July 2021 COVID Update

Dear Friends—

We hope this finds you all healthy and renewed from the 4th of July holiday weekend. Maine has opened up and it is so good to see an energized economy and the state of emergency lifted. Much has changed and continues to change with COVID as we continue to turn the corner to subduing the pandemic. We are so glad to continue the renewal process of seeing our friends and families up close around the dinner table. We have a lot to celebrate, remembering it has been an incredibly challenging year full of tragic loss for so many. The trends continue to move in the right direction: positive tests, ED visits, hospitalizations, and thankfully deaths all continue to decline. We are now at the rates that we experienced last August before the surges.

Maine has done very well with 66.5% of the total population over 12 years of age vaccinated and over 73% of the population over 60 years of age vaccinated with a number of counties approaching 90%. We still have a long road ahead, as the rate of new vaccinations in young adults has declined. While our older population has been more apt to get the vaccine, 7 of our 16 counties have less than 60% of the overall eligible population vaccinated. More information: COVID-19 Vaccination Dashboard | Covid-19 (maine.gov)

While the weekly CDC updates have ended and life feels much more normal, many challenges still remain, especially with the new Delta and Lambda variants. We are still encountering COVID patients at LifeFlight and we are very busy seeing an average of 9 critically ill or injured patients a day. Here is what we are watching, based on science: 

Outdoors is safe. We know this from our experience last summer. Despite the influx of our summer residents and visitors case rates and hospitalizations remained low.

Indoors is safe as long as there is good ventilation. Ventilation and continual air exchange are essential. We know more about this now than we did a year ago and this is hugely important for our restaurants and shops. We use portable air filtering systems with HEPA-grade filtration in our offices and quarters to improve ventilation. LifeFlight teams have taken care of over 1200 known and presumed COVID-positive patients and we selectively encounter the most critically ill patients. With proper PPE and ventilation in the ambulances, helicopters, and airplane no one has become ill due to patient care.

Vaccination works. Despite the Emergency Use Authorization, fully vaccinating is the touchstone to stopping the pandemic. A recent report from the Cleveland Clinic noted 99.6% of the deaths and similar numbers for hospitalizations since January have occurred in non-vaccinated people.

No vaccine works perfectly 100% of the time. We still need to pay attention to the continually evolving virus. The longer it takes us to shut down the pandemic the greater risk of new variants that do not respond to the current vaccines. Thankfully people who have been vaccinated generally have much more mild illness. Long COVID is a huge concern. The science is still evolving but the impact of COVID, even in mild cases seems to last and will be a headwind for many in returning to work and normal life as well as on the economy. We also remain very concerned about the long-term psychological and emotional effects on our healthcare workforce.

The Delta Variant is a wild card. We are seeing rapidly increasing rates of hospitalizations in areas with low vaccination rates across the country and we are extremely concerned this will happen in Maine. We are also seeing increasing rates of hospitalizations and critical illness in young people, none of whom are vaccinated. The Delta Variant appears to have some different symptoms, e.g. sudden and ongoing sneezing. While the evidence is unclear, if you have new and unexplained respiratory symptoms, get tested. The Delta Variant can upend all of the work over the last year. We expect the Delta variant to become the predominant cause of infection in Maine by the end of summer with reports today that rates are much higher nationally due to delays in testing results as well as the slowdown of testing. In areas of low vaccination rates, we are already seeing hospitals encountering numbers of COVID patients in their ICUs similar or higher than last winter’s surge. This may disrupt school and the economy with another surge in the fall and winter. We are also seeing the Delta variant continue to evolve and absorb other mutations from other variants, with Lambda as the most recent. We always need to remember a human generation is 20+ years. A viral generation is 12 hours.

We believe it is good practice if you are hosting a large event with many strangers to ask people attending if they are vaccinated. This is not political nor a value statement. It helps everyone to be more relaxed socially. Travel is safe as long as you maintain situational awareness and practice good personal protection. We still recommend masks, distance, and handwashing when you are in a crowded public transportation vehicle.

Consider wearing a mask when you are indoors or in large groups of people outdoors, especially with people you do not know. Masks help prevent asymptomatic transmission which can occur from a vaccinated person who does not have any signs or symptoms of infections. Similar to vaccination masks are protective nor political. We all hate masks, but we still wear our masks when shopping, not because we are worried about contracting COVID, but because we do not want to pass on any asymptomatic infection to the people working in the stores. It is still the polite thing to do and helps protect everyone.

We said in the beginning that we are all in this together, and that still holds true today. We are close to putting the pandemic in the rearview mirror but we still need to work together. The science of understanding the full impact of the last 18 months will evolve and blossom over the next few years. Hopefully, we will take these lessons on board for the inevitable next version of a novel infectious disease capable of starting a new global pandemic.

In the meantime, we look forward to seeing many of you across the summer at LifeFlight events, the Cross for LifeFlight, and social. Enjoy your summer and stay healthy and safe. 

On behalf of the LifeFlight team, 

Thomas Judge, Paramedic Executive Director
Norm Dinerman, MD, FACEPMedical Director