WELLFLEET — Outer Cape Health Services must reduce its hours and possibly close one of its three clinics at least temporarily because of the financial pressure imposed on the organization by the coronavirus, its directors report.
In a conference call with reporters on Monday, medical director Andrew Jorgensen said the volume of patients has gone down as people self-isolate, “so to be financially responsible we’ll do a reduction in hours.”
Though a new schedule was not final by the Independent’s deadline, the three OCHS clinics in Provincetown, Wellfleet, and Harwich will have phased opening and closing times so that in combination they will be open 8 a.m. to 5 p.m., Jorgensen said. Updates will be made available on outercape.org.
On Tuesday, Executive Director Pat Nadle appealed to donors in an email that began, “In what has been a matter of days, nothing is as it has been before.” Her message was dire: “We are facing an immediate threat to our ability to provide health center care to residents of the Outer and Lower Cape who depend upon us as their only health care resource.”
Nadle’s memo cited compounding threats to federally qualified health centers like OCHS, including new expenses, supply shortages, and a lack of support from the federal government.
“As we are local residents like you, we find the idea of closed health care assets horrifying,” the email continues. “And yet, without your help, our hands are tied. The funds are simply not available to serve our community as we have for decades.”
According to the email, 17,000 patients could be facing closed pharmacies, limited access to local providers, and reduced access to supportive social services.
No one from OCHS would comment on the donor appeal email by the Independent’s deadline on Tuesday.
OCHS clinics are still treating people for common ailments, but there are some COVID-19- related changes. They are doing more telemedicine, in which clinicians provide treatment by phone. This includes psychotherapy — for which there is great demand, especially in this time of anxiety and isolation, said Marta “Dikke” Hansen, director of behavioral health at OCHS.
Those who need to come to a clinic are met at the entrance by a staff member who will ask about COVID-19 symptoms and take their temperature. Those with symptoms will be sent back to their cars to await a phone call or visit from a nurse. OCHS is trying to limit exposure because if the clinic is contaminated it would have to close for 24 hours, Jorgensen explained.
“We are determined to keep our health centers open during the epidemic,” he said.
Tests of Limited Value Now
A shortage of coronavirus test kits and equipment at hospitals and health centers continues.
OCHS had tested 50 people by Monday, mostly at the Wellfleet clinic where the organization now directs those approved for “drive-by” testing. Two residents of Provincetown tested positive at the Wellfleet clinic, said Jorgensen.
On top of the usual screening questions for COVID-19 symptoms, OCHS doctors are making strategic choices, conducting tests only in certain cases, because the tests are in short supply.
The lack of tests is not a major concern at this stage in the pandemic, according to Dr. Michael Shear, a Boston-area emergency room doctor — it is too late for them to be much help.
“Easy access to testing might have helped us in trying to contain the virus,” he told the Independent. “But now, with COVID-19 already widespread, the question becomes what to do with the test results.
“At this point, anyone with symptoms of respiratory illness (cough, sore throat, fever) should stay home and self-isolate,” Shear continued. “They will most likely be fine and will feel better if they just treat the symptoms. Having a test, whether the results are positive or negative, won’t change that advice. The tests are really most useful in helping hospitals decide which of their patients are most in need of stricter isolation.”
In order to preserve scarce protective equipment, OCHS is scheduling COVID-19 tests back to back in Wellfleet as much as possible. That way, gowns and N95 masks do not have to be changed each time a patient is tested from a vehicle, Jorgensen said.
One bright spot in the bleak days since the pandemic began is that Christy Shilling, a molecular scientist with a home in Provincetown, on Monday donated about 200 N95 masks to OCHS. She was not in town, but asked her friend James Frederick to get the masks from her home and bring them to the clinic, Frederick said Tuesday.
Nadle called the donation “a miracle.”
Worst Is Yet to Come
Questions about the medical capacity of this rural area continue.
Cape Cod Healthcare, which owns both hospitals in Barnstable County, has 60 ventilators at Cape Cod Hospital and another 20 at Falmouth Hospital, said spokesman Pat Kane. The two hospitals combined have 34 I.C.U. beds, according to the watchdog Leapfrog Group.
Staying home and socially isolated to avoid infection is the best way each citizen can help, though Sean O’Brien, the county’s emergency preparedness coordinator, stated on Monday that the worst is yet to come.
“If I had to say one thing, it’s that we’re just at the start of this,” he said.