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One Year Later: A look back at Maine's COVID journey

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AUGUSTA – What a year. It was a Sunday night year ago on March 15, 2020 when Maine Gov. Janet Mills declared a state of emergency after 12 cases of the novel coronavirus SARS-CoV-2 were reported across the state. Much about the coronavirus was still unknown back then, but it was already beginning to disrupt the world.

By the time she declared the emergency, then-Pres. Donald Trump had already made the declaration for the U.S. The cruise ship Grand Princess was trapped off the California coast with 100 cases aboard that resulted in eight deaths, while its sister ship Diamond Princess was idled off the coast of Japan with 712 cases and 14 deaths – all of them passengers. The World Health Organization had declared the coronavirus a pandemic.

But that wasn’t all. International travel to the U.S. from China and most of Europe had been banned. As panic selling ensued, rapid declines in the S&P 500 triggered stock market-wide halts in securities trading. The NBA suspended its season after Utah Jazz center Rudy Gobert tested positive just before the team’s game with the Oklahoma City Thunder. And there were already over 3,000 cases in the U.S. and the country had suffered 69 deaths. All that in the span of just weeks.

In the days after Mills declared the public health state of emergency, the Maine legislature passed emergency legislation that would provide funding for the coronavirus response efforts, extend unemployment benefits to the nearly 250,000 Mainers who would eventually file for unemployment claims amid months of business closures, and give Mills emergency authority to change or suspend laws in the absence of lawmakers while the emergency was in effect.

It would be the last time the legislature would meet in full session for almost a full year – they met in a new session for the first time on March 4, 2021. During that time, Mills would go on to issue 79 executive orders to combat the pandemic.

And in the following weeks, terms like “flattening the curve” and “essential businesses” would lead to the temporary closure of many companies across the state that were deemed nonessential under new “Stay at Home” orders. For many, two weeks turned into three months turned into 10 of phased re-openings. Unfortunately, hundreds of businesses across Maine never came back.

And in the year since the Maine Center for Disease Control and Prevention (Maine CDC) – the state agency charged with protecting the public’s health – was activated to respond to the pandemic, the agency has kept track of thousands of cases daily, shipped millions of pieces of personal protection equipment (PPE), managed the distribution of therapeutics and vaccines, investigated hundreds of outbreaks across the state and contact-traced thousands more to prevent more outbreaks.

Yes, it is a year later. Yes, this pandemic has certainly taken its toll. It could have been better. But it could also have been much worse.

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Altered states

No, this isn’t a movie, but it sure has felt like one at times. Some of our fellow citizens have died. Others are still unemployed as some business sectors – particularly hospitality – have been ravaged by restrictions or continued closures as is the case for bars. Businesses that survived are still recovering, having weathering yet again a recent surge in cases over the winter that put some restrictions back in place. And some haven’t seen family members in over a year, especially those under special rules in nursing and other long-term care facilities. Time with grandchildren or a parent may be nonexistent. Or it is scant and now at a premium.

And our lives are different too. Wearing masks makes us all look like we’re in a surgical unit. Our patterns and habits have been drastically altered. And gone are the days when you would see lines outside movie theaters and packed houses inside awaiting the latest superhero flick, or crowded restaurants with tables full and patrons lined deep waiting to order drinks at the bar. Or when dancers at nightclubs would be moving to the pulsing beats of EDM and hip-hop and office building parking lots were full of cars as workers bustled inside.

Instead, you found most parking spots in downtown Bangor empty at the height of the closures and were able to park easily – only to find the stores you hoped to visit closed. You saw empty lots as those who still had work were working remotely from home, and it was eerie to drive on Broadway in Bangor – one of the city’s busiest and most annoying thoroughfares at rush hour – and not see a car in either direction. It was like the scene in Bangor International Airport in Stephen King’s “The Langoliers” or the empty city in “I Am Legend.”

You also learned the new language of “coronaspeak” like zoom-bombing, zumping – yeah, that’s a thing – rona hair, coronacation, coronials and last but not least every derivative of the word quarantine like quarantinis, quaranteam and… well you get the point. George and Charles Merriam and Noah Webster would be horrified.

And let’s not forget the epidemiological terms we’ve come to endear like contact tracing, PPE, N95, community spread, asymptomatic, incubation and isolation – wait, isn’t that the same as quarantine? Along the way we signed up for every streaming service we could afford and joined social media groups like the locally founded Quarantine Kitchen to exhibit our newly discovered cooking prowess or another locally founded page, Quarantine Karaoke, to show off the vocal and musical talents we never knew we had.

Unfortunately, some of us still don’t have them.

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By the numbers

As lighthearted and true the above may be, we still need to be serious. In the year since the novel coronavirus SARS-CoV-2 – renamed COVID-19 – descended upon a susceptible world population, it would eventually end up sickening over 120 million across the globe and killing over 2.6 million, according to the Johns Hopkins Coronavirus Resource Center. More than 29.5 million of those cases have been here in the U.S., and we have lost about 536,000 fellow Americans since the pandemic began.

In Maine, over 47,300 Mainers have been infected, and our collective hearts go out to the families of the 725 of them who have died. Yet cases across the state have been recently declining since the surge that began Oct. 29 hit its peak of 830 in a single day on Jan. 12, a week that saw an astonishing 4,261 cases. For perspective, that lone week in January had more cases than the first five months of the pandemic combined and was just a thousand less than February’s entire total of 5,232. So far, there have been 2,644 cases in the first 14 days of March, putting the month on a similar track like February’s.

Daily gains have largely kept below 200 since Feb. 10 with even a couple of days of double-digit increases sprinkled in. And while recent weeks have let up from months of surging cases and high positivity rates, it wasn’t easy getting here. January’s record of 14,651 cases and December’s tally of 12,937 delayed any chance of returning to normal by months. December itself had more new cases than the rest of 2020 combined.

Deaths have come down as well. According to Robert Long, communications director for the Maine CDC, only two deaths have been reported this week and three so far this month. That is a stark contrast to the 223 deaths recorded in January and 70 that occurred in February. There were 428 for all of 2020, with the majority of those happening in December.

As cases have dropped and things are looking brighter, we’re not out of the woods quite yet. We need to stay vigilant. The Maine CDC announced in early February that the B.1.1.7 variant, also known as the United Kingdom Variant, was discovered in a resident from Franklin County, marking the first case of the new strain in Maine. Dr. Nirav Shah, director for the Maine CDC, said on Feb. 16 that a second case had been detected in a resident in York County.

Just a couple of weeks later on March 4, he said the B.1.351 variant, also known as the South Africa Variant, has also been detected for the first time in Maine among a resident in Cumberland County.

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Protecting the vulnerable

While deaths have slowed considerably since January, what has concerned state health officials in Maine and other states from the beginning is where they have happened. More than half of Maine’s deaths have occurred during outbreaks in nursing, long-term and congregate care facilities. According to data obtained last week by The Maine Edge, 375 of the state’s deaths – or about 52 percent – have occurred in those settings despite having only 13 percent of the state’s cases to date. And some of those locations have had more than one outbreak.

For example, Seal Rock Healthcare in Saco experienced 126 cases of COVID-19 over three separate outbreaks in May, August and the latest one that began Dec. 8 and was closed Feb. 8. The facility has suffered the most deaths in Maine, and 22 of its 25 deaths resulted during the latest outbreak. Similarly, another facility with one of the higher death tolls in Maine, Durgin Pines in Kittery, had all 13 of its deaths tied to a second outbreak in October – its first was back in May.

In all, Maine has had over 400 outbreaks investigated by the Maine CDC in the past year and while only 127 of them were in long-term care facilities, those outbreaks have been a major contributor to Maine’s death toll. Yet since 86 percent of all deaths in Maine have occurred in individuals over the age of 70 and the primary population of those facilities is in that age group, it also could have been worse.

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Help has already arrived

Although December was a tough way to end 2020 with the highest cases and majority of deaths for all last year, the month also brought some relief as vaccines from Pfizer and Moderna arrived across the state. With the new Johnson & Johnson single-dose vaccine slated to join the ranks, state health officials have kept busy ramping up vaccination efforts.

As of Tuesday, 512,284 vaccinations have been conducted across the state with 189,235 of those representing second doses. According to data from the U.S. CDC, Maine has administered about 88 percent of the 583,690 doses the state has received and over 24 percent of Maine’s population has received at least a first dose to date, including about 77 percent of those aged 70 and over.

In an effort to maximize distribution, Mills announced Feb. 26 that vaccines would be expanded to those aged 60 and over beginning March 3, and on that day she said school staff and childcare providers would also be eligible. She accelerated it even further on March 12 to include those aged 50 and over by April 1 all adults by May 1. Still, supply continues to be the driving constraint in expanding further.

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How has Maine compared?

There’s much debate about whether shutdowns, masks, stay-at-home orders and other mitigation efforts have had any effect on COVID-19 infection rates, as the U.S. has essentially seen 50 different experiments play out across the states. Some of that debate is scientific, some of it political. You could ask 50 people whether any of the measures helped and invariably get 50 different answers. But when you look at how some states have fared versus others, there are some metrics that do compare.

Despite having one of the oldest populations, Maine’s per capita case rate is third lowest in the nation next to Hawaii and Vermont and is fourth lowest in its per capita death rate when you add in Alaska. While our largely rural geography may have played a part, Shah attributes much of that result to the state’s data-driven actions to limit the coronavirus’s spread and Mainer’s belief in that data-driven science.

“Maine people believe in science. With few exceptions, people in Maine have embraced data-driven decisions designed to protect public safety and limit potential spread of the virus,” Shah said on Friday. “In doing so, they have adapted in ways that have not been easy, but which have yielded life-saving results.”

Shah also credits Mills for making the tough decisions that tried to balance the economy with saving lives, noting that economies can be revived while lost lives can’t be. “Governor Mills’ swift and decisive actions a year ago and since then also contribute to Maine’s comparatively good position,” he said.

The state has also fared well in testing to catch outbreaks early, as Maine ranks 14th nationally in its testing rate. According to Shah, much of that has to do with changes at the Maine CDC as the agency has adapted to a new environment, including processing 300,000 COVID-19 samples in addition to the many other pathogens it deals with.

“We adapt and strive to get better every day,” Shah said. “Maine CDC is an incredible team.”

Case mortality rates have also been dropping in both in Maine and the nation. In the early months of the pandemic when outbreaks were occurring at long-term care facilities, Maine saw its case mortality rate peak at about 6.43 percent in April. By May, however, that figure had dropped to 3.1 percent and went as low as 0.47 percent by October.

Yet as cases surged after October, the rate spiked to 1.57 percent in November but then leveled off and fell to 1.34 percent in February. In all, the case mortality rate is a quarter of what it was in April and Maine has fared well in contrast to the rest of the country.

Based on the 29.5 million cases in the U.S. and a death toll of 535,560, the case mortality rate across the nation has mirrored Maine's experience and been dropping since the pandemic began. It was about 6.2 percent at its peak in May but has since settled back to about 1.81 percent on Tuesday.

Last modified on Thursday, 18 March 2021 11:58

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