BAR HARBOR — The advice from local, state and federal leaders has not changed. The most important and effective steps everyone can take to limit the spread of the virus that causes COVID-19 are wearing masks or other face coverings, maintaining 6 feet of distance from others and vigilant hand washing.
“It’s all about muscle memory,” MDI Hospital COO Chrissi Maguire said in a recent community forum. Avoid large crowds, she said, and try to “weave the two-arm-length distance even on a crowded street.”
The same goes for hiking trails and roads in Acadia National Park. “If you’re passing someone, put a mask on if you’re getting within 6 feet of them,” Superintendent Kevin Schneider said.
Do what you can to keep a distance, they said, but momentarily passing someone on a sidewalk or trail is relatively low risk compared with longer interactions, especially indoor ones. Contact tracers focus on interactions where people have more than 30 minutes of contact.
In a media briefing Monday, Governor Janet Mills had a message for business owners about wearing masks or face shields and requiring them for employees and customers. “Protecting your customers protects your business,” she said. “It protects our economy.”
At the town forum, Maguire explained the regional and state emergency plans in place should Mount Desert Island see a surge of COVID-19 cases. MDI Hospital works in a regional partnership with Northern Light Eastern Maine Medical Center in Bangor, which is where most COVID-19 patients would go from MDI. That hospital might send other patients with less intensive needs here in an exchange. If the Bangor hospital were overwhelmed, the Cross Center could be used as an overflow location to care for patients.
If an overflow hospital location were needed here on MDI, Maguire said, the Conners Emerson school is part of the extreme surge plan. But if the situation escalated that far, the Federal Emergency Management Agency would be in Bar Harbor “helping do this,” she said.
Earlier in the planning to respond to the virus, before there were any cases in Maine, ambulance services had planned to use a specific ambulance with an isopod, a containment unit that goes on a stretcher, according to Barbara MacPike, MDI Hospital’s infection preventionist.
“However, it quickly became apparent that would not be feasible or necessary,” she said. As the CDC changed its guidelines, new instructions were released “that included how to clean an ambulance following a transfer of a COVID-19–positive or COVID-19–suspected patient,” she said.
“With this guidance, all of the ambulances, including the three ambulance services on MDI, can transfer COVID-19–positive or COVID-19–suspected patients from home to the hospital and from hospital to hospital, and when they are done, there are strict cleaning procedures that they follow.”
Ambulance staff use full personal protective equipment when any patient may have been exposed to COVID-19, MacPike said; “the patient is also given a mask to wear, if they are able to tolerate it.”
Last week, when a World Health Organization official said in a news briefing that it was “very rare” for people without symptoms to spread the novel coronavirus, public health experts rushed to clarify. The official herself, Dr. Maria Van Kerkhove, walked back the statement the following day.
“There’s sometimes a disagreement about what the terms mean,” Dr. Herb Cushing of Spectrum Healthcare in Portland said on the “Maine Calling” radio show last Wednesday. “Asymptomatic patients are folks who never develop symptoms and get tested for some reason and are found to be shedding the virus or can be labeled presumptively positive later, if they have antibodies.
“Pre-symptomatic folks are people who were shedding the virus but then got tested and also developed symptoms,” he continued. “So, there are differences between the two.”
On the same radio show, Dr. Edison Liu, president and CEO of The Jackson Laboratory, explained: “You can’t tell at the time of testing, especially if you don’t follow up on individuals, whether they are pre-symptomatic or totally asymptomatic.
“We have natural experiments that have taken place already that have shown that completely asymptomatic individuals that never have, at least, remembered any symptoms have been able to transmit the disease,” Liu said. “And furthermore, in cases of cruise ships and in aircraft carriers, which are unfortunate natural experiments, 45-50 percent of the individuals who tested positive in that entire situation were asymptomatic.
“And it’s quite clear that at least in the cruise ship, even when they quarantined individuals, the infection continued, which meant that the asymptomatics within that group were able to transmit the disease.”
The claim from the WHO, Liu said, “was based on some private, internal data that they had that hadn’t been published, and that was another source of criticism.
“As scientists, we want to see the data, to argue about it and to see if it’s valid or not.”