Cases of COVID-19 are rising faster in Maine and other New England states than in much of the rest of the country, driven by a dramatic surge in infections among younger, unvaccinated people.
Public health experts believe the surge in youth infections – including a more than 150 percent increase since January among Mainers under age 30 – is likely due to a complex combination of factors, from more transmissible variants to increased sports and social activities and “pandemic fatigue.”
“It’s very difficult, in the moment, to know what is driving any one thing,” said Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention. “Usually, it is a constellation of factors.”
Cases and outbreaks are rising in Maine’s public schools and on college campuses. Bars, restaurants and other social gathering places have reopened or expanded their services, offering young Mainers a taste of near-normalcy after months of winter and COVID isolation.
But with all Maine residents over age 16 now eligible for vaccination – and all adults in New England and nationwide eligible starting Monday – experts say they are hopeful cases will begin to decline soon.
“My expectation is we are going to see things start to stabilize and then drop,” said Samuel Scarpino, assistant professor at Northeastern University and director of the Emergent Epidemics Lab. “We opened up to these younger age groups for vaccinations in the last week to month in a widespread way, which means we are probably four to five weeks out to these folks having immunity. … Plus, the warmer weather is coming and that helps.”
Young people, meanwhile, said last week that they were not surprised about the current case trend given their late arrival to vaccine eligibility. But they also acknowledged that some have clearly let down their guard after many months of rigidity, a decision made easier knowing that their parents and grandparents have had their shots.
Ben Quirion, 29, a University of Southern Maine student from Westbrook, said he couldn’t speak for all millennials, but he definitely sees some people adopting an attitude that if they get the virus, it’ll be mild – and that’s a tradeoff they can live with, in exchange for some sense of normalcy. He hopes that as more are vaccinated, though, this will be more of a blip than a sustained surge.
“I don’t know if people are undermining safety measures or not,” Quirion said. “It’s hard to know. You see a group of people gathered without masks, but you don’t know if they have all been vaccinated or not.”
NEW ENGLAND SURGE
Cases are rising across much of the nation, but New England states are among the hardest hit in the latest surge of the deadly virus.
Maine ranked 10th in the nation as of Friday in the average number of new cases per 100,000 residents during the previous week, according to tracking by The New York Times. Three other New England states – Rhode Island, Connecticut and New Hampshire – were all higher than Maine, with Rhode Island reporting the nation’s second highest rate (43 cases daily per 100,000 residents) after Michigan, which is in the midst of by far the country’s most serious resurgence of the virus. Massachusetts was just behind in the 11th spot, while Vermont had the 18th-highest daily case rate.
Individuals under age 30 are responsible for the lion’s share of cases in the New England states. In Maine, the average age of new positive cases declined from 43 earlier this year to 35 last week.
On Friday, Maine residents below age 30 accounted for 41 percent of the state’s 579 new COVID-19 cases, but the figure had been as high as 46 percent earlier in the week. Similarly, Massachusetts residents under age 30 accounted for 47 percent of new cases during the last two weeks of March, and Connecticut residents in that age group comprised 46 percent of cases in the two-week period ending on April 10.
Since Jan. 1, the number of infections in the under-20 crowd in Maine has ballooned 170 percent and by 128 percent for those in their 20s, compared to an 85 percent increase for those in their 70s and 66 percent for those in their 80s.
Vaccinations are obviously a key reason why infections have slowed among Maine’s oldest residents, who have been targeted for shots since mid-December because of the hugely disproportionate COVID-19 fatality rate among those age 60 or older. Most Maine residents between the ages of 16 and 49 only became eligible for shots on April 7 unless they worked in health care, schools or a handful of other sectors.
But cases are pouring into the Maine CDC at rates not seen since the post-holiday surge in January, despite the fact that roughly 31 percent of the state’s 1.3 million residents had received all of their shots necessary to be fully inoculated against the virus.
Dr. Nirav Shah during Thursday’s online pandemic briefing. Video screenshot
“All of this shows how opportunistic the virus is,” Shah, with the Maine CDC, said during Thursday’s briefing. “As older parts of the state and older populations in the state have been vaccinated, the virus is now spreading more rapidly among younger populations. And as much as we wish they would not be as seriously affected, they are. Hospitalization rates are going up as well.”
Shah said fatigue with the yearlong pandemic, increased travel and socializing, weather and other factors are all likely contributing to Maine’s surge. He did not, however, believe that Maine’s recent reopening of indoor service in bars and tasting rooms was a likely factor.
“The increase in cases we are seeing is relatively uniform across the Northeast with states having differential schedules for reopening,” Shah said. “I don’t want to rule it out as a hypothesis, but I don’t think it’s the leading candidate.”
Missy Castonguay, 27, of Sabattus was shopping in Auburn on Thursday before heading to work at a restaurant where she’s seen more presumably vaccinated older customers recently but also plenty of younger people as well.
The older people she serves have a sense of relief to be out in public with at least some protection. The younger customers, she said, don’t seem fazed.
“I’ve certainly been around people inside without masks who haven’t been vaccinated, just friends and family,” Castonguay said. “And I know it’s a risk every time, but sometimes you’re willing to take that risk.”
She’s also not surprised younger people are driving the surge in cases.
“It makes sense – I mean, isn’t this why we vaccinated older people first?” she said. “I know everyone wants to come down on young people. But I think some of us are just trying to find a balance of taking precautions but also living our lives.”
THE VARIANTS FACTOR
Increased unmasked socializing and gatherings are likely part of the equation. But Shah and other experts believe one of the major culprits is likely the new, more transmissible variants now circulating in Maine.
As of Thursday, Maine CDC had reported 30 cases of the B.1.1.7 variant originally detected in the United Kingdom, three cases of the South African variant B.1.351 and one case of P1, the Brazilian variant. The actual number of variants in Maine is much higher, however, because Maine performs genomic sequencing on only about 5 percent of all positive test results, which is higher than most states.
Scarpino, with Northeastern University’s Emergent Epidemics Lab, also believes the B.1.1.7 variant is a key driver of the growth in New England. Massachusetts has reported 1,100 cases of the B.1.1.7 variant, plus more than 100 of the other two closely watched strains from South Africa and Brazil.
“New England has a lot of rural areas but also has some of the densest population centers in the U.S.,” Scarpino said.
Two of his major concerns are how that U.K. variant, which is more transmissible, could impact the summer tourism season in New England, as well as how the variant is affecting children. While children and young people have not been major sources of transmission of the coronavirus previously, that could be changing with the B.1.1.7 variant – with major potential implications for schools, he said.
“We don’t know enough about what is going on in schools right now with respect to transmission,” Scarpino said.
COVID IN SCHOOLS
The rate of new COVID-19 cases in K-12 schools and on college campuses in Maine has risen significantly in recent weeks.
The number of confirmed or probable cases reported over a 30-day period among students and staff in pre-K through high school in Maine increased from 481 to 883 – or by 84 percent – between March 10 and April 14. Schools accounted for more than 50 of the 76 active outbreaks being monitored in Maine last week, with outbreaks defined as three or more distinct cases.
Nonetheless, state officials as well as public health experts say Maine schools remain safe spaces for in-person instruction. Rather than being the source of the transmission, schools are most often the places where the virus is first detected after students or staff bring it in from the community.
“There is fairly good data around the U.S. and internationally that in schools, the firewalls we put up with with masking and distancing and frequent hand-washing are effective,” said Dr. Laura Blaisdell, a Portland pediatrician who also focuses on infectious diseases and vaccinations. “But when community transmission rates go up, we do expect cases to get into schools.”
Blaisdell said that although vaccinations are expanding rapidly nationwide, “for children the pandemic is far from over” because none of the vaccines have been approved for individuals under age 16. That makes it all the more important to vaccinate as much of the adult population as possible while maintaining those safety protocols in schools as well as in the community.
“I do have to say that many of us, including myself, are nervous about watching this new variant in children and hoping the public health measures will continue to be effective,” Blaisdell said.
OUTBREAK AT BATES
After months of weathering the pandemic with relatively low case rates, Bates College in Lewiston recently locked its campus down for 12 days because of an outbreak that involved more than 70 cases.
On Thursday, several days after the lockdown was lifted, Bates students spread out in small clusters on Garcelon Field, the outdoor sports complex, in the early afternoon sun.
Most were masked. Some were not. Those who were unmasked appeared to be eating or drinking. Students said the shutdown wasn’t a wakeup call exactly, but it definitely shifted the collective mood on campus.
Claire Scott, a 19-year-old freshman from Vancouver, Washington, said she saw plenty of students exercising less caution in the weeks before the lockdown.
“I definitely think that’s what it is,” she said. “We’ve had issues too with campus safety recently. They used to patrol residence halls pretty regularly to disperse gatherings … but they backed off for a little bit. When they backed off, the parties kind of picked up and I think people took advantage of the lack of their presence.”
Olympia Fisher, 21, a senior from Cambridge, Massachusetts, said there is no doubt some are pushing limits.
“People are trying to make calculated risks, I think. Can I go to this small party? I know these people, I know where they’ve been and who they live with,” she said. “I think everyone is trying to make their own choices, but that’s also how this whole lockdown started.”
Both Scott and Fisher, who are friends and members of the Bates women’s rowing team, said upperclassmen seem to be more vigilant about safety measures than younger students.
“One thing I’ve really noticed, and maybe this is just among the people I hang out with and spend my time with – but I think seniors have been the most adamant about following precautions because we have a lot at stake with this,” Fisher said. “These are our final weeks here. We want to be on campus. We don’t want to be sent home.”
Jackson Elkins, a 21-year-old junior from South Deerfield, Massachusetts, said if a major outbreak can happen on a progressive college campus like Bates with relatively strict safety measures, he wonders what is happening in parts of Maine with little or no oversight.
“I think here at Bates, most kids are willing to follow public health guidelines, but in other parts of Maine, I’m sure there are a lot of young people frustrated that their lives have been altered so severely and for so long,” he said. “I don’t want to speak for others, but I think for young people, it’s difficult to have the big picture view sometimes. They might think the virus won’t affect people our age, but they don’t see what it means in the big picture.”
LOOKING AHEAD
On Friday, Bowdoin College in Brunswick became the first higher education institution in Maine to announced that all students and staff will have to be vaccinated against COVID-19 in order to return to campus for the fall semester. Other schools in Maine are expected to follow suit, joining a growing number of colleges and universities nationwide imposing vaccine mandates on their faculty and students.
While the new variants appear to pose more severe risks to younger individuals, COVID-19’s low death and severe disease rate among youths could be a factor in the decision by some to be more cavalier about unmasked, indoor gatherings. But that doesn’t necessarily mean they do not see the value in vaccinations.
Most young people who were interviewed last week said they had either gotten their first doses or were planning to – whenever they could get an appointment.
“I have unselfish reasons for getting vaccinated, wanting to help protect vulnerable people in my family,” said Quirion, the student from Westbrook. “But I have selfish ones too. I have fun plans toward the end of the summer, and I want to be able to follow through.”
Castonguay, the Sabattus resident who works in a restaurant, said she plans to get the vaccine but hasn’t yet. She said she’s waiting for demand to slow down a little.
“I’ll definitely get it, but I’m OK to let some other people go ahead of me,” she said.
Attitudes about vaccinations at Bates seem strong, too. Although there is no dedicated clinic, the college has been running a shuttle bus to the Auburn Mall vaccination site.
“It’s only been a week, but so many people I know have gotten their first dose,” Fisher, the Bates student, said. “So the interest is really high. People want this. It’s really hard to get appointments.”
Added Elkins, another Bates student: “A lot of my friends have gone in already.”
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