Even as Maine has weathered the pandemic better than many states and been a leader in vaccinations, a complicated set of factors has kept its new case counts steadily high in recent weeks.
It is among 14 states that have seen rising case counts in the last two weeks, according to the New York Times. It is also seeing some of the biggest hospitalization increases, with the state averaging 29 percent more admittances now than it did two weeks ago, according to that tracker.
These factors all present a challenge for state health officials in the days leading up to a major shift in Maine’s reopening plan. Starting Saturday, all Americans will be able to travel to Maine without having to quarantine. Businesses will soon be allowed to operate at a higher capacity as long as they follow certain public safety guidelines.
With community transmission long established in Maine, it can be hard to pin down what is causing cases to ebb and flow. But here are some of the factors shaping the pandemic situation in Maine right now:
Who is getting sick
Younger people are increasingly driving new case numbers after being the last prioritized for vaccines. A year ago, people under 20 made up zero percent of cases, and those in their 20s made up just 10 percent. But they have made up around 18 percent and 19 percent of total cases, respectively, since vaccination efforts began and have remained steady as case counts in other age groups have fallen, according to Maine Center for Disease Control and Prevention data.
Those two age groups are also trailing in vaccinations after the state opened up general eligibility three weeks ago, representing only 11 percent of state residents who have received a first dose. An initial surge in interest from younger Mainers has since leveled off.
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Gibson Parrish, a Yarmouth epidemiologist who used to work for the U.S. CDC, sees the increasing cases in younger people as one of the top concerns for the state. That demographic is more likely to be interacting in groups and may be less likely to adhere to social distancing guidelines while doing so, he said.
“My worry is that as we see more schools coming back and we see places open up more for commercial use … that will lead to more opportunities for transmission outside,” he said.
Where outbreaks are occurring
Schools have become a predominant location for outbreaks, making up 70 percent of ongoing outbreaks as of two weeks ago. The Portland Press Herald reported that COVID-19 case rates in schools have reached record highs, although they’re still well below the general population rate.
But those outbreaks are relatively small, and there is not much proof that transmission occurs within schools. Children under the age of 15 are not able to get vaccinated, and only the Pfizer vaccine is cleared for 16- and 17-year-old children.
The state designated four counties as “yellow” last Friday on its color-coded safety system, meaning schools in those counties should consider hybrid learning models to limit the virus’ spread. It was the first time since January when all 16 counties had not been green-lit for in-person learning.
Maine is trying to catch outbreaks at schools more efficiently. The Maine Department of Health and Human Services announced on Tuesday a testing partnership that will allow all K-12 schools to be voluntarily tested once a week in May. The idea is to “pool” testing and test an entire group if a member comes back positive, eliminating the need to individually test most samples.
A different challenge is plaguing nursing homes. Those facilities are seeing new outbreaks after prioritization of residents and staff caused cases there to drop off over the winter. Officials have chalked those challenges up to lagging vaccination rates among staff and break-through cases in which those who have been vaccinated are still getting sick.
What is affecting vaccinations
Weekly vaccinations saw a 20 percent drop last week after the Johnson & Johnson vaccine was paused and the drive to get vaccinated seems to have abated slightly. Experts have tied some of that to hesitancy — which is relatively low in Maine — and some of it to the challenges of reaching a population either willing to wait to get vaccinated or who encounter challenges in accessing shots.
Maine is trying to reach the latter group by encouraging providers to set up small clinics for certain workers who might be at risk of getting the virus. A Monday memo from the Maine CDC encourages clinics specifically for workers in industries such as hospitality and service where social distancing can be a challenge and workers are exposed to many people. The memo also lifted limits on special clinics for higher education students.
Maine CDC Director Nirav Shah said he did not think vaccinations would stall after the federal government restarted Johnson & Johnson vaccine distribution. He said the vaccine’s convenience of needing only one dose will help the state reach lagging age bands.
Walk-in clinics, which were largely conceptual two weeks ago, have become more common. And Maine’s mobile vaccination clinic is offering a mix of walk-ins and appointments in hopes that it can provide more flexibility to people.
More sites are testing the waters with walk-in shots.
Perhaps the biggest is Northern Light Health’s Portland Expo clinic, where walk-ins will be allowed starting Wednesday. Melissa Skahan, the vice president of Northern Light Mercy Hospital, said patients without appointments will be integrated into the clinic’s existing schedule. She was confident the method would be well-used in Portland due to the area’s population and the site’s walkability.
“We’re hopeful it will draw in a new group of people who were unable to register or uninterested in getting the vaccine until now,” she said.