An employee of Portland’s public health center tested presumptively positive for coronavirus, triggering a two-week closure of the clinic and the self-quarantine of more than two dozen other city staffers and volunteers.

The city employee, who is identified only as a Cumberland County resident in his 50s, is the second presumptively positive case of coronavirus in Maine.

The Maine Center for Disease Control and Prevention is also reviewing a preliminary positive test for a third person, a woman in her 20s who is being treated in an isolation unit at Maine Medical Center in Portland. If the Maine CDC verifies her test as a presumptive positive, it then would go to the federal Centers for Disease Control and Prevention, which is providing final confirmation for all tests.

Maine CDC staff and MaineHealth providers are investigating the patients’ travel histories under the assumption that the tests results are presumptive positive.

The new cases, which would give Maine a total of three, are heightening concerns about the spread in Maine of a virus that has sickened more than 130,000 across the globe and killed nearly 5,000 people. Maine health officials urged residents to prepare for more cases – but not panic – and to practice “social distancing” as well as good hygiene in order to avoid larger community transmission of coronavirus.

“We seem to be in this narrowing window of opportunity to make sure to take all of those steps,” Dr. Dora Ann Mills, MaineHealth’s chief health improvement officer, said Friday afternoon. “Making sure that if you are an older person or someone with a serious chronic medical condition, that you are staying away from groups of 10 or more people, that you are not traveling, you are staying at home for the most part and that you are not getting on a plane or a cruise ship … and if you are not in those groups, that you also use social distancing and vigilant respiratory hygiene.”

The disease caused by coronavirus, COVID-19, generally causes mild, flu-like symptoms in healthy individuals, but can result in serious or life-threatening complications in the elderly or those with other serious, chronic medical conditions.

The presumptive positive test for the employee at Portland’s India Street Public Health Center – a facility that treats uninsured or low-income individuals as well as those with substance use disorders – marked an alarming turn in a state that was among the last to report cases of COVID-19.

The first presumptive positive case was announced Thursday in a woman in her 50s, a Navy reservist who recently returned home to Androscoggin County after traveling in Italy.

Dr. Nirav Shah, the director of the Maine CDC, described the woman as “a model citizen” who quarantined herself after noticing symptoms and has cooperated fully with health officials as they reconstruct her interactions with others in recent weeks.

“Fortunately, those contacts were minimal, and Maine CDC has reached all of them to discuss what levels and precautionary measures they need to take, if any,” Shah said. “The individual continues to do well, she has not been hospitalized, and we remain in contact with her. And one of our top priorities right now is to work with her to ensure her speedy recovery.”

The Maine CDC announced early Friday that preliminary tests done by a MaineHealth lab on two people showed potential infections with COVID-19. The man in his 50s, who was subsequently identified as the India Street clinic employee, was later determined to be a “presumptive positive.” The agency was still reviewing the results for the woman in her 20s on Friday.

Portland officials closed City Hall as of 3 p.m. Friday out of what was described as “an abundance of caution.” Additionally, city officials asked 23 employees within the public health division – including all clinic staff – as well as seven volunteers at the clinic, to self-quarantine. The city also began the process of reaching out to clients who may have had contact with the individual who tested presumptively positive.

“We are taking this pandemic very seriously (with the) goal of protecting our staff and public health and safety,” City Manager Jon Jennings said at a news conference.

Nationwide, there were 1,629 confirmed or presumptive positive cases of COVID-19 and 41 deaths in 46 states plus the District of Columbia. Washington state and New York are the hardest hit and account for more than one-half of the reported cases, according to figures from the U.S. CDC.

President Trump declared a national emergency Friday and announced additional steps aimed at addressing the pandemic. But the Trump administration has come under widespread criticism for botching the rollout of coronavirus testing kits to states, a backlog of results and for not testing nearly as aggressively as other countries.

Maine CDC has received one coronavirus test kit containing the tools to conduct roughly 1,000 individual tests. During his daily media briefing in Augusta, Shah said the state has roughly 900 tests remaining from that kit and that there is no backlog in Maine.

“We do expect that we will require more test kits in the state of Maine, as other state health departments across the country will as well,” Shah said. “What we are doing right now is working with the U.S. CDC to make sure we put our order for any subsequent test kits in now so that we don’t have any discontinuities or interruptions in testing.”

The Maine CDC has tested roughly 111 people, with 91 tests coming back negative, 17 pending, two presumptive positives and the one preliminary positive, according to figures on its website that were updated at noon Friday.

Additionally, MaineHealth’s NorDx Laboratories in Scarborough began testing for coronavirus this week in order to expand the state’s capability and speed up results. Mills stressed that the coronavirus test is not as simple as the swab done for, say, strep throat, and must be collected by trained individuals wearing complete protective equipment.

For that reason, Maine CDC and health officials are urging those who are exhibiting symptoms – fever, shortness of breath and a cough – to first contact their doctor’s office by phone to see whether they require testing and to arrange it. Those swabs are then sent to either Maine CDC or NorDx Laboratories for analysis.

Mills said that the test MaineHealth is using differs from the kits sent to Maine CDC, which is why any results are being double-checked by the state and federal officials.

“It does expand our capacity quite a bit, especially over the next few days as we ramp up,” said Mills, a former director of the Maine CDC and the sister of Maine Gov. Janet Mills.

Testing decisions are made by physicians based on a person’s symptoms, travel history or potential contact with individuals who have contracted COVID-19.

Additionally, the Portland-based health care provider InterMed announced Friday that it recently added “outdoor, drive-through, appointment-only testing” for patients whose doctors suspect they may have coronavirus.

“If your provider feels your symptoms and history make you a candidate for COVID-19, we’ll schedule an appointment at the testing location and our staff will be able to quickly perform swabs that will be tested for coronavirus disease as well as its cousin, the seasonal flu,” InterMed’s chief medical officer, Dr. Dan Loiselle, wrote in a note to patients.

The Trump administration announced on Friday a series of steps aimed to boost the availability of coronavirus testing. The Food and Drug Administration has created a 24-hour emergency hotline for laboratories having difficulty getting materials or having issues running tests. Additionally, nearly $1.3 million in federal money will be given to two companies trying to develop rapid COVID-19 tests that could determine within an hour if someone is infected, The Washington Post reported.

MaineHealth officials released a statement Friday morning saying hospital incident command systems have been activated at each of its facilities. Hospital employees in the incident command group gather frequently to plan for the onset of a potential disaster, such as a pandemic, blizzard, flooding or a mass shooting. The process is activated when the hospital anticipates an event that could stress its systems.

“While it is understandably unsettling to members of the community that this outbreak has come to Maine, we are prepared for this across our system,” MaineHealth’s Mills said in a statement.

Dr. Steve Diaz, chief medical officer at Maine General Health and chairman-elect of the Maine Hospital Association, said while coronavirus is a new threat, hospitals routinely train for public health emergencies.

“All of us are doing refreshers,” Diaz said. “The health systems across the state are talking to each other every week and communities are coming together to work with all of our community partners so we can care for patients where they are.”

Businesses, schools and government offices across Maine are canceling events and gearing up for the continued spread of coronavirus.

Gov. Mills announced Thursday that the state is recommending – but not mandating – the cancellation or postponement of all nonessential indoor gatherings of 250 or more people for the next 30 days. Sporting and concert events across the state have already been canceled, including Portland’s St. Patrick’s Day parade.

Late Friday, the Democratic and Republican leaders of the Maine Legislature announced plans to suspend the 2020 legislative session beginning next week. The session was slated to run until April 15, and just Thursday leaders had indicated that they hoped to continue working even as they moved to suspend tours and large-scale gatherings at the State House.

“On Tuesday, we will consider emergency legislation to help the state respond effectively and efficiently to this public health crisis and any critical appropriations before temporarily ending the legislative session next week,” Senate President Troy Jackson of Allagash, House Speaker Sara Gideon of Freeport, Senate Minority Leader Dana Dow of Waldoboro and House Minority Leader Kathleen Dillingham of Oxford said in a joint statement.

Public schools in Maine are responding to the spread of coronavirus by canceling field trips and events, and preparing plans for remote learning. The University of Maine System and Bowdoin College are transitioning to online-only classes. And nursing homes across Maine have started restricting or banning visitors to protect elderly residents who are particularly vulnerable to coronavirus.

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