As cases, hospitalizations and deaths associated with COVID-19 trend downward across the country, Maine and some other New England states are still seeing high and sustained levels of all three.

A significant increase in the number of Mainers getting vaccinated in recent days is reason for hope, health officials said Wednesday, but the continued spread of the delta variant is concerning, and difficult to fully explain.

Maine Center for Disease Control and Prevention Director Dr. Nirav Shah said one likely explanation is simply that these states have largely avoided the major spikes that other states already have experienced.

“Up until recently, rural parts of these states were relatively protected from COVID for a number of reasons,” Shah said during a media briefing Wednesday. “With (the delta variant), the virus is being introduced to parts of the state where there had been virtually no exposure to COVID.”

Dr. James Jarvis, COVID-19 incident commander for Northern Light Health, said some of the explanation for the current trend is human nature. Mainers have mostly followed safety protocols throughout the pandemic but may be letting their guard down.

“People may not be wearing masks indoors as much as they should,” he said. “We’ve seen an increase in gathering. Travel is another thing, people are traveling more.”

The CDC reported 620 new cases on Wednesday and seven additional deaths. The seven-day case average has fluctuated somewhat but is largely unchanged from this time last month, about 460 cases each day.

Across the United States, cases have fallen by 42 percent during that same time, according to the U.S. CDC.

Hospitalizations, meanwhile, have increased by 24 percent in Maine over the last two weeks. As of Wednesday, 209 individuals were in the hospital, including 74 in critical care and 34 on ventilators.

By comparison, hospitalizations have fallen nationally by 20 percent in that time.

Since the pandemic began, there have been 102,469 confirmed or probable cases of COVID-19 in Maine and 1,154 people have died, according to data from the Maine CDC. Both remain among the  lowest per capita of any state.

Despite the recent worrisome trends in Maine, both Shah and Department of Health and Human Services Commissioner Jeanne Lambrew said there are positive signs, too.

The biggest of those is a recent increase in vaccination, not just among those who are receiving booster shots but those who are receiving their initial series.

Over the last two weeks, the average number of second doses of Pfizer or Moderna vaccine, or the one-dose Johnson & Johnson vaccine, have increased from 1,180 per day to 2,600 per day, or 120 percent.

“The recent data prove that people do learn, they do listen, they can change their minds, and that’s very encouraging,” Lambrew said.

Shah said he doesn’t know exactly what’s driving the recent increase in vaccinations but said it’s likely a combination of factors, including the severity of the delta variant and also existing and future vaccine mandates by employers.

Overall, Maine has administered 915,325 final doses of vaccine, which accounts for 68.1 percent of all residents and 77.3 percent of those 12 and older who are eligible, according to Maine CDC data. Maine ranks fourth overall in vaccination rate. The top five states are all in New England.

State officials also sometimes cite federal vaccination data, which indicates a slightly higher rate for Maine because of differences in the counting methodology.

A total of 78,998 people have gotten third doses thus far, according to the Maine CDC. Boosters are recommended for older adults and those with immunodeficiencies, and also for those who received the Johnson & Johnson vaccine.

By next week, the Pfizer vaccine could be approved for children 5 to 11. Shah said there are nearly 80,000 children in that category in Maine.

“This provides a tangible opportunity for children to return to a more normal way of life,” he said.

Although Maine’s overall vaccination rate is high, there are still pockets of the state with large numbers of unvaccinated individuals and that has contributed to high transmission, hospitalizations and deaths.

Those hospitalized with COVID-19 have overwhelmingly been unvaccinated or vaccinated but older and with other serious health conditions.

Within Northern Light Health’s system, there were 46 people hospitalized with COVID-19 on Wednesday, half of them at Eastern Maine Medical Center in Bangor. Of those hospitalized, 37, or  80 percent, are unvaccinated.

Health care providers have been forced to adapt to not only an increased number of COVID patients but ongoing workforce challenges.

On Tuesday, officials with MaineHealth, the parent organization of Portland’s Maine Medical Center and seven other hospitals in the state, said roughly one-third of all elective surgeries are being delayed, and there is a backlog of 1,500 procedures. Other hospitals also have cut back on some services temporarily.

“It will get worse in terms of some of those delays. There’s not an easy solution, or easy end in sight,” said Dr. Joan Boomsma, MaineHealth’s chief medical officer.

A DIFFICULT PHASE

Jarvis said Northern Light hospitals are in a similar position.

“It’s no secret we continue to be in one of the most difficult phases of the pandemic,” he said during a media briefing Wednesday.

Although facilities have not reached capacity, Jarvis warned that some patients, “may need to wait a little longer for care if your needs are not urgent.”

Exacerbating the problem for hospitals has been a lack of available beds in nursing home and skilled rehab facilities, many of which have halted admissions due to staffing shortages. Jarvis said there are 111 patients in Northern Light’s system currently who have been cleared to leave the hospital but don’t have a nursing home or skilled nursing bed to go to.

Although it’s only a small factor, the vaccine mandate for health care workers has exacerbated the staff shortages. A small number of employees have left their jobs rather than get vaccinated and more could be terminated when the state begins enforcing the mandate on Friday.

Lambrew said DHHS will enforce the mandate the same way it enforces other vaccine requirements for health care workers that have been in place for years – mostly through random audits and complaint-driven investigations.