Maine now has a backlog of 56,000 positive COVID-19 tests that have yet to be processed and added to the state’s official case counts, the Maine Center for Disease Control and Prevention announced on Wednesday.

The backlog, which has swelled from 46,000 since last week, has artificially lowered daily case counts and Maine’s official infection rate as the omicron variant has spread rapidly through the state. The state is working to automate and streamline the review process to reduce the backlog, as many other states have done, Dr. Nirav Shah, director of the Maine CDC, said during a media briefing on Wednesday.

Shah said the process to automate is technical and time-consuming, and he didn’t have an estimate on how long it will take to launch the new system.

State officials also announced Wednesday that they are expanding wastewater testing to a total of 23 communities with sewer treatment systems to better track the spread of the COVID-19 in the state’s more densely populated areas and respond to the omicron surge that is driving infections and hospitalizations in Maine.

Sampling of wastewater has begun in Rockland and Boothbay, and soon will begin in other locations, including Wilton, Bath and Guilford-Sangerville, the Maine Department of Health and Human Services announced Wednesday.

Testing already is being done in Yarmouth and at Portland Water District treatment plants in Portland and Westbrook, where recent results have shown a steep decline in virus prevalence from peaks earlier this month.

The expanded testing is the result of two programs, one coordinated by the federal government and one organized by the Maine CDC using $400,000 in federal dollars. The Maine CDC sites will include Blue Hill, Belfast, Augusta, Calais, Brunswick, Presque Isle and Portland, among others.

Shah said at this point in the pandemic, data from wastewater is superior to case counts and a “true population health metric.”

“It’s designed to show what’s going on in my community, how is that changing and what does that mean going forward,” Shah said.

WASTEWATER DATA TO BE POSTED

Shah said some wastewater data could be posted on the Maine CDC website as soon as late next week. In about three months, the sites will not only test for the the prevalence of COVID-19, but also which variants are present.

The Maine CDC has been de-emphasizing case counts in recent weeks as a way to measure current pandemic conditions, both because of the backlog, the proliferation of at-home tests – which typically aren’t reported to the state – and tight testing supplies.

But the backlog also resulted in Maine receiving a smaller shipment of monoclonal antibodies than other states based on a federal formula that considers each state’s confirmed per capita case count and hospitalization rate. After Gov. Janet Mills called the White House over the weekend to point out that Maine’s case count is artificially low because of the backlog, the Biden administration adjusted Maine’s shipment this week from 66 courses of sotrovimab, the monoclonal antibody treatment, to 120 courses.

Maine Health and Human Services Commissioner Jeanne Lambrew said that conversations with White House officials is giving the Mills administration confidence that Maine will not be shortchanged in the coming weeks.

“We believe we will be getting more (courses of antibody treatments) than we have been getting,” Lambrew said during Wednesday’s media briefing, explaining that the Biden administration recognizes that Maine and other states that have not yet moved to automated case counts are reporting artificially low counts, and the formula will be adjusted to ensure the state receives its fair share.

MOVING TO AN AUTOMATED SYSTEM

The move to an automated system means Maine will no longer have CDC staff investigate each positive test to notify close contacts, try to determine the source of the outbreak, and gather information such as residency and vaccination status. The review also has included eliminating duplicates – people who have had more than one positive test while infected – before reporting them as new cases.

Instead, the process of eliminating duplicates and determining basic information such as residency will be done by a computer program. Once the state shifts to the automated system, CDC staff will no longer do contact tracing and full case investigations.

People who test positive will continue to be notified about the test in the same way they have always been. That has not been affected by the backlog.

Shah said with omicron being so contagious – and often transmitted before investigations can begin – the case investigations are far less useful, leading the Maine CDC and many other states to conclude a more automated system will be better. The sheer volume of cases to process has overwhelmed the state’s current capacity to process the tests in the same way they had during much of the past two years, he said.

Meanwhile, the number of Maine hospital patients with COVID-19 declined Wednesday for the third day in a row, according to state data.

COVID-19 hospitalizations stood at 406 on Wednesday, down from 427 on Monday and 416 on Tuesday. Patients in critical care declined from 97 on Tuesday to 88 on Wednesday. Total hospitalizations peaked at 436 on Jan. 13, and ICU patients peaked at 133 on Dec. 19.

The decline in hospitalizations is the latest sign that the omicron wave may be easing in Maine the way it has in other northeastern states.

Dr. James Jarvis, COVID-19 incident commander for Northern Light Health, the parent company of Eastern Maine Medical Center in Bangor and Mercy Hospital in Portland, said that while statewide hospitalizations may be trending downward, the virus is still circulating at very high levels, creating bottlenecks in hospitals.

“Our numbers are still very, very high,” Jarvis said.

The Maine CDC reported 1,524 new cases of COVID-19 on Wednesday, and two additional deaths. Since the pandemic began, Maine has logged 169,998 cases of COVID-19, and 1,716 deaths.

DE-EMPHASIZING CASE COUNTS

Public health officials, including Dr. Anthony Fauci, White House medical director, have been de-emphasizing case counts in recent weeks not only because data is lagging in many states with the omicron wave, but also because the proliferation of at-home tests, which typically aren’t reported to state health agencies, and the lack of testing supplies are skewing results.

Dr. Laura Blaisdell, a South Portland pediatrician and infectious disease expert, said on Wednesday that with the case count data becoming less reliable, it’s difficult to determine where Maine is in the omicron wave. But there are some positive signs the wave is receding, including wastewater testing showing declines in some parts of Maine and other East Coast cities.

“It certainly seems like omicron collapses on itself very quickly,” Blaisdell said.

Blaisdell said it was “incredible” to see schools mostly stay open during the omicron surge, as well as much of society remaining open.

“As we come off of this surge and being in the crisis mode, we’re going to have to continue to think about how we approach living with this virus,” Blaisdell said.

Dr. Dora Anne Mills, the governor’s sister and the chief health improvement officer at MaineHealth, the parent organization of Maine Medical Center in Portland and seven other Maine hospitals, said in a Facebook update on Tuesday that there are some positive trends occurring with the pandemic and some optimistic projections suggest omicron may be the last big wave.

“Some are predicting omicron will be the last big wave here in the U.S., since between its high infection rate and our vaccination rates, we should have a resulting wall of immunity. I certainly hope they are right,” Mills wrote.

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