The state’s top public health officials said Tuesday that Maine’s COVID-19 case numbers could jump significantly in the coming days as staff review a glut of positive test results during this latest coronavirus surge.

Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, also cautioned that the state’s health care network is being “stretched” by the rising number of COVID-related hospitalizations and critical care patients during what was already a busy season for hospitals.

“I’ll be straight with everybody: I’m concerned,” Shah said. “The numbers are high and they are going up. They are largely among individuals who are unvaccinated, they are largely among younger individuals, younger Mainers, and they are largely among rural Mainers who are then being transported to tertiary and secondary-care hospitals.”

Maine’s seven-day average of new COVID-19 cases declined slightly Tuesday – falling to 162 from an average of 174 cases per day early last week – as the Maine CDC reported 363 new cases spread out over three days. But Shah said Maine CDC staff are working through 1,700 positive test results received during the previous 36 hours to isolate new cases from repeat positive results linked to known cases.

Testing volumes have increased substantially recently compared to the early-summer lull before the arrival of the more contagious delta variant, which now accounts for nearly all new cases in Maine.

“What this means is that over the next few days the number of new daily cases is going to go up, perhaps significantly, as we review those 1,700 results,” Shah said. “The bottom line there is you should expect to see more cases per day over the coming days, as compared to the prior few days.”

LOW RATES BUT TROUBLING SIGNS

Maine continues to have among the lowest COVID-19 case and death rates in the nation, and among the highest vaccination rates among the states. Only Vermont and Massachusetts have higher proportions of residents who are fully vaccinated against COVID-19, and all of New England as well as much of the Northeast have comparatively lower case rates than southern states where less of the population is vaccinated.

But Maine is also seeing troubling trends during this most recent surge.

For instance, the number of people hospitalized with COVID-19 in Maine has doubled during the past two weeks, with 117 hospitalizations reported Tuesday. In addition, there are now more people being treated in intensive care units – 59 individuals Tuesday – than were hospitalized two weeks ago, which is the incubation period for coronavirus.

Shah also pointed out that just 52 of Maine’s 329 ICU beds were available as of Monday as hospitals around the state see increases in severely ill COVID and non-COVID patients.

“It continues to be the case that 70 to 75 percent of the people who are in the hospital with COVID-19 are not fully vaccinated,” Shah said. “I can’t think of a starker series of numbers to show the impact that COVID-19, and in particularly the delta variant, have had on Maine just in a two-week period.”

MASKS URGED IN 14 COUNTIES

The number of counties classified with high or substantial levels of community transmission is also rising again as the more contagious delta variant of the virus continues to spread. Genetic sequencing of positive test results this month has identified delta as the variant causing 98 to 100 percent of cases in the state.

Based on the latest data, only Androscoggin and Sagadahoc counties have moderate levels of transmission. Cumberland, Oxford, Kennebec, Lincoln, Knox, Waldo, Hancock and Washington counties are all experiencing substantial levels of transmission while York, Franklin, Somerset, Piscataquis, Penobscot and Aroostook counties have high levels.

Masking is recommended in public, indoor settings for all individuals, regardless of vaccination status, in areas with substantial or high rates of transmission.

To date, the Maine CDC has tracked 74,022 confirmed or probable cases of COVID-19 since the coronavirus was first detected in the state in March 2020. There have been at least 924 deaths linked to the disease in Maine, although the state continues to have one of the lowest infection and death rates in the nation during the pandemic.

COVID IN CHILDREN

With many Maine schools set to reopen next week, there is debate in many communities about whether all students and staff should be required to wear masks indoors regardless of their vaccination status. That is the recommendation of both the Maine and U.S. CDCs.

Data released Tuesday by the state show a wide range of vaccination rates among students aged 12 to 18, who are eligible for a shot. While Portland Public Schools has an estimated vaccination rate of between 85 and 89 percent, the rates in some rural school districts are as low as 15 to 19 percent.

“Families and school communities should work together to ensure access to the COVID-19 vaccine for all who are fortunate enough to be eligible,” Pender Makin, commissioner of the Maine Department of Education, said in a statement. “Our team at Maine Department of Education will continue to offer information, resources, and support to their efforts.”

During his briefing, Shah said while research is still developing on how the coronavirus affects children, this most recent surge is clearly different because of the number of young people who have been infected. Individuals under age 20 now account for 19 percent of all cases that have been detected in the state during the pandemic.

Shah said that existing data suggest that children are contracting the coronavirus at approximately the same rate as unvaccinated adults. The FDA has yet to authorize a vaccine for children under age 12, although clinical trials are underway for those younger age groups.

“Thankfully, they are not landing in the hospital at higher rates,” Shah said. “That continues to be a finding and a good finding. But they are getting COVID at about the same rate as their adult counterparts whereas during previous surges, adults were getting COVID at a much higher rate than children were.”

VACCINATIONS AND BOOSTERS

The pace of vaccinations has also picked up in Maine and across the country in recent weeks as the delta variant spreads. Health care providers have administered one-third more shots per day in Maine in recent weeks than they were earlier in the summer when demand for vaccine plummeted.

As of Tuesday, 70.5 percent of eligible individuals aged 12 or older in Maine had received the full regimen of doses needed to be fully vaccinated against COVID-19. For the entire population, the vaccination rate was 62.1 percent.

Per federal recommendations, individuals with compromised immune systems are now eligible to receive a booster shot of vaccine. Boosters will be available to other vaccinated individuals beginning the week of Sept. 20 based on when they received their initial shots.

But Shah said the Maine CDC was still reviewing whether there will be a need to reopen high-volume vaccination sites, particularly during what is expected to be the busiest time for boosters this winter.

On Monday, the U.S. Food and Drug Administration granted full approval to the vaccine produced by Pfizer, likely opening the door to additional vaccination mandates by businesses, schools and governments across the country. The vaccines produced by Moderna and Johnson & Johnson currently have emergency use authorization from the FDA and are being reviewed for full approval.

REPORTS ON ABBOTT TESTING SYSTEM 

Last week, The New York Times reported that Abbott Laboratories told workers in Maine to destroy stockpiles of unused BinaxNOW antigen tests for COVID-19 as demand for the rapid-result testing platform declined. The company, which is based in Chicago but has facilities in Westbrook and Scarborough, disputed those reports and said that the test cards destroyed were nearing the end of their shelf-life.

The company said it had saved and stored other components of the testing kits, such as reagent bottles, cardboard packaging, and swabs “so that we could have them in the event that we needed to scale back up, which is exactly what’s happening now.”

Shah said Abbott’s BinaxNOW tests have been a critical part of the state’s testing response, particularly during outbreaks, for individuals who work in high-risk situations and during follow-up testing when pooled tests detect an issue. Shah said he and other health officials nationwide are hoping to learn more from the company.

“I read those reports. I was concerned by them and I was disappointed by them,” Shah said. “I am eager to hear from Abbott exactly why it was the case that tests needed to be destroyed versus preserved and kept on the shelf for another period of time.”