A woman walks along State Street in Portland last week under a sign with a phrase in French that translates loosely to “be attentive.” Gregory Rec/Staff Photographer

The state reported 579 new cases of COVID-19 and one additional death on Thursday, adding to a major surge in cases over the last two weeks that has been driven predominantly by younger people who have yet to get vaccinated.

“This shows just how opportunistic the virus is,” Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said in a media briefing. “With older populations vaccinated, the virus is now spreading more rapidly among younger populations.”

The seven-day daily average rose above 400 cases for the first time since Jan. 27.  Two weeks ago, the daily average was 228, and this time last month, 182 new cases per day were being reported, according to data from the Maine CDC.

After having one of the lowest infection rates in the nation for most of the pandemic, Maine now has the 14th-highest rate in the country, according to the Harvard Global Health Institute, at 27.2 cases per 100,000 people, on a seven-day average. Michigan has the worst infection rate in the country at 78.7 cases per 100,000, followed by Rhode Island. Three other New England states – Massachusetts, Connecticut and New Hampshire – are among the top 11 states with high infection rates. Vermont ranks 18th.

Despite New Hampshire’s high rates, Republican Gov. Chris Sununu on Thursday announced a lifting of that state’s mask mandate, effective Friday. When asked whether Maine was considering a similar measure, Shah and Jeanne Lambrew, Maine’s health and human services commissioner, said no.

Other states in the Northeast, such as New York, New Jersey and Pennsylvania, also have infection rates that are among the worst in the nation. Hawaii, Arkansas and Mississippi have the lowest infection rates in the country.

As has been true for the last several days, not all of Thursday’s cases in Maine occurred in the previous 24 hours. The state has been flooded with more test results than it can verify and analyze on a given day. But the upward trend is unmistakable.

 

The rise in cases in Maine is far outpacing the country. In the last month, daily cases have increased on average by about 17 percent. In Maine, the increase has been 119 percent, which is higher than any other New England state. New Hampshire’s cases have increased by 73 percent, Massachusetts’ by 31 percent and Vermont’s by 30 percent, according to data tracked by the New York Times.

However, part of the trend is a reflection of testing. Maine has the highest per-capita testing rate in the country, at 1,632 tests given per 100,000 people. It also has one of the lowest rates of tests returned positive in the country, at about 3 percent, according to Johns Hopkins University. The state reported a positivity rate of 3.5 percent on Thursday.

In states with high positivity rates but low numbers of cases, infection rates are likely higher than what is being reported. Cases are going unreported because not many tests are being given. For instance, Idaho and Iowa are only giving about 60 tests per 100,000 people, a testing rate more than 25 times lower than Maine’s.

Both Idaho and Iowa have per capita infection rates much lower than the national average, but with positivity rates at higher than 20 percent for both states, many cases are going unrecorded. In contrast, states with low positivity rates, like Maine, are reporting more cases of the disease and giving the public a more comprehensive picture of virus activity.

Among the 579 new cases reported Thursday, 265, or 46 percent, were in individuals under 30. There have now been 55,953 confirmed or probable cases of COVID-19 and 758 deaths since the pandemic reached Maine 13 months ago.

Shah said part of what’s happening is that the new variants are more transmissible and more severe, although the vaccines work well against the variants.

As of Thursday, Maine reported 30 cases of the B.1.1.7 variant originally detected in the United Kingdom, three cases of the South African variant B.1.351 and one case of P1, the Brazilian variant. The actual number of variants circulating is much higher than reported because states only perform the genomic sequencing required to identify the variants on a small percentage of positive tests.

The surge in cases also could be related to travel, people not following pandemic safety rules, weather patterns and other reasons, Shah said.

“Usually it’s a constellation of factors, and not one thing,” he said.

Hospitalizations rose again, from 98 people in a Maine hospital with COVID-19 on Wednesday to 107 on Thursday, including 34 in critical care and 13 on ventilators. After spending much of March and April hovering in the 70s and low 80s, hospitalizations have crept higher in recent days, reaching levels not seen since mid-February. In all, 1,751 people have been hospitalized in Maine with COVID-19 at some point.

Vaccinations, meanwhile, have slowed this week, a trend attributable to fewer doses coming in and Tuesday’s nationwide pause in the administration of Johnson & Johnson vaccines so experts can study a small number of cases where people who received the vaccine developed unusual blood clots.

The average number of daily doses given Monday through Wednesday has been about 15,000. Last week, when Maine received tens of thousands more doses and opened eligibility to all residents 16 and older, daily shots averaged more than 20,000 between Monday and Friday.

Still, Maine reached a milestone Wednesday – 30 percent of its population has now been fully vaccinated. Only two other states have rates that high, Alaska and New Mexico, according to a Bloomberg News tracker.

There remain, however, large geographic disparities in vaccination rates here. Washington County leads the way with 36 percent of residents fully vaccinated, followed by Knox County (35 percent) and Lincoln County (34 percent). On the other end, just 22 percent of Androscoggin County residents and 24 percent of those who live in Oxford County have had their final shots.

Androscoggin County reported its third highest daily total of cases ever on Thursday.

Since vaccinations began in December, a total of 945,186 shots have been administered. Of those, 540,611 have been first doses, representing 40.2 percent of Maine residents, and 404,575 have been final doses, or 30.1 percent. Among those over 60, who are at highest risk of hospitalization or death, nearly 70 percent have been fully vaccinated. By comparison, just 14 percent of Maine residents under 40 – the population that is driving the current surge – has been fully vaccinated. That age group has only been eligible for a week.

Lambrew said on Thursday that once supplies increase in May, Maine will start planning dedicated clinics for certain populations, such as those working in the tourism industry, migrant farm workers, grocery store workers and others.

When we get significantly more doses, we can operate targeted special clinics,” Lambrew said. “We’d love to be able to do them, we are just waiting for that supply.”

The supply of the recently approved Johnson & Johnson vaccine has been cut off for at least the next week while federal regulators consider how to respond to a few blood clot complications out of about 7 million J&J doses given that may have been linked to the vaccine. The J&J vaccine has been paused by the Food and Drug Administration and the U.S. CDC pending an investigation. While J&J doses only represented about 5 to 8 percent of all doses given in Maine so far, supplies of the one-shot dose are expected to increase once regulators give the green light to end the pause. The one-shot vaccine has been given in more rural areas of Maine.

Shah told the Washington Post that the decision to keep the Johnson & Johnson vaccine out of use, even for a short time, could have major consequences.

“The extension of the pause will invariably result in the fact that the most vulnerable individuals in the United States who were prime candidates for the Johnson & Johnson vaccine will remain vulnerable,” Shah said. “The most at risk will remain at risk, and those who would benefit immediately from vaccination will remain unvaccinated for an unknown period of time. That would come at a period where the United States is still logging 5,000 deaths in the past seven days across the country.”

Next week, Maine is expected to see a similar number of new doses coming in as it received this week – about 35,000 – although that doesn’t include doses that go directly to retail pharmacies through a partnership with the federal government. Those dose amounts are typically revealed over the weekend.

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