State health officials reported two new COVID-19 outbreaks at social clubs in Sanford on Tuesday, bringing to six the number of outbreaks of the disease in York County.

Dr. Nirav Shah, Maine Center for Disease Control and Prevention director, said six outbreaks in one county at the same time is “deeply concerning” and could lead to unchecked spread. The two new outbreaks are three cases at the Lafayette Club and four cases at the Sanford American Legion.

“As there are more and more outbreaks in York County, what that tells us is that there is ongoing, sustained community-level transmission,” Shah said.

The other previously reported York County outbreaks – all occurring in the past month – include 72 cases at the York County Jail in Alfred, 10 at Calvary Baptist Church in Sanford, eight at Seal Rock Health Care nursing home in Saco and four at the Sanford Fire Department. The jail outbreak is linked to an Aug. 7 wedding and reception in the Millinocket area that has so far been connected to 158 cases and three deaths across the state.

Maine CDC investigations into the outbreaks are continuing, and while health officials haven’t yet found connections among any of the York County outbreaks, the large number in one county was one reason why the Maine Department of Education last week changed York County from a “green” designation to “yellow,” under the state’s advisory system for school reopenings.

In a green designation, schools are given the go-ahead to conduct in-person education with precautions, while under a yellow designation the state recommends that schools conduct hybrid or fully-remote learning.

Many Maine districts had their first day of school Tuesday, welcoming students indoors for the first time since the pandemic began in March.

Shah said the lack of a connection among the York County outbreaks is an indication of community spread.

“The presence of that community transmission gives us pause, because that’s a situation where a few cases in a community could generate an outbreak in a school,” Shah said. “This is evidence of how quickly and widespread COVID-19 can spread. It really is a constant reminder for us that COVID-19 can appear literally in places where we least expect it to.”

But Shah also said that the state’s now-robust levels of testing and low positivity rate – combined with contact tracing – are tools that can reduce the impact of outbreaks. Maine’s seven-day average positivity rate – the percent of tests that come back positive – was 0.55 percent, compared to a national rate of 6 percent.

Testing capacity in Maine has increased by more than 100 percent over the past month, to 362 tests per 100,000 people, compared to the national average of 224 per 100,000.

“Testing coupled with strong contact tracing are foundational to any public health response,” Shah said.

On Tuesday, Maine reported 15 new cases of COVID-19 and no additional deaths.

It was the third day in a row the Maine CDC reported fewer than 20 daily cases. Between Aug. 29 and Sept. 5, Maine experienced case spikes – related in part to outbreaks stemming from the Millinocket-area wedding and reception – including days with 55, 53 and 35 new cases.

A carved wooden lobsterman wearing a mask greets visitors outside a cottage in Camp Ellis last month. Shawn Patrick Ouellette/Staff Photographer

Since the pandemic began in the United States in March, there have been 4,713 cases and 134 deaths in Maine. Hospitalizations remained low, with seven people hospitalized statewide, six in intensive care. With 4,086 people listed as recovered, there were 493 active cases in Maine on Tuesday.

Shah said the investigation into Calvary Baptist Church is continuing, and he’s not sure whether Todd Bell, the church’s pastor, is following state mandates on social distancing, indoor gatherings and mask-wearing in indoor public places. Executive orders put in place by Gov. Janet Mills to slow the spread of the virus require wearing masks in indoor public places, limit indoor gatherings to 50 or fewer people in most cases, as well as physical distancing measures to keep people at least 6 feet apart.

Bell also officiated the Millinocket-area wedding, although investigators have not established a link between the Calvary Baptist Church outbreak and the Aug. 7 wedding and reception.

In recent weeks, videos of Calvary Baptist Church services posted online showed people without masks and not observing social distancing, including choir members who clustered on stage to sing together.

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