The staggering new wave of Maine coronavirus infections is threatening the state’s ability to promptly identify the close contacts of infected people and advise them to quarantine, which is considered a key part of the strategy to contain the virus.
With the volume and complexity of the new cases, the state is now planning to add about 20 additional people to its contact tracing workforce next week, after it hovered around 100 for months. It also plans to train at least a dozen more contact tracers in case they are needed, according to Nirav Shah, director of the Maine Center for Disease Control and Prevention.
During news conferences this week, Shah noted that the initial batch of new contact tracers and case investigators would consist of Maine CDC workers who currently have other assignments, and that some of them would be working part-time while also tracking other health threats such as influenza. He said that the agency is hiring additional people for those roles and staying in touch with volunteers who have offered their services.
But with a record-breaking spike over the last week that’s pushed the state’s seven-day average of new daily infections to nearly 120 — after it went nearly four months without climbing above 40 — Shah cautioned that investigators could have trouble keeping up if new daily cases surpass 200.
“That’ll be a challenge,” he said. “I don’t want to overpromise.”
While Maine CDC previously tried to reach individuals the same day they were diagnosed with COVID-19 or identified as a close contact of someone who was, Shah said the agency is now trying to reach those people within 24 hours instead. Through October, it was able to do that in more than three-quarters of cases, according to Robert Long, a Maine CDC spokesperson.
If cases keep climbing, Shah said that the Maine CDC may have to look to federal guidelines about triaging the investigation of cases, so that higher priority would be given to the ones that may point to new forms of transmission.
“I don’t know that any of us realized how quickly we would go from 20 or 30 or 40 cases to 80 or 90 or 100 cases,” Shah said on Monday. “So that’s what we’re adjusting to right now. Hopefully, we’ll be able to continue staying on top of it. Given the operational plan, that’s certainly our goal.”
Maine is generally regarded as one of the few states that has been able to offer robust contact tracing throughout the pandemic, which has helped it map out the spread of large outbreaks while also tamping down potential clusters of new cases and providing resources such as food, lodging and phones to people who must self-isolate.
By interviewing people who have been infected or exposed to the virus and conducting quick testing, the state was able to track its spread from a wedding in the Katahdin region to two other outbreaks many miles away, in a Somerset County nursing home and the York County Jail, for example. It also was able to flag the risk that potentially hundreds of hockey players and their relatives may have been exposed to the virus after a referee tested positive.
The number of close contacts that the state normally identifies for each infected person varies widely, from zero to well over 100. In October, it managed to identify an average of 5.8 close contacts for each infected person whose case was closed.
But the virus is now widely circulating across Maine — as in the rest of the country — both in large outbreaks at churches, nursing homes and other places, and in a growing number of instances where people caught it from family and friends they’d recently seen in small gatherings.
Shah has urged Mainers to reduce the workload on contact tracers by taking precautions that have long been known to cut down transmission of the virus, such as mask-wearing, social distancing and avoiding indoor gatherings. On Thursday, Gov. Janet Mills announced a new order that Mainers wear face coverings in all public areas, regardless of whether they can socially distance, on top of new limits on indoor gathering that she announced last weekend.
“I don’t want to sugarcoat this for anybody,” Shah said of the possibility that contact tracers could struggle to handle all new cases. “This is tough, and this will be a challenge. That’s why I really need everybody to do their part as well, so we hopefully don’t get to that.”