A class on Judaism is held under a tent set upon outside Temple Beth El, Monday, Aug. 30, 2021, in Augusta, Maine. The recent COVID-19 upsurge is disrupting plans for full-fledged in-person services. Credit: Robert F. Bukaty / AP

Maine is sticking with its COVID-19 strategy as the virus rages through Maine’s unvaccinated population in a first major peak of cases since shots began and restrictions went away.

While Maine has maintained the third-lowest case rate among states during the pandemic, it is being hammered on what looks like the back end of a summer wave of cases in the U.S. driven by the contagious delta variant, seeing the highest two-week growth rate in transmission of any state as of Thursday and setting a new record for critical COVID-19 patients on Friday.

It has come under largely the same relaxed public health policies that date back to the spring and early summer, when politically tricky economic restrictions were phased out. Masks are merely recommended in crowded indoor settings under federal recommendations that Maine is mirroring. State and federal vaccine mandates covering at least two-fifths of the workforce here are likely to take effect this fall, but the effect could come slowly.

Maine Center for Disease Control and Prevention Director Nirav Shah defended the state’s strategy under Gov. Janet Mills on Wednesday, saying the surge is not due to state policies, saying “there is not a place in the world” where cases are not spreading quickly.

“That is as much a function of the ways that the patterns of transmission change as a variant moves through a population,” he said. “As they do, the patterns will modulate. There will be peaks and troughs.”

Viruses spread in fits and spurts, said Robert Horsburgh, an epidemiology professor at Boston University, but the combination of increased tourism with relaxed distancing and masking has allowed the virus to spread widely despite nearly 74 percent of Mainers being fully vaccinated.

Absent stricter policies and as vaccine uptake remains slow, Horsburgh said people should consider masking more and avoiding indoor dining. He also said officials should continue to stress getting initial shots rather than boosters, which could be sped up by Maine’s alignment with the federal labor safety requirements for employers.

“The virus can’t spread unless there’s enough unvaccinated people to keep transmission going,” he said.

For now, there is: Maine had a reproduction number — or the number of people a COVID-19 positive person, on average, spreads the virus to — above one as of Thursday, even though 35 states had gone below one by that time. It means that cases are expected to keep rising here.

Part of the challenge is giving people enough time to get vaccinated. The Pfizer and Moderna vaccines require two shots three weeks apart and a two-week period afterward for someone to be considered fully vaccinated. The one-shot Johnson & Johnson vaccine takes two weeks.

All have proven highly effective in protecting against serious cases of the virus. So-called breakthrough cases in vaccinated people have risen sharply in recent weeks, accounting for 16 percent of cases between Aug. 6 and Sept. 10, but unvaccinated people were still more than eight times likelier to be infected and almost all of these cases were mild.

The timing issue is partially why the Mills administration gave health care workers another month to get vaccinated under its controversial mandate, though the state has said that deadline applies only to enforcement and is not when employees should get vaccinated.

Jeffrey Austin, a lobbyist for the Maine Hospital Association, said some staffers might get vaccinated between Oct. 1 and the Oct. 29 enforcement deadline. Spokespeople for MaineHealth, Northern Light Health and MaineGeneral all said they view the deadline for employees to show proof of vaccination or be removed from the schedule as Oct. 29.

How swiftly large private sector and public employers will have to follow suit is unknown. The state needs to confirm within 30 days of the federal Occupational Safety and Health Administration adopting its final rules. But that timeline is unclear. Lindsay Crete, a Mills spokesperson, said the administration would wait for that to happen before weighing in.

“We recognize that there will be many questions,” she said.