Maine reported 26 new COVID-19 cases on Tuesday, but the state’s top health official said no cases have so far been linked to an infected ice hockey referee who exposed up to 400 people to the virus this month.

However, those who were exposed could still develop symptoms and test positive in the coming days.

Dr. Nirav Shah, Maine Center for Disease Control and Prevention director, said the agency is “keeping a very keen eye out for any cases that could be potentially connected to any of these exposures.”

The referee worked youth and adult recreational ice hockey games Oct. 3 and Oct. 4 at the Biddeford Ice Arena, North Yarmouth Academy, and Merrill Fay Arena in Laconia, N.H.

Because of the way the virus replicates in the body, it may take more than 10 days for people who were exposed to test positive or start developing symptoms, Shah said. As many as 400 people were on the ice during the eight games.

“We are just now entering the time period where anyone who may have been exposed would have developed enough virus and potentially be able to test positive,” Shah said.

Tuesday’s was the lowest one-day count of new cases since Oct. 5, when there were 18 new cases. York County, which has been the epicenter of outbreaks in recent weeks, had five new cases Tuesday, while Cumberland County also reported five new cases. Androscoggin County had two new cases of the disease.

No additional deaths were reported.

Maine’s 14-day average of daily new cases stood at 33.3 on Tuesday, compared to 31.6 a week ago and 21 a month ago. The seven-day average positivity rate, which measures the percentage of tests that come back positive, is now at 0.46 percent – it has fluctuated between o.5 percent and o.6 percent over the past month.

Asked how risky ice hockey might be in spreading the virus, Shah said it’s difficult to say. The sport has some risk factors, but also may be less risky than other activities.

“Any vigorous athletic activity increases the respiratory rate both of the individual referee and those around the referee,” Shah said. “The referee is exhaling more potential virus particles, and those around the referee may be inhaling more.”

But Shah said since the referee is typically skating quickly past the players, the duration of any exposure could have been much less than 15 minutes. Studies show that the longer an exposed person is near someone who is contagious the greater the risk.

Shah said that because the risk factor for ice hockey is unclear, the responsible course is to inform all close contacts, require them to quarantine for 14 days and recommend COVID-19 testing.

Recreational hockey games are canceled while the Maine Amateur Hockey Association works with state health officials to determine whether games can resume.

The state has recommended against hockey games being played indoors among different teams. Intra-squad games are still permitted, according to the community sports guidelines of the Department of Economic and Community Development. State officials are still discussing the winter high school sports season – which includes ice hockey – and it’s unclear which sports will be played.

Fall sports have been permitted in most high schools, but football was altered to become a 7-on-7 touch or flag contest, while volleyball games were canceled, and switched to practicing outdoors. York County received a “yellow” designation in the state’s color-coded school advisory system, meaning there is an elevated risk of spread of COVID-19, and high school sports have been on hold this fall.

Since the pandemic began, Maine has reported 5,780 cases of COVID-19, and 143 deaths. Hospitalization rates remained low Tuesday, with eight patients currently hospitalized and three in intensive care. No patient with COVID-19 in Maine was using a ventilator.

A man sits in Monument Square in Portland on Monday. The state’s total of 26 new cases Tuesday was its lowest number since Oct. 5.  Derek Davis/Staff Photographer.

School districts across the state continue to record new cases, mostly in small numbers.

The Maine Department of Education on Tuesday released an online dashboard of COVID-19 cases in Maine schools.

The dashboard lists pre-K through Grade 12 public and private schools that have one or more COVID-19 cases among Maine residents, including those with an outbreak that remain open, within the last 30 days. The Departments will update this dashboard, which is posted on the DOE website, every Tuesday and Thursday.

In the last 30 days, four pre-K through 12 schools have had COVID-19 outbreaks: Sanford High School, Massabesic Middle School in East Waterboro, Community Regional Charter School in Cornville and Skowhegan, and Coastal Ridge Elementary School in York. During the same period, 55 other schools had at least one case of COVID-19.

Westbrook Middle School reported that one person with COVID-19 was in the school building on Oct. 8. Close contacts of the infected person will be contacted and required to quarantine, according to a letter to the community Monday by Superintendent Peter Lancia. The middle school will be closed the rest of this week.

Coastal Ridge Elementary School in York is closed until at least Oct. 22 because of an outbreak of four cases. Students will participate in distance learning until they return. York High School reported one case on Tuesday, but there are no plans to close the school.

Mabel I. Wilson Elementary School in Cumberland is reporting one case of COVID-19, and will be closed Wednesday. The school sent some students and staff home to quarantine.

Other outbreaks include five cases at the L.L. Bean Distribution Center in Freeport and four cases at the VA Maine Healthcare System – Togus in Augusta.

Shah said the first 26,000 shipment of a rapid antigen test by Abbott Laboratories arrived within the past week, and Maine expects to receive about 400,000 of the tests by the end of the year. He said they are still developing a plan for the rapid tests, which can give results within 15 minutes, but expects schools, police and fire departments, correctional institutions and homeless shelters will be among the first places to begin using them.

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