There are now 89 confirmed cases of coronavirus in Maine, an increase of 33 over the weekend, the Maine Center for Disease Control and Prevention said Sunday. More than half of the cases are in Cumberland County.

Dr. Nirav Shah, director of the public health agency, urged Mainers all over the state – even in counties where cases haven’t been officially confirmed – to start taking precautions now.

“The assumption for everyone should be that coronavirus and the disease it causes, COVID-19, may be in their community,” he said in a conference call with reporters Sunday. “No one should be waiting until there are confirmed cases in their county before they start taking action.”

The Maine CDC recommends that residents practice good hygiene: washing one’s hands often, with soap and water and for at least 20 seconds; avoiding close contact with sick people or touching one’s face with unwashed hands; and staying at home if sick. Public health officials also recommend that Mainers practice social distancing by staying six feet away from others and avoiding large gatherings, or public places where close contact may occur.

Shah also called on the federal government to provide more protective equipment to Maine medical workers. He said the Maine CDC on Monday would distribute thousands of pieces of such equipment across the state, but it needs even more supplies as the number of cases is expected to keep rising.

NEW CASES IN VA SYSTEM

Shah’s call for action came as the VA Maine Health Care System on Sunday reported two cases of coronavirus among its veteran clients and another case in an employee. In response, the system is taking emergency precautions, and all three patients are in isolation at home.

In the latest tally by the Maine CDC, Cumberland County has the greatest number of coronavirus cases – 53 – in part because the county’s population density allows for community transmission, health officials say.

There are a handful of cases in several other counties: eight in York, three in Androscoggin, four in Kennebec, four in Lincoln, four in Oxford, two in Penobscot and three in Sagadahoc. Eight of the 89 patients are in hospitals, according to Shah.

Despite the size of the weekend increase, Shah said a few days isn’t long enough to call it a spike in cases. Epidemiologists – scientists who study the patterns of outbreaks – usually track the spread of a disease over weeks or longer.

An increase measured over a few hours or days “doesn’t really give us much insight into where we might be going,” Shah said in the conference call.

For similar reasons, it will take some time to measure the effect of social distancing recommendations that the Maine CDC and Gov. Janet Mills made this month. The new coronavirus has a long incubation period – the time it takes for a person to show symptoms after infection – which creates a lag in analysis of its spread or prevention.

“It’s like watching something that you think is a live broadcast but was actually recorded two to 16 days ago,” Shah said.

Public health officials will likely allow one full incubation period – at least two weeks – to pass since precautions were recommended before trying to measure how the closure of schools and public gathering places – as well as people’s efforts to keep home and physically distant from others – may have affected the outbreak.

Even then, determining the effectiveness of social distancing is “an epidemiological challenge,” Shah said, because there’s no “counterfactual” to compare it to – a scenario in which Maine didn’t take the same precautions. Scientists may compare Maine’s progress to historical data, a progress that involves “a bit of art,” Shah said.

The number of tests that have come back negative hasn’t been updated since Friday, when it was 2,264. A spokesman for the Maine CDC said Saturday that the public health authority will update that number on Monday because of the difficulty in obtaining an accurate figure from outside labs over the weekend.

The emergency measures the VA Maine Health Care System is taking in response to the three positive tests for coronavirus also include erecting a triage tent outside its Togus facility, opening a drive-up testing operation, halting many elective surgical procedures, and moving to an all-mail prescription service.

MORE HELP FROM FEDS SOUGHT

Shah said the Maine CDC on Monday would distribute thousands of pieces of personal protective equipment, or PPE, across the state: more than 2,000 N95 masks, 8,000 surgical masks, almost 2,000 face shields, and thousands more pairs of gloves.

That effort will include a shipment of supplies to OceanView at Falmouth, a retirement community that has seen six COVID-19 cases among its residents, Shah said.

He said the Maine CDC had recently learned that the Federal Emergency Management Agency plans to send more PPE to Maine.

Still, he said, “What is going to be delivered next is still not sufficient. We are continuing our call for federal officials to release more PPE.”

Mills and the state’s congressional delegation joined that call in letters to U.S. Secretary of Health and Human Services Alex Azar that asked him to release more supplies from the national emergency stockpile.

Maine’s congressional delegation on Sunday also wrote to U.S. Secretary of Agriculture Sonny Perdue, asking him to expand access to federal programs that would allow more Maine schools to provide meals to children from low-income families.

The Maine CDC director said it was important to maintain a sense of social connection during the physical distancing needed to contain the pandemic.

Shah said he preferred to replace the term “social distancing” with “physical distancing, but social connectedness and closeness.”

This moment is an experiment, of sorts, in keeping in touch with others from a distance, he said – an effort that will involve technologies we know, like the phone, but also such new things as virtual cocktail hours and dinner parties.

“I think there’s going to be a lot of innovation that comes into being and shows us ways to connect with one another even though there’s physical distance,” Shah said.

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