State health officials announced plans Tuesday for additional “swab and send” testing sites in Westbrook, Sanford and two other locations as part of a strategy to improve access to coronavirus testing throughout Maine.

With the four additional sites, the Maine Department of Health and Human Services has negotiated agreements to create 22 such sites to provide access to free testing for residents, tourists, seasonal workers and other visitors. While doctor’s orders are not required, individuals who believe they may have been exposed to the coronavirus can qualify under a broad “standing order” from the state.

DHHS officials said they are finalizing agreements for the four facilities – which could be drive-up, drive-thru or mobile sites – with the following organizations: the city of Westbrook, Redington-Fairview General Hospital in Skowhegan, Penobscot Valley Hospital in Lincoln, and York County Community Action Corp./Nasson Health Care in Sanford.

The expansion comes at a time when DHHS officials are still working to launch a mobile testing facility that will significantly expand the Maine Center for Disease Control and Prevention’s test-processing capacity in Augusta. Announced in early June, the mobile lab is expected to allow the Maine CDC to process up to 25,000 additional tests weekly.

Commissioner Jeanne Lambrew said the agency is installing and testing new equipment – some of which arrived later than anticipated – as well as training staff to operate the sensitive equipment.

“We feel like we are getting close to the point where we can move staff into that mobile lab and begin testing,” Lambrew said. “I don’t want to put a specific date on it. … We feel confident that in the coming weeks we will be able to really go to that extra capacity that will happen with the mobile lab. But it is a work in progress.”

A man crosses the intersection of Congress and Oak streets in Portland on Monday. Ben McCanna/Staff Photographer

Maine continues to see relatively low new infection rates compared to most other states, although state health officials are closely watching surging case numbers elsewhere.

The Maine CDC reported 12 new cases of the COVID-19 disease caused by the coronavirus on Tuesday, plus the death of a man in his 70s from Cumberland County. Since March, at least 118 individuals with COVID-19 have died in Maine while the state CDC has tracked 3,723 either confirmed or probable cases of the disease.

On Tuesday, Maine CDC Director Dr. Nirav Shah said his agency is working with managers at a Walmart in Presque Isle to investigate a potential outbreak there. At least three employees have tested positive for COVID-19, although Shah said it was still too early to say whether those individuals contracted the disease at work or elsewhere.

Shah said staff members in his office were still learning what steps Walmart took following the discovery of the cases, how many other employees might have been exposed and what steps the store could take to reduce risks in the future.

“Right now we don’t think there is any added risk of going to Walmart in Presque Isle, if you need to,” Shah said. “But as our investigation unfolds, we may learn more. So this is all the more reason to remind folks to take precautions any time they go out, Walmart included.”

Maine continues to have among the lowest COVID-19 infection rates in the country and was one of just three states where infections were trending downward Tuesday, according to tracking by The New York Times.

After accounting for the 118 deaths and 3,191 people who have recovered from the disease, the Maine CDC was reporting 414 active cases of COVID-19, which is a decrease of 21 from Monday. The state has averaged 407 active cases daily for the week ending Tuesday compared to an average of 445 active cases for the seven-day period ending on July 14.

Cases of the virus continue to surge in some areas of the country, most notably Gulf Coast states and areas of the western U.S. Increasing demand for tests nationwide combined with limited capacity and shortages of testing supplies – including nasal swabs – mean some some individuals are waiting weeks to receive results.

Shah said there is no backlog of tests at the Maine CDC’s lab in Augusta, with most results being turned around within 24 to 48 hours. Shah noted that doesn’t include any additional time it takes for a test sample to make its way from a doctor’s office to Augusta or how long it takes for a physician to notify a patient about the results.

Shah said he is aware of the delays with some national commercial labs, such as Quest Diagnostics and Lab Corps, that operate in Maine. The “swab and send” sites are contracted to send all samples to the Maine CDC’s lab.

“That is one reason why these swab-and-sends, and keeping the tests in Maine, are really important,” Shah said.

Not all test results are the same, however, as Shah noted on Tuesday while highlighting the case of a summer camp where Maine CDC investigated a potential cluster of cases.

Nineteen campers at the camp, which Shah declined to name because there was no public health threat, came back positive for COVID-19 as part of routine testing at the facility. That testing system looked for “antigens,” which are substances that produce an immune system response, indicating current infections. Increasingly common antibody tests, on the other hand, look for markers of past infections.

Shah said he and other CDC staff were surprised by the 19 positive antigen tests because all of the campers as well as staff had previously tested negative and no one was exhibiting symptoms. So Maine CDC immediately launched an investigation and ordered molecular-based tests, which are considered to be more reliable.

All campers ultimately tested negative on those molecular-based tests run by the Maine CDC. As a result, those 19 tests that had been designated as “probable” cases in the Maine CDC’s daily tracking system will be redesignated as negative in Wednesday’s figures.

One possible reason, Shah suggested, could be a faulty piece of equipment.

“It suggests that the public health apparatus and system that we have in place is working the way it should with respect to these atypical situations,” Shah said. “I’m sure there will be things that we can and should learn about this situation.”

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