State health officials reported Tuesday that 37 workers at the Tyson Foods plant in Portland have tested positive for COVID-19, adding Maine to the growing list of states facing outbreaks at meat processing facilities.

The Maine Center for Disease Control and Prevention reported 20 additional positive test results among workers at the poultry processing plant on top of 17 known cases on Monday. The agency also reported four additional deaths among individuals with coronavirus statewide — raising the total to 61 — and 21 other new cases, not including the 20 at the Tyson plant.

There were a total of 1,226 confirmed or probable COVID-19 cases in Maine as of Tuesday – an 18 percent increase over the 1,040 reported one week earlier, reflecting a steady uptick but not the surges that some states are experiencing.

The Maine CDC also reported that 741 people have now recovered from COVID-19, representing 60 percent of all confirmed or probable cases tracked by the agency. After accounting for those recoveries and the 61 deaths, Maine had 424 active cases of the disease, a decrease of four since Monday.

The number of active cases in Maine peaked at 446 on April 17. Public health experts agree that a decline in cases for at least two weeks is one of the most important criteria for determining whether it is safe to begin reopening the economy, which Gov. Janet Mills began on Friday by lifting closure mandates on a handful of sectors.

Dr. Nirav Shah, director of the Maine CDC, said test results were back for the nearly 400 full-time staff at Tyson, but the company and his agency were still awaiting results for about 30 contractors or outside individuals who recently visited the facility.

The plant will remain closed until at least Thursday, Shah said, as test results come in and Maine CDC staff continue to work closely with facility managers.

The company said Monday that numerous changes were being made to better protect employees. Those include installing partitions between workstations, issuing and requiring use of face coverings, erecting tents for additional break areas, checking employees’ temperature and changing policies to encourage sick employees to stay home.

“The health and safety of our team members continues to be our top priority, and we take this responsibility extremely seriously,” Tyson spokesman Worth Sparkman said in a statement. “We’re grateful for the assistance from our third-party medical provider and for the collaboration with Maine CDC. We’ve suspended all operations until the results of the tests are known.”

In the meantime, Maine CDC field epidemiologists have begun the contact tracing process of reaching out to anyone who had close contact with an infected person during the past 16 days.

“We anticipate that it will go on for quite some time as we identify more contacts, more close contacts of contacts, and then another ring thereafter,” Shah said. “It will probably go on for quite some time but, candidly, that is what our team of field epidemiologists does day in and day out.”

Always time-consuming, the contact-tracing process is even more challenging at Tyson’s facility because many employees hail from the Portland area’s diverse community of immigrants. That raises concerns about the risks of transmission to others in the household or immigrant community.

Interpreters with training in medical terminology have been brought in to help overcome language barriers given the complicated, potentially life-threatening situation. But Shah said the Maine CDC is also “especially concerned” because of the disproportionate impact on immigrants and the potential for discrimination.

Nationwide, minorities constitute a disproportionate share of COVID-19 infections and deaths. Incomplete data from the Maine CDC also suggests that black, Hispanic and other minorities account for a larger percentage of cases than their population in the state.

“We are also making sure we are asking about other things that might be going on – for example, making sure we ask whether they have safe, stable housing,” Shah said. “Because if they don’t, that’s a problem not just for them but certainly something that we want to think about as a public health system as well.”

Meat processing facilities across the nation have been closed in recent weeks amid worker outbreaks on a much larger scale than the one playing out in Portland. Last week, the U.S. Centers for Disease Control and Prevention estimated that 4,900 meat processing workers had tested positive for COVID-19 at 115 facilities in 19 states.

Maine’s infection growth rates are trending in the right direction, although Shah and other experts also warn of the potential for a sudden reversal or a second wave of cases if people become too lax in taking steps to avoid transmission.

Maine had the sixth-lowest per capita infection rate for COVID-19 – with 92 cases out of every 100,000 residents – among the 50 states and the District of Columbia, according to the latest figures from the U.S. CDC. Maine’s death rate of five fatalities for every 100,000 people places the state among the lower half of states, according to daily tracking done by The New York Times.

Hospitalization figures also have flattened or declined in recent weeks, and public health experts attribute that trend at least in part to physical distancing protocols, and restrictions on businesses and travel.

But the figures fluctuate from day to day, illustrating the unpredictability of the virus. The four additional deaths reported Tuesday came after two days when the Maine CDC reported no new deaths and was the highest single-day change since April 23.

Shah identified the deceased as one man and one woman from Kennebec County, both in their 70s, and two men in Cumberland County, one in his 70s and one in his 80s.

The Maine CDC is also tracking outbreaks at homeless shelters in Portland and Bangor, as well as at several nursing homes. Shah provided the following update on confirmed cases at long-term care facilities:

• Augusta Center for Health and Rehabilitation: 48 residents, 28 staff, seven deaths

• Edgewood Rehabilitation in Farmington: 10 residents, five staff, one death

• Falmouth By the Sea: 29 residents, 16 staff, two deaths

• Maine Veterans’ Home in Scarborough: 32 residents, 23 staff, 12 deaths

• Tall Pines in Belfast: 32 residents, 11 staff, 12 deaths

• The Cedars in Portland: 10 residents, five staff, one death

Maine had a total of 319 critical care beds in its hospitals Tuesday, of which 157 were available, and a total of 318 ventilators, of which 293 were available. In addition, there were 395 alternative ventilators available.

Testing supplies and capacity have been a challenge in Maine and nationwide. While Maine was among the first states to pursue universal testing of all residents and staff of a facility as soon as three people test positive for COVID-19, the state is not at a point where it can offer preemptive testing of all residents at facilities.

The Maine CDC continues to distribute face masks, gloves and other personal protective equipment to nursing homes, first responders and other health care facilities statewide. But a survey of nursing homes last week found that 17 of 28 reported they had seven or fewer of the nasal swabs needed to conduct tests, and nine of those 17 had no swabs.

Shah said Monday that the Maine CDC is slated to begin receiving 15,000 swabs weekly for distribution around the state.

On the testing issue, Shah said he has been working with an unidentified organization on a deal that would allow the Maine CDC lab to at least double its testing capacity. The goal, Shah said, is to be able to quickly complete tests for any doctor or health care provider who requests one. Presently, the Maine CDC lab’s top priorities for turning around testing results are for hospitalized individuals, residents or staff of nursing homes and other congregate care facilities, health care workers and first responders.

“We hope that an announcement on that is coming soon, but there are of course a lot of moving pieces in any such deal like that … but we hope it is very soon,” Shah said.

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