‘Breakthrough’ COVID Cases Raise Alarm

By: Alan Pollock

Topics: COVID-19

As seen at this week’s Art in the Park event in Harwich Port, while most adults have stopped using face coverings, masks are still important for people who have not been vaccinated, including children. ALAN POLLOCK PHOTO

With concerns growing about the highly transmissible Delta variant of COVID-19, and with Provincetown fighting a localized surge of cases among mostly vaccinated people, you might see more people voluntarily wearing masks in the weeks ahead.

“We are seeing a slight uptick,” Chatham Health and Natural Resources Director Robert Duncanson told the health board this week. The town saw two new cases of COVID-19 in June, and three so far in July, and all recent cases “have been in fully vaccinated individuals,” he said. Known as breakthrough cases, infections among vaccinated people have become more prevalent, but generally cause only mild symptoms of the illness.

“No vaccine is 100 percent effective,” Duncanson said. The Delta variant of the coronavirus is estimated to spread about 225 percent faster than the original virus and leaves infected people with about 1,000 times more copies of the virus in their bodies. “It is highly contagious. It’s pushing the limits of the vaccine,” he said.

Thanks to the high rate of vaccination on Cape Cod – 76 percent of all eligible people are fully vaccinated in Barnstable County – case numbers locally remain low. Early last week, the daily number of new cases ranged from eight to 16, with 27 new cases on Friday and 59 new cases on Monday.

On Monday, public health officials issued an advisory urging residents of Provincetown and visitors to take steps to prevent the spread of COVID, following a cluster of cases there. As of July 16, the state had received reports of 132 confirmed cases connected with Provincetown; of them, 39 are local residents. Gov. Charlie Baker said the surge in cases is most likely related to Independence Day gatherings roughly two weeks earlier.

Health officials from Provincetown and Barnstable County issued a joint statement strongly advising residents and visitors to get tested and stay home if they have even mild symptoms or if they were in contact with someone who has become ill; to be mindful of the risk from large crowds; and to wear masks indoors when social distancing is not possible. The advisory also urges eligible people to get vaccinated if they have not already done so.

“Clearly, vaccinated people are much better off medically,” Duncanson said. A key goal of the vaccine is to reduce the number of deaths and hospitalizations from COVID, and that goal is being achieved.

Masks remain mandatory for people on public and private transportation systems, as well as in healthcare facilities and congregate care homes. On Monday, it was announced that 32 residents and staff members of a West Yarmouth nursing home had tested positive. In an automated call to families Friday, Bill Bogdanovich of Broad Reach Health Care issued a “call to arms” to redouble infection control procedures.

“While we have no positive cases amongst staff, patients, or residents at Liberty Commons and The Victorian, it’s out there in Cape facilities. Right now,” he said. Rather than dwell on the causes of such outbreaks, people should focus on prevention, Bogdanovich said.

“The one thing we know matters is hyper-vigilance to safe and careful practices. All of us. Whether vaccinated or not. Whether we are spending time with people who are vaccinated or not, or people who have chosen not to be vaccinated.” Broad Reach is ensuring that visitors to its facilities wear masks, and will be hosting experts from the state Department of Public Health for a visit this week. “Not for punitive enforcement, but to see what we’re doing and probably suggest a few new things,” Bogdanovich said.

Duncanson told the health board that the uptick in cases on Cape Cod is “more than likely related to the influx of summer residents and visitors,” particularly from Florida, Louisiana and other parts of the country “where vaccination rates are pretty low.” He said that, nationally, vaccination rates are still climbing as more people see the value of getting inoculated.

“I think people now realize that, even though the vaccine is not 100 percent effective, it is still highly effective,” Duncanson said.

On Cape Cod and across the nation, the largest group of unvaccinated people remains children under 12, who remain ineligible to receive the vaccine. Originally, public health officials had hoped that the vaccine would be approved for use in children by September, around back-to-school time.

“Now it’s been pushed off to mid-winter,” Duncanson said, as the CDC seeks to collect additional data on the safety and effectiveness of the vaccine on young people.

State education officials have made it clear that it will be up to local school districts to decide whether students will be required to wear masks when they return to classes. The CDC has recommended the use of masks indoors, particularly for younger children. State officials have indicated that they will make a recommendation closer to the resumption of classes in September, and Duncanson said he will meet with Monomoy school officials to consider a mask-wearing policy.