University of Maine President Joan Ferrini-Mundy holds her test tube and funnel at the COVID-19 testing site at the Collins Center for the Arts on Feb. 5, 2021. Credit: Natalie Williams / BDN

AUGUSTA, Maine — Maine is trying to expand COVID-19 testing in rural areas by enlisting independent pharmacies in a federal program, but the idea may run into familiar workforce challenges as both new cases and demand for testing remain high.

The state reached out to pharmacies on Sept. 17 to gauge interest in joining a federal testing program that would expand testing in independent pharmacies, who often cater to underserved populations. On Thursday, it announced Walgreens would be providing testing at all Maine locations under a federal partnership adding 44 more sites.

Maine is still exploring how to add independent pharmacies to the roster, said Robert Long, a spokesperson for the Maine Center for Disease Control and Prevention. While some said they would be eager to participate in the program, they cited the national worker shortage as a barrier as they also conduct vaccine clinics and balance their other duties.

The testing push comes as health officials are seeing an increased demand for testing and slowed turnaround times. Somerset, Washington and Aroostook counties were singled out by Maine CDC Director Nirav Shah on Wednesday as needing more testing capacity.

Polymerase chain reaction, or PCR, tests are more reliable than rapid tests in gauging whether or not a person has COVID-19, but they take days to return results instead of hours. Many testing mandates, including that of Canada for vaccinated American travelers, require PCR tests within 72 hours of visiting.

At Machias Family Pharmacy, Ben Okafor had 25 at-home rapid tests on his shelf on Thursday morning. He anticipated they would not last until next week, with demand spurred by rising COVID-19 cases, school outbreaks and employers either requiring vaccinations or proof of a negative test to come into work.

Since Okafor is not equipped to provide PCR tests, he must rely on the available supply of rapid tests. He thinks adding testing would be a good idea, but he wondered how he would manage serving potentially sick patients without exposing them to the rest of his customers.

A lack of sufficient testing in rural counties could be reflected in varied positivity rates, a key measure of the share of tests that come back positive. While the state is aiming to keep the rate below 5 percent and it stands at 4.7 percent, 12 counties were above the mark. While the state has plenty of PCR tests, the bigger question is how to get them to rural regions, Shah said.

“It’s all well and good for us to have tests in our warehouse, but we’ve got to get them to the parts of the state where we really need them,” he said.

There could be logistical hurdles to doing so. More testing is needed to get the virus under control in rural populations where vaccination rates are lagging, said John Gale, a University of Maine researcher and president of the National Rural Health Association. But he wondered if small pharmacies have the staffing and the space to do so.

That was a concern for two pharmacists. Charlie Ouellette, who co-owns two small pharmacies in Bangor and Fort Kent, said he was interested in participating in the program, but would need to figure out how to test people outside and away from other customers.

Then there is the question of who would do the testing when the pharmacy is still trying to hire its regular staff. Demand for testing in his region is high as border towns residents try to cross the Canadian border, but he only offers rapid testing and not the needed PCR test.

Joe Bruno, who owns Augusta-based Community Pharmacies, which has nine locations, said he turned down the offer because it would require the hiring of another staff member. He said his busy staff are better off focused on vaccinating people against COVID-19 and the flu.

“Testing for us would be a little much at this time,” he said.