The number of COVID-19 patients in critical care hospital beds in Maine has increased by 25 just in the past four days, reaching a pandemic high of 96 on Tuesday.

Overall, 298 people are now hospitalized across the state, a number that set a record for the sixth time in the last nine days. Of those, 40 people are on ventilators, which is two shy of the record set on Sept. 15. In the last two weeks, the number of daily hospitalizations has increased by 41 percent, and more than 3,000 people have been hospitalized with COVID-19 at some point since the pandemic began.

Maine health officials also reported 1,089 new cases of COVID-19 for the three-day period from Saturday through Monday and 28 additional deaths from the disease, although half of those occurred between Oct. 27 and Nov. 9 and were identified through a periodic review of death certificates. Deaths were reported in 12 of 16 counties. One was a person in their 20s, two were in their 50s, six people were in 60s and 70s, and 13 were over 80.

Since March 2020, there have 116,948 confirmed or probable cases of COVID-19 and 1,300 deaths, according to the Maine Center for Disease Control and Prevention. Even with the recent surge, both are among the lowest per capita of any state.

With the new cases, the seven-day case average now stands at 694, a 35 percent increase from the 513 cases on average two weeks ago and and a 50 percent increase over 463 cases per day this time last month. Despite a high vaccination rate, Maine has seen sustained levels of virus transmission for weeks that could worsen following the Thanksgiving holiday, when many will be gathering in groups indoors.

Hospitalizations, which have been driven in large part by unvaccinated individuals, continue to be a cause for concern. Already, many facilities have postponed elective surgeries and have had to look for ways to create capacity.

“The reality is that it’s happening already,” said Dr. Dora Anne Mills, chief health improvement officer of MaineHealth. “Difficult decisions are being made every day in health care in Maine and across the country. I don’t want to frighten people, but it’s the truth.”

Across the country, hospitalizations have started to tick back up as well. According to the U.S. CDC, the average number of people hospitalized daily with COVID-19 is 42,841, an increase of 6 percent over the last two weeks. Cases have started to climb as well after declining during most of September and October. The seven-day average this week is 91,021, an increase of 23 percent over 73,948 cases per day this time last month.

At hospitals managed by the Maine’s two biggest providers – MaineHealth and Northern Light Health – there were 166 individuals hospitalized with COVID-19 on Tuesday. Of those, 72, or 43 percent, were fully vaccinated. Weeks ago, the percentage of those hospitalized who were vaccinated was much lower, and some vaccine critics has seized on this shift as a sign that the vaccines aren’t working.

But that claim is not accurate and doesn’t consider that the overall pool of vaccinated people in Maine is more than two times larger than the pool of unvaccinated people, and that gap is widening all the time.

Additionally, unvaccinated people are more likely to develop severe symptoms. Among individuals who are in critical care at MaineHealth and Northern Light Health facilities, 19 of 65 are fully vaccinated, or 29 percent. Among those on ventilators, four of 19 (21 percent) are fully vaccinated.

The vast majority of patients in the hospital who are fully vaccinated have been older and have had other serious health conditions.

Mills said as worrisome as things are now, she’s more concerned about the weeks ahead.

“We keep bursting records for numbers of people hospitalized, but that’s really just the tip of iceberg,” she said. “We see many times that number as outpatients, too.”

Vaccinations, meanwhile, have continued at high levels, fueled largely by booster doses and first doses of vaccine for children 5-11. Overall, Maine has administered 910,224 final doses of vaccine, accounting for 67.7 percent of all residents, and 260,225 booster doses, or 19 percent of Mainers, according to the Maine CDC. The number of final doses has decreased over the last several days because some vaccine providers previously reported booster doses as final doses.

Among children 5-11, 23,612 have gotten first doses, which represents 24.5 percent of all children in that range. In Cumberland County, the rate is 42 percent, while seven counties have yet to reach 15 percent.

Although Maine’s overall vaccination rate is high, there are still roughly 400,000 people who have not gotten vaccinated, including many younger children. That leaves large pockets of unvaccinated people in many rural areas and that’s where the virus has been spreading most.

Maine’s recent transmission remains higher than the national average. Over the last seven days, the state is averaging 350 cases per 100,000 people, which ranks 12th, according to the U.S. CDC. The U.S. average over that time has been 192 cases. Nearby New Hampshire and Vermont also are seeing high transmission.