The edges of winter have arrived in Maine and with the cold we are all moving indoors. While we have been sending out these updates monthly, with the changing face of the pandemic we are accelerating this update. Moving indoors increases all of our risks and the update is sobering.
While Maine continues to do well and is one of a handful of states where the Ro—the virus reproduction rate—is around 1, we are facing big challenges in the months ahead. The number of new cases in Maine is up significantly. The MeCDC presented some very concerning trends and we are at a critical inflection point in Maine where the pandemic is poised to grow exponentially if we do not act now. 103 new cases, the highest number yet on Friday from an average of 25-30 previously.14 of the 16 counties in Maine had new cases with no single major source event identified. Hospitalizations are increasing rapidly. Average age of new cases is 45 years old.7 of the new cases are healthcare workers in six different locations.
For LifeFlight this means constant adjustments in keeping our people and patients safe. We are updating our practice protocols and procedures to build additional layers into the safety system; adding new biocontainment technologies to support patients’ respiratory status when they are on constant positive airway pressure (CPAP) without the need to electively intubate the patient and place the patient on a ventilator; adding new ultraviolet decontamination technologies and cleaning agents to more quickly get vehicles back in service because we cannot use liquid agents with 15 minutes of dwell time and leave doors open for an hour when it is 10F on a rooftop helipad in the middle of the night; working to support our staff and keep them safe as they grapple with fatigue and concerns around safety and patient care in this new environment; and finding new ways to help our staff care for patients including providing decision support, intervention strategies and coordination with our clinical leaders and referring physicians while in the air headed to patients.
More concerning nationally, as well as all of the New England states, the trend is extremely worrisome. In the midwest and mountain states the trend is alarming with rapid increases in hospitalizations and ICU admissions quickly overwhelming the healthcare system. Nationally, we have seen 46% increase in hospitalizations with many rural systems being overwhelmed. We are rapidly approaching 100,000 new cases a day with 500,000 new cases last week.Deaths are now over 1,000 a week. The Institute for Healthcare Metrics and Evaluation at the University of Washington estimates deaths might double by early in the new year.
The CDC issued two studies in the most recent Morbidity and Mortality Weekly Report which we have added to our COVID library on our website (Research to Understand COVID-19). The most important take home message is COVID is not the “flu.” 300,000 excess deaths above baseline as compared to same period last year (Feb-Sep) with the highest percentage change in the 25 to 44-year-old age bracket. COVID = much higher hospitalization rates.COVID = 3x longer hospital stay. COVID = 2x greater chance of ending up in the ICU. COVID = 5x greater chance of death while hospitalized.
Unfortunately, this new wave of COVID is washing over Maine. While we are all tired of COVID and the fatigue is real, the virus is unfortunately not tired of us. The next several months are critical and could be among the darkest days we have seen in our lifetimes. We have the opportunity to change the trajectory and the story of COVID but we must act now and act together.
We MUST redouble our efforts to keep ourselves, our colleagues, our families, our patients, and our communities safe. As colder weather becomes the norm and we move inside the risks go up, especially with the holidays coming and family gatherings. There are no cure strategies yet. While we have some medical mitigations the only cure at the moment is prevention. We cannot keep our children safely in the classroom, we cannot keep our economy open and growing, and we cannot hug our grandparents unless we can control and contain the pandemic.
There is good news. We know how to tame the virus growth. We have kept Maine safe for the past seven months. We had a busy summer with hundreds of thousands of tourists and we were able to keep the rates of new infection low through close attention to the W’s—wash your hands, wear your mask, watch your distance—each and every day when you are in public places with other people. Just these three simple steps, if rigorously practiced, can change the trajectory of the virus until spring arrives. We can have our social lives, our economy, our schools, our grandparents and loved ones, and be safe but only if we work together to keep everyone safe.
Please, please, please, our individual actions are what stand between Maine and the way life should be, whether you are here today or thinking about next summer. We continue the journey and we are all in this together.
Here at LifeFlight, we are deeply concerned that 1,144 of the total COVID cases in Maine have been healthcare workers. LifeFlight continues to be there for you when needed. Please help us keep Maine safe and our healthcare workers safe. Maine, stable but very fragile. This is a long run, not a sprint.
On behalf of the LifeFlight team,
Thomas Judge, Paramedic Executive Director
Norm Dinerman, MD, FACEP Medical Director
Measuring Virus Reproduction
Institute for Healthcare Metrics and Evaluation
CDC Weekly Morbidity and Mortality Reports:
Hospitalizations among healthcare workers
Excess death report
In-hospital COVID complications