Maine’s rate of COVID-19 transmission has been rising steadily since bottoming out at the beginning of this month, but the state’s top public health official isn’t overly concerned just yet.

State health officials reported 153 new cases of COVID-19 for the three days from Saturday through Monday but no additional deaths. Maine’s seven-day daily case average has increased to 49, compared with 20 cases on average just weeks ago.

In an interview Tuesday, Maine Center for Disease Control and Prevention Director Dr. Nirav Shah said the recent increase in Maine is similar to what is happening nationally, albeit on a much smaller scale.

“The increase in Maine is thankfully less than the weight of the increase in the rest of the country … and that’s no doubt a function of our very high vaccination rate,” he said.

Shah said he and his team are closely watching the trends, as they have been throughout the pandemic, and it’s not likely that any restrictions will be reinstated anytime soon.

One of the biggest reasons for that, he said, is that the state’s high vaccination rate – especially among older residents – means most people are protected from contracting the virus or becoming sick or dying if they do get it.

Since vaccinations began, there have been 560 so-called “breakthrough” cases of COVID-19 in fully vaccinated people, but only a small number of hospitalizations and fewer than 10 deaths. In each of those deaths, Shah said, the individual had other serious health conditions.

The state tracks breakthrough cases but only updates them weekly, and previous totals were not available on Tuesday. However, between June 9 and Tuesday – a little less than six weeks – there were 1,243 new COVID-19 cases. Of those, 173 cases, or about 1 in 7, have been breakthrough cases. Shah said breakthrough cases will continue to become more and more common as more people become vaccinated. He said the state may provide data on them more regularly.

“When the pool of vaccinated people grows, the number of breakthrough cases continues to go up, even though the rate is really low,” he said. What’s important to remember, though, is that those individuals are at much lower risk of getting a severe case, Shah said.

The U.S. CDC stopped tracking breakthrough infections as of May 1, but many states still track them.

Josh Michaud, associate director of global health policy for the California-based nonprofit health policy analysis group Kaiser Family Foundation, agreed with Shah that the current upward trend is worth watching closely but not yet a cause for alarm.

“I do think you can look at this spike differently,” Michaud said. “The vaccines have blunted the severe impacts of COVID – not entirely, but to a huge degree. That’s not to say there aren’t risks, though. The fact that we are seeing these increased in summer is troubling. Unless we see a major increase in the number vaccinated in many states, which seems unlikely, a fall or winter surge is certain and that could be very challenging.”

Cases have been rising in all 50 states as the delta variant has firmly taken hold this summer, and states with low vaccination rates are being hit hardest. The seven-day case average in the U.S. is just over 26,000, up from a low of about 12,000 this time last month. Deaths and hospitalizations from COVID-19 also have been rising in recent weeks across the country after reaching their lowest points of the pandemic just weeks earlier.

Michaud said the delta variant is so highly transmissible that outbreaks are occurring in places where they might not have months ago.

“Even if you have high rates of vaccination, particularly among older people, there is still a big percentage who are unvaccinated, including many kids who can’t yet get vaccinated,” he said. “So, you have the conditions by which there can still be significant transmission.”

The U.S. CDC estimated on Tuesday that the delta variant is accounting for more than 80 percent of new cases. The same variant has caused major spikes in other countries.

Shah, however, said that there is no evidence yet that the delta variant is widespread in Maine, although he didn’t have updated numbers Tuesday.

According to the U.S. CDC, Maine’s overall case rate per 100,000 people was 17 on Monday, sixth-lowest among all states. The highest rate was in Missouri, which is seeing an average of 237 cases per 100,000 people. Missouri’s COVID-19 vaccination rate is about 40 percent.

Dr. Anthony Fauci, the nation’s top infectious disease expert, said this week that the recent trend is “really unfortunate … because what everybody wants in this country – and elsewhere throughout the world – is to be able to crush this outbreak in the sense of getting the level of vaccination so high that the virus has no place to go.”

Now that the state of emergency has ended, the Maine CDC no longer processes COVID-19 tests on weekends, which means new positive cases from Saturday, Sunday and Monday are not reported until Tuesday.

Of the 153 new cases reported Tuesday, nearly half were in York and Cumberland counties. Additionally, 73 new cases were in individuals younger than 40, who generally have lower vaccination rates, while 43 cases were in people in their 50s or 60s, who have a collective vaccination rate of 77 percent.

Since the pandemic reached Maine in March 2020, there have been 69,627 confirmed or probable cases of COVID-19, and 882 people have died with the virus.

Hospitalizations remain low in Maine – just 27 were hospitalized on Tuesday, including 13 in critical care – but that is often a lagging indicator of increased virus transmission. Hospitalizations have remained steadily in the high 20s or low 30s each day for more than a month.

As for vaccinations, just over 800,000 Mainers have gotten a final dose as of Tuesday, which is roughly 68 percent of the eligible population of those 12 or older and nearly 60 percent of all residents. Maine’s vaccination rate ranks third in the country behind Vermont and Massachusetts, according to a Bloomberg tracker.

Maine also passed a milestone this week with more than 50 percent of those 12 to 19 having now received at least one dose of vaccine, the CDC reported.

Despite the state’s strong vaccination coverage overall, there remain geographic disparities. Among eligible residents, 81 percent of those in Cumberland County are fully vaccinated, which is by far the highest percentage of any county in the state. On the other end, just 54 percent of Somerset County residents are vaccinated.

Asked whether he agreed with U.S. CDC Director Dr. Rochelle Walensky’s recent comments that the pandemic is largely a problem for the unvaccinated, Shah said he doesn’t look at it that way.

He says it’s important to not shame the unvaccinated.

“It’s a delicate balance,” Shah said. “If we’re seen to be hectoring or let alone preaching to folks, then I don’t think the message is getting through.”

As for re-instituting pandemic-related restrictions such as mask mandates, which some hard-hit areas have started to do including Los Angeles County, Shah said there are no plans at the moment to do so in Maine.

Michaud also said he doesn’t think that practice will become widespread.

“Those broad approaches might not be necessary,” he said. “I think it’s going to be a patchwork epidemic going forward, which means a tailored or localized approach based upon trends there make a lot of sense.”

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