A sign about masking stands at the entrance of Fork & Spoon on Main Street in Bangor. Credit: Linda Coan O'Kresik / BDN

As it sees rising cases, hospital ICUs with limited beds and a strong aversion to vaccination from numerous rural residents, Penobscot County has emerged as the Maine population center with the most rapid spread of the highly contagious delta variant.

The 159 cases reported in the county on Thursday were by far the most for a single day since the beginning of the pandemic and the third day in a row that it has led the rest of Maine in cases. And in the absence of a sharp uptick in vaccinations, experts fear daily case numbers could only go up as fall approaches and people spend more time inside. 

Bangor and surrounding communities had long avoided the worst of the pandemic. Cases surged last winter, but not nearly to the extent that they did in southern Maine. Yet the trends have since reversed, with York and Cumberland counties consistently seeing fewer daily cases than Penobscot despite having far more people. 

Virus outbreaks in the area have followed.

The Maine Center for Disease Control and Prevention is investigating outbreaks at four nursing homes in Penobscot County: Colonial Health Care in Lincoln (34 cases), Bangor Nursing and Rehabilitation Center (five cases), Orono Commons (four cases) and the Maine Veterans’ Homes facility in Bangor (three cases). There’s also an open outbreak investigation at Living Innovations in Bangor, which provides services to people with intellectual disabilities and has reported three cases, according to Maine CDC spokesperson Robert Long.

There is little doubt from experts that the more than 60,000 people in Penobscot County who have yet to receive a single shot — the figure includes more than 17,000 ineligible children — are precipitating the spread. Vaccine hesitancy is widespread in rural communities outside of Bangor, which have some of the lowest vaccination rates in the state.  

With so many remaining pockets of unvaccinated people, there is much potential for the virus to spread, said Dr. Noah Nesin, chief medical officer at Penobscot Community Health Care. 

For Nesin, the infectiousness of the delta variant compared to the previously predominant alpha variant cannot be overstated. People with the delta variant carry 1,000 times the viral load in their throats as people who carried the alpha variant. That increase likely makes it two or three times more contagious than the alpha variant, Nesin said. 

The delta variant is also infecting vaccinated people at a rate unseen in prior variants, though they are far less likely to fall ill from the virus than their unvaccinated counterparts. Northern Light Health said Wednesday that only a small fraction of the people with COVID-19 in its hospitals are vaccinated. None of the hospital system’s patients requiring the most intensive level of care, needing a ventilator to breathe, were vaccinated.

Some 87 percent of residents in the zip code that covers Bangor have received at least one dose of a COVID-19 vaccine, which exceeds the statewide rate of about 60 percent. But Bangor’s status as a regional hub for numerous smaller communities from a large swath of Maine with low vaccination rates could be working against it. 

There is a risk of the virus spreading when people from these communities travel to Bangor, whether for work or for shopping and other services, especially if they do not wear masks indoors. 

“Bangor is an urban center,” said Dr. James Jarvis, COVID-19 senior physician executive for Northern Light Heath. “There are activities that happen here that put people in close proximity.” 

There have also been large mass gatherings in Bangor lately, including the Professional Bull Riders events held indoors at the Cross Insurance Center from July 23-25 and concerts on the Bangor waterfront by Luke Bryan on Aug. 5 and Kiss on Aug. 19. However, a Maine CDC spokesperson said the agency has not opened any outbreak investigations associated with those events and has not confirmed that they were significant sources of coronavirus transmission.

Nesin noted that people don’t generally stay within their communities or within county lines, and gatherings of people from various places increase the likelihood of spread. He pointed to the Sturgis Motorcycle rallies held in South Dakota in 2020 and 2021, which attracted people from multiple states and were both linked to spikes in local coronavirus cases. 

Despite the destructive nature of the delta variant, there are some reasons for optimism. COVID-19 hospitalizations are lower than during previous surges in Maine, though a larger share of patients hospitalized this time around are requiring intensive care compared with last winter’s surge. 

In addition, new data seem to indicate that vaccine hesitancy is declining nationwide, Nesin said. In Maine, more than 61,000 doses of the COVID-19 vaccine were administered in August, a 55 percent increase over the number of new doses given in July. 

With the only way out of this being more vaccinations, Nesin said it was incumbent on community leaders and other members of the public to convince those resisting inoculation of the vaccine’s safety, especially compared to the dangerous new delta variant. 

“There is a shared fate for all of us which is dependent on how each of us behave,” Nesin said.

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