Maine’s backlog of positive COVID-19 test results that have yet to be verified as new cases has reached 46,000, a staggering total that reflects how rapidly the omicron variant has spread through the state in just a few weeks.

Maine Center for Disease Control and Prevention Director Dr. Nirav Shah said Wednesday that the “current tsunami of omicron cases” has overwhelmed the agency’s ability to determine which tests are confirmed as new cases and which are retests of infected people. As the Press Herald reported on Wednesday, that means daily case counts are significantly understating the intensity of the omicron wave.

“Daily case counts are, and always have been, an underestimate of the true number of cases out there,” Shah said. “At this point in the pandemic, case counts are not the metric of the moment. The concept of a case count is a function of how many lab results our staff can process in any given day.”

The state has dealt with backlogs before, but nothing on this scale. Over the last seven days, the CDC lab has received an average of 3,172 positive tests every day, more than triple the daily average from just three weeks ago.

Because an infected person can test positive more than once, duplicates must be identified and removed before the state reports the number of confirmed cases. That takes time. Additionally, there are more people than ever taking at-home tests, and those results don’t need to be reported to the state and often are not.

Shah said his staff will continue to look for ways to address the backlog, but didn’t provide specifics. He also once again stressed that hospitalizations and deaths are better metrics for assessing the pandemic right now, and announced that the state will ramp up wastewater testing for COVID-19, which provides a better real-time look at transmission, albeit at a community level. The CDC is expanding testing to about 20 wastewater systems across the state in the coming weeks and will make that data publicly available on its website.

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“The virus is evolving and has evolved. As a result, so too will our tools,” he said.

Dr. Rachael Piltch-Loeb, an expert in public health emergency preparedness and response and risk communication at the Harvard T.H. Chan School of Public Health, said it makes sense for state health departments to move away from daily case counts.

‘THE GAME HAS CHANGED’

“It’s an acknowledgement that the game has changed a little bit,” she said.”We no longer think of a case as just a case. For instance, a positive case in a boosted, otherwise healthy individual is unlikely to cause the same burden on the health care system as an immunocompromised or unvaccinated adult. So, a positive case needs more context now than ever.”

Dr. James Gallea, director of the Emergency Department at Stephens Memorial Hospital in Norway, speaks with a patient in the hall of the emergency department in December. Gregory Rec/Staff Photographer

The number of COVID-19 patients in Maine hospitals remained above 400 on Wednesday for the eighth consecutive day, but the number in critical care dropped to its lowest total since early December.

According to data from the CDC, there were 411 people hospitalized Wednesday, an increase of 11 from Tuesday. Of those, 102 were in critical care beds and 53 were on ventilators.

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As the omicron variant has spread rapidly throughout the state, overall hospitalizations have gone up but the number of patients needing critical care or ventilators has declined, a sign that omicron is causing less severe symptoms for some.

The CDC also reported 30 more deaths on Wednesday, including one person younger than 20. Of those, 17 were identified during a periodic review of vital records and occurred in November and December. Maine’s pandemic death toll is now 1,688. Only Hawaii and Vermont have had fewer deaths per capita during the pandemic.

Shah said he’s somewhat encouraged that omicron is proving to be milder, but he said it remains a “significant illness,” and he pointed to the recent high death totals as a grim reminder.

“Even something milder on an individual level can still have significant impact at a population level,” he said.

Dr. James Jarvis, COVID-19 incident commander for Northern Light Health, said the hospitals in his network are seeing milder illness overall, which has taken some strain off critical care units. He also stressed that evidence overwhelmingly shows that people who are fully vaccinated and have received boosters are far less like to be hospitalized or need critical care.

“We are seeing an increase in the number of breakthrough cases, but those individuals are recovering faster than those who are unvaccinated,” he said.

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Dozens of Maine National Guard members will begin arriving at hospitals across the state Thursday to assist in non-clinical roles that will help free up needed beds.

VACCINATIONS SLOWING DOWN

Vaccinations, meanwhile, have fallen off after a ramp-up in November and December, when boosters were first approved for many adults and when children 5-11 became eligible.

Shah said the state has been averaging 4,646 doses per day over the last seven days, an 18 percent decrease from the previous week.

Overall, Maine has administered 971,527 final doses of vaccine, which means 72.3 percent of all residents are considered fully vaccinated. Additionally, 533,870 individuals have gotten booster shots, which accounts for 39.7 percent of the population. The only state with a higher percentage of residents who have gotten boosters is Vermont, according to a state-by-state tracker from Bloomberg.

Maine Department of Health and Human Services Commissioner Jeanne Lambrew said vaccinations remain the best way for residents to protect themselves.

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“I do think things could be much worse if we didn’t have a high rate of vaccination,” she said.

Lambrew said the state has no plans to reinstitute a mask mandate, even as an increasing number of municipalities have passed local requirements to help mitigate the spread of omicron.

Shah said because of how quickly omicron is spreading, and because it’s leading to so many breakthrough cases, “we may all have a date with it.”

“I just hope it doesn’t all happen on the same day,” he said.

He also said that the rapidity with which the virus is spreading could help get us closer to herd immunity, the threshold epidemiologists say could neutralize the virus. But, Shah pointed out, if that does happen, it will come will tremendous costs, including more deaths.

Piltch-Loeb, the Harvard public health expert, said the pandemic is starting to shift toward endemic, but that will only happen fully once health care systems aren’t so overburdened.

“We’re all fatigued,” she said. “But I think we are moving to a place where we readjust and reconsider the risk COVID is posing both to individuals and to the community.”

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