Maine reported an additional 145 cases of COVID-19 on Friday in the latest sign that the virus is continuing to surge. Waldo County is a hotspot with a case rate 2.5 times greater than what federal officials consider a high transmission rate.

The U.S. Centers for Disease Control and Prevention defines high transmission as cumulative cases of 100 or more per 100,000 people in the last seven days. Waldo County’s current seven-day case rate is 249 cases per 100,000 people.

Robert Long, a spokesman for the Maine CDC, said Friday that case investigations continue to indicate community transmission is behind the numbers in Waldo County. A spokesman for MaineHealth, a network of healthcare providers that includes Waldo County General Hospital in Belfast, said there was no one available from the hospital to speak with a reporter Friday about the cases they’re seeing.

The state also saw more changes to county-level masking guidance based on shifting transmission rates in different parts of the state, which has caused confusion and frustration for some residents and businesses.

The new cases bring the total number since the start of the pandemic to 71,141. No additional deaths were reported, leaving the total 900 people.

The seven-day average of daily new cases is now at 112.9, up from 76.9 one week ago and 14.7 one month ago.

Five Maine counties were classified Friday by the U.S. CDC as having substantial transmission rates, which it defines as more than 50 cases per 100,000 people in the last seven days. The CDC recommends that people in areas of substantial or high transmission wear masks indoors, regardless of vaccination status.

The five counties with substantial transmission were Aroostook, Cumberland, Lincoln, Penobscot and Piscataquis. Two counties that had been listed as “substantial” on Thursday – Franklin and York – moved to a “moderate” designation.

The guidance has been confusing for some residents and business owners, as even slight changes in case counts can result in a different categorization and mask guidance for a county, sometimes on a daily basis.

In downtown Gorham on Friday, businesses appeared to be taking a variety of approaches to masking. Some signs on front doors said masks were required while others said they were encouraged or encouraged only for the unvaccinated. Some people wore masks inside but many did not.

“It kind of leaves us stuck in the middle,” Stephanie Sands, owner of Upcycle Maine, a home furnishing store in Gorham, said about the latest guidance. “I feel as though mandating it was easier for us to enforce. I almost feel like we’re stuck in a position of authority and I don’t feel strongly one way or another.”

When there was a statewide mask mandate under the state of emergency earlier this year, Sands said she was asking customers to wear a mask in her South Street store. Though they are currently open only one day per week, she is leaving decisions about wearing masks indoors up to customers, though she plans to require masks again at an event she is planning for the end of the month.

Nearby at Neu-Du Salon, owner Catherine Chase also is leaving decisions on masking to customers and said she and her staff will wear masks if they are asked to do so by customers. “If they say they’re not vaccinated and feel uncomfortable, we will throw a mask on or if they’re wearing a mask, we ask, ‘Do you want us to?'” Chase said. “Ninety-nine percent of the time we put it on anyway to make them feel comfortable.”

Some clients and staff at the salon wore masks Friday afternoon while others did not. Megan Wentworth wore her mask while getting a haircut because she anticipated there would be an expectation to do so at the salon and had noticed other people wearing them inside. “If they want me to do it, there’s a reason for that, so I’m going to do it and I’m not going to fight against it because it’s just a mask,” said Wentworth, 17.

Chase also sees the challenge in trying to enforce masking while there is no mandate and said the issue can be polarizing. “When masks were mandatory it wasn’t hard because masks were mandatory,” she said. “It is what it is. … I don’t want to say we’re in limbo but that’s kind of how I feel. I’m not going to require you to wear a mask if you don’t want to and I can’t ask if you’re vaccinated.”

Dr. Nirav Shah, director of the Maine CDC, said Thursday that his agency is looking at the guidance and whether a different approach would be a better fit for Maine to determine high-risk areas.

“If we made a change – and that’s a big if – it would be toward rather than having those recommendations updated every 24 hours, we would have them updated perhaps weekly so that businesses have some predictability” and stability to set their policies, Shah said.

To date there have been 712 “breakthrough” cases of COVID-19 among fully vaccinated people in Maine out of 36,785 cases reported since the first date Maine residents could be fully vaccinated. Thirty-two breakthrough cases have required hospitalization and 14 people with breakthrough cases have died, though the CDC noted that COVID-19 is not necessarily the primary cause of hospitalization or death in those cases.

The number of breakthrough cases also is likely an undercount since not all cases are investigated to determine vaccine status and it takes time to validate vaccine status, which can result in a delay in the reporting. Breakthrough cases are expected with any vaccine and the CDC maintains the COVID-19 vaccines are extremely safe and effective, especially at preventing severe illness.

On Friday, there were 44 people hospitalized with COVID-19 in Maine, including 21 in critical care and nine on ventilators.

Around the country, new COVID-19 cases are increasing as the more contagious delta variant spreads, especially among the unvaccinated. The United States reported 127,108 new cases Friday, bringing the seven-day average of daily cases to 100,199. That’s up from a seven-day average of 10,608 one month ago, according to data from the New York Times.

Vaccinations in Maine have slowed, though the state has seen a slight uptick in interest in recent weeks and continues to boast one of the best vaccination rates in the country. On Wednesday, 1,806 shots were administered in Maine – the most in a single day in at least three weeks, according to the Maine CDC. The daily average of shots last week was up slightly from three weeks ago. For the week of July 25-31 the daily average was 1,352, compared to an average of 1,174 shots per day for the week of July 11-17.

As of Thursday, 69 percent of the eligible population age 12 and older had been fully vaccinated. The vaccination rate for the entire population was nearly 61 percent.

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