A shopper wears a mask to help prevent the spread of the coronavirus while checking out sweatshirts on display in the Old Port, Tuesday, Oct. 6, 2020, in Portland. Credit: Robert F. Bukaty / AP

The coronavirus is again spiking in Maine as it did at the height of the pandemic in the spring, breaking a one-day record with 87 new cases on Wednesday and raising increasing alarm among state officials.

Yet this new uptick has some key differences from last spring’s. That first surge was concentrated in three of Maine’s more populous and urban southern counties — especially Cumberland County, in Portland and its suburbs — and largely driven by deadly outbreaks in elder care facilities.

The current spike is more dispersed around Maine, with the virus taking root in more rural and sparsely inhabited regions that had previously seen few cases, most recently Down East and the midcoast. The new cases reported Wednesday were in all but two Maine counties: Piscataquis and Sagadahoc.

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The virus is also affecting a larger portion of young Mainers, with an average age of around 43 in the individuals who tested positive in the last day and more than a dozen of those new cases in children, the youngest of whom is just 8 months old.

And its spread is being propelled more by people who can’t trace their infections back to any known outbreaks in nursing homes, workplaces, schools, churches or social functions, which suggests that the virus is silently circulating across broad swaths of the state.

“This has a very different feeling to it,” said Dora Anne Mills, former head of the Maine Center for Disease Control and Prevention and chief health improvement officer for the MaineHealth hospital group that stretches from southern and western Maine through Waldo County.

“We’re just seeing lots of community transmission and people who have no idea where they got it from,” said Mills, who is the sister of Gov. Janet Mills. “They’ve been to multiple places. They’ll say ‘I got together with friends for dinner two nights ago,’ or ‘I went to a birthday party three nights ago.’ It’s very concerning.”

Public health experts have long anticipated a new rise in infections as colder, dryer weather forces more people to gather inside where the virus can spread easily, and as people resume many of the activities they stayed away from earlier in the pandemic. That uptick is now playing out across nearly the whole country, including in New England, although experts such as Mills are concerned that the uptick may already be striking in Maine with the holiday season ahead.

Maine still joins Vermont and New Hampshire as two of the states with the lowest rates of new daily infections in the country, according to data collected by the New York Times. But Maine’s seven-day average of new daily infections — which smooths out day-to-day swings — hit a new peak of 54 on Tuesday after steadily climbing for the last 2 1/2 months.

The state’s first coronavirus surge crested in late May, when the previous one-day record of 78 new cases was set on May 20 and the seven-day average of new daily cases started to drop a few days later, after hitting 52.

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One big difference between then and now is that Maine’s public and private labs have a more robust ability to test for the coronavirus, but state officials do not believe that increased testing is driving the most recent uptick in positive cases. That’s partly because testing volumes have remained steady for some time, according to Nirav Shah, director of the Maine Center for Disease Control and Prevention. Instead, the portion of those tests coming back positive has been inching up.

The portion of weekly tests coming back positive in Maine has almost doubled in the last two weeks, from 0.42 percent to 0.75 percent. And the number of people hospitalized with COVID-19 has more than doubled in the past week, from seven last week with none in the intensive care unit, to 16 this week with seven in the ICU, Shah said. (Maine’s test positivity rate remains low compared to the rest of the country, which has seen an average positivity rate of 6.2 percent over the past week.)

“That constellation of findings is extremely, strongly suggestive that the new cases are not being detected because of more testing but, rather, are occurring because of more transmission,” Shah said. “The numbers and the increases in cases that we are seeing are being driven by the fact that the virus is everywhere among us.”

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While the state is continuing to identify new outbreaks of COVID-19 that drive new cases, it also is identifying an increasing number of infections not connected to those outbreaks, Shah said. Based on a couple days of data, he said investigators have identified at least two ways that people may be catching the virus in the community: by going to small gatherings at friends’ houses or going out to eat without consistent mask-wearing.

Shah again cautioned Mainers to take proven measures to prevent the spread of the virus, such as avoiding indoor gatherings, wearing masks and social distancing, and he pointed to numerous other states where the virus has recently exploded and strained health care resources.

“The risk facing us is one that we cannot ignore,” he said. “The 70 or so cases that we’re seeing today could in a few days turn into about 140 cases per day, every day. And then a few days after that turn into 300 cases per day, for a few days, and so on and so forth.” He added, “That would be the worst-case scenario, but it’s a scenario that can happen to us.”

But during the same press conference, Gov. Mills said that she is not currently planning to reimpose travel restrictions on states such as Massachusetts or back off a limited Nov. 2 opening of indoor bars and tasting rooms.

Some of the new spike is being felt in Bangor, where Northern Light Eastern Maine Medical Center has recently confirmed four new cases of COVID-19 after going almost an entire month without any new ones, according to Dr. James Jarvis, clinical lead for the incident command of the hospital’s parent organization.

Northern Light Health has so far not needed to hospitalize as many patients as it did during the initial surge of COVID-19, in part because the new cases are increasingly in young people who are less vulnerable to its health effects, and also because the system has learned more about treating the disease so that more patients can remain home or have shorter stays, Jarvis said.

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