After Governor Charles D. Baker Jr. announced a state of emergency for the novel coronavirus earlier this week, healthcare and other organizations across the Upper Cape have boosted their planning efforts in the event of an outbreak, leading to numerous cancellations and procedural changes.
While testing for coronavirus remains limited on Cape Cod, testing efforts are expected to expand this month as commercial laboratories become authorized to begin testing nationwide.
Cape Cod Healthcare
In Cape Cod Healthcare’s weekly coronavirus conference call for the media Thursday, March 12, with Dr. David J. Pombo, the organization’s medical director for infection prevention, said that while the number of confirmed or presumptive positive COVID-19 cases rose to 95 in Massachusetts this week, no cases have yet been detected on Cape Cod.
“We’re still encouraging basic isolation precautions, including hand-washing, social distancing and routine respiratory etiquette. We’re also encouraging people who are not severely ill with a persistent cough, fever or shortness of breath not to present to physicians,” Dr. Pombo said.
Developing a COVID-19 vaccine would require at least an 18-month lead time for testing in large populations, and while there are antiviral treatments under study, there is no treatment yet that is effective against coronavirus, Dr. Pombo said.
The Massachusetts Department of Public Health’s laboratory remains the state’s only testing site this week. However, in the coming weeks, Cape Cod Healthcare will work with commercial laboratories as testing efforts expand nationwide, Dr. Pombo said, noting that the turnaround time for results is now at least four days.
“We don’t have any testing available here on Cape Cod. It’s still available through the state lab, but over the next week there will be a big change to testing as commercial options become available,” Dr. Pombo said.
Revised criteria for testing from the Centers for Disease Control include people who have had contact with a coronavirus case or have been in an area at high risk of an outbreak, as well as anyone who is hospitalized with respiratory symptoms and/or is at high risk for complications from coronavirus.
“Patients who have been tested are advised to go home and quarantine themselves and practice social distancing. Our clinics have instructed patients to wear masks if they have any respiratory symptoms, or not to come to the hospital if their symptoms are not severe,” Dr. Pombo said.
Cape Cod Healthcare is planning to establish a centralized place, probably offsite of Cape Cod and Falmouth hospitals, where patients can be screened, evaluated and tested.
“Information on testing is evolving on a day-to-day basis. We’re not encouraging the general public with respiratory illnesses to get tested at this point, until tests are widely available.”
While Dr. Pombo did not say how many people have been tested for coronavirus on Cape Cod, he did say that if there were enough cases on Cape Cod, Cape Cod Healthcare would establish zones in the hospitals to group patients in cohorts, placing them in negative-pressure, airborne isolation rooms.
“We’re working on possible beds at offsite facilities that could handle patients who need oxygen therapy in a medical setting. We have a supply chain effort to make sure protective equipment is available, and we’re working around the clock,” he said.
As a precaution, Cape Cod Healthcare has canceled all nonessential employee travel and has urged its staff to stay home if they become ill and to keep large-group gatherings to a minimum.
“Avoid large crowds. There’s no documentation of how widespread it is in community, and at this point it’s just common sense to avoid any large gatherings for at least the next week,” Dr. Pombo said. “It’s very hard to predict the future. We’re doing the planning that we can to determine what facilities are available if we have a surge.”
The Massachusetts Department of Public Health has tested more than 200 people as of Wednesday. The department is monitoring more than 445 people under self-quarantine for possible symptoms of COVID-19. Another 638 who had been in isolation have since completed self-quarantine.
Because the first cases of COVID-19 were diagnosed in December, much about the illness is still unknown, including whether it will be similar to influenza in its peaking in winter months and having a very low incidence during the summer, Cape Cod Healthcare wrote on its website.
A breakdown of the first 72,000 cases in China found that 87 percent of the cases affected people ages 30 to 79. The rest of the cases were in those 20 to 29 (8 percent), over 80 (3 percent), 10 to 19 (1 percent) and younger than 10 (1 percent). Researchers are still investigating why it hits some age ranges much harder than others.
The chief symptoms are coughing (67.8 percent) and fever (43.8 percent on admission and 88.7 percent during hospitalization). In the United States, COVID-19 has killed 38 people (compared to more than 16,000 flu deaths this season) as of Thursday, March 12.
The spread of the disease is thought to occur mainly from person to person via respiratory droplets among close contacts. The emergency departments at Cape Cod Hospital and Falmouth Hospital have a checklist for diagnosing patients with respiratory difficulties to isolate quickly any patients who are possibly infected. State labs have an adequate supply of testing equipment from the CDC to quickly evaluate patient swab samples, Cape Cod Healthcare wrote.
Bourne Town Government
A group of Bourne officials met Wednesday, March 11, to discuss the COVID-19 state of emergency. The meeting included town administrators and officials from the Bourne Health Department and board of health; and the Bourne Public Schools and school committee.
“A discussion ensued weighing out the risks, evaluating the unintended consequences, discussing each of the upcoming events and activities, interpretation of the governor’s state of emergency. What was decided was that all town buildings including the schools, would be closed to outside use of the facilities. A joint statement is being drafted that will be shared on the applicable websites,” said Judith M. Froman, chairwoman of the board of selectmen. “The emergency is dynamic and therefore this group of leaders will meet as needed moving forward. No long term decisions have been made.
Upper Cape School Districts
The Falmouth School Committee voted Tuesday, March 10, to cancel a National Art Honors Society field trip to New York City in May, due to risk from the virus. The committee also gave tentative approval to a student trip to the state’s science and engineering fair at Massachusetts Institute of Technology in May. They asked Schools Superintendent Lori Duerr to reconsider approval of the trip, should the risk of infection increase.
In answer to a question about potentially closing the schools, Dr. Duerr said, “It absolutely may be possible that that will be the recommendation [from state and local health departments]. All decisions will be made as a team. We now have a command team, with all the town department heads coming together weekly. This situation is developing daily, so if that is the case, we’d have to make that decision, and we’re prepared to do that, if need be.”
Dr. Duerr said the district has increased the frequency of cleaning the schools, with daily cleaning of all buses and cleaning supplies and hand sanitizer available throughout the schools.
The district is moving toward offering virtual teaching using a digital learning management system, Assistant Superintendent Sonia Tellier said. However, the system is not yet ready to be rolled out to the entire district.
The Sandwich Public Schools spent about $7,000 this week to order and stockpile cleaning supplies for classrooms and buildings, Superintendent Pamela Gould said. Supplies included disinfectants, hand sanitizer, pump sprayers for bulk disinfection and an electrostatic sprayer/disinfecting system.
“We have instructed our custodial staff to focus disinfecting on high-touch surfaces such as doorknobs, bathrooms and desks on the evening shift, as all disinfecting products need time to stand to be effective,” Dr. Gould said.
Absentee Ballot Restrictions
The League of Women Voters of Massachusetts has asked Secretary of State William F. Galvin to suspend the restrictions on absentee ballot voting in local elections for town offices and school committees this spring, and in later elections if needed, to reduce fears that the coronavirus might keep people from voting.
“We are concerned that people, particularly in high-risk demographic groups, will decide not to vote in this spring’s local elections out of fear of being in high-traffic areas,” league co-president Mary Ann Ashton said, noting that the state constitution limits who can vote by absentee ballot.
Also, unrestricted absentee voting would provide alternative access to the ballot for people with respiratory illnesses, Ms. Ashton said.
Free Bandwidth Upgrades
OpenCape, a Barnstable-based nonprofit company that owns and operates the Cape’s only 100 percent fiber-optic network, is offering existing customers free bandwidth upgrades, effective immediately.
“This augmented service will allow businesses to accommodate remote work and tele-meeting capabilities, hospitals to implement innovative screening and assessment applications, educational institutions to offer distance learning for students and will also provide municipalities with enhanced communications to aid in public safety and prompt dissemination of vital information,” Steven Johnston, the company’s chief executive officer, wrote in a press release.
“This strategy is reflective of a nationwide coronavirus response, as thousands of companies across the US are requesting that their employees work remotely, if possible, to help combat the spread of the virus,” Mr. Johnston wrote.