How did they do it? Acknowledging that geography and timing -- and therefore some luck -- was involved, state officials said that a consistent message among state and local leaders and a willingness of the population to take heed of warnings played a major role in flattening the curve of the virus early on and beating it down again when it tried to resurge.
In early April, Maine was looking at a coronavirus caseload that was doubling every four days and saw hospitalizations on the rise. Less than two weeks later, the infection rate had leveled off and the state had halted the spread. Again, in May, state officials were worried when a single assisted living facility had 57 new cases on one day. Gov. Janet Mills then postponed the reopening of restaurant dining rooms in three counties and the state hunkered down again.
Since then, Maine has kept the infection rate down. Last week, the state’s per-capita death rate from the coronavirus was second lowest in the country at 1 per 100,000 residents, behind Vermont, and the positivity rate was 0.8 percent.
That policy of having a consistent message throughout the state was one of the keys to getting that infection rate down, said Dr. John Alexander, chief medical officer at Central Maine Healthcare.
“We recognized that we really needed to have a coordinated effort and I would argue that it was as much the fact that we had the same policies or similar policies across all our healthcare within the state as much as it was the policies themselves,” Alexander said.
They set up screening procedures and changed the hospital’s physical environment to mitigate the spread of the virus even before testing became available. “We wanted to protect our essential workers from the risk of spread of COVID and to protect our patients from the same,” Alexander said. “As testing became available, then we added that to our risk stratification to test high risk because of the testing—we didn’t have testing for everyone so we tested higher risk.”
“Maine has consistently been doing very well and all of these indicators definitely seem incredibly encouraging,” Divya Siddarth, a research fellow at Microsoft and co-author of a series of reports on states’ pandemic response, told the Portland Press Herald. “It’s not a fluke, something is working.”
The state has an older population with many over the age of 60 and more vulnerable to the virus. That may have played a role in the compliance as well as a very targeted education campaign from the state.
“That was an area that we were able to target our education on our residents because there was clearly a link between the coronavirus and an older population with other risk factors,” Alexander said. “We had really great adherence and Maine is not particularly population dense and that played a significant role in helping to prevent any early significant surge in cases.”
The state also was a bit fortuitous in that it got to watch and learn as other states, such as Washington and California, began to suffer from the virus. “Being in the Northeast, we had the luxury of understanding what was occurring initially out in Washington and California and then quickly developing in New York, so geography played a major role for us.”
It allowed the state to being to get out the message, which it did in earnest via radio, newspaper and television as well as regular press conferences from the governor and the head of the state Center for Disease Control and Prevention, and other physician leadership. And those messages of wearing a mask, keeping a safe distance and staying away from crowds still persists from the state’s leadership to its residents.
“The physician leaders in the state have really strong backgrounds in public health so we were well-equipped to speak to the issues that come up,” Alexander said. “It feels like we don’t function like several health systems but like one health system.”
