COVID infections rise in Maine and wastewater testing indicates more to come

COVID-19 cases in Maine and across much of the nation have surged in recent weeks, just as children and college students return to classrooms.

But better tools to combat the virus mean there’s no indication of a return to pandemic-era restrictions such as mask requirements and limits on gatherings.

Maine’s case counts have increased from about 20 to 50 positive tests reported each day in July to roughly 50 to 150 reported each day starting in mid-August. Wastewater testing is showing much higher concentrations in wastewater in most counties in Maine, including a large spike in Cumberland County in August. The presence in wastewater is a real-time indicator that virus prevalence is rising.

Case counts are not as reliable a way to measure how much virus is circulating compared to earlier in the pandemic because of the proliferation of at-home testing. Results of at-home tests are often not reported to public health agencies. Also, people are now more likely to fall ill and recover at home without testing at all.

The overall trend is up, but public health experts are not predicting the dire situation Maine and the nation suffered through before vaccinations began in 2021 and the omicron wave passed in early 2022.

“We are riding smaller waves,” said Dr. Laura Blaisdell, president of the Maine chapter of the American Academy of Pediatrics and an infectious disease expert. “I am worried with the return to school and more indoor activities that we will see increased spreading. But it’s likely we still have protection from vaccination (and infections) and therapeutics are unchanged in their effectiveness. The hope is we have enough tools and common sense knowledge we can stem the tide of hospitalizations.”

COVID-19 hospitalizations are still largely consistent in Maine since late spring, with 42 patients hospitalized with COVID-19 on Friday. That is about 10 times less than the number of patients in January 2022, during the omicron wave, when 436 patients were hospitalized with COVID-19. Since the pandemic began in March 2020 in Maine, the state has reported 7,468 hospitalizations and 3,096 deaths.

The Maine Centers for Disease Control and Prevention is expecting an uptick in hospitalizations this fall and winter from respiratory illnesses, whether it’s COVID-19, influenza, or RSV, a virus that disrupted school schedules last year.

“With more people spending time indoors, the opportunity for these viruses to spread increases,” said Lindsay Hammes, Maine CDC spokeswoman. “Especially for those who are older, very young, or immune-compromised, these viruses can still pose a serious risk.”

And the same trends are playing out nationwide.

Dr. Mandy Cohen, director of the U.S. CDC, said in a video statement this week that hospitalizations across the country have increased to 10,000 per week. That’s up about 25% over the past two weeks, according to an NBC COVID-19 tracker.

“We are seeing an increase in hospitalizations for COVID-19,” Cohen said. “However, as a reminder, last year, we saw up to 40,000 hospitals a week at our highest point in August. We are in a much different and better place in August of 2023. We have stronger immunity and tools to protect ourselves. We have vaccines, at-home tests, effective treatments, and common sense strategies, such as washing hands and staying home when sick.”

Meanwhile, the U.S. CDC continues to monitor variants of COVID-19, including Pirola. That emerging variant may be more transmissible, but there’s no evidence it causes more severe illness.

“CDC’s current assessment is that the updated COVID-19 vaccine, which will be available in mid-September, will likely be effective at reducing severe disease and hospitalization. Immune responses generated from prior infection also help protect against severe outcomes of COVID-19,” according to a U.S. CDC fact page about the Pirola variant.

The updated COVID-19 vaccine expected to be available this month was re-tooled to be more effective against current variants similar to the way scientists change the influenza vaccine every year to try to match circulating strains.

Hammes, with the Maine CDC, said “it’s too early to say whether this COVID wave, compounded by other respiratory viruses, will be as hard-hitting as prior waves.”

But, she said, since the virus spreads in the same way, “Maine people should continue to take protective measures such as covering coughs and sneezes, consider masking if you are feeling unwell or are at higher risk, stay home if you’re feeling sick, regularly wash your hands for at least 20 seconds, and most importantly, make a plan to get your COVID shot this fall, once it becomes available.”

Many physicians will give influenza and COVID-19 shots during the same appointment. Also, a vaccine for RSV is available for pregnant women and those 60 and older, and a preventive therapeutic is available for infants.

Other health protection measures such as masking or increasing room ventilation may also be appropriate, depending on your personal health and family situation.

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