Maine lags New England states in reporting data on pandemic

More than a month after the first confirmed coronavirus case here, Maine is the only New England state that is unable to provide daily reports on the number of people who have been tested for it.

The other five New England states have provided such information for weeks, even though at least three of them rely on outside laboratories for part of their testing, as is the case in Maine. Massachusetts even publicly posts a table of results for each of more than 26 labs that test its patients.

The Maine Center for Disease Control and Prevention has also lagged in gathering or disclosing other types of data relating to the pandemic. The agency was unable to say how many COVID-19 patients were hospitalized on a given day – a key metric of the burden on hospitals – until last Friday, three days after the Portland Press Herald published a story on the shortcoming. The agency had not even asked hospitals for the information until March 31.

Although Maine has the highest proportion of vacation homes in the country – 19 percent of the housing stock – and there have been scattered incidents of people threatening visitors from out of state, the agency has disclosed the number of non-resident cases confirmed here only once, on April 9, the morning after the Press Herald had asked for the information.

Two other states with large numbers of seasonal residents – Hawaii and Florida – post information on non-resident cases on a daily basis, and Florida provides the numbers by county on its website.

The Maine CDC was unable to provide an accurate count of intensive care unit beds and ventilators until the week of April 5, and said that shortcoming was due to the fact that some hospitals – including one large hospital it didn’t identify – had not been providing it. Such capacity numbers are essential for preparing for various surge scenarios for the disease, public health experts said. The CDC still doesn’t include this information on its website, only providing it verbally at its daily press briefings.

“The fact the other states in the region are able to do this shows that states don’t have to be learning these processes in a vacuum,” says Jeremy Youde, who studies the intersection of government and public health at the University of Minnesota Duluth. “It seems imperative to try to do some outreach and see how the other states are able to make it work.”

It is not clear why Maine lags its peers, all of which have statewide public health agencies similar to the Maine CDC. New Hampshire has a similar population, Vermont and Rhode Island are smaller, and as of Monday afternoon Maine had the lowest number of confirmed cases per capita in the region.

The question of why Maine isn’t sharing complete test results is particularly perplexing. Maine CDC Director Dr. Nirav Shah has repeatedly said the problem arose once outside laboratories began testing patients, but it is not clear why other states have not had a problem collecting the same information from such labs. Asked about this, agency spokesman Robert Long said via email that due to “the varying frequency and formats that outside labs use in submitting negative test results,” the agency had decided that weekly reporting “ensures the reliability and accuracy of these data.”

Long also said the underlying problem was that “reporting from labs became inconsistent due to the high volume of tests conducted.” He said the CDC then asked the outside labs to prioritize reporting the most important information, the confirmed tests, so the state could begin tracing each patient’s contacts, and to follow up later with the negative results. “In some cases, those labs are conducting tests on samples from multiple states, so following up with negative results for all of those states, including Maine, is secondary,” he added.

He added that the department was finalizing a contract with an outside vendor “to enhance the presentation of our data and to include additional data sets on our website moving forward.”

The Press Herald asked the CDC’s counterparts in the other five New England states if they had encountered any challenges in gathering negative testing information. Only Rhode Island and Vermont responded with direct answers.

Vermont health department spokesman Ben Truman said there had been no difficulties cooperating with three outside labs. “It has been an exceptional cooperative effort among our health care and other partners during this unprecedented public health crisis,” he said.

Rhode Island, however, said it had experienced challenges. “This is because, while laboratories have systems for reporting positive test results to the state, negative test results are not reported to the state for other diseases,” Department of Health spokesman Joseph Wendelken said via email.

Long said the CDC would gather and report the information on a weekly basis for the time being. On April 9 there were 11,608 negative cases, he said, but he did not provide a county-level breakdown, which would allow residents of counties with few cases to know whether this is due to few people being tested.

Long said the agency was working with outside labs “to develop a more consistent system for reporting negative test results.” But he cautioned that the expected introduction of rapid result tests like those produced in Scarborough by Chicago-based Abbott Laboratories “will need to also be taken into consideration in the future.”

Jennifer Horney, founding director of the epidemiology program at the University of Delaware’s College of Health Sciences, says having and tracking this information is essential. “Knowing the number of negative cases is important because to know the rate of disease among the tested, we need to know the total number of positives divided by the total number of people tested,” she said via email.

Maine, Massachusetts, Vermont and Rhode Island only report confirmed cases by county of residence, a practice public health experts say can protect patient privacy. New Hampshire and Connecticut, however, provide the information by municipality of residence on their public websites, regardless of the size of the community.

Asked about how they decided which information to share, Kate Spiner, a spokesperson for New Hampshire’s COVID-19 joint information center, said via email that all decisions were “based upon whether the release of such information further ensures the health and safety of the public.”

Here’s what Maine shares: