January 19, 2022
With the new year, the Maine Center for Disease Control and Prevention (CDC) has made several changes to its reporting of COVID-19 data to reflect changes from the U.S. CDC as well as the highly contagious nature of the Omicron variant. These changes will affect some metrics and trends as a result.
First, Maine is aligning its definition of a “death with COVID-19” with the U.S. CDC’s recently updated definition. Among other things, this updated definition categorizes an individual as having had a “death with COVID-19” if that person had a positive test for the disease within 30 days of death. Throughout 2020 and 2021, Maine CDC looked back 14 days from a death for a positive test result. It is likely that this change will result in a one-time increase in the number of COVID-19-associated deaths in January as more people are included.
Second, the Maine CDC has changed its definition of a “confirmed outbreak of COVID-19.” From the start of the pandemic, a COVID-19 outbreak was defined as three or more PCR-confirmed cases in a setting within the preceding 14 days. Now, COVID-19 outbreak criteria will depend on facility type. As previously communicated, in pre-K-12 schools, an outbreak of COVID-19 will now be defined as greater than or equal to 15 percent absenteeism among students or staff in a single day, where the majority of those absent are due to COVID-19 illness. For all other facility types, including but not limited to long-term care, hospital, outpatient health care, higher education, and businesses, an outbreak of COVID-19 is now defined as 5 or more people who have been in-person at a facility with confirmed or probable COVID-19 within a 14-day period.
Third, as previously explained during Maine CDC media briefings, the high volume of positive test results being reported to Maine CDC in the last month has far exceeded the staff’s ability to review, deduplicate, and convert a positive test result into a case. As of January 18, over 45,000 positive test results have yet to be reviewed although individuals with positive test results are notified by texts from Maine CDC as well as by the site that conducted the test. While some positive test results may be duplicates, they more accurately reflect what is happening on a daily basis than the number of new cases at this point. At the same time, the number of positive test results is, itself, incomplete since it does not include over-the-counter (home) positive test results which are not routinely reported to Maine CDC. Similarly, as more individuals experience asymptomatic or mild cases of COVID-19, they may not seek a test at all. These epidemiological factors reduce the importance of daily case counts as an informative metric.
The metric on Maine’s dashboard that is updated daily, including weekends and holidays, that most accurately reflects what is happening in real time, is the number of COVID-19 patients in Maine hospitals, particularly those in intensive care unit beds and on ventilators. The number of people with COVID-19 ill enough to require hospitalization, especially in critical care, is a good gauge on the type of response needed to limit the spread of the disease and support our health system.
The COVID-19 pandemic is approaching its third year as a U.S. Department of Health and Human Services-declared public health emergency. Our understanding of the disease, including how to limit its spread and prevent its direct and indirect health consequences, has advanced dramatically. Our own tracking of the disease in Maine has – and will continue – to adapt over time as well.