by Sarah Craighead Dedmon

Down East Community hospital today provided clarification on recent ambulance diversions from its Machias emergency department, which took place over the weekend and ended midday Monday. There is a lot of confusion around the diversion status, said the hospital.

"Declaring diversionary status is a request for EMS to consider an alternate Emergency Department.  Ambulances that arrive are not turned away; we must see the patients," wrote DECH spokesperson Julie Hixson. "Patients that cannot be safely transported to a different hospital are not turned away. Patients coming through our doors are triaged and cared for based upon acuity as usual."

Statewide hospital bed shortages and health care staffing shortages have caused a backup at remote rural hospitals like DECH, which relies on the ability to transfer patients to larger institutions.

"Due to the inability to transfer psychiatric and long-term care patients, the increased acuity of COVID-19 patients, the general delays in transferring patients, and staffing shortages created by the vaccine mandate, we experienced times where we were intermittently on diversion over the weekend, and into Monday," wrote Hixson.

Many of the patients diverted from DECH were redirected to Calais Community Hospital which reportedly did not overload their capabilities. 

DECH last week released a statement urging patience as the hospital's emergency department deals with staffing shortages attributable to the state's health care worker vaccine mandate. Under the mandate, health care workers, or workers in a health care institution including accountants and administrators, must be fully vaccinated by Oct. 29 or be removed from their positions. Statewide and within Washington County, worker vaccination rates increased significantly throughout the month of September.

However, as of this week, DECH's vaccination rate hovers near 87 percent, which leaves roughly 45 individuals yet to comply with the mandate. The hospital's vaccination rate could increase in the coming week, and Maine Department of Health and Human Services (DHHS) says its auditors are empowered to use discretion around enforcement as facilities work to hire employees who have at least one dose of a COVID-19 vaccine prior to their start date.

News of DECH’s diversion status spread quickly on local social media where commenters expressed opinions ranging from concern that ambulances were being diverted, to erroneous assertions that DECH's emergency department was now closed. 

For many, the diversions tapped a growing local concern that the rural hospital's services will be cut if more staff do not comply with the vaccine mandate, which comes on the heels of an exodus of health care workers due to COVID-19, and builds on a pre-existing workforce shortage, especially in Washington County, which has the highest unemployment rate of any county in Maine.

Efforts to overturn the vaccine mandate in the courts hit a block last week when a federal appeals court denied a request for an emergency injunction to block the mandate. An appeal has since been lodged.

During the state's weekly COVID-19 press call, last week DHHS Commissioner Jeanne Lambrew said the state is resolute in its need for the mandate and does not anticipate widespread service shortages.

DHHS data from September shows a steep increase in health care worker vaccination rates statewide and across Washington County.