BAR HARBOR — The state set its all-time record for hospitalizations from COVID-19 this week with 403, the Maine Center for Disease Control and Prevention (CDC) reported on Jan. 10. That total included 107 patients in critical care and 57 on ventilators.
Even as the numbers climb, tired community members wonder if the new year could bring a possible end to the coronavirus pandemic.
It is unclear what the course of the pandemic will look like next year, said Dr. J.R. Krevans Jr., chairman of infection control at Mount Desert Island Hospital. Part of the answer, he said, will be determined by individual behaviors and whether more people will choose to get vaccinated against COVID-19.
If people continue to remain unvaccinated, Krevans said, hospitals will remain overcrowded.
He said that, especially in the busy summer season, MDI Hospital already faces capacity constraints, with health care workers often calling around the state in search of available beds.
“That’s in a non-COVID year,” he said.
Additionally, many elective procedures throughout the state have been put on hold and a backlog of medical care has accumulated.
“There’s going to be tens of thousands of people who are suffering and going to need something right now,” Krevans said. “That’s a big issue that we, as a state, have to be honest about.”
Other factors contributing to the course of the pandemic include the evolution of the virus and variants that emerge. Also, the development of new therapeutics and the increasing availability of those that have already been developed.
The omicron variant is posing a challenge for some treatments, with the Maine CDC announcing on Jan. 7 that health care providers should suspend the use of two out of the three monoclonal antibody therapies, as only sotrovimab remains effective in treating the variant.
Another factor is how well the rest of the world responds to COVID-19.
“It is in the United States’ best interest that we produce the best quality vaccines by the planeload,” Krevans said. He noted the importance of delivering vaccines to lower-income countries with populations who may not have even received a first dose of the vaccine and to countries, namely Russia, where there is a high level of distrust in the government’s vaccine development.
Whether the pandemic can end this year, Krevans said, “My expectation would be that we are going to see ups and downs this year,” with the “ups” including therapeutics and vaccinations staying ahead of variants and decreasing the severity of hospitalizations.
If everyone is vaccinated and there are enough resources to care for those people who do get sick, masking may become unnecessary in many places in society. Some places, such as hospitals and health care systems, will likely not go back, he said. Krevans said some people may continue to choose to wear masks in grocery stores and on mass transit.
Maine’s vaccination rate of eligible residents ages 5 and over who are fully vaccinated stands at about 80 percent, according to the U.S. CDC. That is a relatively high figure compared to the rest of the country.
But Krevans said that number needs to be around 90 percent, including children under 5, who do not have emergency authorization yet from the Food and Drug Administration to get vaccinated.
Additionally, that figure needs to be evenly spread throughout communities in the state, not in pockets of more and less vaccinated populations.
The “longer road” to recovery, where not everyone gets vaccinated, could include obtaining immunity from infection, but Krevans said the data is showing that immunity from infection is not as high quality as the immunity developed from being vaccinated.
In that case, masks may need to continue to be worn in schools.
“Do we want to do it the easy way or the hard way?” Krevans asked.
“As long as large numbers of people are choosing to be unvaccinated, we will continue to see large numbers of people hospitalized,” he said.
He said he is seeing “healthy, young people” die and it is not an easy disease to witness.
“People drown in their own secretions,” Krevans explained. He is seeing it happen at MDI.
Another downside Mainers may experience this year: exhausted health care workers choosing to leave the field.
“People are just tired,” Krevans said. He explained the sentiment shared among health care workers is, “Why should I do this if people aren’t going to do their piece of it?”
Krevans, who served as a public health officer for the U.S. Public Health Service Commissioned Corps from 1984 to 2004, referenced his work in helping control tuberculosis in the country.
“We made a choice as a nation,” in addressing TB, Krevans said.
He said the root of today’s health crisis is the failure to accept science.
The pandemic itself isn’t anything surprising, he added, as medical professionals have been predicting a pandemic for years, especially since they tend to happen about every 50 to 100 years.
It is possible, Krevans said, to get the pandemic under control within two to five years, rather than two to five decades.