The empty Black Cow Burgers & Fries restaurant is seen through the window on Exchange Street in Portland in April. Brianna Soukup/Staff Photographer

Gov. Janet Mills on Wednesday delayed restaurant dine-in reopenings that would have started on June 1 in three counties, citing recent COVID-19 trends. Also, the state reported 28 new cases of the disease caused by coronavirus and two additional deaths.

Mills said she was postponing the reopening of restaurants for dine-in service in Cumberland, York and Androscoggin counties because of rising numbers of new cases and hospitalizations. Dine-in service in restaurants in those counties had been scheduled to begin Monday, but eateries now will only be allowed to offer outdoor dining.

“We believe this change is safer for the health of Maine people,” Mills said at an afternoon news briefing. “It balances the economic needs of these businesses with the priority of the health of Maine people.”

The governor said the state would soon be updating guidance for outdoor dining for restaurants, and she urged municipalities in the three counties to consider closing streets to vehicular traffic so restaurants can establish outdoor seating areas.

Portland is already closing parts of four streets to vehicles to allow for restaurants to more easily have outdoor dining, including sections of Exchange, Milk, Wharf and Dana streets, starting Monday.

Auburn Mayor Jason Levesque sharply criticized Mills in a statement to media.

“I am deeply dismayed and disappointed by this decision and I just don’t understand the governor’s logic on this,” Levesque said, pointing out that many businesses made decisions with June 1 as the reopening date. “This comes at the worst possible time and will bring significant consequences for businesses that are already struggling to survive.”

Enrico Barbiero, owner of Paciarino and Pizzarino, two restaurants on Fore Street in Portland, said he was “literally shocked” to hear the news.

“I was so excited for the restaurants to be back to normal life, to open again,” he said. “Honestly, I’m really shocked. I’m not happy for sure.”

Barbiero, who had planned to open both of his businesses on Monday, said he had already bought wine and had to cancel an order for the ingredients he uses to make his handmade pastas, pizzas and sauces. He said he feels sorry for his kitchen and waitstaff.

“Everybody was waiting,” he said. “I had all my staff ready to come back. Everybody.”

Mills said a date for indoor dining in the three counties will be set in the future. Dine-in seating will be allowed in Penobscot County on Monday, and restaurants in the state’s 12 other counties have been open for about two weeks, under guidelines that require distancing of customers and other steps to prevent virus transmission.

Other businesses, recreational activities and social gatherings will be allowed to reopen on Monday under state guidelines as part of a three-stage plan, Mills said. The increase in limits on the size of gatherings will go from the current 10 to no more than 50 people starting Monday, Mills said.

Dr. Nirav Shah, director of the Maine CDC, said the scientific evidence on COVID-19 transmission provides a number of reasons to delay indoor dining in higher-risk areas of the state. For instance, research shows evidence of outdoor transmission is much less prevalent than indoor transmission.

“It’s not just so much the location but the type of activity,” Shah said. “Restaurant dining (indoors) combines duration as well as density. You have a high-density environment with a longer duration of exposure. Those two things are different from, say, jogging outside in the park.”

The indoor versus outdoor dynamic of the virus has altered Maine’s reopening plans in other ways as well. For instance, the reopening of gyms, which had been scheduled for Monday, has been postponed, Mills announced last week. Meanwhile, private campgrounds had an accelerated reopening that began Memorial Day weekend rather than Monday, as previously scheduled. Outdoor recreational sports such as baseball also are reopening Monday, with physical distancing guidelines in place. People had been allowed to play golf and tennis beginning in May.

Slowdown in cases

After a spike in cases last week related in part to an outbreak at Cape Memory Care, a home in Cape Elizabeth for dementia patients, the daily increase in case numbers has slowed as the state expands its testing capabilities and ability to trace positive cases.

Wednesday’s case numbers showed an increase of 39 people who had recovered, bringing the total recoveries to 1,357. Active cases declined by 13 from Tuesday, to 699. Overall cases stood at 2,137 on Wednesday, with 81 deaths.

A woman in her 70s and a man in his 80s, both from Cumberland County, were the deaths reported Wednesday, Shah said.

He reported an outbreak at Ubuntu Care, a group home in Lewiston serving people with intellectual disabilities, where four staff members tested positive and an epidemiological investigation is underway. The Maine CDC also is investigating a reported outbreak at Milestone Recovery, a substance use disorder service center in Portland, Shah said.

Current hospitalizations ticked down from 60 on Tuesday to 59 on Wednesday. Of the 59 patients, 25 were in critical care, down from 26 on Tuesday. And 14 of the patients were on ventilators, up from 13 on Tuesday.

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 these resources as they study the spread of the disease.

Testing numbers also were released on Wednesday, with 9,183 tests performed during the past week, compared to about 7,000 the previous week and about triple the 3,000 or so tests conducted weekly in April and early May. The positivity rate, the percentage of tests that come back positive, was 3.5 percent for testing that occurred during the past week. Cumulatively, the COVID-19 positivity rate for Maine is 5.2 percent of all tests performed compared to the national average of 11 percent.

Shah said that one of the major goals to contain the spread of the virus is to ramp up testing and contact tracing and drive down the percent that tested positive to levels seen in South Korea, where it is 2-3 percent. South Korea is considered one of the models for how aggressive testing and tracing can contain outbreaks and allow for some relaxing of social distancing requirements.

“We are heading in the right direction, but we know we have more work to do,” Shah said.

The new numbers come on the heels of Tuesday’s announcement by the Maine CDC that it plans to hire 125 more full-time employees for COVID-19 contact tracing, adding to the 30 who are doing the work now. The agency also plans to train 50 volunteers to assist the contact tracers.

Contact tracing has been used by public health officials for hundreds of years to combat diseases 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 toward preventing exponential spread.

Maine Health and Human Services Commissioner Jeanne Lambrew said the state’s goal is to hire a diverse group of contact tracers, particularly in light of the racial disparity in COVID-19 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.

Tourist season

The traditional kickoff to summer – Memorial Day weekend – is now in the rearview mirror, but the Mills administration is still determining how to handle tourist season. It’s a make-or-break time for many of Maine’s businesses, but tourism depends on people traveling and congregating in large crowds, key ways in which the disease spreads.

Mills said the tourist season is a frequent topic among state officials, and they are considering other options besides the current 14-day quarantine required for all visitors to the state, such as more testing of visitors or expanding the use of thermometers to test people for fevers.

There are many concerns about a lack of enforcement of the 14-day quarantine and tourists simply ignoring it.

Mills said state officials are “very wary” of the “influx of as many as 10 to 20 million people into the state of Maine” for tourism from outbreak areas like New York, Boston, Connecticut, New Jersey and parts of Pennsylvania.

She said the 14-day quarantine is “the tool that we have right now to prevent outbreaks being brought into the state of Maine.”

“Any small business in Maine will be lucky to survive this,” Joe Christopher, owner of Three Dollar Dewey’s in Portland and the Saltwater Grille in South Portland, said after the governor announced that the dine-in reopenings had been delayed. “The ramifications are long and difficult.”

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