Visitor cases ‘not an outbreak’; Contact tracing to expand



BAR HARBOR — Mount Desert Island Hospital is set to begin contact tracing work to make sure those who have come into contact with out-of-state visitors who test positive for COVID-19 are aware of the potential exposure. 

MDI Hospital will use the web-based Sara Alert tool to begin contacting those “close contacts” (anyone who has been within six feet of the person for 15 minutes or more) of these out-of-state cases, Maine Center for Disease Control Director Dr. Nirav Shah announced Tuesday. 

Under federal rules, cases of the coronavirus are reported in a person’s state of permanent residence, not in the place where they were tested. Since MDI is a destination for summer residents and visitors from all over the country, residents are nervous about not knowing the true number of cases among people who are or were here. 

Contact tracing investigations are also normally the responsibility of the patient’s home state, and MDI Hospital leaders have been worried that it’s hard to do the job well from hundreds of miles away. Maine CDC conducts case investigations and contact tracing for all confirmed cases of COVID-19 in Maine, including nonresidents whose results are reported to Maine CDC by other states, but that reporting doesn’t always happen. 

The failure to acknowledge, track and trace these individuals has both direct and indirect public health fallout,” Dr. J.R. Krevans told the Portland Press Herald before the new contact tracing program was announced. “Maine, by virtue of both its geography and excellent state leadership, has done very well so far, but this situation represents a clear and present danger that should be addressed.” 

Overall since the pandemic began, according to the Maine CDC, 170 positive cases have been reported among out-of-state residents. Since March, about 35 of those have been in touch with MDI Hospital for advice while in the area, spokesperson Oka Hutchins said. In the last week and a half, about seven people contacted MDI Hospital about having received positive test results after arriving here. 

“We’re not labeling this as a potential outbreak,” Shah said in a media briefing Tuesday. “There’s no indication that these cases are epidemiologically linked.” 

It’s also a bigger problem as some large national labs are taking six days or more to return results. Maine’s travel rules require most visitors to get tested in order to visit without having to observe a 14-day quarantine, having the swab or sample taken no longer than 72 hours before arriving here. That means they may be several days into their vacation before getting a result. 

Quarantine 

“Our guidance is clear,” Shah said. “If you are coming to Maine before you’ve got your negative test result in hand, you should absolutely be quarantining until that result comes in. That does not mean limiting your contact when you go out to eat, it means not going out to eat. It means staying in your hotel room. It means not leaving and exposing anybody. That is the essence. If individuals follow that, which they should be, the theoretical number of contacts with Maine people should be very low.” 

Asked further about which specific activities are prohibited while people are in quarantine, he said it would be okay to “go outside or go for a walk knowing with confidence you will not interact with anybody at all.” If quarantining visitors must do curbside pickup for groceries or other items at stores, he advised to “wait until there’s no one around you whatsoever” to leave the car. 

Sara Alert 

The pilot project with MDI Hospital for visitor contact tracing, Shah said, “will be the same system that’s used for individuals who are Maine residents.” 

A case investigator contacts the person who has received a positive test as soon as possible after the diagnosis is delivered, he said, and compiles a list of their close contacts. (This is why restaurants are asking customers for phone numbers.) 

Then, contact tracers add contact information for those people to the Sara Alert system and get in touch with them via text message, phone call or email. The system sends automated messages for a period of time to ask those contacts whether they are experiencing symptoms. 

“Typically, Sara Alert has been used by hospitals to conduct symptom tracking,” Shah said. “We’re adjusting Sara Alert to make it useful for this situation.” 

Should any local close contacts later test positive for COVID-19, Maine CDC would commence case investigation and contact tracing. 

“We look forward to seeing how this system works and how we can use it to keep everyone in Maine safe,” he said. 

Cases climb 

The number of cases of COVID-19 among Hancock County residents nearly doubled in the last week, from 18 to 34and MDI Hospital reported three new cases from samples collected there (all nonresidents), but the “sentinel” testing program for employees of Mount Desert Island tourism businesses has yet to surface a positive case. 

Between March 31 and July 15, when the first 18 cases were reported for Hancock County, there was never more than one new case on any given day. 

Then came news last week of outbreaks at two blueberry companies in Ellsworth, five confirmed new cases July 28 and three at a different company July 29, bringing the county’s cumulative total from 18 to 26 in a hurry. 

All of the new Hancock County cases reported July 28-29 are associated with blueberry companies Hancock Foods and Merrill Farms. At both facilities, the workers were tested by the Maine Mobile Health Program. The affected workers are now quarantined in Bangor. 

On Saturday, seven more confirmed and one more probable case in Hancock County were added. Most of those were also associated with the two local blueberry processing facilities. 

MDI Hospital publishes total number of confirmed cases from samples taken there on its website; the number is cumulative since the pandemic began. No new positive cases, resident or nonresident, have been reported since July 29.

This article has been updated.

Liz Graves

Liz Graves

Reporter at Mount Desert Islander
Former Islander reporter and editor Liz Graves grew up in California and came to Maine as a schooner sailor.

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