The Maine Center for Disease Control and Prevention reported 499 coronavirus cases in the state on Monday – an increase of 29 from Sunday – but the number of deaths held steady at 10.

The latest Maine CDC numbers show that 92 people have been hospitalized at some point and that 158 people have recovered from the COVID-19 disease caused by coronavirus. While the growth of new cases slowed somewhat over the weekend, Maine CDC Director Dr. Nirav Shah cautioned against reading too much into daily changes and warned that the roughly 500 confirmed cases is likely “a fraction” of the total in Maine.

“Right now, where we are in this outbreak, it probably does reflect more day-to-day variation and just the natural flow of an outbreak,” Shah said during his daily media briefing on the coronavirus crisis.

Shah said that after distributing 109,000 pieces of personal protective equipment on Friday alone, the CDC is prioritizing distributions this week to long-term care facilities, such as nursing homes and assisted-living facilities. Nationwide, there have been numerous outbreaks of COVID-19 in such congregate settings, and at least one retirement community in Maine, OceanView at Falmouth, has experienced multiple cases.

There are now 13 total cases at independent senior-living communities, with at least three communities besides OceanView also having infections. Additionally, two individuals at two separate nursing homes have tested positive for COVID-19. The Maine CDC provided those figures on Monday but has declined to name specific facilities or communities.

The Maine CDC is continuing to work on locating several alternative care “modules” outside of hospitals to treat patients in the event of a surge in coronavirus cases. Each module contains roughly 50 stations complete with cots and equipment to care for patients, although Shah said the large modules could be broken up into smaller units for deployment in different areas.

The first module will likely be activated in southern Maine, which is bearing the brunt of the COVID-19 crisis right now, but Shah said the agency is developing plans for potential additional sites in northern, eastern and western Maine, if needed.

Some hospitals around the state have erected external triage or testing tents as a way to process potentially infected patients without exposing other, non-COVID patients. The VA Maine Healthcare, for instance, worked with the Maine National Guard to open a triage tent outside of the Togus VA hospital near Augusta on March 23.

Shah said he planned to release additional information on the larger, more comprehensive alternative care modules Tuesday.

“It would partly be staffed by some individuals in Maine state government, but it would also be done as a joint effort with staff from hospitals and other health care systems across the state,” Shah said. “There is much more detail to come on that. These staffing plans, as you can imagine, are quite challenging.”

As of Monday morning, Maine had 120 intensive care unit beds available out of 300 statewide, 268 ventilators available out of 320 statewide and 130 respiratory technicians available. Additionally, Shah said there were nearly 200 alternative ventilators approved for use by the federal government.

He also offered thanks and praise to health care workers. “This is one of those situations where being courageous is not the same thing as being oblivious to risk, ” he said, yet health care workers are “continuing to charge to the front lines because they know that is the right thing to do.”

Cumberland County continues to account for roughly half of the COVID-19 cases – 249 of the 499 cases, as of Monday – while York County was reporting 108 cases. Health officials have said that both counties are experiencing “community transmission,” and they are investigating whether community spread is happening in other counties.

Piscataquis was the only county in Maine without any confirmed cases as of Monday.

The CDC cautions that the number of actual cases is likely higher than the number confirmed because not all individuals are being tested. The agency is recommending that doctors diagnose COVID‑19 based on symptoms, unless the individual is someone at higher risk who should be given a test.

Most Maine residents are currently under a statewide stay-at-home order announced by Gov. Janet Mills last week. The order prohibits Mainers from traveling outside their homes except when engaging in essential activities. These include: grocery shopping, obtaining medical care or medication, providing care to another person or livestock, engaging in outdoor exercise or walking a pet, travels related to child care, or commuting to and from work for an essential job.

Shah praised Mainers on Monday for largely complying with the stay-at-home order.

To illustrate his point about the seriousness of COVID-19, Shah recounted a conversation he had over the weekend with a physician colleague who has contracted the disease along with her husband, who is also a doctor.

“What she told me, was … ‘Nirav, this is really bad,'” Shah said. “She said repeatedly, she and her husband have woken up in the middle of the night with shortness of breath, wondering if one should take the other to the hospital. And these are both individuals who are physicians.”

Shah repeated that community transmission typically begins happening days before it is finally documented by epidemiologists.

“I hope there is not anyone out there who is taking a look at our relatively lower numbers compared to Boston, New York and others, and saying, ‘This is not a risk in Maine,'” Shah said. ‘I say that because, in any outbreak situation, we are only seeing a fraction of the cases that are actually out there.”

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