BAR HARBOR — Mount Desert Island Hospital is set to begin contact tracing work to make sure that those who have come into contact with out-of-state visitors who test positive for COVID-19 are aware of the potential exposure.
MDI Hospital will use the web-based Sara Alert tool to begin contacting those “close contacts” (anyone who has been within 6 feet of the person for 15 minutes or more) of these out-of-state cases, Maine Center for Disease Control and Prevention (CDC) Director Dr. Nirav Shah announced Tuesday.
Under federal rules, cases of the coronavirus are reported in a person’s state of residence, not in the place where they were tested. Since MDI is a destination for summer residents and visitors from all over the world, residents are nervous about not knowing the true number of cases among people who are or were in the area.
Contact tracing investigations are also normally the responsibility of the patient’s home state, and MDI Hospital leaders have worried that it is hard to do the job well from hundreds of miles away. Maine CDC conducts case investigations and contact tracing for all confirmed cases of COVID-19 in Maine, including nonresidents whose results are reported to Maine CDC by other states, but that reporting doesn’t always happen.
“The failure to acknowledge, track and trace these individuals has both direct and indirect public health fallout,” Dr. J.R. Krevans told the Portland Press Herald before the new contact tracing program was announced. “Maine, by virtue of both its geography and excellent state leadership, has done very well so far, but this situation represents a clear and present danger that should be addressed.”
Overall, since the pandemic began, according to the Maine CDC, 170 positive cases have been reported among out-of-state residents. Since March, about 35 of those have been in touch with MDI Hospital for advice while in the area, spokeswoman Oka Hutchins said. In the last week and a half, about seven people contacted MDI Hospital about having received positive test results after arriving here.
“We’re not labeling this as a potential outbreak,” Maine CDC Director Shah said in a media briefing Tuesday. “There’s no indication that these cases are epidemiologically linked.”
Some travelers to Maine are having difficulty getting test results in the mandated timeline. Some large national labs are taking six days or more to return results. Maine’s travel rules require most visitors to get tested no longer than 72 hours before arriving in the state in order to avoid a 14-day quarantine. That means visitors may be several days into their vacation before getting a result. They are supposed to quarantine during that time.
“Our guidance is clear,” Shah said. “If you are coming to Maine before you’ve got your negative test result in hand, you should absolutely be quarantining until that result comes in. That does not mean limiting your contact when you go out to eat, it means not going out to eat. It means staying in your hotel room. It means not leaving and exposing anybody. That is the essence. If individuals follow that, which they should be, the theoretical number of contacts with Maine people should be very low.”
Asked further about which specific activities are prohibited while people are in quarantine, he said it would be OK to “go outside or go for a walk knowing with confidence you will not interact with anybody at all.” If quarantining visitors must do curbside pickup for groceries or other items at stores, he advised to “wait until there’s no one around you whatsoever” to leave the car.
The pilot project with MDI Hospital for visitor contact tracing, Shah said, “will be the same system that’s used for individuals who are Maine residents.”
A case investigator contacts the person who has received a positive test as soon as possible after the diagnosis is delivered, he said, and compiles a list of his or her close contacts. (This is why restaurants are asking customers for phone numbers.)
Then, contact tracers add contact information for those people to the Sara Alert system and get in touch with them via text message, phone call or email. The system sends automated messages for a period of time to ask those contacts whether they are experiencing symptoms.
“Typically, Sara Alert has been used by hospitals to conduct symptom tracking,” Shah said. “We’re adjusting Sara Alert to make it useful for this situation.”
Should any local close contacts later test positive for COVID-19, Maine CDC would commence case investigation and contact tracing.
“We look forward to seeing how this system works and how we can use it to keep everyone in Maine safe,” he said.
The number of cases of COVID-19 among Hancock County residents nearly doubled in the last week, from 18 to 34, and MDI Hospital reported three new cases from samples collected there (all nonresidents). But a “sentinel” testing program for employees of Mount Desert Island tourism businesses has yet to surface a positive case.