formula that considers each state’s confirmed per capita case count and hospitalization rate. After Gov. Janet Mills called the White House over the weekend to point out that Maine’s case count is artificially low because of the backlog, the Biden administration adjusted Maine’s shipment this week from 66 courses of sotrovimab, the monoclonal antibody treatment, to 120 courses.

Robert Long, Maine CDC spokesman, said on Tuesday that Dr. Nirav Shah, Maine CDC director, “will provide an update on case processing during Wednesday’s media briefing.” Shah briefs the media at 2 p.m. every Wednesday.

On Monday, Long had said that the state is taking steps to address the backlog.

“Because of omicron’s sustained strain on our case reporting system, Maine CDC is evaluating potential changes to its case investigation and contact tracing processes in an effort to address the backlog and improve its reporting on COVID-19 prevalence and trends in Maine,” he added.

A LABOR INTENSIVE PROCESS

Long said in a statement on Monday that the process of confirming cases is “labor intensive.”

“Maine CDC focuses on eliminating duplicate results in Maine’s data, ensuring that individuals who tested positive repeatedly within a few days are not double counted. For the month of December, for example, this represented 8 percent of all positive test results,” Long said in a statement. “However, while the Maine CDC de-duplicates results and confirms residency, it also determines whether the case is probable or confirmed, whether the individual is hospitalized or potentially part of an outbreak, is vaccinated, has previously had COVID-19, or is pregnant, all of which take additional time on the part of Maine CDC staff.”

Long said the time-consuming process “in part is why other jurisdictions across the country have scaled back or altogether stopped conducting case investigations. Those that stopped case investigations have been able to move toward automation.”

For instance, Wisconsin has moved toward an automated system to clear a large backlog of tests.

Maine also will soon expand efforts to conduct testing for COVID-19 to 20 or 21 wastewater systems, as sewage testing is considered a strong metric in measuring real-time virus conditions. Yarmouth and Portland, two of the few municipalities in the state currently conducting wastewater testing, have seen virus prevalence plummet since early January.

The new program – using $400,000 in federal aid and encompassing 20 or so locations – is expected to launch in a few weeks.

Maine has the nation’s second-highest vaccination rate, with 72 percent of the state’s 1.3 million residents fully vaccinated, placing it behind only Vermont, according to the Bloomberg News Vaccine Tracker. Maine’s most vaccinated county, Cumberland County, has an immunization rate of 83 percent, while the least-vaccinated counties, Somerset and Piscataquis, have vaccination rates below 60 percent.