Sign Maine Travel Agency Agreement Mobile

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good afternoon everyone my name is nirv shaw i'm the director of maine's center for disease control and prevention i'm joined this afternoon afternoon by commissioner gene lambrew from maine's department of health and human services commissioner lambrew and i are here to provide everyone an update on all things covet 19 that are going on for today monday november 9th of 2020. i'll start by providing the public health update and then turning things over to commissioner lambrew we begin today's briefing by reporting on two additional deaths that maine cdc reported on and recorded this past saturday one was a man in his 70s from somerset county the other was a woman in her 80s also from somerset county collectively their passings mark the 151st and 152nd deaths with covet 19 across the state of maine we'd like to take a second to recognize their passing and to offer our deepest condolences to the friends family and communities of both of these individuals may their memories live with their friends and families forever right now statewide there are a total of 7 897 cases of covid19 an increase of 204 cases just since yesterday that marks our single largest one-day increase of cases since we began this work back in in january of this year of those cases 7031 are confirmed an increase of 188 confirmed cases and 866 are probable a rise of 16 probable cases among those 6020 have recovered an increase of 85 recoveries in terms of hospitalizations 529 people have been hospitalized at some point and just in the past 30 days 60 people have been hospitalized with covid19 right now in maine 49 people are currently hospitalized 14 of whom are in the intensive care unit 35 of you who are in non-intensive care unit beds and five of whom are on ventilators that amounts to a hospitalization rate right now in maine of 3.65 hospitalizations for every hundred thousand people to put that number in a bit of perspective the national hospitalization rate right now stands at 15 people for every hundred thousand across the country just a few weeks ago in maine our hospitalization rate was one per hundred thousand and today it stands at triple that at 3.65 as i mentioned a moment ago there have been 152 deaths among individuals with covet 19 since we began our activation and overall 1278 of our cases are among health care workers to talk just looking at the cases from yesterday 31 of yesterday's cases were from cumberland county and 25 of yesterday's cases were among folks from androscoggin county let's turn for some updates on outbreaks i'd like to talk first about some new outbreak investigations that maine cdc has opened recently one is at kids peace in ellsworth where we are aware of four positive cases at that facility laboratory tests across that facility are outstanding right now and we'll have more information about other potential cases if any as those laboratory results come in we've also opened an investigation into the pentecostals of jonesport church in washington county where we are aware of a total of nine cases associated with that house of worship we've also opened an investigation into rubies in york a restaurant there where there are a total of nine cases six of which have been identified amongst attendees or patrons of the restaurant three of which have been identified among staff members and finally we've recently opened an investigation into the portland pie establishment in windham after detecting three cases associated with portland pie there next a few updates on some open outbreak investigations at russell park in lewiston we are aware of now a total of 72 cases associated with that facility 45 among residents and 27 among staff one of which includes an outside vendor on saturday the team at maine cdc as well as other agencies had a productive call with russell park to make sure that they have everything they need from an infection control standpoint from a ppe standpoint as well as from a testing standpoint there are two rounds of testing that are underway at russell park one today and another tomorrow after which point we'll have a better sense of how that outbreak has evolved within that facility also at durgan pines in york county we are currently aware of a total of 33 cases there at that facility we we are working with durgan pines to make sure that they've got everything they need from a ppe perspective an infection control perspective as well as from a testing perspective we'll have additional updates on both of those as additional data come in and finally a quick note on where things stand with respect to testing right now our 7-day positivity rate for pcr tests in maine stands at 2.14 percent two weeks ago today that rate was 0.66 and thus in one in one incubation period of covet 19 the positivity rate in maine has more than tripled from 0.66 to where it stands now 2.14 to put that number in perspective the national positivity rate for pcr tests currently stands at seven percent across the country and finally in terms of testing volume our volume in maine right now stands at 573 tests for every 100 000 people in maine the national average for testing volume is at 387 tests for every 100 000 people and again our rate in maine stands at 573 with that i'd like to turn things over to commissioner lambert thank you dr shaw today the mills administration is announcing the launch of two new mobile clovid19 testing sites in maine through a partnership with promerica health the additional sites expand access to standard and rapid kovid19 testing to people in maine who think that they need a test regardless of symptoms and without the need for a referral from a health care provider at a time of rising curvid 19 cases in maine these new testing sites are especially important in identifying and isolating people with as contagious and deadly disease the new sites in portland and auburn expand our already robust testing capacity we thank pro america health for helping to make this happen testing at the portland international jetport is available seven days a week from 11 30 am to 10 30 pm starting today it is inside the terminal and accessible to both travelers and members of the public alike this friday pre-america health will begin offering mobile testing at the downtown auburn transportation center appointments will be available five days a week from 9 30 a.m to 4 30 p.m appointments at both sites can now be scheduled online at clovidtas4meme.com that's covetedtest4me.com proamerica is providing standard pcr tests at the jetport and auburn sites for free under a swab and send agreement with the department additionally promerica health will offer rapid abbott avid id now cleveland 19 testing at the jetpar jetport at a cost of 25 per test by appointment subject to availability main testing capacity is among the best in the nation this capacity which is 552 percent of maine's testing target according to the global health institute is made possible through partnerships be it the idex now testing agreement our health care providers who've been swab incense for these months as well as the dedicated and hard work of our health and environmental testing lab maine has proven able to test at volume all that said more needs to be done to continue to identify and isolate people with kovi 19 as we try to tackle this pandemic for a list of types all sites providing tests of people without symptoms and without requiring a provider referral visit the keep maine healthy website with that i'll turn it back over to dr shaw for questions great thank you commissioner we will turn now to our colleagues in the media and the first question for the afternoon goes to steve porter from seacoast media thank you dr shaw and commissioner lambrew i wanted to ask a question about rubies in york i understand from maine cdc records that the restaurant has been dinged a couple of times now for failing to follow covet 19 protocols does your team have a sense for whether the restaurant's conduct directly contributed to this outbreak um can you comment on that yeah steve that's that's a question that we've been thinking through internally at this stage of where we are in our outbreak we can't draw a direct line between those two uh certainly however this is a reminder that the best practices and protocols that are set forth in the checklists and governor mills executive orders are there and designed to prevent any types of transmission occurring within any kind of healthcare i'm sorry any kind of lodging or eating establishment at this time we've got to do more epidemiological investigation to try to make sure we can say one way or the other whether the compliance or in this case the non-compliance may have contributed we have to look at the timelines we've got to do those things because what you're asking is a scientific question but i think this is a good reminder that these guidelines are not designed to be in the abstract they are designed to keep people safe and that is why we expect full compliance with them and have they been cooperative and forthcoming with the contact tracing process uh they have uh we our investigators have been able to to get a good sense of where employees may have been exposed as well as anyone else who may have been at the facility during that time great thank you and just one quick follow-up with durgan pines um we understand from the director of that facility that there may be more than 40 cases at this point do we expect that number to go up tomorrow what can you tell us about that yes we do expect that number to increase uh the numbers that we have are as is noted on our website sort of as of late last night sorry late last night and very very early into this morning as the investigations continue throughout the day we learn of and associate additional cases sadly the outbreak of jurgen kinds is quite concerning and we expect that there will be additional cases associated with it thank you i'm going to turn next to sarah dedman at the machias valley news observer thank you dr shah and commissioner lambrew um the washington county case count has increased a lot in the past 30 days and testing um locally remains an obstacle there are whispers of a brief strike coming at callous regional hospital which is currently the county's only schwabensend site and we're still hearing from readers who simply cannot get themselves to either ellsworth or callus both one hour from machias in order to be tested as you know we have you know a tremendous elderly population here and there's all kinds of other obstacles commissioner lambrew late last month you mentioned that you were working toward a way to help address testing needs in towns like machias and obviously you've made some strides even just we heard about today but do you have any updates on that goal that might help a rural town like ours yeah we do continue to work on every available option to provide testing on site much highest we don't want to prematurely announce what that would be until we are ready to go all that said we recognize the gap in the map we are working to solve it we also are closely following what's going on in calais we appreciate the fact that there could be some uncertainty about the testing volume that's happened at callus regional hospital it has just for a reference really been producing significant volume of testing we appreciate the partnership that we've had with calais regional hospital in doing testing as well as all of our swab and send sites but we appreciate the gap we are closely monitoring what's going on in washington county and we hope we have news to announce soon great thank you and one other question kind of a kind of a big one maine as you know hit its single day high today with new cases are we nearing a point where the state considers going back into a lockdown so dr shaw can address this as well as i can we every single day talk about what more we can be doing what are different options what are best ways to help protect people in maine from the spread of coven 19 we are in the throes of implementing the actions we announced last week from lowering the indoor gathering limit from 100 to 50 to ensuring that people are wearing face coverings in public settings defining what public settings are for example we're working now to figure out how we get the word out that if you do for example go to a restaurant don't just wear a face covering going in and out of the restaurant where where when you're sitting down when you're not eating or drinking where when you're out for a walk when you might run into people on the sidewalk so using your common sense but also recognizing that you're wearing that face covering can protect other people is important we continue to look at activities like sports and announce some limits on friday on sports recognizing that there is for moderate and higher risk sports greater engagement greater potential risk for spread so we do continue to implement the recently announced policies to see if those policies will begin to make a difference but every single day we look at what else we can be doing to better protect people in maine knowing that we all have the tools at our disposal as well following those basic public health precautions of keeping your hands clean not touching your face wearing the face covering and keeping that six foot or more physical distance when possible thank you gonna turn now to steve at wmtw uh doctor you've heard the news from pfizer this morning about a potential vaccine does this give you reason to be excited should we be excited um steve here's here's my take on the data and i've read as much of it as has been made public that is to say and i say that for a reason we need to see all the data we should not be conducting scientific policy through press releases so i will be better able to speak about what this data and this announcement means once pfizer has actually published all the data and once it's gone through the peer review process and once the expert scientists the career scientists at the fda have analyzed it and gone through it with a fine-tooth comb then i think we'll really be able to make pronouncements and projections about what this announcement really means based on what i've read based on what was made publicly available it's encouraging but we need to see all of it we've got to make sure that we all have insight into other data that might exist that wasn't put forth today once we've got that complete picture then we'll be able to really analyze it what was released was encouraging it sounds favorable but this is the beginning of the process by no means the end of the analysis going to turn next to hannah dineen at news center hi there thank you for taking my questions a few for you today i first for uh both dr shaw and director lambrou uh at this moment in time as the cases of kobe 19 in maine continue to rise what are your biggest concern or what is your biggest concern about the state of covid in maine i'll start and then commissioner would love to get your thoughts as well my biggest concern hannah is unchecked community transmission uh what has what has started to happen is that the ground in maine has been seated with a lot of covet cases and what i'm concerned about as with any seating is that there will now start to be clumps outbreaks that pop up across the state because of that low level or now increasingly high level of seating we've talked about some of the ways in which what we're contending with now is different from what we were contending with in march april april and may in keeping with that one of the concerns i've got there is that when you combine this community transmission this seating what can happen is that today's community transmission can become tomorrow's outbreaks so my biggest fear is that today's community transmissions will soon start to become and snowball into tomorrow's outbreaks the reason that this is a concern among the obvious human told takes is that the places in which these outbreaks arise may be different from the traditional places we've seen so far so far we've seen a number of outbreaks in places like congregate living settings going forward given this seeding that has happened across the state we are likely to see outbreaks in varied and different places house olds family gatherings barbecues places like that any type of place where people are together could be a place where we start to see outbreaks to me it's like a giant pot of water that you put to boil on the stove i know that bubbles are going to start to come to the surface i just don't know where but we know they're going to happen that's the biggest concern that i've got and i'll add that while dr shaw said there's some changes in new facets of kevin 19 this fall compared to the spring we remain concerned about those people who are most vulnerable people who live in nursing facilities people are in hospitals people who are older who have chronic illness so we continue to work with our health care providers across the sea to remind them of best practices for infection prevention and control to make sure that they have the pp and other supports that they need to keep themselves and their residents safe and to try to make sure that we prevent the worst of what happens with covenant 19 which is severe illness and death just to round it out the other the last thing that i'm concerned about is that the unacceptable racial and ethnic disparities that we have seen emerge could become exacerbated as we go into this next spike uh those those we've talked at length about those disparities we have commissioner lambrew and i as well as the governor have called them what they are which is flatly unacceptable we've made strides with various organizations and groups to make sure we were doing everything we can the other thing that i'm concerned about as we think about community spread is that those existing disparities could become even wider and wider absolutely and dr shah with what you said in mind about i these new outbreaks being in homes being in places that we haven't talked about uh at great length or we have talked about but we haven't seen uh up until this point and people are planning for thanksgiving what are your plans for thanksgiving um i think this this thanksgiving for for me and my immediate family will be a lot different um my family and i love to cook it's what we do it's what we spend our time on the weekends doing that part of thanksgiving is not going to change but who is at our table is going to look a lot different this year than it has in previous years for us thanksgiving has always been the one day of the year where we throw open our doors and invite everybody and their dog literally everybody and their dog to come to our house to spend time with us this year it's probably just going to be me and my immediate family and our dog and that's sad that's tough but the world's different this year than it was last year let's hope that next year looks brighter absolutely and just quickly a few of our viewers have messaged us for about two weeks out from a series of campaign events uh seen across the state of maine have there been any uh outbreaks connect connected to those campaign events that we saw about two weeks ago um you know our case investigators when they interview anyone who's tested positive for covet newly tested positive we ask among a slew of questions we ask about any recent large gatherings they may have attended because we're looking out for those types of associations as of right now we're continuing to look for any type of connection between any large gathering and an uptick in cases as of right now we haven't found anything concrete we've seen some hints but nothing concrete so at this time we don't really have more but our investigators are continuing to investigate that if we see any evidence of any association with any sort of gathering we'll make sure we report that thank you i'm going to turn now to evan poppe hi dr shaw thank you um so you mentioned um about the 500 vaccine needing more information before you kind of definitively talk about that but i'm wondering if that was eventually approved it sounds like it will need constant and intense refrigeration and can you describe how that process would work in maine and if the cdc and others are taking steps to increase cold storage and transportation capacity and whether there's any concern that small hospitals or mainers in rural areas might struggle to have access to the vaccine sure so evan let me first start by saying i can't predict what those data will look like let alone whether the u.s fda will authorize or approve the vaccine that that that is an unknown that being said we're not waiting until that authorization or approval comes down the pike if it does in order to plan we're planning right now for that possibility that the pfizer vaccine may be approved or authorized as you note it does require ultra cold storage for storage it can be taken out of storage for a number of days during the administration process so it need it need not always be kept in ultra-cold storage it can quote survive outside of an ultra-cold environment for a number of days on its journey toward its ultimate administration site that being said what we have been briefed upon by the uscdc is that the pfizer vaccine is the type of vaccine where you want to bring the people to the vaccine rather than the vaccine to the people so we are working to expand the scope of ultra cold storage that we've got in maine we've already talked to the various hospitals in maine that have such facilities and then we on our side are acquiring or working to acquire additional freezers to bolster our internal capacity to store that vaccine we've been working with the hospitals that say they not only have the storage but also the space to accommodate positioning the vaccine if it were to be approved there are concerns as you noted about rural areas of the state so for that reason we're working with a depot model where again given that the vaccine can exist outside of the ultra cold environment where it can be brought to smaller hospitals if that's the route that those hospitals choose to go upon there are other vaccines in the pipeline not too far behind the pfizer one so we're trying to make sure we can both accommodate the pfizer vaccine at the places where it can be optimally controlled as well as plan for the other vaccines it is definitely a logistics challenge but this is what we do at the maine cdc and at dhhs we take tough logistics challenges and we take them head on thank you um and uh commissioner lambrew i was wondering if there was any update on um federal money provided for vaccine distribution i remember that you said in october that the state had received 800 000 and that there was concern about whether that was enough um is there any more money coming from washington are you expecting any to come in the future so we have a small update uh maine cdc heard last week that there would be additional money coming we don't know how much money there is coming all that said secretary azar continues to make it clear that they are planning on funding most of the vaccine effort federally directly to pharmacies healthcare facilities they issued a set of rules emergency rules two weeks ago that required all types of health insurance to cover the cost of an individual getting the coven 19 vaccine they also created a new program for uninsured people who need to cover 19 vaccine to get that vaccine for free so at this point the short answer is we have not seen additional money yet from the federal government beyond the 800 000 we may get some more given what we heard last week but our understanding is the federal government is planning to directly fund most of the vaccine effort directly great um and then just one last question i was hoping quickly dr shaw if you have any update on the main correctional center outbreak in windham if there's any latest numbers on that outbreak sure i can provide just the latest numbers as you noted uh for on for operational uh updates uh i referred you over to doc they'll have the latest on the ground there um at the main correctional center there are a total now as of this morning of 131 total cases 13 of which are among staff members and 118 of which are among residents thank you i'm going to turn over to isha at the bdn next thank you dr shaw can you hear me sure not kisha great thanks uh so i have two questions for either you or commissioner lambert today um the first one is about college campuses are you concerned about uh cases spiking on college campuses and also um students will be leaving for thanksgiving so are you concerned that that might lead to further outbreaks both in maine and across the country when uh students go home and uh i'll let you answer that before asking a second one sure um you know isha we've been we've continued to keep uh in in close contact with colleges and universities and other higher education facilities across maine uh we've got a team or a liaison that works directly with them so that any needs and requests they've got we can get answered and filtered up to the right folks we do we are concerned uh with the latest increase in cases they have occurred not just and i'm concerned not just for the numbers but also the geographic spread we've started to see cases uh in college campuses across the state which up until very recently have not seen very many at all the increase that we've seen however is consistent with the overall increase statewide but that being said anytime you're in an environment as one as kids are on college campuses where they're close together there's the possibility of transmission what concerns me specifically esha are reports that our case investigators have relayed that some of the transmission events that we've seen on college campuses are related to parties and so if you happen to be a college kid and you're watching this i'm going to ask again you got to do the right thing here at a time like this with covet all around being at a party with your peers is not the right call in fact what we've seen from other college campuses specifically in a paper that researchers in wisconsin found is that increases in cases on college campuses can then in a matter of a few weeks lead to more cases in other places in the town in which the college may be so we've all got a chance here to keep a lid on things for the college kids watching i'm asking you to do the right thing thank you uh my second question is about restaurants are restaurants proving to be uh a specific a concerning source of coven 19 transmission and are there uh contract tracing challenges associated with restaurants that are uniquely uh you know limited to restaurant contact tracing also the second part of that question is are you considering reinstating some of the restrictions on indoor dining apart from the ones that were included in the governor's masked mandate uh last week sure i'll talk about the epidemiological side and then uh maybe the commissioner can talk about the policy issues there um restaurants have been a concern and you know certainly throughout uh they just right now for example uh we've got three open outbreak investigations at least three associated with eating establishments i mentioned two today uh the the portland pie company as well as rubies and that comes on top of an increasing increase an outbreak at pat's pizza in the old port which is increasing in size so restaurants have been a source of transmission as well as a source of risk now with respect to the challenges posed by contact tracing one of the uh items that has been helpful has been the requirement under the checklists for restaurants to at least get the first name and phone number of parties who dine there so we are able to touch base with restaurants and learn who may have been in proximity to any of the positive cases and alert them that they may have been exposed and enroll them in our contact racing process that has been helpful both from uh informing people of that that they may have been exposed as well as from a helping them monitor their symptoms perspective but any time you've got a diffuse group of people in a large room figuring out who exactly constituted that close contact fifteen minutes within six feet that's an added challenge and for all sectors of maine's economy there is guidance called curvin 19 prevention checklist that provide clear protocols best practices for every type of establishment including restaurants to follow to keep their staff and their patrons safe again we've just recently changed our guidance about public settings to increase the protections and decrease the gathering limits which affect restaurants as well as other sites we're going to do a close watch to see how those new protective measures work but i do know that while we do believe that the key to a healthy economy is a healthy population we also are respectful of the importance of many of the sectors of maine's economy to keep going so we will closely monitor the change that we make to see if they're making a difference um and take action as needed but there's no announcements to announce today thank you in case i didn't mention the outbreak at pat's pizza stands at 32. thanks uh i'm gonna turn next to joe lawler at the press carol um yes hi uh just a super quick clarifying question for commissioner lambro before my main questions um you mentioned uh the at the jetport uh 25 fee for rapid antigen test can you explain why that's uh there's a fee for that where the other antigen tests will be free in other places sure so we have three different types of tests there's the traditional pcr test the molecular test which is the gold standard that we use here in maine we through our state lab our partnership with edx and our relationship with these so-called swabinson sites are using federal grant dollars that we have to support that effort we also got from the federal government are getting i should say up to 400 000 binax now tests which are the rapid antigen tests who which have a fairly good if not as good as the pcr test uh predictive value and dr shock and talk in detail about that we are through the um through our arrangement with walmart and other providers providing that at no cost to people the third type of test the abbott id now test we did get some support from the federal government for those tests not as much support those tests are good for purposes like travel which is why we support it at the york hospital where during the summer many people drove back and forth between maine and other states and got tests we support that work at the jetport where again travelers are coming in and out but because it's not quite as precise a test as the other two we do think that it probably doesn't deserve as much state support okay okay got it thank you um and then i i wanted to ask about the pfizer vaccine and one other topic if you could just um i'm trying to get a sense of the scope of the preparedness um so if you could explain like for instance how many additional freezers that you'll need how many doses you're expecting and um and and which hospitals will will be uh distributing the the vaccine if if it's approved sure um joe i would just go back to your earlier question just really really quickly for extreme clarity the the the rapid test at the jetport is not the antigen test it's the id now which is also rapid but not an antigen test maybe two in the weeds but just wanted to be crystal clear on that one um so with respect to the advanced preparation around the the potential pfizer vaccine again it requires minus 80 storage a minus 80 ultra cold freezer but not for the entire duration again it can be taken out and and survive out of the minus 80 environment for a number of days as it's being taken on its way for administration early on in our vaccine planning process we worked with hospitals and healthcare facilities to do a complete inventory of what their vaccine assets were and based on that inventory we were able to identify five hospitals in the state that possessed ultra cold storage i'll get you the full list joe uh but it's it's everywhere from ar gould uh cmmc mmc uh emmc etc they all have ultra cold storage capacities one of the challenges with the pfizer vaccine however is that it will come in lots of 975 doses so now we have an additional question not just whether you've got an ultra cold freezer but how much space do you have in that freezer so where we are with the hosp tals right now is going to ground on that second level question how much physical space do you have and how much additional vaccine can you accommodate in your current freezer how much can you free up so on and so forth for what hospitals do not have space for we will plan to hold in a depot fashion at our public health warehouse for that process we are going to acquire at least one potentially two ultra ultra cold freezers for that purpose there is a shortage on those freezers but thanks to the ingenuity of the main cdc public health emergency preparedness team we've been working with vendors who have some of them on stock in stock so we're working to acquire at least one perhaps two so that we can be the secondary intermediate depot while the hot while the vac while the hospitals are working to administer it on their side does that answer your questions i yes thank you um and then just uh sorry sorry joe let me just commissioner the commissioner wanted to weigh in as well well i do want to go back and correct myself joe so the buy next now test we're working in partnership with walgreens to deliver that test so i just want to make sure that that was clear i misspoke okay thank you um yes so uh yeah just a couple more little things um so uh i know moderna is a possibly and the could be the next one after pfizer approved is that the same type of deep freeze storage that you would need for morderna as for pfizer and then my last question is just simply uh with the increase in cases is there any thought about doing surveillance testing for uh hospital healthcare workers thank you sure um so joe on the vaccine front first let me let me kind of uh just tie up on the the pfizer vaccine because of these unique storage requirements uh it has been the opinion of the uscdc that this vaccine will be optimum for healthcare workers and first responders as i mentioned a moment ago this is the sort of vaccine where you bring people to the vaccine rather than necessarily bringing the vaccine to people even though it can quote survive outside of that deep freeze for some period of time it really is one based on what we've been instructed so far it's really one where because of that nature uh it will probably be one that's best for hospitals so that's the way we are approaching that planning right now in working with the hospitals to query their ultra cold storage capacity the moderna vaccine which is also working its way through its final stages of clinical trials at this time will not require that deep ultra cold storage it will require storage between negative minus two and minus eight centigrade not minus 80 centigrade so that will open up the doors for broader applications whereas the pfizer one may be one where we bring people to it and limit it not limited but make it ideal for healthcare workers the moderna vaccine may be one that has broader applications perhaps for nursing homes and other congregate living settings as well as for applications just in the community as a whole so again these logistics really do drive how we think about who might be optimally suited for the vaccine as well as the clinical data which as i mentioned a moment ago we haven't seen yet so we've gotta we've gotta put all of these factors into our planning as we think about which vaccine should go where and for whom and with respect to surveillance testing joe different hospitals are undertaking different protocols for surveillance testing we do require surveillance testing to be done for employees of long-term care and other congregate living settings and that is on a schedule that is set forth uh in in partnership with federal cms based on the level of of transmission that's occurring in the county in which the facility is located now that is already required it's been ongoing for a while and as i've reported we've actually detected cases and potentially prevented outbreaks as a result of that proactive surveillance testing hospitals are taking different strategies some hospitals are offering it to their employees to their symptomatic employees at this time we haven't moved we haven't moved forward with that same degree of surveillance testing at the hospital level we've really focused on long-term care and other nursing facilities because of the unique vulnerable state of the residents there whereas at hospitals the the contact may be a bit more transient there's also greater access to ppe so for that reason we haven't moved in on hospitals yet it's notable that and i think we talked about this last week transmission at the hospital level from staff member to employee has thankfully been the rare occurrence not the norm and again i think that's because of the nature of hospital work and the greater availability of ppe so that's where we are right now nothing is off the table and certainly if we start seeing increases we'll have to start working with the hospitals more to detect cases i'm going to turn now to amy brown at weru thank you dr shah i have a couple of questions from listeners and i think these could go to either one of you the first is a listener from waldo county says that they tried to reach out to police for help recently after initially trying to go into a store to shop and then later trying to use a public outdoor space and in both places finding a large number of people not wearing masks and not observing distancing they were told by the police to call 2-1-1 um and actually they said that when they tried calling 2-1-1 it said it was out of service i've tried it since it's working fine now but they asked what uh so i don't know what two on one would have told them but they asked you they asked us to ask you all what they should do in that kind of situation and whether or not it's true that police are not able to step in and that's just one of another i have another so i'll begin by saying we have through the key name healthy grant program provided up to 13 million dollars to municipal governments to help them with education and enforcement efforts every city and every town is a little bit different in terms of how they approach different types of public health activities um we do think that they're typically partners with us so in most places there is a partner in the local health officer local law enforcement who help us with this but we also do think that um the more we can use education about the importance of this this is partly going to be you know the the spread will partly be stopped through enforcement efforts but mostly we believe by trying to continue to educate people to provide them with the information the tools and the other kind of bigger measures like gathering limits because as dr shah has previously said we do know that there are some settings um that are harder to slow the spread of cova 19 in and that does include large gatherings so is there something she should have done in that situation differently i mean she's obviously not going to be able to provide education to all of those folks but they're asking for concrete advice if they want to go shopping and they don't feel like it's safe i think typically in large retail stores they are subject to the enforcement requirement talking to the store manager is one option i do believe what she already tried which is talking to the local law enforcement is an option we do have a portal where any individual domain can submit a complaint about uh the lack of a protocol in a public setting that is something we talked about previously and so we recommend all the above for people who are interested in reporting concerns yeah she's another one who brought up the issue of that's not anonymous and so she was afraid to make a complaint small town we did talk about that i believe on friday you commented on looking into getting an anonymous kind of reporting situation set up sure and let me just speak to that for one minute which is you know we do have limits on what we can do here in state government there's public access rules that most reporters are very familiar with about providing information that people submit to state government and we just can't be exempted from that all that said we do have workplace whistleblower laws for example so employees do have certain protections when it comes to workplace safety there are other different avenues for people in settings that they can't avoid like workplaces to report things so well we don't at this point have an anonymous system and that's partly because there have been concerns raised will there be a competitor continually submitting anonymous complaints about their other actor on the block as a means to try to get them to have a competitive advantage we know that there's some challenges with anonymous complaint lines which is why i think we have continued to hope that working with our local communities about the importance of public health is the best way to go okay the second question was from a listener who wonders if you have any advice for people who are in blended families where kids are shuttling back and forth between different homes there are different schools involved and people are not being consistent with following protocols safety protocols you know i think amy the the best thing there is that the advice that we've now learned that is the most effective at this stage of covid is that the basics like wearing a face covering maintaining distance good proper hand washing those are the best tools regardless of the composition or structure of the family now of course it's harder when there are different rules in one household than another but those basics like wearing a face covering even as we are going all indoors trying to keep distance and making sure we're good with washing our hands those basics still apply i think regardless and across multiple situations okay and one more uh some municipalities are testing wastewater for covid college campuses in the state have been doing that do you know how many are and is that being tracked by the cdc we're aware of a number uh i'd have to check with our environmental health program uh who keeps in touch with those municipalities we are aware of quite a few across the state and we can check and see what the latest number is they're not required to report those to us but we do offer to work with them uh to provide technical assistance and best practices and tips on how to interpret the data but the challenge being what to do next after it's detected all right thank you uh before i turn to the next question i want to go back to jill lawler joe i wanted to correct the record on something that i said i told you i think erroneously that the moderna vaccine required storage between minus two and minus eight uh that wasn't that was incorrect the moderna vaccine requires storage at minus 20. i was just looking at my notes there and realized i misspoke so i wanted to correct the record there asap i'm going to turn now to brian sullivan at wabi thank you dr shaw i have a question about college systems specifically the university of maine system the latest numbers from humane i think uh say there are 33 cases and i believe 13 come from their facilities management office uh in the on the orono campus but i we haven't heard that listed as an outbreak uh during these briefings is there a difference in the way that the ums uh reportings uh go along with the main cdc recordings and why it hasn't been listed as an outbreak uh no it's it's not so much that there's a difference we're just trying to sort out whether as with all work setting outbreaks whether there was transmission that may have occurred there or whether it was incidentally detected there um so that's that's that's the principal reason there um but in addition to that for matters involving humane they would have better insight into where they are in terms of the case numbers from the outbreak perspective we're also we're always just trying to sort out whether transmission may have occurred at that location um we did speak with uh umaine today and that those were the numbers that they they gave us so do you not consider that an outbreak uh on the on the arnold campus right now no i'd have to i would have to check with our epidemiology team to see if we've opened an investigation uh generally the outbreaks that i comment on here are ones where there's not a spokesperson associated with the facility or somewhere where there is a health care facility involved where loved ones may be at risk or a place of general common access like a restaurant those are the ones that i tend to focus on if i haven't mentioned it it's not to suggest that nothing is going on it's just that i want to make sure i'm spending my time talking to folks about the ones that we know are potentially places that might affect people understood that makes sense uh and i have a question about uh the island of north haven we've talked to some people there and uh when covid19 does make its way to an island uh i guess specific sets of of dangers or advice for the people on an island when there is uh the illness present there sure um you know commissioner rambo and i have been briefed on this situation and have been in touch uh with folks who are involved uh we've been concerned about this situation about situations of this nature that could manifest in island communities that's one reason actually last week as we were thinking about uh distributions of the binax now this rapid antigen kit we made sure we put a focus on communities where we needed to get testing answers because uh because of their somewhat more remote nature as well as the fact that there's more interconnectedness and more opportunities to spread so i think brian that kind of points a light toward what i would recommend as best practices for island communities which is to say making sure that the things that make island life really great which is that deep connection with your neighbors don't accidentally generate transmission that's the concern we're facing right now when i talk about household transmission community level transmission it's occurring on the islands it can occur on the islands just as much as it can occur on the mainland and i think we're starting to see that on north haven thank you i'm going to turn now to patty white at maine public thanks dr shah i've got a question about the new swab and send sites obviously it's good news to have more testing but what's that going to do for the turnaround time for results and also the follow-up from case investigators and contact tracers is that going to create any delays especially with the increase in daily cases so i'll i'll go ahead i'll go ahead and start and then commissioner can chime in on top of that v so the the bottom line patty is that um you know the primary goal here the prime directive is to offer and expand the amount of testing that we that we can across the state uh to especially places uh like in androscoggin county where we we we've heard from community members that more testing is needed but similarly we recognize that that may place additional demands on our epidemiology and our lab staff so we're continuing to turn up the dial to make sure that we've got the staff necessary to respond when we see positive test results we are continuing to make sure that we can redeploy staff from within maine cdc to serve as case investigators as well soon as contact tracers we're simultaneously starting new and more frequent training classes to train more individuals in case investigation and contact facing we've got to make sure we can expand testing if that means getting more staff to turn up the dial on case investigation that's what we'll do and are the i know you gave an update on some of those numbers for how much you're trying to increase last week are those numbers the same or those changed they are largely the same as what we talked about last week which is to say starting this morning approximately 25 additional sorry 25 individuals within maine cdc who were previously trained to be case investigators have redeployed and that's as of this morning we are simultaneously working with other groups to tap into resources across state government to train more case investigators and contact tracers we're also working to streamline the process to see if there are quality imp ovements that we can make say for example in the reports that come into us in paper format trying to see if there are ways that we can make all of that more and more electronic to be a lot more efficient in the way that we investigate cases okay thanks and then um if i could just ask about the the outbreaks at the nursing homes russell park and durgan pines what can you tell us about how those outbreaks started i mean typically in the past has been through you know it comes in through staff but can you tell us anything else you know did it start at a household gathering that a staff member was at and bring it in or what else can you tell us about how those started so you know we had a really detailed and productive call i'll focus on russell park we had a very detailed and productive call uh with the leadership at russell park uh particularly their administrator who has really been on top of this in this situation based on what we understand in russell park the first symptomatic individual based on where we are in our investigation right now the first symptomatic individual was in fact a resident but as we know from nursing facilities and as you hinted at patty it's typically brought in by staff for the most part we haven't identified yet specifically which staff member may have been the first to introduce it we're not aware of reports of staff members who were symptomatic but of course we know now that much of the transmission can occur before folks have symptoms we're trying to identify who or which set of staff members may have been among the first to introduce it into russell park and then we'll be able to go back in time with them to determine whether they acquired it say at a family gathering so on and so forth we've just opened the investigation just in the recent days so we haven't figured that layer out yet but that's where we're looking into but patty the other thing that we have seen now in multiple occasions at healthcare facility outbreaks is related to where within the facility the transmission may have occurred and i want to say this really delicately because it's a sensitive topic and i want to preface what i'm about to say by acknowledging that healthcare workers across the country and across the state have been working tireless countless hours since the beginning of the pandemic under extremely difficult conditions in a world that has been turned upside down that being said we have identified in certain facility outbreaks some concerns that while resident while employees are in break rooms or on uh are working outside when they're not in direct patient care they may have let their guard down a little bit it's human nature we are we've been conditioned so far in the pandemic to focus on times when we're interacting with patients with residents and that's when we've got our ppe guard up but that maybe when we're with our colleagues we let it down a little bit so if you're a health care worker who's watching right now i hear you i understand how difficult the conditions you've been working under are my ask to you today is that you keep your ppe guard up even when you're not working with a direct patient when you are in the break room or when you're on your lunch break stay six feet apart keep your mask on and your n95 on as much as you can if you've got we know you've got to eat lunch try to do so alone those are the best ways to keep our guard up and limit transmission thanks i'm going to turn now to brad rogers at gme hey we've seen a rise in hospitalizations uh in augusta and now perhaps it will happen in lewiston and portland as well uh you know what are you what feedback are you getting from hospitals doctors and nurses you know how concerned are they with this spike we went four months with relatively little low numbers and now all sudden they're shooting they shot way back up brad i can i'll speak for myself only and what i've learned from providers and and obviously like commissioner ambry wayne as well i had the opportunity just over the weekend to check in with colleagues of mine who are healthcare providers and physicians uh across the state uh and they expressed significant concern uh both about what they've been seeing in their own patients as well as what they've been seeing in their facilities uh from their own from their patient perspective uh they're worried because the people who get hospitalized in maine are often those who already have pre-existing health conditions so from just a human perspective the increase in hospitalizations presents challenges for any healthcare provider but from a facility's perspective they want to make sure that we don't enter a situation that other states say like wisconsin and south dakota have started to experience which is shortages around those vital facilities we haven't seen those in maine and we think we're far off from having shortages of beds but we've got to take steps right now because there's a time in the period of every single hospital that is experiencing a shortage in beds where they weren't experiencing a shortage in beds now is the time for all of us in maine to take steps so we don't get to that place commissioner and we had done this in the spring we continued it over the summer and we are doubling down to make sure that we have sufficient ppe that we've looked at our testing supplies to make sure that they're sufficient that we have alternative care site models ready to go that we have projections that are aligned so we have increased our pace of engagement to ensure that we maintain sufficient capacity for treating people in hospitals and other sites of care because we are committed to making sure that we not only prevent the spread of covenanting that we treat those who get it as well thank you both and the final question for the afternoon goes to patrick whittle for the ap thank you very much um i wanted to piggyback on an earlier question and ask if if it's possible that uh stay at home or stay healthy at home orders could possibly resurface it sounds like what i'm hearing is that it's being considered and it's a possibility but nothing is eminent and also uh joe biden has said a few times that as president he would be interested in doing a nationwide mass mandate curious if the dhhs or governor's office or maine cdc has a position on that so to start out with we always look at all options look back on what worked in the spring in the summer what other states are contemplating so as dr shah said nothing is off the table but there are no actions or changes to announce today we will continue to keep people apprised our goal is to keep public health as our north star but to allow people to engage on those essential functions and important functions as possible so long as it doesn't interfere with our goal of preventing the spread of kevin 19. going to the potential for a national requirement for face coverings i can't imagine that there is a requirement that will come that's different than what we have here in maine i think the governor has decided early on in gradual stages to begin to target face coverings to settings and places and to make sure that we've learned from those settings what works best just again last week with our definition of what is a public setting and eliminating the um exemption when there can be physical distancing in a public setting those are best practices that we've seen in different places and we're quite comfortable that whatever might come from a national policy would be consistent with what we have here in maine thanks patrick uh before we close for the afternoon uh i would just like to mention a few things the first is that we have started the process of moving these briefings back to a monday wednesday friday schedule to increase and make sure that everyone is aware of where things stand with covet given the increases in cases hospitalizations positivity rates as well as additional activity on the national front we want to make sure that everyone in maine has full visibility into trans and transparency into where things stand right now so as we move back to that monday wednesday friday schedule we'll be adding more briefings normally the next briefing would be on wednesday however in honor of veterans day we will be holding a briefing not on wednesday of this week but on thursday of this week not on wednesday and so since we will not be reconvening as a group until after veterans day i wanted to close today by thanking each and every veteran as well as their families for their incredible service to our country we'd like to take a moment to honor the sacrifices that all of you have made for the common good of our state and for our country so with that we thank you for joining us this afternoon as always do the right thing wear a mask be kind take care of one another we'll talk again on thursday