New tests suggest dangerous delta variant more prevalent in Maine, sending most COVID hospital patients to intensive care

The prevalence of the highly contagious delta variant of COVID-19 in Maine is likely much higher than official statistics suggest, according to data from new tests of inpatient screening samples.

And the presence of the variant likely explains a recent dramatic increase in the proportion of patients infected with COVID requiring intensive care.

MaineHealth, the state’s largest hospital network and parent of Maine Medical Center in Portland, began testing some nasal swab samples from COVID-positive patients on July 1 using a new test capable of detecting the delta variant, a virulent form of the disease first detected in India whose rapid spread forced the UK, Australia and other countries to further lockdowns last month.

The test is expensive and its ingredients are scarce, so MaineHealth only tested 49 samples from screened patients who exhibited puzzling characteristics, such as very sick young people or fully vaccinated people who found – usually to their surprise – that they were infected. Eighteen of them – 36.7% – tested positive for the delta variant, MaineHealth’s health improvement manager Dr Dora Anne Mills said on Friday.

This is worrying because the official statewide tally for confirmed patients with the delta variant is only four, although the latest data only covers testing until June 18, there is nearly four weeks. This means that in just over a week, a handful of tests revealed more than four times as many delta cases than this official tally.

“The Maine CDC expects to see a greater impact of the Delta variant in the state in the coming weeks,” Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said via email. “While Maine’s high vaccination rate limits the routes of transmission, the Delta variant is opportunistic.

“Vaccination remains the best way for people in Maine to protect themselves from the Delta variant and other forms of COVID-19, as our partners at hospitals in Maine tell us that the majority of patients requiring treatment for severe symptoms of COVID-19 are not fully immunized, ”added Shah.

The state variant data only includes cases validated by a full DNA sequencing test, a process typically conducted at the Jackson Laboratory in Bar Harbor. MaineHealth’s testing uses a rapid PCR method which, although 95% accurate, is believed to give only preliminary results. Mills said the 18 samples positive for the delta variant have been forwarded to the Maine CDC for full sequencing, in which case they would appear in the state tally.

The state last updated its COVID variant case numbers on July 2, releasing the results until June 18. These data suggest a clear slowdown in the number of samples processed during the first half of June: 67 to 18. against 821 in May.

The long delay is not unusual for this type of genetic variant testing, which is time consuming and considered a less urgent priority than regular COVID testing, Maine CDC spokesperson Robert Long said in a letter. electronic, noting the US CDC’s latest report on nationwide genome sequencing. is also dated July 2 and covers data on samples taken up to June 19.

“It’s a longer process with less urgency than diagnostic testing,” Long said. “The turnaround time for diagnostic PCR tests, which is a better indicator of the risk of transmission, has not changed.”

The delta variant has spread at an explosive rate elsewhere in the world. Within weeks, it swept away the alpha variant to become the dominant strain in the UK, despite the country’s high vaccination rate.

VARIANTS AND INCREASING NUMBER OF USI

The delta variant and its cousins ​​- alpha and gamma – are believed to be responsible for a second development that has taken place in the past three weeks. While hospitalizations for COVID-19 have remained low, the vast majority of people admitted with the disease have been placed in intensive care.

The situation was particularly acute at the state’s largest hospital, Maine Medical Center, where, as of Thursday, every COVID hospital patient over 16 of the previous 21 days had to be treated in their intensive care unit. In the three weeks ending Thursday, Maine Med recorded a total of 210 COVID patient-nights, 86% of which in intensive care.

Statewide on Thursday, the majority of hospital patients who tested positive for COVID were in intensive care – 16 out of 30. In earlier stages of the pandemic, hospitals in Maine typically only had about a third of their COVID patients in intensive care.

The proportion of patients who entered the hospital due to symptoms of COVID and required intensive care is likely even higher, according to Dr Mills, who is a former director of the Maine CDC. This is because some of the patients who are not in intensive care are hospitalized for other reasons but are counted because they have tested positive for the virus.

Many of the COVID-positive hospital patients that its 10-member hospital network had reported in recent weeks are vaccinated people who went to hospital due to an accident or other unrelated condition and turned out to be have low levels of the virus when their routine test results arrive. back, Mills said.

“They’re here for something else and we catch them because we look at everyone who gets in,” Mills said. “These are usually people who have low levels of the virus, no symptoms and probably cannot transmit it very effectively. “

Those who come in for COVID are usually very sick, Mills said, and the new virulent variants are to blame. “They tend to be younger and from rural areas and the vast majority are unvaccinated,” said Mills, who is the sister of Governor Janet Mills. “We just weren’t accepting people in their twenties, thirties and forties a year ago. “

Despite the presence of the variants, the number of COVID hospital patients has been very low in most hospitals in Maine in recent weeks.

In the past three weeks, Southern Maine Health Care Medical Center in Biddeford has had a total of 44 days of COVID hospitalization, for example, including 19 in intensive care. The Northern Light health system of 10 hospitals treated only three to six COVID inpatients per day during this time, but clinicians say the majority have been in intensive care.

Dr James Jarvis, incident commanding physician at Northern Light, said it was difficult to draw statistically significant conclusions for his hospital network when the numbers were so small.

“It’s good news that we have a small number of inpatients, but what stands out today is that these are generally younger people. Their body mass index (a measure of obesity) is lower. And it’s different from what we’ve seen before.

Jarvis said Northern Light does not test and track every patient’s strain of COVID-19, so he had no evidence as to whether the more virulent and contagious variants were to blame.

Mills said she expected there to be more bumps on the road for Maine from COVID-19, but the state was in a good position.

“Maine is one of the safest places in the world for COVID, because of our high vaccination rates and because it is summer now and we are outside,” she said. declared. “There will likely be new chapters and a few roller coaster rides, but I’m confident Maine has seen the worst of the pandemic. “

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