ELLSWORTH — The most recent updates from Maine Center for Disease Control and Prevention (CDC) and the Department of Health and Human Services highlight the rapid increase in positive COVID-19 cases and outbreaks. While the Maine CDC expected a positive case spike following the Thanksgiving holiday, the increase is beyond its current staffing and funding resources to open investigations and conduct contact tracing for all positive cases, Executive Director Dr. Nirav Shah said Monday.
The Maine CDC cross-checks each positive case to ensure it hasn’t been reported more than once and also checks for dual lab reports, from a lab and an individual’s doctor.
“The number of reports coming in has exceeded our ability to do that review process on a daily basis,” Shah said. “We thought we could keep up on it, but surge on top of a surge that we saw last week challenged the process.” There is no current backlog of positive tests awaiting review, he added.
In response to the case increase, the Maine CDC has changed how it will conduct its investigations “to focus on the highest risk, most vulnerable individuals,” Shah said. “These discussions and decisions were extremely difficult, unpalatable and necessary in this time of an unprecedented surge.”
He likened the Maine CDC’s current situation to “a very busy crowded emergency room.”
“We have to take our available resources to make sure we are serving those in the highest need in their greatest moment of need,” Shah said. “Those choices are difficult.”
Individuals with positive test cases from the following groups deemed high risk for COVID-19 or for transmitting the virus will still trigger investigations: people under 18; people 65 and over; first responders and health-care workers; people who are hospitalized, from a demographic identified as having a higher burden disease in Maine or identified with a disability; those living in congregate living settings, such as nursing homes and correctional facilities, or those associated with schools or daycare centers.
Case investigations and contact tracing are two sides of a coin, Shah explained. Case investigators question where someone might have gotten infected with COVID-19, while contact tracing seeks to determine who the infected person may have given the disease to through inadvertent exposure.
Now, anyone who receives a positive COVID-19 test will be notified by the Maine Department of Health and Human Services (DHHS), which will offer assistance throughout the isolation process. But the person will be responsible for notifying anyone he or she has come in recent contact with. That person should then quarantine for 10 days. The quarantine period was decreased from 14 days, in line with new federal CDC guidelines.
“If you test positive, before you hear from anybody, think about the folks you have come into close contact with and notify them as soon as you can,” Shah said.
Maine is not alone in rolling back case investigations and contact tracing for people from low-risk groups. Shah said several states have already begun what Maine is now doing, and “we were able to discuss with them how they went about making similar changes.”
DHHS Commissioner Jeanne Lambrew noted that with most transmission in homes “away from the reach of state government, at the end of the day, it’s up to each of us to protect ourselves and our families.”
Shah also reported that the National Guard will continue to play a role in the pandemic through March of 2021, and the Maine CDC is looking at ways to use them in the vaccination process, along with pharmacists, primary care providers and emergency medical services clinicians. The final number of vaccinations Maine will initially receive has not been finalized, Shah said, but the 12,000 on the table right now is “far less than what is needed for Maine,” he noted on Dec. 4.
Shah and Lambrew hold a public, live-streamed briefing every Monday, Wednesday and Friday at 2 p.m., available at www.maine.gov/covid19/cdc-livestream and recorded for later viewing.