How it started, how it’s going, and where to next

By Dr. Cheryl Liechty, MPH | May 27, 2021

The late winter and spring 2020 was a time we would rather forget: A new virus causing widespread severe illness in faraway places. There were many unknowns. Once cases were identified in the U.S., the country battened down the hatches.

Then we began to see cases here in Maine, and a "surge" that was especially devastating for many nursing home communities. Hospitals were very stressed, especially our larger centers.

But the Maine experience was better than almost anywhere else in the country. Things cooled down in late spring. Despite fears about what visitors would bring, Maine had a very successful summer COVID-wise.

Unfortunately, things picked up again in the fall. Our second surge resulted in dramatically higher numbers of hospitalizations, including in parts of Maine that was not heavily affected in the spring.

But something transformative happened in early December: The advent of incredibly safe and effective COVID-19 vaccines. Healthcare workers and residents of long-term care facilities were the first to access them. When offered the shots, these groups, who either had close-range experience with the impact of COVID-19 or knew the stakes if they became infected, said yes in droves.

What happened next? Very quickly, hospitalizations of COVID-19 cases from congregate living settings essentially evaporated. Locally, we noticed the change by the end of January.

I remember the week we learned two Midcoast nursing facilities identified a few cases. We worried: experience from 2020 was that one or two cases at a long-term care facility would invariably become a devastating event.

Then…nothing. No hospitalizations or deaths from those small outbreaks. It was amazing.

In early 2021, Maine began vaccinating members of the general public. Setting up vaccine clinics was a mammoth — and unprecedented in our lifetimes — undertaking.

Across the country, various attempts at implementing large scale telephone or web-based scheduling systems were complicated and quickly overwhelmed by demand. Vaccine supplies were limited. But we used them as quickly as we got them. The vaccine clinics were “the happiest places on earth.”

Where are we now? After a significant decline in COVID-19 cases in early 2021, Maine saw another rise — not just in new cases, but also in severe COVID-19 illness.

Why? Probably due to a mix of a few factors: chiefly pandemic fatigue, new viral variants that appear to be more easily transmitted and uneven uptake of vaccine.

But current state-wide data is again looking better — rates of new cases, ER visits and new hospitalization numbers are starting to decline overall. In our community, we are still seeing quite a few new cases of COVID-19, but mostly in younger people. Why? Younger people are much less likely to be vaccinated.

In Knox County, over 85% of residents age 60 and above have completed COVID-19 vaccination; that number in Waldo County is almost 80%. This is really really impressive. As a result, Pen Bay Medical Center and Waldo County General Hospital have not seen a single COVID-19 hospitalization in a fully vaccinated person.

We are continuing to see cases of severe illness in unvaccinated people. It is heartbreaking, because we know these cases are preventable.

Masks, social distancing, hand hygiene, isolation of sick individuals and quarantine of exposed people all limit the spread of COVID-19, but who wants to continue to live like this?

Vaccines are the solution: Their safety profiles are excellent. They are extremely effective, especially at preventing severe COVID-19 illness — and severe illness is the reason we care about this virus at all.

Because they work so well, a vaccinated person is very unlikely to become a source of COVID-19 spread to others. As vaccination results in fewer cases, the virus will have fewer opportunities to evolve into new variants.

Pen Bay and Waldo County General Hospital — two small community hospitals in rural Maine — team and community volunteers are very proud to have administered nearly 40,000 doses of COVID-19 vaccine.

We are not done yet. Our vaccine clinics are open on a walk-in basis. We are doing everything we can to offer clinic hours that are as convenient as possible.

We are now collaborating with area schools to provide vaccinations to students age 12 and up. I am absolutely thrilled this means my 12- and 15-year-old children will imminently be getting their first doses of COVID-19 vaccine at school.

They are pretty excited too — they can’t wait to be "quarantine-proof," and they hope to be in class every day this fall without masks or social distancing. They also recognize they will be doing their part to protect the health of our community as a whole.

Older adults have shown us what to do — get vaccinated. The 12- to 15-year-olds are just getting their vaccine chance now. Just under half of residents ages 16 to 59 in Knox and Waldo counties have received final doses of COVID-19 vaccine.

If we as a community can continue to move the needle in the direction of increasing vaccine coverage, we should expect to see further sustained reductions in cases, hospitalizations and deaths. MaineHealth likes to say “We are in this 'til we win this.”

From my perspective, it’s not just catchy; it’s sincere. In the U.S., we are privileged to have excellent access to the keys to winning in this pandemic — vaccines.

Let’s all use them.

Dr. Cheryl Liechty is MaineHealth's clinical lead for its Midcoast COVID-19 response efforts.

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