More Mainers are being advised to wear masks indoors as county-level COVID-19 transmission rates rise, with Portland officials issuing a recommendation Thursday that everyone mask-up indoors regardless of vaccination status.

“The city is committed to the health and wellbeing of our residents and visitors,” Portland Mayor Kate Snyder said in a news release. “In consideration of the COVID-19 delta variant throughout Maine and the nation, and the fact that this variant is more contagious than other COVID-19 strains, we’re asking that people take extra precautions by wearing a mask inside during this time in order to protect our community.”

The recommendation from Portland officials comes as Maine reported another 152 cases of the virus on Thursday, bringing the total number of cases since the start of the pandemic to 70,996. No additional deaths were reported, leaving the number at 900.

The latest numbers bring the seven-day average of new cases in the state to 107.6, which is up from 69 one week ago and 20 cases per day one month ago.

The new case numbers reflect rising rates of infection in Aroostook and Franklin counties, where new cases reported Thursday placed them in the “substantial” transmission category that triggers the U.S. Centers for Disease Control and Prevention recommendation for all people, regardless of vaccination, to wear masks indoors. Cumberland, Lincoln, Penobscot, Piscataquis and York counties already were in the substantial transmission category.

Waldo County remains in the “high” transmission category, where mask wearing also is recommended. All other counties are in the “moderate” category. The U.S. CDC defines high transmission as cumulative cases of 100 or more per 100,000 people in the last seven days. Waldo County’s current seven-day case rate is 199 cases per 100,000 people.

The masking classifications follow U.S. CDC guidance released last week that has caused confusion for some business owners and residents as they try to navigate daily changes to the county classifications that can result in different masking guidance.

At Portland Stage, Executive and Artistic Director Anita Stewart said they have adjusted protocols to have all audience members wear masks when attending shows in order to meet the U.S. CDC recommendation. The theater has advised current ticket-holders of their plan and posted the protocols on its website.

In order to avoid confusion, Stewart said the theater is planning to stick with a masked audience as long as transmission levels remain elevated in Cumberland County and until it is clear the county is back in a sustained period of low transmission. “So if you come to the theater, you will need a mask, even if on one day the numbers pull Cumberland out of the high zone,” Stewart said in an email.

Several other entertainment venues did not return messages seeking information on their masking policies Thursday.

On Monday, Maine Center for Disease Center for Disease Control and Prevention Director Dr. Nirav Shah said on the Maine Public radio program “Maine Calling” that Maine’s low population levels make the state particularly susceptible to fluctuations in the U.S. CDC risk levels and that his agency would be researching whether a different approach would be a better fit for Maine to determine high-risk areas.

“We have been and are still looking at a different way to cut it,” Shah said in an interview Thursday. “There are pros and cons and no final decisions have been made on that.”

Shah said “whipsawing” between recommendations – where masking is recommended in a county on Monday, not on Tuesday but recommended again on Wednesday – can undermine confidence in public health. So any shift to a new recommendation system would be aimed at providing Mainers with more clarity and stability, Shah said.

But the situation has changed in the past week so that there has been more clarity from the U.S. CDC as well as more stability “because we are all headed in the same direction.” Unfortunately for Maine, that direction is toward transmission rates rising to the point that masks may soon be recommended in most if not all counties, Shah said.

Even if the Maine CDC adopted a different system, however, it would still likely be based on the U.S. CDC’s assessments, data and risk calibrations, Shah said.

“If we made a change – and that’s a big if – it would be toward rather than having those recommendations updated every 24 hours, we would have them updated perhaps weekly so that businesses have some predictability” and stability to set their policies, Shah said.

He said the Maine CDC is taking a close look at why Waldo County is seeing such high transmission rates, but there’s no clear answer right now.

“There is not an outbreak that is driving it and thus, because there’s not an outbreak, it is community transmission,” Shah said. “But why there? … I don’t know the answer to it yet.”

As county transmission levels are expected to change daily, the city of Portland is asking the public to remain aware of the current recommendations by visiting the CDC’s website, reading and watching the news, following the requirements of private establishments and when in doubt, wearing a mask.

City Manager Jon Jennings is reimplementing increased mask requirements for city staff in city buildings as well. City Hall remains closed to the general public and is currently open for limited in-person services. “I’m committed to protecting the health of our staff as well as the public we serve, and as such we will continue to monitor public health recommendations and requirements and make sure we’re doing what’s in the best interest of our community,” Jennings said in the city’s release.

On Thursday there were 44 people hospitalized with COVID-19 in Maine, including 18 in critical care and seven on ventilators.

Vaccinations have dropped off in recent weeks but the state continues to have one of the best vaccination rates in the country, with 69 percent of the vaccination-eligible population of those 12 and over fully inoculated and 60 percent of the entire population. Shots are still going into arms with more than 3,000 doses administered between Monday and Tuesday of this week, according to Maine CDC data.

Across the U.S., coronavirus case numbers have been rising due to the spread of the delta variant, mostly among the unvaccinated. The U.S. reported 112,270 new cases Thursday, bringing the seven-day average of daily new cases to 96,036. That’s up from a seven-day average of 12,434 one month ago, according to data from the New York Times.

Maine had reported 75 cases of the delta variant as of July 30, though that is likely an undercount as genomic sequencing tests that identify variants are not performed for every case. Of the 61 samples that were sequenced in July, 60.7 percent were identified as the delta variant.

Shah has stated he believes that 60-80 percent of new cases in Maine are resulting from the delta variant, which is consistent with findings in other northeastern states. The CDC also has noted that treatment of the delta variant does not differ from other strains of the virus, nor do isolation or quarantine protocols.

The rising case counts are prompting employers, healthcare providers and universities to announce COVID-19 vaccine requirements and incentives. The town of South Thomaston said Wednesday it would pay $200 to residents or others who frequent the town for getting vaccinated.

The University of Maine System is requiring vaccines for on-campus students this fall, accelerating a previously stated timeline that called for a vaccine requirement for students and staff after a vaccine received full approval from the U.S. Food and Drug Administration.

The College of the Atlantic in Bar Harbor, which also had previously said it would wait for full FDA approval before moving ahead with a vaccine requirement, announced Thursday all faculty, staff and students who plan to be on campus this academic year must be vaccinated.

Staff Writer Kevin Miller contributed to this report. 

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