A sign praising nursing home employees as heroes is pictured outside the Presque Isle Rehab and Nursing Center on Dec. 2, 2020 Credit: David Marino Jr. / BDN

Maine saw a higher rate of COVID-19 cases in nursing homes in May, but lowering death rates point to the effectiveness of vaccines in keeping vulnerable residents safe.

The average weekly case rate in Maine was 22.6 per 1,000 residents last month, compared with 6.2 in the same period nationally, according to federal data. It was higher than any other state last month, although the federal government cautions that more recent case data are less reliable and could be updated.

It came on the back end of an increase in cases that began in April and peaked in early May, according to state data. During that time, Maine had one of the highest levels of new reported cases in the country, although other measures such as wastewater have become more of a preferred method of tracking transmission with increasing use of at-home tests.

The uptick is a familiar problem for nursing homes hit hard by the virus early in the pandemic and still struggling to rebuild their workforce. While outbreaks have continued, including eight in early May, they are far less deadly. The situation reflects the challenges of limiting the spread of the more contagious strains of the virus now circulating, two experts said.

“We expected the surge, but it came on the back of another surge,” said Dr. Jabbar Fazeli, who leads the Maine Medical Directors Association and administers a handful of southern Maine nursing homes.

The most recent data show outbreaks are getting considerably less dangerous, noted Angela Westhoff, the president of the Maine Health Care Association. While outbreaks remain a challenge for stretched homes, the average weekly death rate for Maine nursing homes in May was only 0.5 per 1,000 residents, less than half of the January rate.

The speediness of the virus can also mean case rates shift dramatically, said Maine Center of Disease Control and Prevention spokesperson Robert Long. While the nursing home rate was high in May, he noted the state currently has among the lower transmission rates in the country according to federal data. Maine has also had one of the lower rates of preventable COVID-19 deaths.

“That longer-view approach to measuring the impact of COVID-19 on Maine people provides a more comprehensive perspective on the virus’ impact than one-month case rates for selected segments of the population,” he said.

Public health requirements and recommendations for nursing homes have mirrored a more lax approach to the pandemic in the last few months, with Fazeli saying they are lagging behind what is needed to prevent the spread of the omicron variant.

The federal Centers for Disease Control and Prevention only recommends health care providers wear N95 masks when the county they work in has substantial or high transmission rates. It has been interpreted by many facilities to mean wearing more protective masks is only necessary during surges or to only wear a surgical mask and face shield with patients, Fazeli said.

Facilities not being allowed to deny visitors based on vaccination status and not requiring workers to get boosted presents a challenge, Fazeli said. Gov. Janet Mills’ vaccine requirement instituted for Maine health care workers last fall only applies to initial shots, as does a similar one on the federal level.

But his support for more restrictions is not universally shared across the industry. Westhoff said she was unsure how new ones would affect an industry already lagging efforts to draw in staff with other sectors including retail and hospitality able to pay more at a time of rising costs and inflation.

“We have tools now that we didn’t have during the beginning of the pandemic,” she said.