State looks for explanations as COVID-19 case counts inch higher

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Eric Russell, Portland Press Herald, Maine
·6 min read
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Mar. 18—Maine's seven-day daily average of new COVID-19 cases has reached 200 for the first time in more than a month, prompting health officials to take a closer look at what might be driving the recent increase.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, acknowledged Thursday that young people seem to be contributing to the higher case counts. He said one explanation could be that fatigue is setting in and younger people might be gathering in groups or wearing masks less frequently. Or, he said, it could simply be an "epidemiological phenomenon," from the state's efforts to vaccinate older residents. If more older individuals are protected from the virus, cases are naturally going to skew younger.

Regardless of the cause, Shah said the rise in new cases is concerning.

"We're keeping a very close eye on these epidemiological trends ... to see what might be causing them and where we might be able to intervene," he said.

The CDC reported 241 new cases Thursday and two additional deaths. It was the fourth time in seven days that cases have topped 200 and the highest single-day total since Feb. 9.

The seven-day daily case average is now the highest it's been since Feb. 12, up from 159 two weeks ago and from 148 this time last month. Cases peaked above 600 daily in mid-January following the holiday season before decreasing within a month only to level off before beginning the recent upward trend. The state's positivity rate for PCR tests — another measure of how fast the virus might be spreading — has increased to 1.72 percent, compared to 1.44 last week and 1.29 percent two weeks ago. Among the outbreaks under investigation is one at the Maine State Prison in Warren, where 12 residents have tested positive.

There have now been 47,832 confirmed or probable cases of COVID-19 and 727 deaths since the pandemic reached Maine more than one year ago.

The number of people hospitalized in Maine with COVID-19 dropped to 76 on Thursday, 10 fewer than just two days earlier. Of those, 23 are in critical care and six are on ventilators. Hospitalizations had been falling across the state after peaking above 200 in mid-January but started to climb again as cases have increased. In the last 30 days, 102 people have been treated for COVID-19 at a Maine hospital.

Cases and hospitalizations have been rising in other states as well, fueled in part by the emergence of new and more contagious variants of COVID-19 that have taken over some European countries. Maine is one of four New England states — New Hampshire, Massachusetts and Connecticut are the others — that has seen cases rise by at least 10 percent in the last month, according to the U.S. CDC. The rises come as many states have started to relax pandemic restrictions that have been in place through the winter.

So far, Maine has detected seven cases of the variant known as B.1.1.7, which was first detected in the United Kingdom, and one case of the B.1.351 variant that originated in South Africa. Confirming those cases involves a process known as genomic sequencing that can take time.

Maine works with The Jackson Laboratory in Bar Harbor and other labs to conduct that sequencing of positive tests. As recently as last month, Maine ranked behind only Hawaii with 2.31 percent of positive tests in 2021 submitted for sequencing. The national rate was below 1 percent.

Shah believes that some of the recent virus spread in Maine and elsewhere could be linked to these variants, which are 40-60 percent more transmissible.

"But the extent to which those variants are accounting for increases, that's the harder question," he said.

On a positive note, Shah said Maine's death rate has been declining. In the last 30 days, just one resident of a long-term care facility has died. Those facilities have been hard hit and at-risk throughout much of the pandemic, but especially last spring.

"It's still one person too many, make no mistake," he said.

Meanwhile, as of Thursday morning, 545,102 shots had been administered, including 341,842 first doses, representing 25.4 percent of Maine's population, and 203,260 final doses, or 15.1 percent of residents. Maine ranks ninth among states for percent of population fully vaccinated, according to Bloomberg News' state-by-state tracker. That total includes 53 percent of residents over 70, the demographic at the greatest risk of dying.

"We are in a race between vaccinations and variants," Gov. Janet Mills said in a statement Wednesday announcing that she was extending the civil state of emergency another 30 days. "But we have got to keep our foot on the gas to get more people vaccinated, to keep people alive and healthy, and to get us back to normal sooner. The summer is fast approaching and the finish line is on the horizon."

Currently, those 60 and older are being prioritized for vaccinations, along with teachers, school staff and licensed child care workers. Eligibility will open up to people in their 50s on April 1, and all adults will be eligible by May 1.

Maine is expected to receive 35,190 doses of vaccine next week, just a 3.4 percent increase over this week, as well as an undetermined amount that will go directly to retail pharmacies as part of a partnership with the federal government and to certain federally qualified health centers. Vaccine allotments are projected to increase by the end of the month or early next month.

Shah admitted he was disappointed Maine isn't getting more doses.

"It's disappointing because our goal is to vaccinate as quickly and equitably as possible," he said. "But I'm also not frustrated because we've been told what to expect."

Shah also sought to reassure Mainers about any concerns they might have about getting the vaccine. He said the vaccines are not only abundantly safe, they offer tangible benefits for individuals, even those who don't think they are at high risk. One of them is that they don't have to quarantine if they have been exposed to someone with COVID-19.

"But being vaccinated also opens up the possibility of other areas where you don't need to quarantine, for example the possibility of more widespread travel," he said.

On a more personal level, Shah said being vaccinated protects "those in your life who are not able to be vaccinated or who are not yet eligible."

"Imagine being able to gather indoors at your house with your friends and your family for a celebratory meal or a special event," he said. "That day is coming, but only if we do what needs to be done to keep ourselves, our family and our community safe."