Two women walk on Portland’s Exchange Street, which has been blocked to vehicular traffic, on Monday. Ben McCanna/Staff Photographer

Maine reported 20 new cases of COVID-19 and no additional deaths on Friday, as the state moves forward with the opening of 22 new swab-and-send test sites.

Six of the new sites are now in operation, a key part of the ramp-up in Maine’s testing, tracing and isolation strategy. If these methods are successful, the state will further drive down the prevalence of COVID-19. Maine’s seven-day prevalence rate is 1.5 per 100,000 people, third lowest in the nation, according to the Harvard Global Health Institute, above only Hawaii and Vermont.

In Cumberland County, Maine’s most populous county and the one that’s been hardest hit by COVID-19, the seven-day prevalence is 3.6 per 100,000, still far below most of the nation and similar to statewide rates in New York and Massachusetts. In states currently suffering through uncontrolled spread of COVID-19 – such as Florida, Texas, Louisiana and Nevada – seven-day prevalence rates are above 30 per 100,000.

Dr. Thomas Tsai, assistant professor with the Harvard Global Health Institute, which has been studying coronavirus trends, said states with low prevalence like Maine have a chance to replicate the South Korean model, which through testing and tracing has suppressed the virus to very low levels.

Tsai said a strong testing program along with other efforts, such as limiting tourism from states with higher rates of COVID-19, can work together to control the pandemic. Maine has placed limits on tourism, requiring a negative test result or a 14-day quarantine upon entering the state for visitors hailing from states with higher levels of COVID-19. Other states have enacted similar measures, such as New York, and most recently, Massachusetts on Friday.

“The testing capacity allows you to have a strategy,” Tsai said. “If you don’t have enough tests you can’t have a strategy. You have to tie together all these different strategies to control the underlying community transmission.”

Maine has expanded its testing capacity from 110 tests per 100,000 population in late June to 180 tests per 100,000, according to Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention.

Capacity will again increase with the additional swab-and-send sites. Those that have opened in the past 10 days are in Augusta, Bar Harbor, Brewer, Old Town, Belfast and Calais. In the next few weeks, the remaining 16 will open, including in Portland, South Portland, Westbrook, Sanford and Waterville. The state has an online list of all test sites, including the swab-and-send sites.

Unlike the week or longer wait times to produce test results from some of the testing locations that use national laboratories – such as at CVS, InterMed and some walk-in clinics – most of Maine’s COVID-19 testing system is able to turn around results within 48 hours. That’s because Maine state government and its hospital systems built their own capacity rather than relying on national labs.

The swab-and-send sites are part of Maine’s in-state testing capacity, and Maine soon will launch a public information campaign to let people know they can get results quickly from the 22 locations, state officials have said.

Tsai said even when case counts are low, states must maintain testing capacity and stay ready with all of its virus suppression tools to control the pandemic.

“This pandemic can turn on a dime,” he said.

Dr. Dora Anne Mills, vice president of community health at MaineHealth, the parent company of Maine Medical Center, said in a facebook post Thursday that she worries about Maine being vulnerable to a “super-spreading” event from a large house party. News reports peg at least 10 COVID-19 cases to a recent house party in Chatham, Massachusetts.

“This virus is known for spreading at such events. I keep seeing photos of similar gatherings from across Maine (and jog or drive by some as well). It only takes two or three such events to launch us into a surge,” wrote Mills, a sister of Maine Gov. Janet Mills. “You don’t want your celebration to be written up as a super spreading event that caused disease, death, or schools to remain closed. This virus is not finished with us! Please please be careful. Wear masks, watch your distance, and wash your hands.”

Meanwhile, an investigation into an outbreak at a Lewiston nursing home continues.

Eleven of the 20 cases reported Friday were at Marshwood Center in Lewiston. The Maine CDC announced the outbreak on Thursday and said the 11 cases would be added to Friday’s numbers. Shah said Thursday that Marshwood had been routinely testing all staff, but the investigation into the outbreak was still in its early stages.

Overall, there have been 3,757 cases in Maine since the pandemic began, and 118 deaths. Another key metric, the positivity rate of tests, also has been declining, with the seven-day average of tests that returned positive at 0.97 percent. The national average is 9 percent, and states with uncontrolled spread have positivity rates of 20 percent or higher.

If the percent of tests that come back positive are low, that generally means the state is finding most cases of the disease and gives state health workers a better chance of halting disease transmission by testing, tracing cases and isolating those who are contagious.

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