PROVINCETOWN — The Delta variant of Covid-19 arrived in Provincetown like a hurricane. There was fear, economic devastation, a news camera on every corner, even a catchy name: the Provincetown Cluster.
The cluster ended as hurricanes often do, with a long stretch of surprisingly calm days. Case numbers fell quickly and have stayed quite low. Provincetown’s mask mandate was suspended on Aug. 31 and something more like ordinary life resumed.
As of Provincetown’s last update, posted on Sept. 13, there were seven “active cases” in town — a local metric that includes confirmed and probable cases in both year-round and seasonal residents.
As of Sept. 18, Truro had six “active cases.” Eastham had seven confirmed cases in the two weeks ending on Sept. 11, and Wellfleet had fewer than five. (“Confirmed cases” are those identified by molecular PCR tests, rather than by rapid tests.)
Against the background of Delta’s spread across the rest of the country, especially in the South and Plains states, the whole Northeast has exceptionally low case numbers. The state pulled its mobile testing van out of Provincetown on Sept. 6 because the positive test rate had been low and stable for weeks.
That van offered free PCR tests for five hours a day, seven days a week, for the eight weeks it was here. Now, there is no single every-day location for people on the Outer Cape to get a Covid test. Instead, there is a constellation of sources: health-care providers, pharmacies, county sites, online deliveries.
Outer Cape Health
Outer Cape Health Services has been the primary testing resource on the Outer Cape since at least December, when the state started delivering a free supply of BinaxNOW rapid antigen test kits. Drive-through testing hours are 12:30 to 1:30 p.m. on Mondays, Wednesdays, and Fridays in Provincetown, and 10 to 11 a.m. on Tuesdays and Thursdays in Wellfleet.
Because it is a health-care provider, however, rather than a standalone testing clinic, OCHS has some protocols that other kinds of testing sites do not. People with symptoms may require a telehealth screening to assess their symptoms and other possible causes of illness. And people who are not OCHS patients may be asked to fill out a patient-intake form before being tested.
“We do test non-OCHS individuals … who are from here or out of town,” said OCHS Communications Director Gerry Desautels. People who live elsewhere, or who have a different health-care provider, can still get a test. But they will need to fill out forms for care authorization and for contact tracing, said Desautels. Drive-through appointments can be scheduled by calling 508-905-2888.
Rapid tests at OCHS are always free. PCR tests, which are often required for large events or international travel, are $110.
Eastham Police Dept.
The Barnstable County Health Dept. is running a new once-a-week free testing clinic at the Eastham Police Station on Tuesdays from 2 to 4 p.m. It is staffed by volunteers from the Cape Cod Medical Reserve Corps and offers PCR tests.
Cape Cod Healthcare
The closest guaranteed seven-days-a-week testing resource to the Outer Cape is Cape Cod Hospital in Hyannis. Its community testing program offers free drive-through testing to everyone, symptomatic or not, every day from 7:30 to 11 a.m., and weekday afternoons from 3:30 to 6. The PCR tests are processed at an onsite laboratory and deliver results within 24 hours.
Cape Cod Healthcare also offers a new rapid PCR test at its urgent care centers, including the one in Harwich. The Abbott ID Now is “a different type of PCR technology than RT-PCR,” according to capecodhealth.org, “which allows for more rapid turnaround, and results are available in 15 minutes.” An ID Now test costs $125.
Through the Mail
The state government has also endorsed a through-the-mail testing option offered by Labcorp. A link from the state’s testing website now leads to pixel.labcorp.com/ma-testing, where it’s possible to enter insurance information and receive a free PCR test kit via FedEx. Testing is billed either to insurance or to the federal government, according to the website.
In fact, nearly all the testing locations described so far are funded in roughly similar ways: by insurance when possible, and otherwise by the federal government’s Covid funds. Insurance companies are prohibited from passing along co-pays related to Covid testing.
Where Are the Rapid Tests?
Many of the pharmacies in Provincetown, Orleans, and towns farther up Cape sell rapid tests over the counter, but they are often out of stock.
On Tuesday, Sept. 21, at the deadline for this edition of the Independent, there were no rapid antigen tests available for sale on Amazon.com. (There were three through-the-mail PCR testing kits available, and at least five books about Covid tests.)
This was partly because rapid tests are becoming a major tool for large employers. The Biden administration’s new vaccine mandate for large private employers includes a weekly testing alternative for those who remain unvaccinated. Many of those weekly tests are likely to be rapid tests.
Provincetown’s weekly testing alternative for unvaccinated staff, for instance, will be a state-provided supply of BinaxNOW rapid tests, according to Town Manager Alex Morse.
Likewise, many school systems are moving toward rapid testing of students who are exposed to Covid, rather than forcing all exposed students to quarantine at home. Massachusetts is one of the first states to endorse the “test-and-stay” approach, which involves daily BinaxNOW rapid testing for every exposed student for seven days after exposure.
These movements toward rapid testing by large institutions could keep the tests relatively scarce on store shelves, at least for a while.
Is It Enough?
State Sen. Julian Cyr said he thinks the testing options are more than enough to identify any new outbreak, and that resources could be ramped up if one were to develop.
“I think we have a good early warning system,” said Cyr. “We were just days away from July 4th and Outer Cape Health Services had picked up on it,” said Cyr, referring to the beginnings of the Provincetown Cluster. “People were coming in with symptoms that they didn’t think were Covid, and the protocols they had in place identified them.
“We also have wastewater data now,” added Cyr.
Wastewater testing had been discontinued in Provincetown in spring 2021 but was resumed again during the Cluster. Nantucket’s wastewater testing from Biobot Analytics has tracked and even anticipated that island’s case count with a high degree of accuracy. Provincetown had been participating in a different wastewater testing program through Columbia University and AECOM, but is now also using Biobot tests for its wastewater.
“I think this community saw the level of resources that will come in when the need is there,” Cyr said. “Until the data show otherwise, I think we need to stay the course, and continue to be focused on increasing vaccinations.”
In other words, from an individual point of view, finding a test might be a hassle — but from a public health point of view, the amount of testing available now might be sufficient.