PORTLAND – (Portland Press Herald)  – With Maine breaking records for COVID-19 hospitalizations and cases this fall, the state’s hospitals are activating strategies to expand capacity to meet the demand of surging patients.

Steven Michaud, president of the Maine Hospital Association, said the increasing numbers of patients hospitalized with COVID-19 is “extremely concerning.”

The state reported 323 patients were hospitalized with COVID-19 on Saturday, the latest data available, including 104 in critical care and 40 on a ventilator.  On Nov. 18, Maine had 271 patients hospitalized with COVID-19.

That’s because hospitals are using some of their tools to increase capacity, such as delaying elective surgeries, using rural hospitals to care for COVID-19 patients and bringing in temporary workers, such as recent retirees, to volunteer or for paid work. The temporary workers could work in other areas of health care, such as vaccine clinics, to free up the permanent employees to care for COVID-19 patients.

The Mills administration has encouraged rural hospitals to support the regional medical centers and has begun encouraging volunteers or temporary health care workers to help with the pandemic.

Michaud said there’s still more give in the system, because hospitals can increase usage of the tools. For instance, regarding delaying elective surgeries, such as hip and knee replacements, hospitals can “tap the brakes” by delaying some surgeries or “push hard on the brakes” and delay most elective surgeries. Michaud said most hospitals in Maine can do more to delay additional surgeries if needed.

The Mills administration recently eased some regulatory rules that now permit smaller, rural hospitals to care for COVID-19 patients. So, for instance, hospitals in Machias, Millinocket, Farmington, Calais and other rural hospitals are now permitted to care for COVID-19 patients, although severe cases are always transferred to major hospitals such as Maine Medical Center in Portland and Eastern Maine Medical Center in Bangor.

One specific area of concern is the capacity of the state’s intensive care units, where the most severely ill patients are cared for. The state CDC said Maine hospitals had about 55 available ICU beds as of Thursday, including those for adults and for youth.

Michaud said hospitals can convert non-ICU beds to intensive care beds. But a bigger issue is a limited number of nurses and other workers to staff the beds.

Yet another challenge that the health care system is trying to address is a lack of capacity in nursing homes and other skilled care facilities, which is making it difficult to discharge patients and make room for new admissions. Opening up beds in nursing facilities would mean that patients who need to be discharged into skilled care don’t spend more time than is necessary at the hospital, Michaud said.