Maine CDC reports 71 new coronavirus cases as outbreak hits Cape Elizabeth memory care home

Cape Memory Care in Cape Elizabeth. Shawn Patrick Ouellette/Staff Photographer

An outbreak of at least 57 cases at a Cape Elizabeth long-term care home contributed to another spike in Maine’s coronavirus caseload on Friday.

State health officials also reported two additional deaths among individuals with COVID-19: two women in their 80s, one from Kennebec County and the other from Aroostook County.

The Maine Center for Disease Control and Prevention reported 71 new cases Friday of COVID-19, the disease caused by the coronavirus, raising the statewide total to 1,948. The 71 new cases included most but not all of the 57 cases reported late Thursday at Cape Memory Care, a facility for individuals with Alzheimer’s or dementia, the CDC said.

As of Friday afternoon, 45 of Cape Memory’s 66 residents and 12 of the facility’s 35 staffers had tested positive. Results for some staff members were still outstanding.

Dr. Nirav Shah, director of the Maine CDC, said staff at his agency are in regular contact with management at Cape Memory Care to discuss staffing, infection control, the epidemiology of the outbreak and to chart a path forward. The CDC also immediately sent a large package of protective gear and sanitizing supplies to the 72-bed facility.

“We continue to work very closely with Cape Memory Center as we now look to investigate how the outbreak started and what steps could be put into place to prevent similar outbreaks in the future,” Shah said during his daily afternoon briefing.

A representative for Cape Memory Care said the facility “has been following all of the guidance from Maine CDC for more than two months” and that the staff member who first tested positive had passed a routine medical screening before his or her last shift before becoming ill. It was not clear if that person introduced the virus to the home or was exposed to it there.

Matthew Walters, managing member of Cape Memory Care, said Friday that the “situation is very fluid.”

“As of Tuesday morning, nobody had any symptoms. As of (Thursday) night, about half of the residents that tested positive were symptomatic to varying degrees,” Walters said in a statement. “We are monitoring residents closely and working around the clock to manage this outbreak with the guidance of Maine CDC and each residents’ healthcare providers. My understanding is that most of the staff that tested positive were not exhibiting any symptoms.”

According to Maine CDC protocol, skilled nursing facilities are supposed to notify family members or guardians of residents who meet the criteria for a probable or confirmed case within 24 hours. But one local family with a relative at Cape Memory Care says that communication with management at the facility has been poor. They said they are worried about their elderly mother’s well-being after she tested positive for COVID-19.

“We don’t really know what’s going on,” said a woman who wished to remain anonymous because she feared speaking out could affect her mother’s care the center. “I can’t see her. I can’t put my hand on her forehead. I don’t really know how she’s doing.”

According to Cape Memory Care’s online licensing report with the Maine Department of Health and Human Services, the facility’s license is up-to-date and set to expire in September of this year. There are no listed license violations.

OUTBREAKS AMID REOPENING

The Cape Elizabeth outbreak underscores the continued threat posed by COVID-19 to vulnerable communities at a time when sectors of Maine’s economy are gradually reopening. More than half of Maine’s 75 deaths have occurred in nursing homes or other long-term care facilities.

Like her counterparts across the country, Maine Gov. Janet Mills is under pressure to lift restrictions on businesses – particularly in rural, less hard-hit areas – in order to revive the state’s economy. Two thirds of Maine’s cases have been in Cumberland and York counties. Meanwhile, Maine’s unemployment rate approached 11 percent in April, which is a record since the current methodology was adopted in 1976.

Asked about calls to accelerate Maine’s reopening plan, Mills said a “significant portion of our population” is older than age 65 or suffers from medical conditions such as heart disease, diabetes or obesity that put individuals at higher risk from COVID-19.

“We are not just talking about people in nursing homes, we are talking about the entire population of the state of Maine,” Mills said, adding it wasn’t “fair” or realistic to expect families with vulnerable members to “just stay home.” “We all need to protect the vulnerable people in our society.”

Shah said new research suggests a “strong linkage” between the background rate of COVID-19 in a community and outbreaks at nursing homes. Data in Maine shows that most of the new cases have been confined to the four counties where community transmission is occurring: Cumberland, York, Androscoggin and Penobscot.

“On one hand, there is this continuing risk that’s been talked about in the literature that higher rates of cases could lead to outbreaks in nursing homes,” Shah said. “But on the other side we haven’t seen those high rates of cases yet materialize in Maine in rural counties. We are still doing more testing in those counties, so I think, for that reason, the bottom line is it is too early to tell.”

Dr. Dora Anne Mills, the governor’s sister and the chief health improvement officer for MaineHealth, the parent company of Maine Medical Center, said the novel coronavirus is so new, scientists are still learning about how it is spread.

“What is most striking about it is how contagious it is in congregate care settings where social distancing and masking are difficult,” said Mills, pointing out that it would be nearly impossible to mask and maintain the physical distancing of patients with dementia or Alzheimer’s, such as those at Cape Memory Care.

In late April, the Maine CDC directed long-term care facilities to notify the public health agency within 24 hours of a resident or staff member testing positive for COVID-19. Other guidelines included restricting visitation, limiting residents to essential outside activities (such as going to a medical appointment), and screening staff and visitors.

Since March, the Maine CDC has touched base with long-term care facilities in weekly phone calls to provide information and guidance. That interaction was recently expanded to include virtual meetings with the facilities’ medical directors.

But it only takes one or two contagious people coming into close contact with others – especially indoors – for the disease to spread rapidly among many people, Dr. Mills said. She pointed to a study released by the U.S. Centers for Disease Control and Prevention in May about one 2 ½-hour choir practice in Washington state that sickened 52 of 61 of those attending with COVID-19. Two choir members later died of the disease.

Sen. Susan Collins announced Friday that Maine nursing homes will receive $17.9 million in federal funding to help them combat the coronavirus and pay for related expenses or lost revenue. The funding is part of the CARES Act, the Paycheck Protection Program, and the Health Care Enhancement Act.

Each Maine nursing home will receive $50,000 plus a distribution of $2,500 per bed, Collins’ office said in a statement.

In other news Friday, a prisoner in his 30s at the Maine Correctional Center in Windham became the second inmate at the facility to test test positive for COVID-19, the Department of Corrections said in a news release. Universal testing at the prison began after an inmate in his 20s tested positive on Tuesday, becoming the first case at a prison in Maine.

About 600 of the more than 700 test samples that were collected from staff, inmates and contracted vendors have been processed, the department said.

UPWARD TREND

Maine’s total case count of confirmed and probable cases climbed to 1,948 on Friday, according to the latest figures from the Maine CDC.

While Maine has among the lowest per-capita COVID-19 infection rates in the country, it is among the six states with the largest growth in new cases over the past week, based on The New York Times’ detailed case and death tracking system.

Case numbers have, indeed, been rising steadily in Maine.

The number of active cases in the state – calculated by deducting the 75 deaths and 1,192 recoveries from total cases – rose by 22 on Friday to 681. Maine averaged 614 active cases per day for the seven-day period ending Thursday. That’s an increase from the average of 515 active cases per day for the week ending May 15.

Part of the reason for the recent spike is a significant expansion in testing capacity both at the Maine CDC lab and at private laboratories. The Maine CDC more than tripled its capacity this week, allowing for more “universal testing” within congregate care settings and enabling doctors statewide to submit tests for symptomatic patients who were not prioritized for testing prior to the expansion.

That expanded capacity will enable the Maine CDC to quickly conduct universal testing in nursing homes and in other congregate settings after cases emerge.

But the new cases at the Cape Elizabeth dementia care home as well as other recent outbreaks – including at some workplaces such Bristol Seafood’s Portland plant and a Cianbro construction site – could put pressure on the Mills administration to slow down or even ratchet back its phased economic reopening plan.

Retail stores and restaurants in 12 of Maine’s 16 counties were allowed to reopen earlier this month on a limited basis with safety precautions. Private campgrounds and RV parks statewide also were permitted to begin serving Maine residents on Friday. And retail stores and restaurants in the remaining four counties – Cumberland, York, Penobscot and Androscoggin – are tentatively slated to be allowed to reopen with restrictions on June 1.

Several lawsuits have been filed against the Mills administration over the restrictions on businesses. Additionally, Republican leaders in the Legislature are proposing to rescind some of the emergency powers granted to the governor, although it is unclear when or if those measures will be considered.

Mills said her administration continues to monitor the case trends, hospitalization rates and other health metrics as well as consider the economic issues at play amid the coronavirus pandemic. Mills said while her executive orders and stay-at-home mandate have impacted the economy, so have factors such as changes in consumer confidence and spending, lower travel, trade and border restrictions.

Mills said her staff at the Maine Department of Economic and Community Development have heard from “hundreds and hundreds of voices every week” that have requested to do business in ways that will protect public health.