The Maine Center for Disease Control and Prevention has opened 20 new COVID-19 outbreak investigations in the last two days, prompting the agency’s director to plead anew with Mainers to do their part to limit further spread.

“What was for so many of us an abstract concept is now very real,” Dr. Nirav Shah said on Friday. “If we don’t do something different, nothing is going to change. We will stay on this trajectory of increasing cases, which each passing day will make it harder and harder to put a lid on things.”

The CDC reported 224 new cases of COVID-19 on Friday, and two more deaths. It’s the 15th time in the last 17 days that daily cases have topped 150 and the fifth time in the last 11 days that cases have gone over 200. The seven-day average for daily cases is now 188, up from just 32 one month ago.

There have been 26 deaths so far this month, the third most of any month after April (51) and May (37). Only six people died in October. The latest deaths were a man in his 80s from Androscoggin County and a woman in her 70s from Somerset County.

As of Friday, 90 individuals were hospitalized with COVID-19 – the highest total since the pandemic began. More than half, 49, were in critical care and 12 were on ventilators. Exactly one month ago, just nine people were hospitalized.

Hospitals have begun preparing for more patients and have the ability to convert beds to critical care, but officials are increasingly concerned that if the current trend worsens it could overwhelm the health care system.

The impact on hospitals already is being felt. MaineHealth confirmed Friday that at least three staff members at Maine Medical Center’s cardiothoracic ICU tested positive for COVID-19 Monday, resulting in all elective surgical procedures that rely on the unit to be postponed while other staff members are tested and retested.

MaineHealth spokesman John Porter said the staff members were presumed to have been exposed in the community while off-duty.

“At the moment, people need to be hyper-vigilant because it’s everywhere,” he said.

The unit – which handles post-operative chest surgery patients – is still treating emergency and emergent cases.

Gov. Janet Mills has taken a series of steps in recent weeks in an effort to help control the virus’ spread.

On Thursday, Mills announced a 9 p.m. curfew for all restaurants, movie theaters, tasting rooms and casinos – her administration’s latest attempt to curb what has now been sustained spread over the last month. The limited hours run through Dec. 6.

Mills previously reduced the limit on indoor gatherings, strengthened the state’s mask mandate for public places and pushed back indefinitely the opening of bars. She also removed Massachusetts from the list of states whose visitors were exempt from a 14-day quarantine or negative test. On Friday, Massachusetts reciprocated by announcing that Maine visitors would have to quarantine or test negative.

The governor also warned that “other steps may be necessary in the coming weeks if we do not get this virus under control.”

On Friday, she updated the state’s color-coded system for schools and moved York County back into the yellow category, where it joined Androscoggin, Franklin, Somerset and Washington counties. York had been designated as yellow back in September, then moved to green last month.

A yellow categorization means elevated risk and advises schools to consider additional precautions such as hybrid learning models or reducing the number of people in classrooms. Many schools, even those in counties with green designations, already are taking extra safety measures.

Knox County, which had been categorized as yellow, moved back to green since its per capita case rate dipped below the state average. Cumberland, Hancock and Kennebec remain green but will be closely monitored. All other counties are classified as green.

Since public K-12 schools reopened, there have 259 confirmed or probable cases among students or staff, according to data from the Maine Department of Education. As of Friday, there were 17 schools with open outbreaks, including three with more than five cases: Guy Rowe Elementary in Norway, Farrington Elementary School in Augusta and Thornton Academy in Saco.

A man visits the check-in area for the COVID-19 testing site at the Portland International Jetport this month. There have been 26 deaths so far in November, the third-most of any month after April (51) and May (37). Shawn Patrick Ouellette/Staff Photographer

In addition to the cases, there have been hundreds, even thousands, of students and teachers who have been forced to quarantine because of possible exposure.

Shah said the state still has not seen sustained transmission in schools, but said that could change with more community transmission. He also said the lack of transmission in schools is not an accident, but the result of all the work that’s been done by teachers, administrators and others.

“Children in Maine are to varying degrees able to participate in in-class education,” he said. “And that’s important, for children and for our communities.”

Also Friday, Mills announced that she was dedicating an additional $6.2 million from the state’s federal coronavirus relief funds to Maine Housing’s COVID-19 Rental Relief Program. It will allow the program to extend through December for renters who cannot afford to pay their rent.

“I join my fellow governors of both parties nationwide in calling on the U.S. Senate and the president to pass desperately needed relief for Maine families struggling to make ends meet during this pandemic,” Mills said in a statement. “In the meantime, I will do all I can to keep people secure in their homes this holiday season.”

Since the pandemic began, there have been 9,958 confirmed or probable cases in Maine, 628 people have been hospitalized at some point and 173 people have died. The number of active cases Friday climbed to 2,195, which is 35 more than Thursday and more than triple the number this time last month (637). New cases were reported in every county except Sagadahoc, led by York County with 44, Cumberland with 43 and Androscoggin with 40.

Among the new outbreaks announced Friday was an outbreak of 10 cases at Bath Iron Works, one of the state’s largest employers. The defense contractor said it would allow more employees to work from home and spread employees across all three shifts to reduce the risk of transmission. Testing also will be offered to employees in the areas affected. Since the pandemic began, there have been 30 cases associated with BIW.

The Maine Department of Corrections said Friday that an outbreak at Maine Correctional Center in Windham is up to 156 cases, which includes 143 inmates and 13 employees. It is the largest outbreak at a single site in Maine. Eleven employees and 111 inmates have now recovered and the outbreak has been contained within two specific housing units.

A third employee at the state’s only youth prison has tested positive for COVID-19. The department said it was not clear whether that case was connected to two employees who tested positive this month. Two employees at Mountain View Correctional Facility in Charleston also have tested positive during the last two weeks, but results for other inmates and staff were negative.

There are active cases in all 16 counties, and 13 counties in Maine 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. That’s up from five counties with high transmission just two weeks ago.

Somerset County has the highest rate – 47.94 cases per 10,000 people, followed by Washington County at 45.25 cases.

Two counties – Piscataquis and Sagadahoc – 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.

Only Aroostook County has low or no community transmission, defined as a new case rate of less than eight per 10,000 people. Its rate is 4.62 cases per 10,000 people.

Maine has not been alone in the recent surge. Nearly every other state has seen dramatic increases in cases, hospitalizations and deaths. According to the COVID Tracking project, there were more than 183,000 new cases Thursday across the country and 81,000 people currently hospitalized. Both were records. There also were 1,971 deaths, the highest daily total since May 7.

Total cases in the United States have gone over 11 million and deaths have eclipsed 250,000.

Shah spent several minutes at Friday’s briefing imploring Maine residents to reframe the way they’ve been thinking about the pandemic.

“There is a stickiness in the way the human brain perceives events,” he said. “Our first impression is often the lasting impression. Even when the facts around that change, our brain has a tendency to explain those facts away as anomalies or noise.

“Sometimes we have to recognize that the fundamentals of things can change significantly.”

Shah told a personal story about his father, who immigrated from India, buying a car for the first time. One of the first things his dad was told was to change the oil every 3,000 miles no matter what. Even as time went on and cars got better “my dad couldn’t appreciate that the world has changed and he didn’t need to change oil as frequently,” Shah said.

Turning back to the pandemic, Shah said many things have changed since the spring. It’s no longer just a problem in urban areas, large gatherings are no longer the main source of risk and the average age of new cases has dropped considerably.

Most importantly, he said, “Growth used to be linear, today it’s exponential.”

Staff Writers Colin Woodard and Megan Gray contributed to this report.

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