Masks are once again recommended when indoors in eight of 16 counties in Maine as hospitalizations climb and the state records the highest COVID infection rate in the nation.

The U.S. Centers for Disease Control and Prevention updated its county-level assessments late Thursday and designated Cumberland County, the midcoast region and most of northern Maine as having high community levels of COVID-19 and being at risk of placing a strain on local hospitals. In counties designated as having high levels, the federal agency recommends that everyone wears a mask when indoors in public spaces.

What Maine is experiencing is “the war going on between the virus and humans,” said Dr. Michael Osterholm, a specialist in infectious diseases and professor at the University of Minnesota. And the rise in cases and hospitalizations in Maine suggests the virus is winning the current battle here, he said.

The Maine counties designated as having high levels are Cumberland, Sagadahoc, Lincoln, Knox, Hancock, Penobscot, Piscataquis and Aroostook. Seven counties are now designated as having medium levels, which means masks are recommended for people who are older or have underlying medical conditions. Those counties are York, Kennebec, Oxford, Franklin, Somerset, Waldo and  Washington. Androscoggin County retained its low-level designation, which means the U.S. CDC does not formally recommend mask wearing.

The community levels are based on the number of new infections reported in the last seven days, new COVID-19 hospital admissions and the percent of staffed inpatient beds in use by COVID-19 patients. A county in the high category is considered to be at risk of straining hospital capacity.

The change in risk assessments follows a steep rise in cases in Maine and the Northeast resulting from the emergence of three omicron subvariants, each of which is more contagious than the omicron strain that caused the record surge of cases over the winter. Maine is experiencing the latest surge a couple of weeks after more populated states in the Northeast.

Osterholm said the virus tries to spread among human hosts, and to do that variants and sub-variants develop. That’s what’s happening in Maine, he said, with subvariants of the omicron variant that caused a spike in cases over the winter.

It’s hard to predict precisely what subvariants will emerge, but easy to predict that new versions of the virus will crop up at some point, said Osterholm, who was a member of the Transition COVID-19 Advisory Board that was appointed by President-elect Joe Biden in November 2020.

“The whole country is far from done with this,” he said, “even though people want to think we are.”

BIT OF GOOD NEWS

The one bit of good news for Maine in the current wave, Osterholm said, is that a rising level of immunity in the population should keep the latest outbreak from reaching the levels seen in December and January, and also limit the number of deaths and severe COVID cases that require hospitalization in intensive care units. The number of severe cases, he said, is not expected to match the peaks reached this past winter.

The number of patients in Maine hospitals with COVID-19 climbed to 203 as of Friday morning, a 50 percent increase from two weeks ago. Of those patients, 35 are in intensive care and four are on ventilators.

The state also reported 930 new cases on Friday and 12 additional deaths. The deaths reported by the state are not all within the previous 24 hours. Maine health officials review death certificates and periodically add deaths that were not counted weeks or even months ago.

As of Friday, Maine had reported 421 new cases per 100,000 residents over the previous seven days, nearly three times higher than the national average of 142 cases, according to the U.S. CDC. Maine is followed by Rhode Island, Vermont and New York.

Infections have spiked over the past few weeks in Maine and other northeastern states as new and more contagious versions of the virus spread across the region. The omicron BA.2 subvariant and two closely related subvariants – BA.2.12 and BA.2.12.1 – now account for 80 percent of the new infections in Maine, according to data released by the state.

Maine infectious disease experts echoed Osterholm’s suggestion that the current outbreak will not be as widespread as the spread of the omicron variant over the winter, but the virus isn’t going to completely disappear.

VIRUS SHOULD WANE IN WARMER WEATHER

Suzanne Moreshead, associate vice president of infection prevention for Northern Light Health, said the latest version of the virus is more transmissible but not as severe.

She said Maine is in a transition season and there are still a number of indoor gatherings for communities and families, such as Mother’s Day, Father’s Day and high school graduations. But once summer hits, she said, most people head outside where transmission is more difficult, making it likely that the spread of the virus will wane during warm-weather months.

Still, Moreshead said, there’s also a likelihood of another resurgence in the fall, when gatherings again tend to shift indoors.

COVID “is obviously going to be with us now for the foreseeable future,” she said. “It’s going to wax and wane.”

Laura L. Blaisdell, a Maine pediatrician and infectious disease expert, said public health officials are rightfully happy that 88 percent of Mainers have been vaccinated. But that still leaves about 150,000 Mainers who didn’t get the shots, she said, and “the virus will find you.”

She said the rising number of COVID patients requiring hospitalization in Maine shows how quickly the sense of how well, or poorly, the pandemic is being managed can shift.

“We are once again in the unenviable position of having fought well early in the war but (currently) losing the battle in terms of hospitalizations,” Blaisdell said. “We do need to be humble in trying to project what’s going to happen.”

Dr. Nirav Shah, director of the Maine CDC, was not available Friday, but his office said the state’s increased case count “is consistent with what other jurisdictions experienced with the omicron subvariants that are now common in Maine.”

Following the federal CDC’s advice “helps individuals limit their COVID-19 risk,” the statement from Maine CDC spokesman Robert Long said.

Long said state health officials recommend that Mainers stay up to date on vaccinations and make a plan with a health care provider to get Paxlovid, a COVID-19 treatment, if they test positive for COVID-19, to reduce the risk of hospitalization.

BANGOR SCHOOLS TO REQUIRE MASKS

Bangor school officials announced Friday that masks will be required in schools next week because of the increased spread of the virus.

In Portland, officials said they have seen rises in COVID-19 in both local wastewater detection and school testing, and they are recommending that masks be worn inside schools, but are not mandating it except for those who have tested positive and are returning to school after an isolation period.

The surge in Maine’s COVID cases is consistent around the state, and there is no specific region showing a significantly higher rate of COVID than any other, according to MaineHealth, the parent organization of Maine Medical Center in Portland and seven other Maine hospitals.

With exceptions, there are two major groups of people admitted to hospitals specifically because of COVID, said Dr. Dora Anne Mills, chief health improvement officer for the MaineHealth and former state CDC director. Those are older vaccinated people and younger unvaccinated people.

Mills and other public health officials have continued to encourage Maine residents to protect themselves from contracting COVID by masking, getting vaccinated and boosted, choosing to gather outdoors when possible and testing regularly.

 

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