Bus driver Rycc Smith welcomes Montello Elementary School students Thursday afternoon as they return after nearly a month of remote learning forced by a COVID-19 outbreak. Smith, who has been driving a school bus for the past 40 years, said students have been very cooperative in wearing masks and staying distant from one another. Principal Jim Cliffe said the vast majority of them are glad to be back at school. “Who would have thought that?” Smith asked.  Russ Dillingham/Sun Journal Buy this Photo

Maine public health officials will distribute an increased amount of COVID-19 vaccine doses to outpatient health groups and independent pharmacies next week as the state moves forward with targeting older residents.

There were 636 new cases reported Friday, along with four additional deaths, as inoculations continued at a steady-but-slower-than-expected pace due to limited supply.

Maine’s allotment of the Pfizer and Moderna vaccines next week is 17,575 doses, nearly 1,000 fewer than it received this week. Of those, the biggest share, 10,900 doses, will still go to hospitals, with four facilities – Maine Medical Center in Portland, Eastern Maine Medical Center in Bangor, MaineGeneral Medical Center in Augusta and Central Maine Medical Center in Lewiston – accounting for 8,400, or 77 percent.

However, the 3,575 doses that will go to outpatient practices such as Martin’s Point, InterMed and Penobscot Community Health Care in Bangor are the most those providers have received in the first seven weeks of Maine’s vaccination effort. The doses will be used to vaccinate older residents.

Notably, no doses are being directed next week to the pharmacy chains CVS and Walgreens, which have been conducting vaccination clinics for staff and residents of long-term care facilities. State officials said they have paused sending additional vaccines to the retail pharmacy program operated by the U.S. Centers for Disease Control and Prevention because it has sufficient doses. Instead, 2,900 doses will be given to 14 independent pharmacies, which also is the highest weekly total for that category.

Some health organizations are already having to triage their limited vaccine doses.

Dr. Dan Loiselle, chief medical officer for InterMed, a large physician-owned private practice that serves southern Maine, said in a message to patients Friday morning that the organization was focusing its “vaccination efforts on patients 80 years and older, particularly those with a medical condition that puts them at greater risk of serious complications from COVID.”

The supply InterMed received this week, Loiselle wrote, is less than one-third of what is needed to vaccinate its patients who are 80 and older.

“We also ask that you do not call or email with questions about vaccine availability so that our phone lines can be free for patients who are calling with acute medical issues,” he said.

As of Friday, 78,395 people had gotten at least one dose of vaccine and 19,876 people had received both doses. Since the first dose was administered on Dec. 15, the state has averaged about 2,500 shots per day. It’s not clear how many of each have been health care workers, first responders or residents and staff of long-term care facilities – the categories in Phase 1A of the state’s vaccination plan.

Even with limited supply, plans are underway for large-scale vaccination clinics. MaineHealth announced Thursday that it plans to open a mass vaccination site at Scarborough Downs, although it could still be weeks before enough vaccines make that feasible. Other sites are under discussion as well.

“We are hopeful that very soon we can continue to build out our distribution sites, to rural Maine and smaller sites,” Maine Department of Health and Human Services Commissioner Jeanne Lambrew said Thursday in response to concerns raised by independent practitioners who felt left out of the conversation.

Meanwhile, COVID-19 cases surged in the latter part of this week, adding to the recent up-and-down pattern in Maine. After four consecutive days of new cases below 450 between Saturday and Tuesday, the cases rose above 625 in each of the last three days.

The seven-day average for daily cases is now 528, which is down from 621 last Friday but up from 461 this time last month and 205 two months ago. New cases were reported Friday in every Maine county, led by Cumberland with 203 and York with 104.

Maine Center for Disease Control and Prevention Director Dr. Nirav Shah explained Thursday that the recent pattern is a function of when people are getting tested. More are going in for tests on Monday or Tuesday, which yields results – and subsequently more cases – on Wednesday, Thursday and Friday. He said more important than those fluctuations are the broader trends over seven or 14 days. Right now the picture is not clear, although there are some glimmers. Maine’s testing positivity has decreased from 5.9 percent to 3.9 in the last two weeks, or one incubation period, partly due to an increase in testing volume.

“There are signs on the horizon for example that because testing has expanded, which had brought our positivity rate down, we are going to be better able to detect more cases. That’s a good thing,” he said. “I will say I remain concerned about the hospitalization numbers, particularly the increase of individuals who are in the intensive care unit.”

Hospitalizations increased by eight to 190 on Friday, including 61 in intensive care and 19 on ventilators. Since the beginning of the pandemic, 1,309 individuals in Maine have been hospitalized with COVID-19 at some point. So far in 2021, hospitalizations have remained high, ranging from 180 on Jan. 3 to 207 on Jan. 13. The number of patients in intensive care units has not dropped below 50 since Jan. 3.

Overall, there have now been 36,274 confirmed or probable cases and 540 deaths in Maine since the pandemic hit 10 months ago. Total cases have doubled in just over one month. The number of deaths has more than tripled since two months ago, right before Thanksgiving.

Thursday was exactly one year after the first COVID-19 case was detected in the United States. Since then, there have been nearly 25 million cases nationwide and more than 400,000 people have died from the virus – the most of any country by far.

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