In a response that flexes both their emergency response skills and their ability to improvise, Lower Cape officials are doing what they can to prevent the spread of COVID-19 while keeping essential government services going.
As of Friday morning, there were five confirmed cases of the novel coronavirus in Barnstable County, but with the increased availability of test kits, public health officials expect that number to climb. One confirmed case was identified as a Sandwich resident who is said to be showing symptoms and is being isolated; on Sunday, town officials were made aware that the man had been present at the Chatham Community Center on Feb. 29. Town officials immediately closed the community center for cleaning out of “an abundance of caution.” Board of selectmen Chairman Shareen Davis notified residents of the closure in a reverse-911 phone call Sunday afternoon. There have been no reported cases of the virus in Chatham and community center staff have not reported any symptoms. Director of Natural Resources Dr. Robert Duncanson said the town reached out to the teaching group in the class the man attended and none have symptoms. The building, as well as other town buildings, is being disinfected.
Town officials urge anyone experiencing symptoms, including fever, cough or difficulty breathing, to self-isolate and call their healthcare provider.
Federal, state and county governments have declared states of emergency, and on Friday the town of Chatham followed suit.
All public buildings in Chatham have been closed to the general public for the next two weeks, though the public will continue to have emergency access to the lobbies of the police and fire stations. The Eldredge Public Library, the community center and the council on aging are closed indefinitely, and the town is coordinating its response to the virus from an emergency operations center established at the fire station. Leading the effort is Duncanson, who is assisted by Emergency Manager John Kondratowicz and additional town staff, as well as the coordinator of the new regional Community Emergency Response Team (CERT), David Miller.
“The key is continuity of operations for the town,” Duncanson said. Town staff will continue to work.
The EOC will be staffed from 8 a.m. to 4 p.m. Monday to Friday and can be reached at 508-945-5191 or via email at email@example.com to answer citizen’s questions and addresses their concerns specific to Chatham’s response to the virus and mitigation efforts. Calls for emergency assistance should continue to be directed to 911, or Chatham Police or Fire.
With the closure of the council on aging, efforts are underway to continue services for senior citizens who may be isolated and in need. Meals on Wheels deliveries will continue as normal, though it may not be possible for volunteers to deliver meals directly into clients’ homes. The town is continuing to provide van transportation for seniors who need transportation to medical appointments or other essential business, though participation is being limited to ensure that riders can practice adequate social distancing. The Family Pantry of Cape Cod’s mobile pantry will also continue to operate for needy seniors, with CERT volunteers helping distribute groceries using a drive-through delivery system, “so that they don’t have to get out of the car and into the building at all,” Duncanson said. Finally, the council on aging will continue offering SHINE health insurance counseling by telephone or email.
At the town offices annex, staff are working on a system that will allow construction and other permit applications to be submitted without face-to-face interactions between the public and staff. Residents are urged to order their beach, transfer station, recycling and shellfishing permits by mail. The transfer station will also remain open, though people who feel sick or are self-quarantining are urged to wait until they are well to visit. Any residents who are self-isolating and who run short of food, medicine or other supplies during the emergency are encouraged to reach out to the town for support.
As of Monday, town officials were seeking to rectify computer problems that were interfering with telephone and online communications with the emergency operations center. With so many people working from home, “Microsoft is overloaded,” Kondratowicz said.
With only a few exceptions, all meetings of town boards, committees and commissions have been canceled. On Monday, the board of selectmen held its meeting but ordered it closed to the public. The session was televised live and the public had the opportunity to submit questions and comments live by email.
“These are uncharted waters, and we are navigating our direction as a town with the utmost caution,” Davis said Monday. While social distancing is critical now, she said, “it doesn’t suggest we stop being humane with each other.” Davis urged people to use the time to enjoy nature, to spend time with family and to check on friends in need. “Do not lose connectivity. It is critical right now,” Davis said.
On Monday, Interim Town Administrator Joseph Powers ordered all town buildings to be closed to the public, though limited access to the lobby at the police and fire station will be maintained. Most town employees will remain at work, though offices will be reconfigured to provide for proper social distancing. Monday’s meeting of the board of selectmen was canceled.
Health Director Meggan Eldredge said Monday that the town is doing what it can to encourage social distancing by closing buildings and canceling events that would put more than 25 people in one space.
“We will continue to conduct as much business as possible through telephone, email and regular mail. We are currently working on plans to accept documents and will distribute that information as soon as possible,” she said. “Information regarding public meetings of regulatory boards will be forthcoming from the Interim Town Administrator.”
The steps are necessary to limit the possibility of spreading the illness to a large amount of people at once, Eldredge said.
“Having coronavirus within our community is inevitable, however the goal of these public health measures is to reduce the number of people who require medical intervention so we don’t overwhelm our healthcare system. A surge in medical needs due to COVID-19 has the potential to limit the ability of our emergency services to treat all needs such as heart attacks, strokes, motor vehicle accidents and other traumatic events,” she said.
Deputy Harwich Fire Chief David LeBlanc said Monday morning that his department has had no calls related to the COVID-19 virus. A Harwich firefighter was diagnosed with the flu a week ago and he was examined at Cape Cod Hospital for symptoms of influenza. The member is at home, following the instructions provided by the emergency room doctors. Despite a test confirming the flu, a social media post has circulated saying the firefighter had been quarantined because of COVID-19.
“There is a strong potential for inaccurate information to be shared within the coming weeks,” LeBlanc said. “Please verify all information you receive regarding COVID-19, town actions and potential patients.”
The deputy fire chief said his department has sufficient supplies to respond to virus-related calls in the short term, but the potential long-term impacts remain unknown. The department has the recommended face shields, N95 masks and gowns to protect its members when responding to help a presumed coronavirus patient, LeBlanc said.
At the council on aging, the town chef and health director are implementing a food distribution plan for people who typically come to lunches at the senior center, COA Director Emily Mitchell said. “This supplements the Elder Services Meals on Wheels program which many Harwich residents benefit from,” she added. The COA is also offering essential van transportation this week, with vans at half capacity to provide more distance between passengers. “After that, we are working with local agencies, volunteers, and stores, to see what options are available to get food and supplies to people who otherwise rely on COA transportation for these services,” she said.
One-on-one appointments with the town nurse will continue on Mondays and Wednesdays, though appointments are now required. Remote SHINE appointments are also available for seniors with health insurance questions.
“We’ve been getting a lot of calls from people interested in volunteering with us during this difficult time. I am hoping to match volunteers with other patrons/residents with similar interests to connect by phone to help build community and combat increased isolation and loneliness,” Mitchell said. “These volunteers will likely prove vital as we explore other food and grocery distribution options as well.
Following a special joint meeting, the Orleans selectmen and health board ordered the closure of all town buildings last Thursday through April 5. The closure does not include the transfer station, police or fire department.
“The town is in the process of updating its website to provide details to the public on how to contact town departments about conducting business,” the town announcement reads. Officials encouraged people to cover their coughs and sneezes, properly dispose of used tissues, wash hands frequently and properly, and exercise social distancing.
“If you feel sick, stay home,” the notice reads. “The town appreciates your patience as we navigate this difficult situation.”
With town hall's temporary closure, a cascade of meeting cancellations followed; information about viewing these meetings and participating remotely was not available at press time. Members of the public who have business at town hall should communicate by email or telephone, town officials said.
“Individuals should use the town's website to obtain the contact information for the individual departments,” officials said in a statement. “The town will continue to receive mail and will institute the use of a drop off box at the front entrance of town Hall.”
While Meals on Wheels service continues, the council on aging has discontinued its on-site feeding program.
“We are not able to purchase the quantity of food that we need,” COA Director Judi Wilson said. The town is working with the Nauset School System to provide some supplemental food for seniors in need, and Wilson said she hopes a system will be in place next week. While some supermarkets still offer deliveries, they may require online ordering, which is unfamiliar for some seniors, she said.
The COA is providing essential transportation for seniors needing to visit the doctor, grocery store, pharmacy and the like, but is not providing rides for non-essential errands. Senior center staff are calling to check on vulnerable elders and clients who use the adult day program, Wilson added.
A number of people have called to volunteer to help reach out to elders in need, and while the COA appreciates their offers, having volunteers meeting with many seniors could only potentially speed the spread of the virus. “That is exactly what we’re trying not to do right now,” she said. Instead, if people who know someone who lives alone, “we’re asking them to call them and check up on them, because isolation and loneliness is going to become an issue,” Wilson said.
On Monday, Cape Cod Healthcare announced a partnership with Barnstable County and Cape Cod Community College to establish a drive-through testing center for COVID-19 at the college. To be tested, all patients must have a doctor’s order.
Cape Cod Healthcare CEO Mike Lauf said anyone who is experiencing a fever, a deep cough or other symptoms of the coronavirus should begin by calling their primary care physician, rather than visiting a medical facility. Those without primary doctors should call a medical center for advice. A healthcare worker will then triage the caller by telephone, learning about their symptoms, their travel history and any other medical conditions that may make them more susceptible to the virus. Some callers will simply be sent home to recover in self-quarantine, and others will receive a doctor’s order for testing.
When that happens, the patient will be given a specific appointment time and detailed instructions for when they should arrive at the college. After their appointment is verified, patients will drive up to a testing area where health care workers in protective clothing will administer a nasal swab. The patient then rolls up the car window and drives home to self-quarantine until the test results are available.
“Keep in mind, not everyone in our community will be tested,” Lauf said. Still available in limited quantities, tests will be reserved for those who are at highest risk of becoming seriously ill. One goal of the drive-through clinic is to control the use of test kits and protective gear, which “is at critical shortages,” he said. Critically important is that people who feel ill do not show up unexpected at the hospital or at urgent care facilities seeking tests.
“We can’t possibly handle everybody that wants a test showing up at our ER’s,” Lauf said.
Cyr Offers Resources
State Senator Julian Cyr, D–Truro, is on a senate working group that is identifying policy, legislative and budgetary needs at the state level. He said the group is looking at a list of about 150 issues ranging from urgent needs like those for personal protective equipment for healthcare workers, to less immediate problems like helping cities, towns and small businesses.
“The list goes on and on,” Cyr said. Of particular interest to him are efforts related to older adults, including working with nursing homes, skilled nursing facilities and direct care workers. Given that tests are still not widely available, Cyr said he believes there are many unconfirmed cases in the towns.
“It's safe to assume community spread is already occurring,” he said.
From a financial perspective, Cyr said he expects towns’ local revenues as well as state revenues to “crater,” but said thanks to the state’s $4 billion rainy day fund, Massachusetts is “in a strong position to respond.” On Tuesday, Gov. Charlie Baker pledged $5 million in emergency funds to support local boards of health, as well as additional types of assistance. When it comes to potential ways the state can help residents through the crisis, whether it’s solutions for cities and towns, revenue infusions or bailouts, “it's all on the table,” Cyr said.
Cyr has compiled a list of useful links for constituents, available at www.senatorcyr.com/covid19.
Tim Wood, William F. Galvin and Ed Maroney contributed to this story.
This article has been revised several times to include additional information.
Stop The Spread
• Wash hands frequently
• Practice cough etiquette
• Avoid groups of people
• Stay at least six feet away from others
• visit www.CDC.gov and town websites for more tips