An employee works in the coronavirus unit at the Durgin Pines nursing home in Kittery last fall. Credit: Courtesy of Jabbar Fazeli

Long-term care facilities, which were host to some of the worst coronavirus outbreaks early in the pandemic, have been spared the worst of the latest resurgence in the virus across Maine. That’s likely because of high vaccination rates among residents and staff in those locations, according to experts.

There have been about 40 COVID-19 cases in residents and staff members in five long-term care home outbreaks since the beginning of July, along with one death at the assisted living facility Gorham House, according to Maine Center for Disease Control and Prevention data.

The Gorham House resident who died was vaccinated and tested positive for COVID-19 while in hospice care after leaving the facility, said Sarah O’Sullivan, a Gorham House spokesperson. The resident wasn’t exhibiting COVID-19 symptoms, she said.

By contrast, long-term care facilities recorded about three dozen virus outbreaks last January, as COVID-19 was surging before residents and staff members were widely vaccinated. Some 36 people died in those outbreaks, according to Maine CDC data.

High vaccination rates among residents and staff as well as strict adherence to health protocols developed during the pandemic have kept the current rise in COVID cases from translating into a spike in long-term care cases, said Angela Westhoff, CEO of the Maine Health Care Association, which represents nursing homes.

“Those things are helping us not to see outbreaks in long-term care facilities that we might have seen previously,” Westhoff said.

Long-term care facilities were once at the center of the COVID-19 pandemic, with coronavirus deaths in nursing homes peaking at 6,000 a week nationwide in December last year, according to U.S. CDC data. By contrast, the week ending on Aug. 8 saw 215 deaths in such facilities nationally.

Only about a quarter of staff members at Maine nursing homes and assisting housing facilities are unvaccinated, Westhoff said. With the vaccine now being mandated for all long-term care workers (along with all health care workers) by Oct. 1, that number is expected to rise close to 100 percent in less than two months.

Westhoff said it was too soon to tell if the mandate could deplete staffing in nursing homes across the state.

“We anticipate that there will be some folks who choose to leave their jobs,” Westhoff said. “We hope that it’s low, but, obviously, patient safety is priority number one.”

While the community spread has not not come into Maine’s long-term care facilities, that doesn’t mean it never could, Westhoff said. She said staff continued to remain vigilant as they kept up with delta variant developments.

The delta variant has made up 100 percent of the coronavirus cases sampled in the state this month so far, according to the Maine CDC.

Capitol City Manor in Augusta saw 21 cases in an outbreak beginning on July 21 — 18 among residents and three among staff. But everyone who tested positive for the virus was vaccinated, a Capitol City Manor representative said.

Deaths and hospitalizations in breakthrough cases are uncommon, but they do occur, said Dr. Peter Millard, a former CDC epidemiology staffer and family physician. Most of the vaccinated people who have died in breakthrough cases are over the age of 80, Millard said, a demographic that is well-represented in long-term care facilities.

But vaccines had clearly stemmed the tide of COVID-19 deaths and hospitalizations in Maine’s long-term care facilities, Millard said.

Breakthrough cases are of concern, Millard said, but a much smaller set of primarily asymptomatic breakthrough cases was a much preferable alternative to what the delta variant could have done without inoculations. And there will always be some risk as long as COVID-19 is circulating somewhere in the world, he said.

“As you get a higher vaccination rate, a higher proportion of your cases are going to be vaccinated because vaccines are not 100 percent effective,” Millard said.

BDN writer Alexander MacDougall contributed reporting.