Maine health officials reported an additional four deaths and 36 more confirmed coronavirus cases on Wednesday as they continue to track outbreaks at several long-term care facilities in the state.

At least 24 Maine residents have died from COVID-19 while 770 have tested positive for the disease, according to the latest figures from the Maine Center for Disease Control and Prevention. Six deaths were among residents of long-term care facilities, which now account for roughly 18 percent of confirmed coronavirus cases in Maine.

The additional deaths included a woman in her 70s from Cumberland County, two men in their 70s from Cumberland County and man in his 80s from Androscoggin County who was the first reported death in that county.

The additional 36 confirmed cases represent a 5 percent increase over Tuesday and a 43 percent increase from one week earlier. After accounting for the 24 deaths and 305 people who have recovered from the disease, Maine had 441 active cases of COVID-19 on Wednesday.

Health officials caution that the actual number of Maine residents who have contracted the coronavirus is much higher because of limited testing and because it can take anywhere from one to 14 days after initial exposure for a person to begin exhibiting symptoms. More than 14,000 people have tested negative to date.

Dr. Nirav Shah, director of the Maine CDC, pointed out that 166 of the confirmed cases were among health care workers, which is roughly 21 percent of the total cases in the state.

“I’d just like to take a moment to thank, as Governor Mills did, all of those health care workers – first responders, individuals who work in hospitals, individuals who work in long-term care facilities – for their selfless, quiet, powerful acts of heroism, going to work as they do every day to keep Maine people healthy,” Shah said in his briefing.

The briefing was delayed several hours on Wednesday as police, firefighters and state emergency response crews dealt with an explosion at the Androscoggin Mill in Jay.

Speaking at the beginning of the briefing, Mills noted that the explosion comes at a time when Maine is already dealing with the coronavirus pandemic and its economic impacts as well as two spring storms that knocked out power to hundreds of thousands of Mainers. But Mills said she was grateful there was no loss of life or serious injuries in the massive explosion.

“Without question, the burden for us now is heavy, but Maine people can carry it and we will carry it,” Mills said. “I just want to say, if ever there was a day when we should believe in miracles, today is it.”

Still, Wednesday brought more troublesome news about COVID-19 cases at Maine nursing homes and other long-term care facilities. Nationwide, the virus has taken a heavy toll on many such facilities, with reports of at least 45 deaths in a Virginia nursing home and nearly 40 deaths at a veterans home in Holyoke, Massachusetts.

Shah reported that there are now 137 confirmed cases among residents or staff at long-term care facilities in Maine.

Those include 69 cases at Augusta Center for Health and Rehabilitation, 38 cases at at the Maine Veterans’ Homes facility in Scarborough and 25 cases at the Tall Pines retirement community in Belfast. Each of the three facilities has lost two residents to the disease.

Additionally, the Maine CDC reported five cases – three residents and two staff – at The Cedars assisted-living facility in Portland.

Staff at The Cedars first alerted the Maine CDC about three positive cases on Saturday, but the state did not agree to conduct facility-wide testing of the staff and residents until a fourth case was reported on Tuesday. That appears to be contrary to Maine CDC policy that they begin “universal testing” of residents and staff when there are three cases.

Shah said Wednesday that the agency is “actively and aggressively doing more searching for cases” at nursing homes and other “congregate care” facilities. But Shah said the state adjusts its strategy based on events in other states and developing medical research.

“We do anticipate finding additional cases in long-term care facilities, whether that is the ones we are already aware of or others that are out there,” Shah said. “That’s not a sign that anything has gone astray or that anything has gone awry. It’s a sign that we want to know what’s out there so that we can provide the best available evidence and public health guidance to keep our friends, our spouses, our parents who live in these facilities safe.”

Maine CDC reported that 48 people were hospitalized as of Wednesday and that 22 individuals were being treated in intensive care units. Nine individuals in ICUS were hooked up to ventilators, which assist with breathing in patients suffering respiratory failure because of the virus.

There were 304 ventilators available statewide as of Wednesday morning out of a total pool of 344, and 147 of 314 ICU beds were available. Additionally, Maine has 240 “alternative ventilators” approved for use by federal regulators.

Maine has not received any of the 400 additional ventilators that state officials requested from the national stockpile in the event of a worse-case surge of patients. Federal officials say ventilators from the stockpile were “being sent with prioritization given to the areas of greatest need.”

Shah said the state had received a shipment of 145,000 N95 respirators from the Federal Emergency Management Agency and was continuing to search for additional protective equipment from the federal government and other sources, including private manufacturers in Maine.

Altogether, 126 individuals – or roughly 16 percent of confirmed cases in Maine – have been hospitalized at some point during their illness. Studies show that roughly 20 percent of people who contract COVID-19 need hospital care.

Cumberland County is home to the state’s largest cluster and added eight new cases since Tuesday, increasing to 339 confirmed cases. There are also 156 confirmed cases in York County, giving the two counties the majority of the cases statewide. Maine CDC officials have said “community transmission” of the disease is taking place in Cumberland, York and Penobscot counties.

A woman is reflected in the doors to Fore Play Sports Pub on Fore Street in Portland on Tuesday. Despite the sign, bars and restaurants remain closed to inside dining or gathering. Derek Davis/Staff Photographer

The breakdown of cases in the other Maine counties is: 36 in Penobscot; 31 in Androscoggin; 30 in Waldo; 15 in Sagadahoc; 13 each in Oxford and Somerset; 12 each in Knox and Lincoln; nine in Franklin; five in Hancock; two each in Washington and Aroostook; and zero in Piscataquis. The county of residence for two cases was unknown.

On Tuesday, Gov. Janet Mills extended the civil state of emergency for an additional 30 days until May 15 in response to the ongoing coronavirus pandemic. The state of emergency proclamation allows Mills to quickly marshal state or federal resources and to impose mandatory restrictions – such as business closures or the current statewide stay-at-home order – in order to protect public health.

While Maine has to date been spared the high infection rates and death toll witnessed in other, more populous northeastern states, it is unclear where Maine is on the infection curve.

Mills is expected to participate in another conference call with other governors, Vice President Mike Pence and other Trump administration officials on Thursday. Earlier this week, President Trump sparred with governors about who has the ultimate authority to “reopen” the economy, with many governors and constitutional experts suggesting that the Trump is inflating his executive powers.

Mills said it is too early to say when when her administration will begin to lift restrictions on businesses or end the “stay-at-home” order in effect through at least April 30. But she said her administration is having those conversations daily with businesses leaders and economic experts

“We don’t take significant steps towards reviving the economy until we defeat the virus because without healthy people, you can’t have a healthy economy,” Mills said.

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