Maine’s top public health official said Thursday that the disturbing and sustained trend of rising COVID-19 cases as the winter months approach should serve as a “call to action” for everyone to continue wearing masks and physically distance in public.

“The virus is here, it is all around us and it’s spreading with ferocity,” Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said during a briefing with reporters.

The state added 194 new cases on Thursday, as well as one more death – a man in his 70s from Androscoggin County – continuing what has been the worst stretch since the pandemic began.

The seven-day average for daily cases rose to 165 on Thursday. That’s up from 118 cases one week ago, 59 cases two weeks ago and exactly five times the average of 33 cases one month ago. New cases have been outpacing recoveries by far and the number of active cases now sits at 1,962, more than double what it was two weeks ago, and the highest number Maine has seen.

To date, there have been 8,396 confirmed or probable cases in Maine and 159 people have died. Thirteen of those deaths have occurred since Oct. 30. There were none in the preceding two-week period.

In addition to a steep rise in cases, hospitalizations have been increasing at an alarming rate. As of Thursday, there were 62 people hospitalized, including 16 in critical care – the highest totals since May, but still well below the national average, Shah said. Maine’s rate of hospitalization is 4.6 per 100,000 people; the national rate is about 13.

“We are concerned where things are going with respect to hospitalizations,” Shah said, adding that patients who are diagnosed now are not being hospitalized as often as earlier in the pandemic. In other words, people were more likely to be sent to the hospital months ago, but hospitalizations are still climbing rapidly.

The number of critical care beds available in Maine has decreased from about 200 in June to a little more than 100 currently. Hospitals are concerned because back in the spring, most kept as many beds empty as possible anticipating a surge that never happened. Now, many beds are occupied by non-COVID patients. Shah and Maine Department of Health and Human Services Commissioner Jeanne Lambrew said Thursday that most hospitals do have the ability to convert some beds to critical care beds as the need arises.

Lambrew also said the state continues to update plans for alternative care sites that would be “ready to go on a day’s notice.”

“We are not close to that yet,” she said.

Maine’s rising case numbers, as well as increasing hospitalizations and deaths, mirrors what is happening across the country. The United States passed another sobering milestone in the pandemic on Thursday, setting records for cases and hospitalizations, with 152,391 new cases and 66,606 people hospitalized.

According to Johns Hopkins University, the number of cases in the U.S. has now gone over 10.4 million and the number of deaths is more than 240,000. Unlike early on in the pandemic, when cases were driven by outbreaks from large gatherings, states are seeing spread from smaller get-togethers in private homes where people might not be wearing masks or physically distancing. As such, cases in Maine are showing up more regularly in rural areas.

Shah said in the last 24 hours alone, the CDC has opened investigations into five outbreaks in western Maine, an area that had been mostly spared until now.

“Those clusters are now generating outbreaks, even in places where there were previously few,” he said.

DHHS announced Thursday that it was forced to close its Portland office after an employee tested positive. The department is in the processing of identifying close contacts and said the office would reopen as soon as possible. The employee was last in the office on Monday.

Two more local restaurants are experiencing outbreaks among staff members as well – J’s Oyster in Portland and Willow’s Restaurant in South Portland, Shah said.

New cases were reported Thursday in every Maine county except Piscataquis, a sign of how widespread the virus has become. Androscoggin County saw the biggest increase, with 38 new cases, followed by Cumberland (30), York (28), Kennebec (22) and Penobscot, Hancock and Oxford (13 each).

There are active cases in all 16 counties, and five 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. They are: Franklin, Knox, Somerset, Waldo and Washington. Somerset has the highest rate – 30.31 per 10,000 people.

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.

The Maine Department of Education updated its dashboard Thursday of cases associated with public schools. Over the last 30 days there have been 196 confirmed cases in 126 different schools across the state. There are nine schools currently with open outbreaks of five or more cases.

Shah said Thursday that schools have done a good job limiting outbreaks and credited them for taking safety measures seriously.

Another thing Maine has going for itself is good testing capacity. Maine’s testing volume is 606 per 100,000 people, compared to the national rate of 363 per 100,000. That’s one of the reasons the state’s positivity rate, about 2.47 percent, is less than half the national rate of 6 percent.

DHHS also announced Thursday that 10 additional rapid testing sites will open Friday at Walgreens locations across the state, with another 55 coming on line by Nov. 23. The so-called antigen point-of-care tests, produced by Abbott Laboratories, are offered at no cost to Maine residents who are experiencing COVID-19 symptoms.

The tests will be available by appointment to adults and children age 3 and older who meet screening criteria. Appointments can be made by following the steps on Walgreens.com/COVID19Testing. Walgreens patrons will self-collect a sample with a nasal swab under the supervision of Walgreens staff and submit the sample through the drive-thru window, with results available in as little as an hour.

Gov. Janet Mills has reimposed some restrictions over the last few weeks, and has tightened the state’s mask mandate for public places, but has resisted the type of lockdown measures that occurred in March and April

On Thursday, Mills announced with her counterparts in six other northeastern states that interstate youth hockey activity would be suspended beginning Saturday and running through Dec. 31. Several outbreaks have been linked to youth hockey, which is deemed a moderate-risk activity under Maine’s Community Sports Guidelines. The shutdown does not affect collegiate or professional hockey activities.

The state already had updated its Community Sports Guidelines to push back all youth hockey and high school practices until Dec. 14 and games until Jan. 11.

Asked what the state can do that it hasn’t already done to limit the virus from spreading further, Shah said he and his team are always looking at ideas.

“One of the ways the pandemic has changed … is that people’s frame of reference is still large gatherings,” he said. “People think if they avoid those, they are safe, but that’s not the case. That’s one reason why it’s important to keep talking about it. … There is a lot at stake.”

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