The number of coronavirus cases in Maine continues to climb. And now Gov. Janet Mills is taking steps she had originally hoped to avoid, including the mandatory halting of dine-in services at restaurants and bars and a prohibition on gatherings of 10 or more people.
Meanwhile, the Maine Center for Disease Control continues to grapple with a problem confronting every state in the country — a shortage of protective equipment for first responders and health care providers. The shortage is limiting more expansive testing and increasing concerns that health officials are losing track of infected people.
Wednesday's daily briefing in Augusta by Maine CDC director Nirav Shah began with more sobering news: "as of this morning, the Maine CDC is reporting a total 42 cases of Covid-19 across the state. That includes an increase of 14 cases since yesterday."
The increase in numbers is accompanied by a spread in geography that now reaches eight of Maine's 16 counties, with Wednesday's confirmed case in Penobscot County.
Shah says four people are hospitalized, but another person has fully recovered.
That small bit of good news was quickly eclipsed when Mills announced restrictions that are certain to impact Maine's businesses and workers for the foreseeable future.
"Under the authority granted to me under … a state of civil emergency, I'm issuing an executive order today mandating that all restaurants and bars statewide close to dine-in customers effective today at 6 p.m." Mills says.
The restaurant and bar closure lasts until March 31, and it's a move that the governor was reluctant to make as recently as Sunday. At more than 60,000 jobs, the industry represents nearly 10 percent of the state's workforce, in addition to $2.5 billion in sales — sales that are certain to dip under the mandate.
Mills also announced a prohibition on all gatherings of 10 or more people, including, "community, civic, public, leisure, faith-based events, social clubs, sporting events with spectators, concerts, conventions, fundraisers, parades, fairs and festivals."
Prohibiting such gatherings is allowed because of the civil emergency that Gov. Mills announced Sunday.
She also announced another step, although this one was a recommendation: the two-week closure of all public-facing businesses such as gyms, hair salons, movie theaters, casinos and shopping malls.
Some Maine businesses have already temporarily closed as a precaution, but the governor's guidance is likely to force more storefronts to darken for the next two weeks.
Mills acknowledged the potential impact on the Maine economy, but says the steps she took Wednesday were all designed to further the strategy of social distancing.
"Covid-19 continues to spread across Maine. Experts have been clear that implementing social distancing that includes these measures is the most effective method to mitigate its spread and to protect public health," Mills says.
And protecting public health — and even measuring the scope of the outbreak in Maine — continues to be a challenge.
CDC Director Nirav Shah has previously said that community transmission of Covid-19 is occurring in Cumberland County, which so far has the most cases with 24, as of Wednesday. But there's a fear there are more people infected, but who remain unknown to the state and local health officials.
Darcy Shargo is the CEO of the Maine Primary Care Association, which represents the state's Federally Qualified Health Centers.
"Part of the challenge with this whole response is that we can't with great accuracy yet predict how big it's going to get," Shargo says.
And Shargo says one of the challenges is the inability to ramp up community testing because there's a shortage of personal protection equipment, or PPE, which people administering the tests must wear.
CDC Director Shah has acknowledged the problem, and says that he's hoping that recent deliveries of masks, gowns and face shields from the federal government's Strategic Reserve can help.
"That distribution is coming in. Most critically, the distribution of N-95 masks that we requested has come in. That's approximately 12,700 N-95 masks," he says.
Shah has also acknowledged reports that the Strategic Reserve may not have enough supply of PPE to meet the demand, but he's hopeful the federal government will take additional action.
On Wednesday, President Donald Trump announced that it would: "we'll be invoking the Defense Production Act just in case we need it. In other words, I think you all know what it is, and it can do a lot of good things if we need it."
The Defense Production Act is a 1950s wartime law that allows the federal government to order American industry to produce critically-needed medical equipment. Trump did not specify how he would use the law, but his decision to invoke it had been urged by health officials for weeks. Just how quickly the manufacture of PPE equipment can take place and make its way to Maine and other states is unclear.
But Shah says the unknown cases of Covid-19 are worrisome, particularly amid new research from China showing that six in seven cases went undetected and helped worsen the outbreak.
"As you can imagine, if individuals who do not have symptoms are able to spread the disease in high numbers, that means more of the iceberg is being unseen," Shah says.
More of the iceberg could be revealed when the CDC holds another briefing Thursday.
Mills warned that the news is likely to get worse before it gets better.
Originally published 4:44 p.m. March 18, 2020