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These days we sit mostly home while lockdowns and social distancing restrict those things that make life good, whether it be church, social events, or eating at our favorite restaurant. For many it is much more critical, affecting the ability to earn a living and put food on the table. We all wonder when it will all end.
Mainers are fortunate that early action by state leadership, combined with general cooperation from our citizens, has led to a flattening of our curve. This means the number of new cases per day is stabilizing. As I write this on Monday, Maine has more than 800 confirmed COVID-19 cases, making our case rate low at about 64 per 100,000 population. This rate compares to New York at 1,248, Massachusetts at 552, and the nation at 239. Our death rate per 100,000 population so far is 27 percent of the national average, and less than 5 percent of that of New York where the outbreak became out of control. Our new case rate is averaging 30 to 40 per day with all our shut-down measures to limit disease transmission remaining in effect. The course of COVID-19 will, as it has already, be different in different areas of America.
We know that 95 percent of Mainers who have been tested for COVID-19 have been negative. Though this is good, it also means that they, along with most untested Mainers, have not yet been infected by the virus, and thus continue to remain at risk for infection.
At some point, we will be deciding when and how to lift the restrictions that have allowed us to achieve our low COVID-19 rates. In so doing, we must remember there remains a significant risk to the majority of our population, despite Maine’s early success.
There are competing forces that will come to bear in deciding when to lift restrictions, thus increasing COVID-19 infection risk to the majority of the Maine population still susceptible. The economic forces will range from those workers and small local businesses who are made financially destitute by the shutdown, to corporations where their main goal is profit. Social forces will include the desire to get back to life as usual with education, social activities, etc.
There will be a force to move more cautiously to safeguard the health of Mainers, and avoid a fallback into an Italy or New York scenario. This will be tempered by the continued gathering of information. More testing for active disease, and eventually for protective antibodies, will be part of this. A critical scientific assessment should weigh most heavily in these decisions.
These forces will be tempered by the political will, and it is likely that decisions will likely be made differently around America. Our leadership nationally and among the states varies in what they believe government’s duty should be, in what sources of information and advice they respect, and in what political price they are willing to risk for their decisions. Some leadership will not see beyond the next election, some will concentrate on making the right choices.
Given the variability of political leadership and regional decisions we can expect, Maine managing its own COVID-19 response makes sense. Coordinating as much as possible with our neighboring states also makes sense.
Until the holy grail in resolving this pandemic becomes available with access to an effective and safe vaccine, one of Maine’s best protections will be limiting its spread with the appropriate public health restrictions tailored to our needs.
Daniel Cassidy is a gastroenterologist who practices in Bangor and Blue Hill.