Officials: COVID-19 May Be Nearing Peak

By: Alan Pollock

Topics: COVID-19

Members of the 1058th Transportation Company of the Massachusetts National Guard deliver personal protective equipment from the Mass. Emergency Management Agency to the Harwich Fire Department last week.  DAVID LeBLANC PHOTO

Though the official toll increases daily, the number of people sickened by COVID-19 is expected to peak or plateau this week or next, public health officials say.

In coronavirus hotspots like New York, California and Washington State, statistics hint that “we’re potentially seeing the caseload level off,” County Health Director Sean O’Brien said Tuesday. Here, the timing of the peak number of cases depends on social distancing and citizens’ willingness to stay at home to prevent spreading the disease.

“It’s working. It helps,” he said. As of Tuesday, Cape Cod had 383 positive cases of COVID-19, with seven fatalities. Chatham reported three active cases and one inactive case, representing a patient who had completed the treatment protocol. Orleans reported two confirmed active cases and three closed cases, and Harwich health officials have not released the number of cases in town. Health Department Director Meggan Eldredge said that decision should be up to the board of selectmen, which will address the question at its meeting tonight (Thursday, April 9). A 59-year-old Harwich resident who died last week is the town's only known victim of the virus (see separate story).

State public health officials previously instructed city and town health agents not to disclose numbers of people who have contracted COVID-19 in their specific communities, but last week backed off that directive, the decision up to local officials.

Social distancing remains critically important, and public health officials are urging people to stay at home except for essential trips to get food or medicine. Local officials have embraced new CDC guidelines advising people to wear non-medical face masks when outdoors and unable to maintain the recommended six-foot distance from other people.

“If you have to go out, you have to go out,” O’Brien said. But it now makes sense to avoid trips to the supermarket unless absolutely necessary. “It’s freezer time,” he quipped.

In Chatham, town officials closed playgrounds to the public over the weekend, cordoning them off with caution tape or temporary fencing. The public was also reminded that the town-owned Seaside Links Golf Course is closed. Beaches and nature trails remain open, but people are warned to keep adequate distance from one another when outdoors. Health and Natural Resources Director Robert Duncanson said there had been no symptomatic cases of COVID-19 reported by Broad Reach Health Care, which operates Liberty Commons nursing home. “They really are practicing and putting in place all of the appropriate guidelines,” he said. “I think those things are working out well.”

When a person tests positive for the illness, the town nurse or the Visiting Nurse Association is charged with identifying and notifying all of the individuals with whom the person has had close contact. A new state initiative aims to provide additional people to help communities with contact tracing. Duncanson said the system has its limitations, however. If a patient reports having been in contact with only one or two people but has really been around 20 or 30 people, “we don’t know that,” he said. Also, people are often tested only after they show symptoms of COVID-19, and a substantial number of people are believed to be infected but appear healthy.

Harwich and Orleans have already received shipments of gowns, N95 masks, face shields and other personal protective equipment (PPE) from the state, and Chatham was expected to take delivery this week. The equipment will be used by first responders, and other PPEs are being distributed to local health care providers through the state public health department. Cape Cod Healthcare CEO Michael Lauf said efforts are underway to procure more PPEs for Cape Cod Hospital and other Cape Cod Healthcare facilities, but they have been reserved for front line workers.

“We want to protect everybody. But if you have limited supplies, you have to go through protocols,” he said in a news conference last week. Lauf praised those who have donated PPEs or helped identify vendors who can provide them.

“There have been so many people in this incredible community who have gone above and beyond,” he said. Key is to make sure that N95 masks are available for workers providing COVID-19 patient care, O’Brien said. As for the general public wearing masks, he said he supports the new CDC guidance promoting that.

“The big question is whether or not we’re going to have enough of them,” he said. A number of volunteers have begun making homemade face coverings for use where face masks are not available, and the U.S. Surgeon General even published an instructional video showing how to make a mask from an old T-shirt.

It would be technically possible for local boards of health to mandate the use of masks or gloves by members of the public, but doing so would be “extremely unwieldy,” Duncanson told selectmen Monday afternoon. “It would be difficult to enforce.” On Monday, the Chatham health board is expected to meet to discuss potential protective measures designed to fight COVID-19, including possibly limitations on construction projects where workers may not be exercising social distancing.

Preparing for a possible surge in cases, state officials announced the possibility of opening a field hospital on Joint Base Cape Cod, the Upper Cape military base that includes Camp Edwards. Shortly after the news was announced, some people began showing up at the base’s gates seeking treatment. County officials issued a statement Tuesday stressing that the medical facility remains in the planning stage and is not open.

Lauf announced last week that Cape Cod Healthcare has been asked by the state to create a “post-acute surge plan” for the treatment of people recovering from COVID-19, and they have identified two facilities on the Cape which could be used for this purpose. “None of it has come to fruition yet,” he said. Staffing and managing the facilities would be “a monumental task, and we’re working hard to make sure that we do it well,” he said.

Public health officials also confirmed that plans are underway to handle any surge in deaths related to the pandemic. The effort will be coordinated by the state’s Office of the Chief Medical Examiner.

The broader availability of more rapid COVID-19 tests is a reason for optimism, public health officials say. Currently, tests carried out on Cape Cod typically yield results in one to two days, which helps public health officials track patient contacts and isolate cases. On Monday, it was announced that new technology could allow five-minute tests, and a drive-through testing clinic was set to open in the Boston area. Work also continues on developing an antibody test that could help identify how widespread the virus is among people who do not show signs of COVID-19.