The number of people hospitalized with COVID-19 in Maine reached a pandemic high on Friday, and some health officials are wondering how much worse things could get as winter approaches.

According to data from the Maine Center for Disease Control and Prevention, the number of individuals hospitalized rose to 248, which eclipses the previous high of 235 set on Sept. 25. Among those currently hospitalized, 72 are in critical care and 31 are on ventilators.

Prior to September, hospitalizations had not been above 200 since January. Now, the number has been above 200 for 21 of the last 22 days.

“Our folks are fried. They are burned out,” said Steven Michaud, president of the Maine Hospital Association. “A nurse friend said to me recently that what used to be a bad day is now every day.”

New cases were not updated Friday because Thursday was a federal and state holiday, but recent trends suggest the pandemic could worsen with the holiday season approaching and more people gathering indoors. As of Thursday, Maine’s seven-day daily average stood at 553 cases, up from 462 cases two weeks earlier and 368 cases on average one month ago.

“Maine CDC expects that those case counts will remain high,” Dr. Nirav Shah, the agency’s director, said this week. “For how long they remain high is fundamentally up to all of us.”

Since the pandemic reached Maine nearly 19 months ago, there have been 110,346 confirmed or probable cases of COVID-19 and 1,220 deaths, according to CDC data. Despite the recent surge, both metrics remain among the lowest per capita of any state.

Across the United States, cases have started to inch up after declining steadily since mid-September. According to the U.S. CDC, the seven-day case average is about 74,500, compared with roughly 72,000 two weeks ago.

Hospitalizations across the country are trending downward overall and averaging just under 40,000, compared with more than 60,000 a month ago, but some states, including Maine, have yet to see their numbers subside.

Michaud said he worries about how much worse things might get. Last year, hospitals braced for a surge around the holidays, and it came, but that was during a time when universal masking and other safety measures were more widespread.

“We could really be in for it this winter,” he said.

One of the major challenges, Michaud said, will be effectively treating patients for injuries or illnesses unrelated to the pandemic. In addition to new patients being admitted, hospitals are struggling to discharge other patients into nursing homes or other facilities because of staffing shortages.

“I keep saying, somewhat flippantly, you better hope you don’t need a hip replacement because you’re not going to get it for a while,” he said.

Several hospitals hit record levels of COVID-19 inpatients this week, including Central Maine Medical Center in Lewiston, MaineGeneral in Augusta and Northern Light Maine Coast Hospital in Ellsworth.

At MaineHealth, the parent organization of Maine Medical Center and seven other hospitals in the state, there were 78 people hospitalized with COVID-19 on Friday, which spokesman John Porter referred to as “a big number for us.” Of those, 30 are in critical care (22 unvaccinated) and 12 are on ventilators (11 unvaccinated).

‘A VERY CHALLENGING SITUATION’

Dr. Dora Anne Mills, chief health improvement officer at MaineHealth, agreed that it’s especially disconcerting because experts don’t necessarily know what things might look like in the weeks ahead.

“Influenza has been around for hundreds of years, and we still can’t always predict that. With COVID, we can predict it even less,” she said. “I can’t emphasize strongly enough to the public what a very challenging situation we’re in.”

Vaccinations, meanwhile, continue at a steady pace, including among 5- to 11-year-olds, who are now eligible. The daily rate of vaccine doses has doubled over the past month, and the state has now administered 948,623 vaccines, which represents 70.6 percent of all Mainers. In less than a week, 6,774 elementary school-age children have gotten their first doses of vaccine, with 58 percent coming from Cumberland and York counties.

Although Maine’s overall vaccination rate is among the best of any state – the top five states for vaccinations are all in New England – it’s not uniform across counties, and that disparity is what has been driving transmission of late, Shah said this week. Many rural parts of the state have barely reached a vaccination rate of 60 percent, which means large pockets of people remain unvaccinated, giving the virus room to spread. Across the state, there are still nearly 400,000 people who are not yet fully vaccinated.

Over the past 28 days, according to CDC data, the lowest rate of virus transmission has been in Cumberland County, which has the highest vaccination rate. By comparison, the two counties with the highest rates of transmission during that time – Somerset and Franklin – have the second- and third-lowest vaccination rates, respectively.

Shah said he understands people may be confused and disheartened by the recent surge in Maine, but he reiterated that vaccines remain the best path out of the pandemic, and he again encouraged anyone who has yet to get vaccinated to consider doing so.

“None of this is to undermine or undercut the fact that the vaccines and vaccinations continue to work,” he said. “If you’re vaccinated, your risk of getting severely ill from COVID or ending up in a hospital or dying remain low.”