Maine CDC reports a hard-hit nursing home and 2 more deaths

Maine’s top public health official expressed optimism that the state would be able to overcome a coronavirus testing setback and increase its testing capacity in the coming weeks, as the COVID-19 death toll mounted to 16 with two more deaths and 23 new confirmed cases were reported Thursday.

But Dr. Nirav Shah also highlighted concerns about coronavirus outbreaks in nursing homes, particularly at Tall Pines in Belfast, where 10 residents and three health care workers have tested positive for COVID-19, the disease caused by the virus.

Shah, the director of the Maine Center for Disease Control and Prevention, also offered a few details from epidemiological research that showed household transmissions and the contacts of a traveling salesperson were among the factors driving the spread of the disease in Maine.

The deaths were a man in his 80s from Cumberland County and a woman in her 90s from Waldo County. Shah said 11,608 people have tested negative for the coronavirus. The 23 new cases bring the total of confirmed coronavirus cases since the state began testing to 560. A total of 202 people have recovered, and 105 have been hospitalized. Subtracting the deaths and recoveries from total confirmed cases leaves the state with 342 active cases.

As of Wednesday evening, 13 Maine residents have tested positive for COVID-19 in another state, and 17 people who are residents of other states have tested positive in Maine, Shah said.

He said a “top concern” of the CDC is the Tall Pines nursing home in Belfast. The state shipped personal protective equipment for staff at Tall Pines this week and provided guidance on testing, assessing who was at risk and other needs, Shah said.

The CDC has reported two deaths in Waldo County, but Shah refused to say whether they were from the Tall Pines facility, citing privacy concerns.

Shah reported that Maine’s ICU bed capacity stood at 308, with 149 beds available, while the state had 333 ventilators with 283 available, along with 232 alternative ventilators.

He also reported that Maine is expected to receive a shipment of 15,000 surgical gowns and 16,000 surgical gloves, masks and shoe coverings from the federal government within the next two days.

At MaineHealth, the health care system which includes Maine Medical Center in Portland, staff began saving discarded N95 respirator masks to be disinfected and potentially reused in a worst-case scenario. There has been a nationwide shortage of protective gear, and while Maine has not experienced such shortages, hospital systems are preparing in case there’s a wave of COVID-19 patients in the coming weeks.

“This week, MaineHealth began asking employees to tag their used, intact N95 masks so they can be collected at the end of each shift or when they are wet or visibly soiled. This is part of a preliminary effort to evaluate the safety and efficacy of reprocessing N95s for future reuse on a limited basis. These masks will not be reintroduced into the supply stream unless this strategy is deemed necessary due to supply shortage,” John Porter, MaineHealth’s spokesman, said in a statement.

PROMISING DEVELOPMENTS IN TESTING

Shah said there are now promising developments with testing, a day after he disclosed that Maine had received only 5 percent – 115 – of the 2,300 tests it was expecting from the federal government of tests made at Abbott Laboratories in Scarborough.

He said the Maine CDC is working with Martin’s Point Healthcare in Portland, which received 1,000 of the rapid tests, to share tests.

“These talks have been extremely collaborative and productive,” Shah said. He said more details of the partnership are expected on Friday. A Martin’s Point executive said on Wednesday evening that they would be willing to work with the Maine CDC on sharing tests.

Shah said he also spoke with a senior Abbott executive on Wednesday and placed an order for more tests.

“Additional tests may be on the way,” he said. Robert Long, Maine CDC spokesman, said an order for 1,150 Abbott tests was placed with a U.S. CDC website.

The Abbott tests are key, Shah said, because they generate results within minutes. That means they can be used to help hospitals conserve protective gear, such as masks, gloves and shoe coverings, as well as increase overall testing capacity. Maine’s current testing capacity is about 3,000 to 3,500 tests.

Shah said reagents, some of the chemicals needed to perform the tests are in greater supply, which is an encouraging sign that testing capacity can increase.

“The availability of some of the chemicals have improved, and that’s a good thing,” Shah said.

Maine also has no backlog of tests, and can typically turn around a test within 24 hours. Two weeks ago, Maine’s backlog was in the thousands.

Overall, Maine has run more than 12,000 tests since March, and per capita that is the 13th most in the nation, according to an analysis by the Maine Department of Health and Human Services.

He said with improved testing capability, Maine is looking at expanding the categories of people considered “high priority” to receive a test. Currently, people at the front of the line for tests are those who are hospitalized, health care workers and those living in congregate settings, such as nursing homes.

The ability to test more potential COVID-19 positive patients is one of the crucial tools for public health agencies to use to battle the coronavirus.

The lack of robust nationwide testing when COVID-19 cases were low in numbers in late February and early March was a glaring weakness in the Trump administration’s response to the pandemic. While improved since then, testing per capita still lags other countries, such as South Korea, which ramped up testing in the early days of the pandemic and by identifying and isolating cases early has had far fewer deaths per capita. South Korea has had four deaths per 1 million population, compared to 49 deaths per 1 million population in the United States, according to the Worldometer website.

Testing in the United States has since rebounded and is now at 7,017 tests per 1 million, compared with 9,310 tests per 1 million population in South Korea.

SALESPERSON WAS ‘SUPER SPREADER’

Also, Shah reported a “super spreader,” a traveling salesperson who may have infected a cluster of cases in Maine, and in other states. Shah said state epidemiologists traced infections leading back to a salesperson earlier in the outbreak, in March. He said that after the salesperson visited an “establishment” in Maine, a number of other people became infected. Long said no further information about the traveling salesperson was being released Thursday.

“This individual because of the nature of their job visited other similar establishments in other states,” Shah said, further spreading the novel coronavirus. He said the epidemiologists also had identified a pattern of people within households infecting each other, contributing to the spread.

Shah said physical distancing measures are saving lives, and he could not predict when the state would begin reopening segments of society. Schools, businesses, beaches, parks, sports, hotels and much of society have shut down in an attempt to fight the spread of the virus and reduce deaths.

“There will be ways in which we do return to normal. When that happens is difficult to know. How that happens is difficult to know,” Shah said.

Shah said one positive sign that social distancing is working is the reduction in traffic, including declines of more than 60 percent compared to the same time a year ago along some sections of I-95 and I-295, and reductions of 30 to 40 percent along rural roads.

“If we limit movement we can disrupt the flow of the virus,” Shah said. “We have seen significant reductions in traffic along roadways.”