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pandemic

    PANDEMIC

    Outer Cape’s Covid Infection Rates Remain Low

    Those who got the Pfizer vaccine and are over 65, or at risk, can now get boosters

    By

    PROVINCETOWN — Three months after a steep rise in Covid-19 cases tied to Provincetown’s 4th of July weekend crowds, the number of cases on the Outer Cape is low compared to other regions of the state.

    Thirty-five new cases of the virus have been reported in all of Barnstable County in the last 30 days, according to the state’s database.

    There are nine active cases in Eastham, Director of Health and Environment Jane Crowley said on Monday, Oct. 4.

    There are six active cases in Wellfleet and four probable cases, according to a statement from town Health Agent Hillary Greenberg-Lemos on the morning of Tuesday, Oct. 5. “Confirmed active cases” are those reported following positive results from PCR tests, whereas “probable cases” are those that follow positive results from rapid antigen tests and are still awaiting results from PCR tests.

    Four active cases were reported in Truro’s Oct. 2 report, the most recent update from that town.

    There were just two active cases in Provincetown, according to the health department’s website, updated on Monday afternoon, Oct. 4.

    As of Monday, Barnstable County had an overall 2.8-percent positivity rate, according to data from the Centers for Disease Control and Prevention. The “positivity rate” is the percentage of all coronavirus tests performed that yield positive results.

    According to the Johns Hopkins Bloomberg School of Public Health website, the positivity rate is a critical measure not only because it indicates how widespread infection is in the area, but also whether levels of testing are keeping up with levels of disease transmission. A high positivity rate can mean that the number of total tests is too low.

    Booster shots to supplement the Pfizer Covid-19 vaccine are now available at local pharmacies to people 65 and over and to people 18 to 64 with underlying medical conditions. Employees who work in settings with increased risk of Covid-19 transmission are also eligible. This includes front-line health-care workers employed at hospitals, nursing homes, and health clinics.

    To find out where to get a shot, go to vaxfinder.mass.gov and fill in your zip code. A list of pharmacies will pop up. Only the Pfizer booster vaccine is available at present, while the Moderna and Johnson & Johnson booster vaccines are still awaiting FDA approval, according to the database.

    Patients of Outer Cape Health Services are asked to stop in or call to book an appointment and to present their vaccination cards when they arrive.

    “People in the recommended groups who got the Moderna or J&J/Janssen vaccine will likely need a booster shot,” said Outer Cape Health Chief Medical Officer Andrew Jorgensen. “More data on the effectiveness and safety of Moderna and J&J/Janssen booster shots are expected soon.

    “Immunocompromised individuals may receive a third dose of the Moderna Covid‑19 vaccine,” Jorgensen added. “It is important to note that this is not a booster. It is a third vaccination shot. This Moderna third shot for immunocompromised individuals can be given at least one month after the second Moderna dose,” he explained, noting that, at Outer Cape Health Services, “We advise patients to first consult with their clinicians to determine eligibility.”

    Booster recipients need to be six months out from their second Pfizer shot, OCHS Senior Development and Communications Officer Gerry Desautels said.

    “There’s definitely a lot of interest, just as there was initially for the vaccination,” he said.

    DAY 286

    The Stay-at-Home School Vacation Week

    Ideas for getting outdoors, ditching the screen, and connecting in the kitchen

    By

    On Christmas Eve, it will have been 286 days since social distancing became our new normal and our school, work, and home lives merged into one, sometimes overly close, space. The constant togetherness has many Outer Cape children and parents looking forward to the 12-day school vacation ahead with more trepidation than joy.

    Compounding the problem of stay-at-home fatigue: our usual celebrations are curtailed — visits with grandparents and friends, too — and money is tight. Yet we all know our families need some good times more than ever. We asked three local authorities for some practical advice on getting through this holiday break as happily as possible.

    Routines and Plans

    During stressful times, says Nancy O’Connell, a recently retired integrated preschool teacher from Wellfleet, don’t forget that comfort can come from having a plan and schedule for how the days will go. While you may feel the pressure to make this time special, “focus on creating a routine,” O’Connell says. “It helps children feel safe and secure.”

    Routines should involve play, O’Connell adds, and for younger children, two kinds of games are especially important. Hands-on, imaginative play is one. Make playdough, for example, and notice all the free play that follows.

    Physical games are important, too, she says. “Red Light, Green Light” is a game she likes because it encourages children to experiment with self-regulation. And it always brings on lots of laughter.

    Still, older children, especially, will want to know something different can happen during their time off from school. They should definitely be involved in planning it. Our family made a list together, so everyone could have a say. It includes creating a family cookbook, looking at old pictures, having restaurant nights, exercising every day, having a spa day, going on moonlit walks, drawing a family tree, writing and putting on a play, and spending a whole day without screens.

    Sharing Trails

    Yvonne Barocas is the kind of person you’d want to have in charge of your family’s homemade vacation. A retired teacher and school psychologist, she and her husband, Moe, owned Abiyoyo, Wellfleet’s toy store, for almost 40 years. But her top piece of advice for this school break isn’t about any particular toy or game. It’s this: “Spend as much time outdoors as the weather will allow.”

    Shannon Fallon of Wellfleet, age nine, blazes a trail for a tandem hike with the new neighbors. (Photo Theresa Fallon)

    Theresa Fallon, a massage therapist in Wellfleet who has been home-schooling her nine-year-old daughter Shannon since September, is for that. They have come up with a way of hiking in tandem with another family. “A new friend on Shannon’s hockey team moved here from Philadelphia this summer,” explains Fallon. “So, we are going to show them woods paths in the National Seashore — but from a distance.”

    Fallon and her daughter have already started drawing colorful markers — temporary blazes for some favorite trails. “Next week, during school vacation, we will go out and flag a trail,” she says. Their friends will follow, and they plan to cheer them across the finish line. Their neighbors get to learn about a good trail, and everyone gets the chance to see the face of a friend for a few minutes. Even if you don’t have a brand-new friend, marking trails for tandem walks is a fun outdoor adventure that allows for plenty of physical distancing.

    Sketch Pads, not Screens

    “Because children are on screens all day for schoolwork,” Barocas says, “downtime should try to minimize any more of that.”

    Short drawing sessions produce a fun record of a family’s take on everyday life. (Photo Molly Newman)

    Molly Newman, a teacher at Nauset Regional Middle School, agrees. Newman’s own family — she has a daughter in elementary school and another in middle school — has taken up drawing as one “old school” way to spend time together.

    “We each have our own sketchbook,” Newman says, “and each of us takes a turn picking a subject to draw.” Those have included a dragon, a queen, the family dog, a flower. They don’t labor over their pieces, she says: “We spend about 15 minutes drawing our subject, then we all compare. It’s simple, fun, and now we have a great record of the time we’ve spent together.”

    A Family Recipe

    When the weather doesn’t cooperate, Barocas recommends getting in the kitchen with kids. For younger ones, she says, learning to measure and follow a recipe is a good challenge.

    After you get Auntie Debbie’s cupcake secrets over FaceTime, the recipe becomes part of a family cookbook. (Photo Susannah Elisabeth Fulcher)

    Teenagers might appreciate the privilege of planning and cooking a meal for the rest of the family. And they just might introduce the family to new foods of their choosing, such as a vegan meal or a dish from another place and culture.

    At our house, we used FaceTime to connect with Auntie Debbie, a professional baker and cake decorator in Spencer. She taught us all her secrets for decorating cupcakes using real buttercream frosting. Now we plan to create a family cookbook by connecting with other family members to make their favorite recipes together. A chocolate mousse with the girls’ grandma in Paris is next.

    At the end of the day, mealtime can open the way to appreciation of our stay-at-home vacations. Rituals like naming something each of you is grateful for will bring up moments you’ve savored on this long strange trip.

    PANDEMIC WAVES

    Covid Infection Patterns Shift

    Cape Cod’s July cases look different from last spring’s

    By

    PROVINCETOWN — Look closely, and Barnstable County’s graphs of new Covid cases and deaths tell a story. There’s an upward swell of discovered cases that begins a couple weeks after July 4, continues throughout the second half of July, and then starts to fall off again in August. It’s not a huge wave compared to what happened here in the spring, but it’s real.

    The graph of deaths, thankfully, is scraping the bottom of the chart. As of Sunday, Aug. 9, there were no coronavirus patients being treated at Cape Cod Hospital or Falmouth Hospital — not just in intensive care units, but anywhere in either hospital. Hospitalization numbers have been very low while the July wave of cases was being identified.

    A tale of two graphs: new cases and new deaths on Cape Cod. (Source: barnstablecountyhealth.org)

    There are two stories to tell here — one about what’s happening now, in July and August, and one about what happened in March, April, and May, when case and death numbers looked very different.

    The July Wave

    According to Sean O’Brien, the health and environment director for Barnstable County, many of the cases discovered in July and August have been people who are of working age who were infected at social gatherings. “The Chatham house party, as they’re calling it, and the Falmouth lifeguards party are, in fact, pretty significant drivers for this bump in cases we’ve discovered,” said O’Brien.

    On Friday, Aug. 7, Gov. Charlie Baker reduced the limit for outdoor gatherings from 100 people to 50 and announced that police departments can enforce rules that had been previously assigned primarily to health departments. Provincetown had decided a month before, on July 2, to direct its police dept. to help manage the size of private gatherings.

    “Our contact tracing teams have demonstrated that parties that are held in people’s homes and back yards have contributed to community spread and new Covid clusters,” said Gov. Baker. “These parties are too big, too crowded, and people are simply not being responsible — 40 or 50 people in somebody’s back yard.”

    Meg Payne, the operations manager for the largest contact tracing effort in Barnstable County, said that both the Chatham and the Falmouth parties happened at specific residential addresses, although she didn’t know if they were indoors, outdoors, or both. “No one was wearing masks and maintaining social distancing at either party,” she added.

    “There have been some events that, not surprisingly, have caused the governor to put some new restrictions in,” said O’Brien. “But in the same breath, we have zero Covid patients in each hospital today. I think, in a lot of ways, people are doing the right thing — staying outside, using hand sanitizer, social distancing, wearing a mask. In the long run, this seems to be working.”

    The March-April-May Wave

    Comparing the present data to the spring wave of cases leads to one enormous difference between then and now: nursing homes.

    More than half of Cape Cod’s Covid casualties have been residents of just five nursing homes. Twenty-one residents died at Wingate in Harwich, 19 at Pleasant Bay of Brewster, 18 at Royal Cape Cod in Bourne, 17 at Cape Regency in Centerville, and 11 at South Dennis Healthcare Center. Another four nursing homes together account for 16 more casualties. These 102 deaths in nine facilities are 65 percent of Cape Cod’s total of 158 dead so far.

    That means two-thirds of Cape Cod’s deaths have come from just nine locations.

    Meanwhile, 11 nursing homes on Cape Cod reported zero deaths among residents from Covid. A close look at the numbers shows that in 17 out of 20 nursing homes, either no one died or a lot of people did.

    “We had situations where Covid was going rampant, just ripping through some of these facilities,” said O’Brien. The damage was done early on. Nearly all these deaths had already transpired when information on deaths-per-facility was released by the state in late May.

    Horrible as they are, these numbers are not at all unusual. According to the New York Times, in Massachusetts, 64 percent of deaths from Covid are linked to long-term care facilities. That number is 78 percent in Rhode Island, 74 percent in Connecticut, and 82 percent in New Hampshire.

    The story of declining death rates is, in part, the story of nursing homes shutting themselves off from the world. In these facilities, phase one never really ended, and near-lockdown conditions are heading into their sixth month. “If you think about the mental health issues with that — the isolation, the families on the outside, what this does to communities,” said O’Brien. “After we get through this, I think you’re going to see changes nationwide to how we take care of our seniors.”

    In the meantime, a look back at the graphs shows what hasn’t happened yet this summer. The virus hasn’t found its way back into densely housed populations where it can kill by the dozen — not just in nursing homes but in assisted living facilities, apartment complexes, firehouses, or the county jail. Connect the virus to those places, and a season of pretty good numbers could deteriorate into another season of bad ones.

    THE YEAR-ROUNDER

    We Need a New Compact

    The Pilgrims had the right idea; it’s time to update it

    By

    Exactly 400 years ago this coming November, the good ship Mayflower sailed into Provincetown Harbor and anchored (a fact infuriatingly underreported in our national media). There were 102 souls on board. A year later, after a long, harsh winter, 45 of those souls were gone: that’s a mortality rate of 44 percent.

    The Pilgrims were no angels — just ask a Wampanoag — but they were tough, resilient, self-reliant, and courageous. They also banded together and helped one another (remember the Mayflower Compact, signed in our harbor?), although the terms of their assistance could be harsh — just ask Hester Prynne. They also had an abiding faith in God, and a guiding belief that they were meant to be here and they were meant to succeed, that this continent was theirs for the taking.

    In the face of the current pandemic, we have some things we can learn from them, and some we cannot. Their resiliency and self-reliance is inspirational; there was very little wailing and moaning, and no self-pity. We should aim for that quality.

    Their belief in a beneficent Almighty might be harder to copy. Even among those of us who believe in a Creative Force, there is a significant fraction who do not see that force as one that can intervene on the level of a nation, let alone an individual. The deity system that makes most sense to many might be the pantheistic Greek model: numerous gods “up there,” amusing themselves by tossing various challenges down to Earth to see what we poor mortals will do.

    The evidence for this dominates the history of the human race to this day. It is difficult for many of us to find solace in religion, although many still do. I envy them.

    The other component of their belief system that is fast eroding is that the Earth was placed here for the sole purpose of supporting human enterprise and expansion. Many, of course, do believe this — Manifest Destiny is alive and well. But more progressive thinking is that we are not the rightful inheritors of the bounty of the Earth, not the overall self-appointed stewards of this planet; rather, we are creatures desperately dependent on its sustaining elements, even as we are destroying them.

    Many of the most threatening challenges to our survival, including the current pandemic, have roots in the incursions that humans have made into the natural environment. We must learn to make amends, make peace with the Earth, learn to live within natural systems — and we must do so in a hurry. That means no more going to the outdoor market to buy a wild pangolin in a cage and have it butchered for dinner on the spot; but it also means no more sitting in your car outside Stop & Shop with your engine mindlessly idling.

    Progressive thinking also addresses the Pilgrims’ concept of community with some important updates. We are each of us a Stranger and a Saint, an insider somewhere and an outsider everywhere else; we each of us deserve the regard of the community-at-large regardless of our nationality, race, gender, sexual orientation, economic status, or belief system. We are, to borrow a phrase, all God’s children.

    Many of us think putting children at our southern border in cages is inherently evil, even though there are devout churchgoers who see nothing wrong with this. Most of us think health care and access to education and useful and gainful employment and so many of society’s benefits should be more equally distributed. The situation is so much more pressing in this time of emergency. We are all in this together, we are told.

    In the midst of this pandemic, we need a new Compact.

     

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