Although Maine by noon Tuesday had no confirmed or presumptive positive cases of the coronavirus disease that has swept across the planet, experts believe that is likely to change.
The epidemic has touched most states, including the rest of New England. Maine public health officials on Tuesday were awaiting results from tests sent to the U.S. Centers for Disease Control and Prevention in Atlanta because until Monday, March 9, Maine was not able to perform its own tests.
The disease, 2019 Novel Coronavirus or COVID-19, is a respiratory illness that originated in China. According to The New York Times, more than 500 cases had been identified in the United States as of Monday, March 9, and 22 people had died. Approximately 110,000 cases of the virus have been documented around the world.
Robert Long, a spokesman for the Maine Center for Disease Control and Prevention, said his agency began monitoring the virus as soon as it appeared in China, and began planning for a potential outbreak.
“A team of almost 40 Maine CDC staff, including epidemiologists, emergency preparedness experts and others, have been working since then to ensure that Maine people would be ready if the virus shows up here,” Long said. “At this time, Maine has no confirmed cases of COVID-19. It’s more a matter of being focused on protecting public health than ‘concern.’”
The Maine CDC also has received new testing equipment, and lab staff is preparing to use that equipment in the coming days. Long said the U.S. CDC updated its testing criteria as recently as March 4.
“The number of requests for testing will increase as the COVID-19 situation continues to rapidly evolve globally and in the United States,” the Maine CDC said in a press release. “Moving forward, tests will be conducted at both the Maine CDC and U.S. CDC to facilitate prompt results.”
The Maine CDC also on Tuesday said it would conduct daily weekday press briefings to share developments.
New England response
Massachusetts as of Tuesday had more than 40 cases of the virus. The St. Patrick’s Day parade in South Boston, scheduled for Sunday, March 15, was canceled; Harvard University and Amherst College moved classes online.
New Hampshire had four confirmed coronavirus patients as of early this week. The first was an employee of the Dartmouth-Hitchcock Medical Center in Lebanon with “mild” conditions, according to the New Hampshire Union Leader. This individual also went into self-quarantine.
Rhode Island declared a state of emergency Tuesday. Four people in the state were infected and nearly 300 were in quarantine.
On Monday, Vermont confirmed its first case of the virus. Connecticut also confirmed one positive test for the virus.
While the CDC has not been recommending self-quarantine as a preventative measure, the agency did advise practicing “social distancing” and staying home for 14 days after leaving an area “with widespread, ongoing community spread.”
As a result of the virus, cleaning and disinfecting products have become increasingly more difficult to buy. In Maine, hand sanitizer and other products, such as medical face masks, have become virtually impossible to find at stores and pharmacies.
According to the U.S. CDC, the virus outbreak has a link to animal-to-human spread, likely from a large seafood or animal market. However, the virus soon became transferable by person-to-person contact and has been spread by people who did not know they were infected.
The World Health Organization declared the outbreak a public health emergency of international concern.
Symptoms of COVID-19 include fever and difficulty breathing, and may take up to two weeks to appear after coronavirus exposure.
Portland officials released a statement last week that they will follow guidelines set by the state government, and that the city emergency management team is prepared to respond to anyone diagnosed, and that city employees have been given guidance.
“The city is in communication with the Maine CDC and has been participating in their briefings,” City Manager Jon Jennings said in a statement. “The state has a very knowledgeable team in place, and here in Portland we are fully prepared to follow Maine CDC guidance and ready to participate in any response as needed.”
Maine schools and universities have also been impacted.
On Tuesday, the University of Maine System prohibited all university-sponsored non-essential air travel and encouraged students to stay on campus over spring break due to coronavirus fears. It previously recalled 14 students who were studying abroad in Italy, which has now been completely locked down.
A press release from the university system said it decided to close the Italian program and evacuate students by March 10 when the State Department issued a Level 2 travel advisory for Italy. The system is also tracking students and faculty who traveled through countries with heightened alerts and travel prohibitions. There are no UMS students in China, although there is one faculty member.
Portland Public Schools Superintendent Xavier Botana sent out a district-wide letter at the end of February, letting families know the schools have been preparing for the virus. He cautioned that there were no outbreaks in Maine, and the risk of an outbreak is “quite low.”
Botana said school custodians are disinfecting frequently touched items and surfaces daily, and school nurses and administrators are working with the city Health Department and the Maine CDC to stay up to date on the situation. Botana said in the event of an outbreak, the district will follow recommendations from the CDC.
“Those recommendations could include school closings,” Botana said. “School closing decisions are typically made by the Maine CDC, and depend on the number of people infected and the risk of the disease spreading. We are working with (the Maine Department of Education) to develop plans for continued learning during any closing.”
Last week, South Berwick students who had traveled to Italy for a non-school-sponsored trip were in self-quarantine, after the CDC raised the threat level. The students, part of Maine School Administrative District 35, had not initially been asked to go into self-quarantine, and their quarantine period ended on Sunday.
Long, of the Maine CDC, said the most important thing for Mainers to remember at this point is to take precautions to guard against the virus: Eat well, get plenty of sleep, cover your coughs, and stay home when you feel sick.
“It’s also important to note that if you feel ill with symptoms of COVID-19 – fever, cough, shortness of breath – you should call your medical provider before going to the (doctor’s) office or a walk-in clinic,” Long said. “Maine CDC has been regularly working with the state’s medical community on COVID-19 since the outbreak was first identified, so your medical care provider can best advise you how to proceed if you don’t feel well.”
He said it is up to individual superintendents and school districts to decide if and when to cancel classes and events because of the virus.
“Maine CDC has been in regular contact with the Department of Education to ensure that local school officials have the best tools at their disposal to make decisions,” Long said.
The virus threat is also affecting Maine businesses.
Wex, the large, publicly owned payment processing service based in Portland, said the company’s business has been negatively impacted, including travel, shipping activity, and fuel prices. The company expects first-quarter revenue in 2020 to be 2 or 3 percent lower than previously expected.
The company could not forecast what impact coronavirus may have on the second quarter. Wex employs about 1,500 workers in Maine and 4,700 in 10 countries around the world.
The Portland Regional Chamber of Commerce urged employers to be ready to implement a workforce plan in the event of a virus outbreak. The chamber advises employers to actively encourage sick employees to stay home, practice good hygiene, perform routine cleaning in the workplace, and advise employees on what steps to take ahead of traveling.
Another possibly troubling development on the horizon for Maine is the scheduled arrival of the first cruise ship of the season in April. The U.S. CDC recommends travelers, particularly those with underlying health issues, defer all cruise ship travel worldwide after there were widespread outbreaks of COVID-19 aboard several ships.
Smaller cities and towns are responsible for developing individual emergency management plans. For example, in the town of Falmouth, Fire Chief Howard Rice is the director of the Falmouth Emergency Agency. Rice works with the town manager and Town Council chair to monitor the situation.
“Chief Rice is working with Cumberland County Emergency Management and Maine CDC to monitor any potential spread of COVID-19 in our area,” a press release read. “Falmouth EMA is prepared and ready to assist our emergency preparedness partners as needed.”
Gov. Janet Mills created a Coronavirus Response Team, which is headed by the director of the Maine CDC, Dr. Nirav Shah. According to a release from the governor’s office, the task force will meet regularly to gather and share information. Mills also participated in a briefing with Vice President Mike Pence, U.S. Secretary of Health and Human Services Alex Azar and other federal officials.
“The state must be prepared to respond swiftly and effectively to any potential cases in Maine,” Mills said in a prepared statement. “The Coronavirus Response Team, led by Dr. Shah, will build on our preparation and response efforts, coordinate across state government and ensure that we are taking every precaution necessary in partnership with local health officials, hospitals, school districts, municipalities, and others to make sure Maine is fully prepared and to fully inform and protect all Maine people.”
Shah said the Maine CDC continues to prepare for the virus. “As we keep working to minimize the risk of community spread,” he said, “the best thing Maine people can do is take common-sense steps to stay healthy, such as frequent hand washing.”
Long said the Maine CDC is working to ensure the public gets the correct information regarding the virus, and “to ensure that misinformation does not spread faster than the virus.”
“In addition to the website,” he said, “we have participated in dozens of information-sharing sessions with a wide range of stakeholders – schools, hospitals, EMS, Maine’s tribes, physicians, municipal officials, the military, etc. – to ensure that Maine people can get accurate information from people they trust.”
Shah no stranger to epidemics, controversy
Dr. Nirav Shah has been the director of the Maine Center for Disease Control and Prevention since 2019. He previously was director of the Illinois Department of Public Health.
Shah, who holds medical and law degrees from the University of Chicago and studied economics at Oxford University, also served in the Ministry of Health in Cambodia, where he investigated and managed disease outbreaks. He has also advised governments around the world on health care, reducing maternal and infant mortality, and reducing childhood lead poisoning.
He was appointed to the Maine position by Health and Human Services Commissioner Jeanne Lambrew, who said Shah’s “expertise and enthusiasm will serve the state well as he leads the revitalization of our public health system to improve the health and wellbeing of Maine people.”
But Shah’s history is not without controversy. The Maine Center for Public Interest Reporting last year reported Shah was criticized for how he handled a multi-year health crisis in Illinois that ended with the deaths of 13 people in a state-run home for veterans.
The deaths resulted from an outbreak of Legionnaires’ disease, a form of pneumonia, from 2015-2018. In all, at least 74 residents, volunteers and staff became ill.
The criticism of Shah began after he did not notify families for several days in 2015, despite suspecting the outbreak had begun. A grand jury subpoenaed hundreds of records from Shah’s department on its handling of the outbreak and subsequent response.
Shah was appointed to the Illinois position by then-Gov. Bruce Rauner. When the Republican governor lost his re-election bid, Democrats in Illinois called for Shah’s resignation. Rauner’s opposition made the Legionnaires’ controversy a key issue in the campaign. Despite the calls for his resignation, Shah remained in the job until 2019 to see the transition to the next administration.
Maine Gov. Janet Mills and Commissioner Lambrew have stressed their confidence in Shah, who is now charged with leading Maine through the coronavirus epidemic, as head of the state’s Coronavirus Response Team.
— Colin Ellis