Maine’s reproduction rate for COVID-19 is the highest in the country over the last two weeks, according to a website that tracks national case data, another sign that the virus is spreading throughout the state unabated.

The website rt.live, which uses state data from the COVID Tracking Project, estimates the average number of people who become infected by each infectious person – a key metric for how fast the virus spreads. If the R number is above 1.0, the virus will spread quickly; if it’s below 1.0, infections will be slow.

Maine’s R number is estimated at 1.43, which is higher than every other state. From May 10 through Sept. 25, Maine’s R number was below 1 – and in July it was the lowest in the nation – and the state often was hailed as one of the best for controlling the virus’ spread. Since late September, however, the rate has continued to climb. Many other states, including nearby Vermont and New Hampshire, are seeing similar trends, according to rt.live.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, didn’t dispute the data Tuesday but said that he doesn’t put too much importance on the state’s R number. He said the metric is no more or less alarming than some of the other trends that have been reported in recent weeks, including the seven-day average of new cases, which has increased from 32 cases to 165 cases in one month.

“No one in Maine should be surprised that our case growth is really high. I’ve been saying for three or four weeks that it’s coming,” Shah said in an interview.

The COVID Tracking Project

 

For many weeks, state health officials have determined that case growth has been driven largely by people gathering in small groups while not wearing masks or appropriately distancing. Collectively, that has been just as problematic as outbreaks from large gatherings.

Josh Michaud, director of global health policy at the Kaiser Family Foundation in Washington, D.C., also cautioned against drawing conclusions from one data set, but agreed that Maine is heading in the wrong direction.

“The data used to calculate these rates can be incomplete and sometimes messy, but the fact that Maine was below 1 for many months and is now significantly above 1 means that by all indications the epidemic is spreading fast,” he said. “The way the trajectory of cases is going bodes poorly for the coming days and weeks.”

Shah explained that for epidemiological purposes, calculating R numbers is difficult to do with any scientific precision. Indeed, the numbers produced by rt.live are projections. Shah also said that because they rely on percent changes, a state like Maine that started with a low number of cases is going to see a greater percent change.

“So, if you look at where things are now, the lowest R (number) is Mississippi,” he said. “But if you go to Mississippi and look at new cases, you see 297 new cases per million over the last seven days. In Maine, it’s 100 per million. So which is more concerning?”

Shah has been warning about community spread for some time. There are active cases in all 16 counties, and five counties in Maine now have high or substantial community transmission, which is defined as a new case rate greater than or equal to 16 per 10,000 people over the last 28 days. They are: Franklin, Knox, Somerset, Waldo and Washington. Somerset has the highest rate – 30.31 per 10,000 people.

Seen through the windshield of her vehicle under a red tent, Haylie Morris of Freeport uses a self-administered swab at a COVID-19 testing site at the Westbrook Public Safety building on Tuesday. At left is Westbrook firefighter Conor Battaglia. Derek Davis/Staff Photographer

Androscoggin, Cumberland, Kennebec and York counties are seeing moderate community transmission, which is defined as a new case rate greater than or equal to eight but less than 16 per 10,000 people.

The remaining counties – Hancock, Aroostook, Lincoln, Oxford, Sagadahoc, Penobscot and Piscataquis – have low or no community transmission, defined as a new case rate of less than eight per 10,000 people. Piscataquis County has the state’s lowest rate – 1.19 per 10,000 people.

Hospitalizations have been rising steadily in Maine, as well, which should be a major cause for concern, Shah said. In the spring, most hospitals had emptied to prepare for a surge that never came. Now, many hospital beds are full, which means if things get worse, bed capacity could be a real problem.

Michaud, with the Kaiser Family Foundation, said what’s happening in Maine mirrors what other states have seen, a progression away from spread in urban areas linked to large gatherings and toward more rural areas where smaller gatherings are driving cases.

“We have seen broadly a move from dense urban areas to more rural areas over the country,” he said. “But no geography is immune. It might take time for the virus to get a foothold, but once it does, it can spread in rural areas just as easily.”

Shah said that shift may not be fully understood by the general population.

“The way we look at COVID today, we still look at it through the lens of how we first came to understand it,” he said. “So, people think, ‘If I don’t go to a nightclub or a crowded bar, I’ll be OK.’”

As Maine’s case trends have worsened, Gov. Janet Mills has reinstituted some safety measures, including reducing the limit on indoor gatherings. She also has strengthened the state’s mask mandate.

Michaud said despite the worrisome spread in Maine, it can be reversed.

“Everything is under our control,” he said. “It depends on both individual behavior and public policy. I certainly understand fatigue, but safety measures are more important than ever as it gets colder and more people are going to be driven indoors.”

One silver lining, Michaud said, is the news this week that a vaccine is imminent.

“We’re no longer in an endless tunnel,” he said.

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