People wearing protective masks stay apart near a bus stop on Congress Street in Portland on Tuesday. Shawn Patrick Ouellette/Staff Photographer

Maine’s top health officials are preparing to more than quadruple the number of employees available to conduct contact tracing, a critical tool to prevent future outbreaks of COVID-19.

Maine Health and Human Services Commissioner Jeanne Lambrew said Tuesday that her agency plans to hire 125 more full-time employees in phases as needed, adding to the 30 who are doing the work now. Additionally, the state will begin training next week of 50 volunteers who will assist with contact tracing, and has begun using an electronic system called Sara Alert, to help people easily self-report.

Lambrew is hoping the state’s caseload stays low enough that the new contact tracers won’t all be needed.

“But our job is to be ready,” she said.

Tuesday’s announcement came as the state logged 35 additional cases of COVID-19, the disease caused by the coronavirus, and one new death, a man in his 80s who had been a resident of Cape Memory Care in Cape Elizabeth. Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said there are now 67 confirmed cases – 47 residents and 20 staff – associated with the outbreak at that long-term care facility, but this was the first death.

Maine now has seen 2,109 cases overall and 79 deaths since the pandemic reached the state in March. The national death toll topped 100,000 on Tuesday.

Nearly two-thirds of the cases in Maine (1,318) have recovered and the number of active cases sits at 712, which is six more than Monday’s total. Maine’s caseload includes 1,894 confirmed cases and 215 probable cases, which are determined based on symptoms and a person’s exposure to a confirmed case.

So far, 258 people have been hospitalized at some point, with 60 individuals in the hospital as of Tuesday, up from 59 on Monday and 37 a week ago. Among those hospitalized Tuesday, 26 were in critical care and 13 were using a mechanical ventilator to help them breathe. There were 25 people in critical care on Monday.

Hospitalization rates and death trends are key metrics for tracking the progress of the virus and efforts to contain transmission. Intensive care beds and ventilators are critical tools for treating hospitalized patients, and epidemiologists closely monitor the demand for those tools as they study the spread of the disease.

Shah said he follows hospitalizations closely but cautioned that they are often a “lagging indicator” of the virus’ spread. He also said the recent increase in hospitalizations is tied, at least in part, to the outbreak at Cape Memory Care.

Tuesday marked the first day after the long Memorial Day weekend, a stretch during which many people likely ventured out in public more than they had in the previous two months, although Maine Turnpike traffic was down 33 percent from last year. Asked to give his thoughts on how Mainers, and out-of-state visitors, handled themselves and abided by public health guidelines, Shah said he was encouraged.

“In my goings out over the weekend … what we saw was remarkable compliance,” he said, referring to people maintaining physical distancing and wearing face coverings when appropriate. “I think it speaks a lot to the fact that people want to do what’s best for their community.”

Shah did acknowledge that “not everyone is going to want to be on board.”

“The No. 1 question we can all ask other people … is not so much what they believe but why? What would it take for someone to come around to the idea that this is a serious concern?”

Lambrew said the state’s approach to enforcing the guidelines has been to remind people that this is a public health crisis and “violations put people in imminent risk.” She said the state is always looking at whether to adjust its guidelines, including the 14-day quarantine required for out-of-state visitors, but absent treatment or a vaccine, there are “not that many good alternatives.”

Cases have been rising steadily in Maine, especially in Cumberland and Androscoggin counties, sparking fears that a resurgence has arrived just as the state begins lifting stay-at-home measures.

Over the most recent seven-day period, there have been an average of 52.6 cases each day, compared to an average of 37.7 cases over the previous seven-day period.

Some of that increase, however, can be attributed to an increase in testing capacity since Maine partnered with Westbrook-based animal diagnostic firm Idexx. As of last week, Maine had conducted a little more than 37,000 tests.

As more cases are confirmed, contact tracing becomes critical to limit outbreaks.

Contact tracing has been used by public health officials for millennia to combat things like tuberculosis, smallpox and, more recently, the Ebola virus. It involves identifying both people who have contracted the virus and those who might have come into contact with those individuals during their infectious period.

Once a list of contacts is built, those people are then called and told to quarantine for 14 days. Even the smallest disruption of transmission goes a long way to preventing exponential spread.

Currently, the Maine CDC has a team of 30 contact tracers – up from 15 from before the current pandemic – but has begun adding more. Lambrew said the goal is to hire a diverse group, particularly in light of the racial disparity in cases. Including the volunteers, Maine could have 205 individuals working on contact tracing, which is line with experts’ recommendations of 15 per 100,000 people.

She estimated that the cost to boost contact tracing would be about $7.5 million and would come entirely from federal coronavirus relief funds provided to the state.

In addition to hiring new employees, the Maine CDC has implemented a new tool – Sara Alert – that makes it easier to monitor people who have been diagnosed or potentially exposed. The system lets people report daily symptoms through web portals, by text or email, or by phone. The more that can be done electronically, the more time contact tracers have to spend on calls and investigations.

Lambrew said the system already had logged 345 contacts as of Monday.

Finally, Lambrew said DHHS is working with local community action programs (CAPs) to provide increased support to people who might be forced to quarantine, including food and medication deliveries, child care and behavioral health services.

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