Blood samples from coronavirus patients are prepared for analysis as part of the TACTIC-R trial, in the Blood Processing Lab in the Cambridge Institute of Therapeutic Immunology and Infectious Disease, in Cambridge, England, Thursday, May 21, 2020. Credit: Kirsty Wigglesworth | Pool via AP

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There are now more than 40 active coronavirus outbreaks in Maine, with the addition of four more announced Monday.

And while outbreaks at nursing homes have accounted for some of the largest numbers of cases and more than half of Maine’s coronavirus deaths, group homes for people with intellectual disabilities have made up nearly half of the state’s outbreak sites, according to data from the Maine Center for Disease Control and Prevention.

[Our COVID-19 tracker contains the most recent information on Maine cases by county]

Group home outbreaks are smaller than most of the nursing home outbreaks Maine has seen because they’re generally limited to a small number of residents in each home and the staff who care for them, but they’re at special risk for transmission of the coronavirus.

Of 42 active outbreaks listed by the Maine CDC on Monday, at least 18 were at group homes. The type of facility where some outbreaks occurred couldn’t immediately be identified.

On Monday, a group home run by Auburn-based John F. Murphy Homes was the location of one of four new outbreaks reported in the state. Two others were reported at long-term care facilities in Portland — Birchwoods at Canco Assisted Living and the city-run Barron Center nursing and rehabilitation facility. The fourth was reported at Portland’s family shelter.

Four staff members and one resident at the John F. Murphy Homes facility, five employees at Birchwoods assisted living, three staffers and one resident at the Barron Center, and 15 clients staying at Portland’s family shelter all tested positive for the coronavirus.

An outbreak is defined as three or more connected cases in a single location. The locations of some of the state’s earliest and largest outbreaks — such as the Tall Pines nursing facility in Belfast and the Augusta Center for Health and Rehabilitation — are no longer considered active outbreaks because they have gone weeks without any new cases.

The John F. Murphy Homes outbreak announced Monday marks the fourth since mid-April for the organization, which runs 37 group homes in the Lewiston-Auburn area, said Todd Goodwin, the organization’s CEO. As of Tuesday morning, the organization had seen 29 staff members and nine residents test positive at 13 group homes since April 14. (Group homes that have had fewer than three cases are not considered outbreak sites.)

John F. Murphy Homes is completing a round of universal testing this week across the organization, which also runs day and work support programs for adults with intellectual disabilities.

The organization expects to have tested more than 500 employees and clients by the end of Wednesday, Goodwin said. The universal testing helped John F. Murphy Homes identify its third and fourth group home outbreaks, he said.

“Our universal testing certainly is resulting in a higher number of positive cases, but it’s been good to recognize those cases when we do, so we can take appropriate measures to mitigate further spread of the virus,” he said.

John F. Murphy Homes isn’t the only organization that runs group homes to report multiple outbreaks. Granite Bay Care, which runs dozens of group homes throughout southern Maine, had reported outbreaks at six of its homes as of late Monday, according to the Maine CDC.

The group home environment presents distinct risks for transmission of the coronavirus because the small numbers of residents who live in each home require care by staff members 24 hours a day, Goodwin said. Some staff members work in multiple homes, a practice that John F. Murphy Homes has tried to reduce but can’t eliminate due to staffing shortages, he said.

“We have upwards of 300 direct support professionals that are working 24 hours a day, seven days a week, three shifts a day,” he said. “We have a lot of people coming and going. That’s one of the unique challenges — just the sheer number of care workers that are required to operate group homes that are coming and going.”

John F. Murphy Homes has set up an isolation unit for residents who have tested positive, and employees who test positive remain home with a paid time off benefit that wouldn’t otherwise be available, Goodwin said. Nobody at the organization who has tested positive has required hospitalization.

Meanwhile, the coronavirus pandemic has resulted in a financial toll with increased overtime for a staff that’s stretched thin and a range of other costs, Goodwin said.

“At the state level, we have been grateful that the state of Maine has put forward some level of financial relief, but it is woefully inadequate,” he said. No federal stimulus package has made funds available for group home operators, he added.

Watch: Should you remove loved ones from care facilities during the outbreak?

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