Coronavirus crisis: Maine focuses on congregate-care spread of COVID-19

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Gov. Janet Mills on Tuesday extended Maine’s state of civil emergency for another 30 days as the state continues to respond to the coronavirus pandemic.

Mills said the action gives her the power to extend all emergency declarations already in effect, although she has not yet decided whether to extend a stay-at-home directive due to expire at the end of April.

The state of civil emergency that now extends to May 15 also allows the governor to deploy resources and seek access to federal aid, Mills said in an Augusta news briefing where she joined Dr. Nirav Shah, director of the Maine Centers for Disease Control and Prevention.

As COVID-19 cases increase nearly statewide, Maine health officials are clearly focused on the spread at long-term care facilities.

Shah on Monday said 48 of the state’s latest then-confirmed 698 cases of the novel coronavirus were individuals associated with long-term, congregate-care facilities: 35 residents and 13 health-care workers.

On Tuesday, the number of confirmed cases had grown to 734, according to the Maine CDC. There have been 20 deaths.

A large part of the day-to-day increase in confirmed cases is a result of individuals in the congregate housing facilities, Shah said.

Shah on Tuesday said the CDC is particularly focused on three outbreaks: the Tall Pines facility in Belfast, with 19 residents and five staffers who tested positive, the Maine Veterans Home in Scarborough, where 38 residents and staffers tested positive, and the Augusta Center for Health and Rehabilitation, which had 63 residents and test positive.

Another center of the outbreak is the OceanView retirement community in Falmouth, where 11 individuals have tested positive for the virus.

“We have been working very closely with these facilities,” Shah said Monday.

He noted the significance of the Scarborough veterans home.

“These residents here are individuals who provided selfless services to this country in a time of need,” Shah said. “And it is our intention to do the same.”

Shah said congregate-care facilities, ranging from nursing homes to homeless shelters, are a major area of focus for several reasons. First, they are often populated with medically vulnerable residents who are often in close contact with each other, and with staff.

“We know coronavirus can spread rapidly within these facilities,” Shah said.

He urged people to remember the residents of these facilities are often “our friends, our parents, our siblings and our spouses.”

Jeanne Lambrew, commissioner of the  Maine Department of Health and Human Services, said the state began focusing on these facilities well before the first positive case was confirmed. There were weekly webinars held for staff, and facilities were provided with information on how best to respond to the crisis. 

She said each facility also has to have an emergency care plan in place, and the DHHS will consult with every facility to see if their plan is appropriate or can be improved. Lambrew said DHHS will continue to offer webinars and other services and funding for these facilities for as long as needed during the pandemic.

“We’re all in, and we will continue to take steps necessary to protect our older citizens,” she said.

Shah also praised the health-care workers in these facilities, who put themselves at risk to provide care to those residents.

“The front line is the bedside of our parents, of our veterans and of our families,” he said.

While there remains a dire need for personal protective equipment throughout the state, Shah said, these congregate-care facilities are receiving the appropriate shipments. He said the Augusta Health and Rehabilitation center last received a shipment on April 10, and Tall Pines and the Maine Veterans Home each received shipments on April 6 and 9.

“We are standing by to assist these facilities in every way possible,” Shah said.

He said the state currently has an available stock of 48,000 N95 masks, 45,000 surgical masks, 13,000 face shields, 92,000 gloves, 1,000 disposable protective suits, 19,000 surgical gowns, and 186 coveralls. He said the state continues to seek additional sources of PPE, both from national suppliers and in-state producers, especially since Maine will not receive any further shipments from the national stockpile.

On Monday, Shah said there were 314 intensive care unit beds in the state, 158 of which are available. There are 328 traditional ventilators, 283 of which are available. There are also 234 alternative ventilators available.

He said there are 110 health-care workers in the state who have been infected with the virus, which can cause mild symptoms such as a cough or fever that clear up in a few weeks. For some, especially in older adults or those with existing health problems, the virus can cause more severe illness, even death.

Three counties – York, Cumberland and Penobscot – have shown to have instances of community transmission. So far, 20 individuals across Maine have died from the virus. Two hundred and ninety-two people have recovered by U.S. CDC standards. One hundred and twenty-four people have been hospitalized, 61 of whom are still in hospitals. Of those, 39 are in regular patient beds and 22 remained in intensive care. Shah said as of Monday there were nine people on ventilators.

At the congregate-care facilities, Shah said as soon as there is the faintest hint that a person may have the virus, the CDC recommends universal testing of all residents and staffers. However, he said the fact there are high numbers of people who test positive does not mean there are high numbers of people who are critically ill. He said most of the positive results the CDC has seen have been from individual residents who have not shown symptoms of COVID-19.

Mills on Tuesday urged Mainers to be kind to their children, their neighbors and themselves, and to continue to practice physical distancing.

“Stay the course, stick with us,” the governor said. “You’re saving lives, hundreds of lives, by staying home.”

Maine Secretary of State Matt Dunlap.

Virus prompts Maine to delay primary elections

Gov. Janet Mills’ decision last week to postpone statewide primary elections by more than a month, to July 14 from June 9, followed hours of discussions, Secretary of State Matt Dunlap said Monday.

Dunlap said the “journey had changed significantly” as the spread of COVID-19 increased. He said early on his office began to look at ways of adapting the upcoming June primary to allow the largest number of people to participate.

“We started toying with the idea of an all-absentee ballot election,” Dunlap said.

However, he said there was a “panic” that this wouldn’t work as the virus spread, and town offices were closed. He said that’s when his office started working with Mills to push the election date back. 

On April 10, Mills issued the order to move the primary to July 14.

“It’s easier now that we have that executive order in hand,” Dunlap said, adding the order may get “tweaked” for things like mail-in deadlines.

Dunlap said the order only applies to the statewide elections, and that town and city-specific measures, such as Portland’s annual school budget vote, are not part of Mills’ executive order.

“We don’t govern town elections,” Dunlap said, adding that there was a joke that “every day is Election Day somewhere in Maine.”

“I know the governor is looking at how they can assist with municipal deadlines,” he said. “They decided not to wrap this into the order (because) it would be too much to do.”

Dunlap said he, along with his counterparts in several other states, have been in discussions with U.S. House Speaker Nancy Pelosi, D-California, over appropriations for elections. With the Maine Legislature not in session, he said, appropriating any kind of funding is difficult.

“There’s a lot of things we can do, and the landscape will change between now and the end of April, and also by the end of May,” Dunlap said. “With any luck we’ve just moved Election Day, and people will see what they are used to seeing at the polling stations.”

The June ballot would have included party primaries for various federal offices, including the U.S. Senate seat held by Republican Sen. Susan Collins and the seats in the U.S. House of Representative held by Democratic Reps. Chellie Pingree in Maine’s 1st Congressional District and Jared Golden in the 2nd District. Primaries are also possible in all 35 state Senate districts and the 151 state House of Representatives districts, as well as for many county government offices.

Dunlap, who is in his last year as secretary of state, praised the way Mainers have responded to the coronavirus crisis. He said no one ever starts out the day planning to face a crisis, but said people have handled the situation well.

“In the time that we’re in,” Dunlap said. “The problems I have to solve seem to be relatively minor.”

— Colin Ellis