Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, speaks at a news conference Monday, March 16, 2020, in Augusta, Maine. Credit: Robert F. Bukaty | AP

As of noon Wednesday, March 18, 30 Maine residents have been confirmed positive and 12 others are presumed positive for the coronavirus, according to the state. Click here for the latest coronavirus news, which the BDN has made free for the public. You can support this mission by purchasing a digital subscription.

AUGUSTA, Maine — The Maine Center for Disease Control and Prevention was slowly filling vacancies after years of budget cuts when the outbreak of the new coronavirus reached the United States earlier this year.

The outbreak has thrust the agency into the spotlight and added to the workload of its 230 employees. Some are working “double and triple duty,” Maine CDC Director Nirav Shah said this week. As of Wednesday, there were 42 confirmed or likely cases of coronavirus in Maine.

With an additional $1 million in funding from Gov. Janet Mills’ supplemental budget, which passed the Legislature on Tuesday, the agency plans to hire additional public health nurses. But hiring staff takes time and effort and has been relatively slow over the past year as the state is forced to confront the spread of the highly contagious virus.

Under former Gov. Paul LePage, a Republican who served from 2011 to 2019, the Maine CDC lost 111 workers as positions were eliminated and LePage’s administration declined to fill vacancies. When he took office, Maine had 50 public health nurses. By 2018, the ranks had fallen below 20 during the LePage administration, which resisted hiring more nurses even after the Legislature passed a law requiring that the program be restored and a state senator sued to enforce the law.

[Interactive map: The number of confirmed coronavirus cases in each state]

LePage oversaw another $5 million cut in 2017 that ended funding to public health councils, which were responsible for ensuring localities could respond to health emergencies such as outbreaks, among other things. When Mills, a Democrat, took office in January 2019, she sought to reverse some of those trends and boost the agency’s ranks.

The CDC has 56 more employees now than it did when Mills took office and has made strides in key areas, said Jackie Farwell, spokesperson for the Department of Health and Human Services, who said the agency has prepared for the outbreak since late December and “is well positioned to continue responding.”

Not all positions have been filled, however. Maine now has 38 public health nurses, who are on the frontlines of the state’s response to the virus, fielding phone calls from physicians and assisting with disease investigations. There are still 17 vacancies in that program, down from 26 in January 2019.

Shah acknowledged that “hiring has been a challenge” for the department, though he said Mills’ emergency declaration might make it easier. Jan Morrissette, who directed the public nursing program from 2005 to 2011, said hiring nurses was always difficult due to an overall shortage of nurses in the U.S. and the CDC’s inability to match hospital wages.

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Morrissette characterized a shortage of public health nurses during an epidemic as “problematic,” saying it would force Maine to triage cases and work with community partners to ensure certain issues are not overlooked. She said nurses were ideally equipped to tackle the coronavirus outbreak given experience with other diseases, such as tuberculosis.

“Going into this kind of environment isn’t something that is brand new for public health nurses,” she said. “It is something that is in their toolbox.”

Shah, who was hired in May 2019 after a stint leading the Illinois Department of Public Health, said this week that the activation to tackle the coronavirus had “reached across the Maine CDC, either directly or indirectly,” with more than 50 staffers spending part of their time on the response.

“Many of those individuals are doing two jobs,” Shah said. “For example, our influenza coordinator is an epidemiologist, who is now doing two jobs. Her first job is to continue to be our full-time influenza epidemiologist. We are still getting the flu reports out every Tuesday. Her other full-time job is as a disease investigator working with coronavirus.”

There were eight vacancies in the state’s epidemiology program in January 2019; now there are only two. Farwell said that the state had also contracted with a former Maine CDC epidemiologist to assist with its response to the coronavirus.

“This is going to be a situation of a marathon as well as a sprint, and I know that my team are up to it,” Shah said.