Dr. Nirav D. Shah, director of the Maine Center for Disease Control and Prevention Derek Davis / Portland Press Herald

BRUNSWICK — Mid Coast Hospital’s COVID-19 cases have remained low throughout the summer, but with the winter fast approaching, Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, is warning that the combination of the coronavirus and seasonal influenza could be “potentially significant in every sense of the word.” 

In a web panel hosted by the Brunswick Downtown Association on Wednesday, Shah told Lois Skillings, CEO and president of Mid Coast Hospital, that while it is impossible to predict the magnitude of the flu this year, “it doesn’t matter.”

“Make sure you have made your plans to get your flu shot as soon as your health care provider tells you it’s appropriate, or as soon as you can in the near future,” he said.

Aside from keeping people healthy, the flu shot and the resulting decreased rates of influenza will free up space and resources for hospitals and medical professionals to treat COVID-19 patients if cases of the illness continue to rise.

Local cases have remained relatively low throughout the pandemic. So far there have been 4,491 confirmed or presumptive positive cases of the virus in Maine. Of those, according to the Maine CDC, 31 have been in Brunswick, 21 in Freeport, 21 in Topsham and 17 in Bath. 

Mid Coast Hospital has treated 20 inpatients for COVID-19 since the first case was reported in March, according to hospital spokesperson Judy Kelsh. 

The hospital is not currently treating any inpatients for COVID-19 and has not had a patient with the virus since August 3. Officials have tested 6,510 individuals with just 64 positive results.

Still, Shah said recent outbreaks in parts of the state that have previously not had many, such as schools in Androscoggin County or paper mills in Oxford County, are cause for concern.

While the cooler months are a sure sign that cold and flu season will be ramping up, Shah said he and other public health officials are concerned that when the temperature drops, Mainers will lose the “protective effect” of being outside. 

Experts believe the risk of contracting or transmitting the virus is significantly lowered outside, so throughout the summer, many have been gathering with friends and families outdoors. 

Shah doesn’t believe people are going to stop gathering once the weather turns, he thinks those gatherings will just move inside. 

That can be risky. 

The thing that is so “insidious” about COVID-19, he said, it that it “takes advantage of the things that make us not just human, that that make us a community. It takes advantage of the fact that we like to gather in groups.” 

The activities that make life “vibrant and worth living” also carry higher risks of infection, he said, and “we’ve got to keep that in mind as we go into the winter.” 

It will be important to continue to wear a face covering indoors, limit large gatherings and keep the recommended six feet apart. 

The best way to increase mask wearing is to “make sure each and every one of us is to do our part,” he said. “Make sure that the rule is the baseline.” 

These precautions should be as expected as wearing a bicycle helmet, buckling a seatbelt or driving the speed limit, Shah said. If a business isn’t enforcing the mandate, he suggested talking to the manager about what should change or why it’s important. 

“Individuals should make sure they are setting the norm,” he said. 

While officials urge the public to make time to get their flu shots this year, they are still unsure when a vaccine for the coronavirus might be available. 

“The bottom line is that nobody really knows,” Shah said, but added that there are a number of candidate vaccines in study, so it could be that when the time comes, there will be more than one to choose from. 

One may be more effective for younger people, another for older, but right now there are still too many unknowns to speculate, he said. 

When a vaccine is ready for approval it’s also likely that there won’t be enough of the vaccine available to satisfy the demand immediately, Shah cautioned. 

In some cases, companies are ramping up manufacturing so that if and when a vaccine does get approved, they will be ready to ship “higher than anticipated” doses, he said. 

Conversations surrounding who should be first in line to get a vaccine, whether healthcare workers, school aged-children, nursing home employees and residents, are still in the works and no decisions have been made. 

The “when” is still the “central question on everyone’s mind,” he said.