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Covid-19 testing

    CURRENTS

    This Week in Provincetown

    By

    Meetings Ahead

    Meetings are held remotely. Go to provincetown-ma.gov and click on the meeting you want to watch.

    Thursday, Aug. 27

    • Water & Sewer Board, 1 p.m.
    • Planning Board, 6 p.m.

    Friday, Aug. 28

    • Local Comprehensive Planning, 10 a.m.

    Tuesday, Sept. 1

    • Conservation Commission 6 p.m.

    Wednesday, Sept. 2

    • Historic District Commission, 4 p.m.

    Thursday, Sept. 3

    • Zoning Board of Appeals, 6 p.m.

    Conversation Starters

    Covid-19 Update

    As of Aug. 25, there was one active case of the virus in town, and 31 cases were considered recovered. There has been one death as a result of Covid-19.

    Town and School Staff Tested

    A pilot program to deliver faster Covid-19 test results for local business owners wanting to test asymptomatic staff came off smoothly when over 100 Provincetown and Truro municipal and school staff members got tested at MacMillan Pier on Thursday, Aug. 20.

    Provincetown Health Director Morgan Clark said over 100 people voluntarily took the test and the results were returned within two days. She would not say if anyone tested positive, explaining that if there were just one positive result among town staff it would be easy to identify that person in this small town.

    In any case, the pilot program showed great promise for Provincetown and Truro businesses who want to test employees in the future for two reasons, Clark said. One, the PCR tests, which are the most reliable available, came back fast; earlier popup test results took over a week to come back. Two, each test cost only $70 as opposed to $150 in previous testing.

    “This is all brand new, and to run an asymptomatic program takes a lot of back-end work,” Clark said. “I’ve been working on it since July.”

    Lower Cape Ambulance staff administered the tests to patients. Cambridge Innovation Center and the Broad Institute conducted the molecular PCR tests.

    If there is interest, then the tests would be offered for asymptomatic workers in Provincetown and Truro starting in September, Clark said. Business owners would pay for the tests, while the towns and Lower Cape Ambulance would pay administrative and personnel costs.

    Town Meeting Will Be Outdoors

    Voters can enjoy the crisp fall weather for town meeting this year, as it will be held outdoors, on Monday, Sept. 21, at 5 p.m. The location, St. Peter the Apostle Church parking lot at 11 Prince Street, will make it convenient for those who are praying for a short meeting.

    But with only 30 articles —and 11 of those just routine housekeeping — it already looks like this will be a shorter town meeting than Provincetown’s usual marathons, which often extend beyond three nights. This time, since it is outdoors to allow for social distancing and to prevent Covid-19 virus spread, officials limited the articles on the warrant, said Assistant Town Manager David Gardner.

    If it rains, the meeting will be delayed until the next evening. Parking will be next door at the Grace Hall lot.

    To get a head start on the warrant, a virtual forum to discuss the articles will be held on Wednesday, Sept. 16, at 6 p.m. —K.C. Myers

    THE NEW NORMAL

    Wait Time for Covid Test Results Presents Challenge

    Screening efforts are increasing, but cost and speed matter

    By

    PROVINCETOWN — The goal is clear and workable: at some point, we’ll be able to systematically screen for coronavirus, identify asymptomatic carriers early, and effectively squelch community spread.

    What we once achieved through lockdowns, we would then be able to maintain through intensive testing and contact tracing. Screening programs are the bridge to get us from a post-lockdown world to a vaccinated one. They have been successful in other countries.

    Here in the Northeast, where case numbers have remained low since the end of May, this goal is still within reach.

    Still, obstacles remain. Testing is expensive — and testing in large numbers is very expensive. Finding the money is an issue.

    Additionally, there’s a nationwide surge in testing that’s overwhelming laboratory capacity and threatening to make supplies scarce. The turnaround time for test results has been getting longer — it’s currently around eight days, according to Dr. John Cornwell, a medical director at CareWell Urgent Care clinics.

    A lot of interaction and virus spread can happen in eight days, particularly for people who aren’t showing symptoms. Getting that turnaround time shorter is another key problem that state and local officials are working to solve.

    Who Pays for Screening?

    The Outer Cape’s first experience with an asymptomatic screening program was on June 17 and 18, when the state’s dept. of public health organized two days of free testing, open to anyone, at 50 locations statewide. There were 2,188 tests performed at the Provincetown, Wellfleet, and Harwich clinics of Outer Cape Health Services, according to OCHS communications officer Gerry Desautels. The state paid $144.27 per test — $100 to the lab, Quest Diagnostics, and $44.27 to OCHS for collecting the samples. At that rate, the two days of testing at these three sites cost the state $315,000.

    On July 22, Provincetown conducted its first homegrown asymptomatic testing effort, organized by the town’s health dept. in conjunction with local employers. Employers in the hospitality industry are paying half the cost of a test for their frontline public-facing employees, or $75, while the town picks up the other $75. As part of this program, 136 people were tested, with the town and employers each putting up around $10,000.

    “We’re working to set up a more regular asymptomatic testing capacity for a variety of workers,” said Provincetown’s health director, Morgan Clark. The health dept. started with hotel, restaurant, and retail employees, because they were most directly exposed to travelers during July 4th weekend, said Steve Katsurinis, chair of the Provincetown Board of Health.

    Nantucket has already launched an asymptomatic screening program in which high-contact individuals are invited to get a test by the health dept. The select board of Nantucket has allocated up to $100,000 for these tests.

    The largest and oldest asymptomatic testing program in the region is on Martha’s Vineyard. Since late May, more than 6,000 tests of asymptomatic people have been conducted through the public-private partnership TestMV. That’s in addition to 2,600 tests of symptomatic or contact-traced people conducted at Martha’s Vineyard Hospital.

    At the industry standard of $150 per test, 6,000 asymptomatic tests would cost $900,000.

    What About Insurance?

    State Rep. Sarah Peake is trying to get an amendment through the Mass. House that would require insurance companies to pay for asymptomatic screening tests for people working in high-contact fields, she said on Monday.

    “Housekeepers, people who work in restaurants, grocery store workers, EMS, police,” Peake said. “[State Sen. Julian Cyr] and I have had lengthy conversations about this. Especially in our area, where there’s been an influx of people, the need for this has become very clear.” Insurance companies are better able to pay than individual businesses or towns, she added.

    Having insurance pay could allow screening efforts to be scaled up dramatically. That would only increase pressure on the wait for results.

    Many Reasons to Test

    A surge of testing related to the massive coronavirus outbreaks in the southern and western United States has overwhelmed laboratories, including Quest Diagnostics, said Sean O’Brien, emergency preparedness coordinator for Barnstable County.

    “We are definitely looking to other laboratories to try to diversify, since Quest is so backlogged,” said Cyr. “The Broad Institute is a network of research labs in Boston — at the statewide level, they’re helping a lot. Cape Cod Hospital has a really great piece of equipment that can turn out results in four hours — but they have to reserve its capacity for their incoming patients, and there’s also a worry about running out of the supplies that are unique to that machine,” Cyr added.

    Barnstable County is coordinating a mobile testing effort that can access Cape Cod Hospital’s super-fast machine.

    “So, because of that big house party in Chatham [on July 12] where we know a lot of people were exposed, we are sending out the mobile test clinic, and those 50 tests will be collected today and processed very quickly,” said O’Brien. “If it were something smaller, a cluster of four or five, we probably would use a different lab, but with something that significant Cape Cod Healthcare was happy to help.”

    Quest Diagnostics chart
    Quest Diagnostics organizes incoming test samples into prioritized categories. (Source: questdiagnostics.com)

    Quest also has a tiered processing system, with some people getting results faster than others. Health-care workers with symptoms are in the most expedited tier. People with symptoms who are over 65 or have underlying health conditions are in the next tier. The third tier contains ordinary people with symptoms and some first responders, and the fourth tier is everyone else — including those contacted by a tracer.

    It makes sense that more vulnerable people get their results first. But for people who are contact traced and don’t feel sick, it means staying home and away from work for up to eight days while waiting for test results to come in. With an eight-day wait, the screening program is alerting us to dangerous spread after it happens, not before.

    And the number tests needed is bound to grow. Many schools and universities are planning to require a negative Covid test to be on campus. The governor’s new mandatory quarantine rules require a negative test result, from a sample taken less than 72 hours prior to travel, from travelers from 42 states entering Massachusetts. If your results are delayed, you must quarantine upon arrival until those results clear you. The fines for breaking these new rules are $500 a day.

    If students and travelers need to be cleared by a lab test, then the backlog may get worse.

    “We can’t manage a pandemic waiting eight days for test results,” said Peake. “This has to be improved.”

     

    CORONAVIRUS

    With Few Positives, Gaps in Reporting Remain

    Visitors’ Covid test results are unavailable

    By

    WELLFLEET — There were no positive Covid-19 tests among the 987 people tested in Provincetown and Wellfleet during a two-day period in June, the Independent has learned. The tests, administered to 538 people in Provincetown and 449 in Wellfleet on June 17 and 18 at Outer Cape Health Services, followed large gatherings sparked by the Black Lives Matters movement. They were ordered by the state Dept. of Public Health to see if the virus had spread as a result of the rallies.

    OCHS also tested 1,255 people in Harwich, according to Gerry Desautels, a communications officer. Seven of those tested positive, according to a source at the state DPH.

    At the same time, it has been hard to find and confirm accurate information about test results in a timely and useful fashion.

    A week after the June tests, health agents in Truro and Wellfleet told their respective select boards that no positive cases had been reported. Provincetown’s health dept. also received no notice of a positive test, said Morgan Clark, the director of health and environment. And since the number of positive cases listed on Eastham’s website has remained at 10 for several weeks, it appears that no Eastham residents tested positive, either. This means no one who has an Outer Cape zip code tested positive on June 17 and 18.

    This does not, however, inform the public about those who may have been visiting here but returned home after being tested. The state DPH sends notice of positive tests to the patient’s town health dept.; the reports go to the town of residence, not the test location.

    This gap in the flow of information should be addressed by careful contact tracing, said state Sen. Julian Cyr of Truro, who is on the Cape Cod Reopening Task Force.

    Outer Cape Health Services refused to release the full results of the tests. The Independent was able to get them from a DPH spokesperson.

    The seven positive tests out of 2,242 at the three OCHS sites combined equals a rate of 0.3 percent, considerably lower than the statewide positive rate during that time. Gov. Baker at first announced that statewide positive rate for those two testing days was 2.5 percent of the 16,526 people tested. This figure was later lowered to 1.3 percent, according to the Boston Globe.

    Hillary Greenberg-Lemos, the Wellfleet health and conservation agent, told the select board that 122 Wellfleet residents were among those tested. None of the other town health agents, nor Outer Cape Health, would provide corresponding information.

    Contact tracing would notify anyone who had been in contact with a positive person within 14 days, said Cyr. It’s a system that works well in Massachusetts but may not be as well executed in other states.

    The biggest problem in testing remains the time it takes to receive results, Cyr said. Results take a week because of the demand. New Cape Cod cases were averaging four to five a day, but recently have increased to 9 or 10 a day, Cyr added.

    HEALTH

    How Much Is a Covid Test? Who Can Get One?

    The answer, as usual: it’s complicated

    By

    PROVINCETOWN — Health care is rarely simple. The question of who can access it, where, when, and for how much often gets a conditional and specific answer that’s different for each particular constellation of symptoms, insurer, and office. The Covid-19 pandemic hasn’t changed the system — it’s just made it more visible.

    The primary question for getting Covid tests is the famous one from Chicago politics: who sent you? If you have symptoms, or if a contact tracer told you that you were in close proximity to an infected person for a prolonged period of time — then, a test is considered medically necessary. The office visit, sample collection, and laboratory work may all be billed separately, but insurance should cover nearly all of it.

    For the uninsured, undocumented, or people from out of state, however, things can quickly get complicated. Health Safety Net is a state program that can cover some of these situations, according to Gerry Desautels of Outer Cape Health Services, but an out-of-pocket bill is still possible. State money could pay for the test itself, for instance, but not for the office visit where the sample is collected — or vice versa.

    A lot of energy and money is going into making sure that people who are contact-traced get tested. Local health departments may have money for a test if the state or insurance companies aren’t helping. In general, people who have symptoms or have been contact-traced can find financial support for getting tested.

    Testing Without Symptoms

    What makes this coronavirus so dangerous, of course, is that it can be spread by people who never feel symptoms and don’t know they’re infected. Testing those people is part of the solution, too, but the questions of how and who pays still exist.

    CareWell Urgent Care in South Dennis is the closest location to get Covid-19 lab tests for asymptomatic people. It’s at 4834 Route 134, in a former Pizza Hut. (Photo CareWell Urgent Care)

    Insurance generally doesn’t cover testing in symptomless people who have not been contact-traced. CareWell Urgent Care, a network of 17 private clinics in Massachusetts and Rhode Island, offers a lab-based Covid test for $160 for asymptomatic people. Its South Dennis clinic is the closest place to the Outer Cape that offers testing to people on these terms.

    Some of the people who come to CareWell for a Covid test want to know if they can safely see their elderly parents or extended family, according to Sarah McLain, a senior market leader at CareWell. Others want to send their kids to camp or clear themselves for travel.

    “These are diagnostic tests — they weren’t really designed for some of these social decisions,” said McLain. “There is a chance of a false negative, and we explain that. But we’re going to use the tools we have for the situations we face.”

    Expanded Screening

    Some jurisdictions have begun systematically screening workers in high-contact industries. Rhode Island has an asymptomatic testing program that includes bus drivers, child-care workers, first responders, and restaurant workers. Nantucket’s health dept. specifically invites groups of essential workers to get screening tests, and on Martha’s Vineyard anyone who believes they may have been exposed can get a free test.

    Provincetown is working on a testing program for workers who are heavily exposed to the public, said Health Director Morgan Clark and board of health chair Steve Katsurinis. Employers would pay half the $150 cost of each test, and the town would pay the other half.

    Even picking up half the cost can add up. Provincetown is hoping to see 200 frontline workers tested next week, according to Katsurinis. At $75 per test, the town could spend up to $15,000. The timing of the program, two to three weeks after July 4th weekend, is meant to find out whether the crowds that were here ended up spreading the virus. Provincetown hasn’t reported any infections in almost six weeks, and the health dept. is hoping to find new cases early.

    The Cape’s state legislators are working to bring a mobile testing program to Barnstable County. State senators Julian Cyr and Susan Moran added $250,000 for this purpose to a bill that passed the senate but still has to be reconciled with one from the state house of representatives.

    Delayed Results

    Large-scale testing is limited by more than just available funds, however. According to Dr. John Cornwell, regional medical director for CareWell, “Dramatically expanding the testing would be ideal … but it’s overwhelming the work force and the equipment available,” especially in the labs.

    Early in the crisis, when all tests were processed by the Centers for Disease Control lab, results took about 7 to 10 days, said Cornwell. “When the private sector got their labs going, turnaround time was down to around four days,” he said. “Now that capacity is overextended, and results take about eight days.”

    Waiting eight days for a Covid test result can be a real hardship, especially for people who have symptoms or were identified by a contact tracer — they often have to self-isolate until results come back. Three days is a relatively small disruption; eight days is an entire week of income.

    There is a rapid test that gives results in 15 minutes: it costs about the same, but its false negative rate is more than double that of the lab test, according to Cornwell. False negatives are the bête noire of screening — they give people an implicit sense that they can safely mingle, and thus contribute to the very spread of virus that screening was meant to stop. This is why lab tests remain the standard for now.

    CORONAVIRUS

    No Cases but Lots of Questions

    Is it not here, or are we not finding it?

    By

    PROVINCETOWN — For four weeks now, Provincetown has detected zero new cases of coronavirus.

    Memorial Day weekend came and went. Phase two of the statewide reopening was announced; lodgings, retail shops, and restaurants cautiously opened. Owners and renters returned for the season, and every weekend there were more visitors. All of this arriving and circulating humanity — and Provincetown has not detected one new case.

    No new confirmed cases of Covid-19 have been reported in Truro, Wellfleet, or Eastham for at least the last two weeks, either.

    All good news, probably, but it raises lots of questions.

    Dr. Randall Sell, a professor of public health at Drexel University and a part-time resident of Provincetown, offered the town’s health dept. some pro-bono assistance with developing models of potential case importation back in early May. With no new cases, Sell said, “To me, that’s the interesting discussion. We looked at the case rate for the rest of the state, and we projected that as more people arrived, we would become more like that statewide number.

    “One of the first possible answers is that the people coming here aren’t the same, in terms of the virus, as the statewide population,” Dr. Sell continued.

    This could be more complex than just pointing out that Provincetown is expensive.

    “It could be anecdote, but I hear a lot of visitors say they’ve been totally isolated in their cities,” said Dr. Sell. “It could be that the people who spend money now are the people who worked from home, who could afford masks and health care, who could afford to stay home, and were cooped up enough to decide to travel.” People could be motivated to come here specifically because they have been so alone, and those people could have a correspondingly low incidence of virus.

    “Alternately, people could be coming here and they don’t know where to get tested,” he said. “They don’t get tested. Or if they’re here for a short time, their physician is back home and they say they’ll get tested when they go home.” In that scenario, Sell explained, “They’re here, they’re walking around, but we don’t find them.”

    Even looking only at local residents, our testing could be slanted towards the “worried well.”

    “There are always health-care access issues,” said Dr. Sell. “People don’t have a physician, or they don’t have insurance, or they don’t have the time or the money. Or they don’t know how to get a test. I don’t know what the test costs out-of-pocket. Most people don’t know.”

    The answer to the cost question is complicated. At present, Outer Cape Health Services offers free tests to people who are symptomatic or have been exposed to someone who is. The related office visit costs $200, but could be covered, depending on a patient’s insurance.

    People whose work puts them at higher risk could be the least likely to get a test. Also, a test could be scary if the consequences are scary.

    “One of the public health concerns is, how do you protect the most vulnerable without further traumatizing them,” said Dr. Sell. “Closing down workplaces when people need to work. Traumatizing the traumatized.

    “I don’t need to be told that poor people are more likely to get sick,” he added. “I need to be told ways to help them.”

    Where’s the Limit?

    Provincetown’s models are meant to predict how many cases will exist among those who are living here. People who are here for a short time will go back home. The active management of resident cases, on the other hand, puts a variety of burdens on the health dept., including contact tracing and quarantine support.

    “With the social behavior we have in the Northeast, it’s not about 50 cases exploding into 250,” said Steve Katsurinis, chair of the Provincetown Board of Health. “That kind of exponential growth isn’t happening here. It’s more about what it means to care for 50 cases.

    “We already fell to zero,” Katsurinis continued. “If there’s a slow angle of ascent, because of all these restrictions, then it’s about our capacity to care for people. We have to keep the DPW staff healthy, the ambulance crews, the health dept. staff. And if the number of people sick starts to outstrip our ability to care for them, that’s when you’ll start to hear that we need to go backwards.”

     

    CORONAVIRUS

    Early Test Results Look Good

    But a negative test shouldn’t change behavior

    By

    WELLFLEET — The 449 free Covid-19 tests conducted at Outer Cape Health Services here on June 17 and 18 have so far showed zero positive results.

    Wellfleet’s clinic was one of 50 in the state to offer free tests to anyone, with or without symptoms, in reaction to potential viral spread at crowded Black Lives Matter rallies.

    On Tuesday, Gov. Charlie Baker reported that, statewide, 2.5 percent of 17,617 tests came back positive — good news, he said, since it’s close to the 1.9-percent rate of recent tests in the state. It appears that demonstrations did not spread the virus, he added, noting that most protestors wore masks and stayed outdoors.

    Only partial results from the Wellfleet clinic were available by the Independent’s deadline. No results from the 538 tests given in Provincetown were available as of Tuesday afternoon, according to Morgan Clark, Provincetown’s health director.

    Another 1,255 people were tested at the OCHS clinic in Harwich.

    The local testing pool included 122 Wellfleet residents, and some results were still pending, Wellfleet Health Director Hillary Greenberg-Lemos said on Tuesday.

    The tests themselves are about 96 percent accurate, said Stephen Katsurinis, chair of the Provincetown Board of Health.

    But a negative test reflects your status only on the day of the test, and doesn’t mean you didn’t pick up the virus the day after, he said.

    “We’re living in a place where there is contagion,” so a negative test should not change your behavior much, said Katsurinis.

    With a positive test, even if you’re asymptomatic, you should isolate yourself for 14 days. It also triggers the contact tracing system to find others who may also have the virus.

    Baker said the state’s positive-test rate is down 93 percent since April 15.

    Still, he cautioned, other states that have opened up restrictions on social distancing have seen surges. So people must continue to wear masks, stay home if not well, and wash hands frequently.

    The Wellfleet clinic is still offering tests daily from 1:30 to 3 p.m. for those who have symptoms or have been exposed to people with symptoms.

    currents

    This Week in Provincetown

    By

    Meetings Ahead

    From provincetown-ma.gov, click on the calendar or the list on the meeting you’re interested in. When event details are in view, click on the link provided. From there click on the agenda for the meeting. Instructions on viewing and participating are included there.

     Monday, April 27

    • Select Board, 7 p.m.

     Tuesday, April 28

    • Licensing Board, 5:15 p.m.

    Conversation Starters

    Coronavirus Update

    As of April 20, Provincetown had three confirmed active cases of coronavirus and one death from complications related to Covid-19; 22 additional cases are considered recovered and have been cleared from quarantine by the public health nurse.

    Testing at Seashore Point

    On Monday, April 20, Pleasant Bay Nursing & Rehabilitation Center, a facility owned by the same company that recently purchased Seashore Point in Provincetown, reported that 60 of its 92 residents had tested positive for the coronavirus.

    The Pointe Group, which bought Seashore Point last year and renamed the nursing facility Advinia Care, participated in on-site testing provided by the state, said David Ball, the Pointe Group’s spokesman. The residents and staff of the nursing facility at Seashore Point were also tested but the results were not available at the Independent’s deadline Tuesday, Ball stated.

    The Pointe Group agreed to the testing voluntarily in order to see who had the virus. This information is useful since many cases are asymptomatic, but those patients may still be able to transmit the virus, according to a company spokesman.

    Though the testing at Seashore Point was done voluntarily, town boards of health can order long-term care facilities to test all of their residents, said Sean O’Brien, emergency management coordinator for Barnstable County. But there must be a good reason to set mandatory rules, said Steve Katsurinis, chair of the Provincetown Board of Health. There was no compelling reason to order mandatory testing at Seashore Point, Katsurinis said, whereas at Pleasant Bay many patients had complained of symptoms prior to the April 10 testing, according to the Cape Cod Times.

    Over half of the deaths in the state are at long-term care facilities. Age is the biggest predictor of the outcome of the coronavirus, Katsurinis said.

    Anyone concerned about nursing home residents and Covid-19 may call the state Dept. of Public Health’s Nursing Home Family Resource hotline at 617-660-5399. The hotline is open from 9 a.m. to 5 p.m. seven days a week to answer questions and connect people to resources.

    To see the number of positive tests at specific hospitals and nursing homes, the state offers a list updated daily at 4 p.m. at: mass.gov/info-details/covid-19-response-reporting.

    To check Seashore Point’s cases look under Advinia Care in Barnstable County. —K.C. Myers

    CASES

    Two Patients With COVID-19 Describe Their Ordeals

    From frightening diagnosis to compassionate community support

    By

    As the number of new COVID-19 cases grows daily and the Outer Cape braces for the coming wave of severe illness, now expected to peak in mid-April, two local residents who are recovering from coronavirus disease agreed to describe their alarming symptoms in interviews with the Independent this week. Their stories show the swells of both fear and kindness coursing through the community.

    A recent study suggests that 40 percent of the population in every community will be infected with the virus in the next year, and 20 percent of those infected will require hospitalization. Both patients who spoke about their illnesses considered going to the hospital but decided against it.

    Shoshanna DeVries-Dibble
    Shoshannah DeVries-Dibble in Costa Rica, where she had traveled before getting a positive test for COVID-19. (Photo courtesy Shoshannah DeVries-Dibble)

    Shoshannah DeVries-Dibble, 43, grew up in Eastham, graduated from Nauset Regional High School in 1994, and now lives in Orleans. She had traveled to Costa Rica and Vermont in the first half of March. Bob Keary, 40, a bartender who lives in Provincetown, had also traveled in early March, to New Orleans, before being sickened by an outbreak that some local residents insisted was being overhyped.

    “It’s real,” said DeVries-Dibble this week as she began to feel better, “and it’s scary.”

    On Monday, March 16, she had just returned from her two-week vacation and she needed to catch up on errands, but she felt utterly exhausted.

    “I was worried I was getting the flu,” she said.

    At first she had none of the telltale respiratory symptoms of COVID-19, but she has severe asthma. “I was petrified I would get sick,” she said. “I was Purelling everything.”

    She consulted her doctor at Nauset Family Practice, who was confused, she said, by the absence of breathing difficulties. She would never have received one of the severely rationed tests for the virus if not for her high-risk status and her recent travel, DeVries-Dibble said.

    During that first week, she suffered from a high fever, headaches, and joint and body aches. She took Tylenol and aspirin every four hours and lay under a weighted blanket for relief.

    After a week, her COVID-19 test came back positive. The next day, the virus hit her lungs.

    “It was a small dog sitting on my chest,” she said. She always keeps a nebulizer and inhaler nearby, and she needed them badly that day.

    The next day, her respiratory problems were acute. A friend who is an I.C.U. nurse at Cape Cod Hospital advised her to pack a suitcase and go there.

    “But I really wanted to stay home,” she said. “I didn’t want to be cared for by nurses who were caring for everyone else.”

    She battled rising fear.

    “By the way, if you panic with breathing problems, that makes it so much worse,” she said.

    Both her children, Zoe, 21, and Logan, 19, quarantined themselves at home with her. Test results on Monday confirmed both children had it, though their symptoms were very mild.

    On Thursday, March 26, DeVries-Dibble felt “a little wave of better,” and then on Friday her fever broke.

    She posted her diagnosis on Facebook to warn her friends that this is real, and it can get really bad. Friends from high school remembered her asthma and called her when they heard the news.

    As of Monday, she was still receiving food, medicine, and visits from friends. They spoke to her through her glass door.

    “It’s like I’m an animal in a zoo,” she said.

    Her doctor cleared her to go outside again on Monday because her fever was gone for several days and her first symptoms were so long ago. Her children are quarantined until April 2.

    She still wonders, “How long are people going to think I’m the plague?”

    From Talk to Lockdown

    Bob Keary
    Bob Keary (right) with his husband, Peter Sullivan, in New Orleans, about a week before Keary tested positive for coronavirus. (Photo courtesy Bob Keary)

    Bob Keary traveled to New Orleans for a friend’s birthday on March 12. While he was there, the country went from talking about coronavirus to locking down.

    Keary said he watched police drive down Bourbon Street honking and telling people to go home.

    “It got really scary,” he said.

    Keary was among a circle of 20 to 30 people who went to different events related to the celebration. He shared a house with 15 friends; none of his travel companions has become sick, he said on Monday.

    When he returned to Provincetown on March 16, everything had changed. Restaurants were serving takeout only. Though he felt fine, he and his husband decided to self-isolate and left their house only to get food or walk on the beach.

    On Friday, March 20, Keary woke up with fever, chills, and body aches.

    “It was sudden and it was bad,” he said.

    Dr. William Shay of Outer Cape Health Services, in regular contact through phone and email, did not order a COVID-19 test at first because Keary had no respiratory symptoms. But over the weekend he started to cough, lost his sense of smell, and became short of breath.

    “I couldn’t make it up and down my stairs without getting winded,” Keary said.

    On Monday, March 23, Dr. Shay swabbed him in the parking lot of the Provincetown OCHS clinic.

    The results came back positive Wednesday night.

    “It was sort of comforting to have that confirmation, I guess,” Keary said.

    Keary said he has never been so sick for so long. His fever lasted nine days. He had two days of severe nausea; he couldn’t even sip water.

    “I could hardly breath,” he said, “and I had no appetite.”

    A regimen of Dayquil, Nyquil, and Tylenol kept his pain down.

    When the vomiting with fever and sweats got overwhelming, he considered going to the hospital. His doctor advised against it unless the fever topped 102 or “you really cannot breathe and you cannot stand up without losing breath or balance,” Keary said.

    Living in Provincetown, Keary has watched as Facebook metastasized with hateful posts about second-home owners bringing the virus here and other finger-pointing.

    “I have sick friends who are afraid to say anything,” Keary said. “And I thought, this isn’t right. You shouldn’t feel afraid to admit you’re sick.”

    He hoped that by posting about his own illness, people’s better natures would emerge, and they did.

    “Everyone — year-round and part-timer — offered to help,” Keary said. “That to me is really Provincetown. Not what you’re seeing on Facebook.”

    Devin Sean Martin contributed reporting to this article.

     

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