Covid: Provincetown Delta Variant Outbreak, Gay Community

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Going to Provincetown for Circuit Week is a tradition for Michael Donnelly. “It’s a great opportunity to meet up with friends,” says the data scientist, who lives in New York City. The popular theme week, also known as Twink Week, begins on the weekend of July 4th and is immediately followed by Bear Week, another major draw for tourists.

Evan Snavely moved to Provincetown full time in 2020 and works in a brewery, so he is well versed in the various communities that descend on the Cape Cod destination throughout the year. “Circuit Week is, like, more of a rave vibe. It’s a muscular, younger and more urban set, ”he explains. “And then bear week is, I mean, bears are literally older, heavier, hairy men. Bear week is perhaps a little stranger too; a little more diverse in the types of people it attracts. But both are the busiest two weeks of the year.

Donnelly was eager to return to Provincetown this summer, as states lifted restrictions on Covid-19, and CDC guidelines at the time suggested his vaccine essentially made him party-ready. But with so much enthusiasm after the lockdown, the accommodation was full and he and her husband were unable to find accommodation. So on July 10, as Circuit Week wrapped up and the bear crowd arrived for their festivities, Donnelly, who had been treating FOMO all week, texted New York friends who were leaving Cape Town delighted to making plans for that night when they’d all be back in town.

It had been a rainy week, so the outdoors and beach time had given way to sweaty dance parties. There was an atmosphere of catharsis during the celebrations. “It really felt like it was busier than every two years,” Snavely said. “There were queues for some bars and clubs in the city that took to the streets. People were so excited to get back together.

As Donnelly chatted with his friends on the road, one learned that someone they had vacationed with had fallen with Covid. The jubilant atmosphere evaporated. The group stopped for a quick test along the way. An hour later, Donnelly received another text: three of the five people in the car had tested positive. Evening plans canceled. Instead, Donnelly spent the rest answering calls from growing numbers of friends telling him that someone they knew had caught Covid. “It was really scary,” he says. “All of these people were fully vaccinated upon entering Provincetown and in most cases had been fully vaccinated for months. “

After working with city officials in early 2020 to give advice on closing the New York pandemic, Donnelly knew these cases could be normal breakouts, but they appeared to be more than that. He continued to reach out to people and started recording data on a spreadsheet. “I started contacting or following people and said, ‘Tell me what you really know,’” he says. ” Have you been tested? What were your test results? When were you tested? What kind of test did you take? When were you vaccinated? What vaccine did you receive? Who was in your house [in Provincetown]? Do you know for sure if they have been tested? “”

In less than 48 hours, he had spoken to a dozen people and learned the test results of 51 people in total. 21 were positive. All had been vaccinated. On Monday, July 12, Donnelly contacted Dr Demetre Daskalakis, a former New York City health official with whom Donnelly contacted during the initial pandemic mitigation efforts and who had since been hired by the CDC to also lead the agency’s HIV prevention efforts. as aiding in the Covid response.

Dr Daskalakis called Donnelly on Tuesday morning. “Michael contacts me to really put rocket fuel in the engine to move it quickly,” says Dr. Daskalakis. “He had amassed a first type of epidemic report. Dr Daskalakis forwarded this report to the ranks of the CDC’s Covid team, reinforcing the importance of the outbreak to the agency.

On July 10, Sean Corbett arrived in Provincetown from Boston. A scientist who studies bioinformatics, Corbett was eager to revive his favorite thematic week after lockdown. “I’m mostly attracted to bigger, hairier guys so it’s kind of like a fantasy for me,” he says. “As we got out of spring this year and vaccination rates started to rise, especially in Massachusetts, it seemed like everything was improving.” He shared a rental house with friends and shared a room with a friend from New York. Almost immediately upon arrival, reports and discussions on social media stated that there was Covid in Heaven. By the end of the week, Corbett and his friends had stopped going out to parties and clubs, focusing mostly on the beach. It was too late. As he made coffee the following Monday morning, he realized he couldn’t smell it. “I was like, ‘Oh, here we go,’” he said.

By early August, more than 1,000 infections had been located in Provincetown, originating from July 3 to 17, most with mild or no symptoms. Local and county leaders responded to an increase in cases after July 4. City manager Alex Morse called for two mobile test units at the start of Bear Week, and revelers took full advantage: more than 8,000 tests have been administered since then.

Barnstable County public health nurse Deirdre Arvidson also noticed an increase in positive tests around July 4. She and three other public health nurses started making phone calls; they managed the contact tracing for all those who lived in Provincetown or who isolated themselves there after their diagnosis. “Everyone cooperated,” she says, including people outside their jurisdiction. “We spread the word: if you were visiting and got sick, please call us. And we have received calls and emails. Lots of people have let us know if they are from out of state and ended up with coronavirus. “

The study released July 30 by the CDC on a subset of the Provincetown outbreak found that 90 percent of the infections examined were from the Delta variant and three-quarters were in people who had been vaccinated. The results led to the reinstatement of mask recommendations for people vaccinated indoors, demonstrated the possibility that vaccinated people could still spread the virus, and updated our overall understanding of the highly contagious Delta variant. None of this would have been possible without the wealth of data provided to contract tracers by those infected. In that sense, the success of this outbreak is how it was documented and reported by the community of people, largely gay men, who were in Provincetown at the time. “There was an enthusiasm in helping to facilitate the investigation that is not seen in many other communities,” says Dr. Daskalakis. “Not only were people saying, ‘I sniffed and my taste was bad,’ they were like, ‘and let me give you my route minute by minute so you all can do your jobs. “”

Corbett, in Boston, had only one mild case, and when he got a call from the Massachusetts Community Tracing Collaborative, the person he spoke with had already had enough successful in-depth conversations that he was quite familiar with Ptown nightlife routines including everyone’s favorite after hours spot. “This lady who’s never been to Provincetown said to me, ‘Oh, so you went to Spiritus Pizza after the party?’ And I was like, ‘How did you know about this?’ He answered all questions about the two calls he received from where he believed he contracted the Covid where he had breakfast on a given day. “I was very willing to provide these details,” he says. “Especially in the original spikes of the ancestral variant, there was a lot of stigma and shame around people disclosing that they had been infected, and now there is an element of wanting to destigmatize by contracting Delta. everything I was supposed to do and still got sick.

Benwa Kramer, who lives in Provincetown year-round and holds four service jobs during the summer, says he’s disappointed he never heard of a contact tracer after his test came back positive on the 16th. July. However, he himself tracked down Arvidson’s Barnstable County office, ensuring his case was registered. “I was really worried, like, am I counted or not?” ” he explains. (A representative from Arvidson’s office noted that sometimes a case may be filed in a different jurisdiction, which might explain why their department had no record of it.)

Disclosing details about your health, caring for each other in your community, and advocating for your own health care have been integral to gay culture since the start of the HIV / AIDS pandemic in the 1980s. “Many of them we grew up before PrEP [a daily medication that prevents HIV], so in order to protect ourselves, we had to disclose our HIV status, get tested regularly, and use condoms when we had sex with new partners, ”says Donnelly. “Nobody wants to talk about medical stuff with someone they are going to get in touch with, but we now have support in the community for those conversations.” He credits a pro-science attitude and a willingness to speak openly about the health risks to having made tracing this outbreak so successful.

“The queer community is really good at this,” Snavely says, which means regularly talking about health topics with friends and partners. He thinks there is something special about the city’s legacy in gay culture as well. “Provincetown is a place where people came during the HIV and AIDS crisis to be sick, to die, to care for one another – so the lineage would live there. “

Dr Daskalakis is not surprised that this group of homosexuals has escalated. “The relationship between gay men and other men who have sex with men with public health has been tempered by fire into a new kind of trust,” he says. “The lives of the people of this community have been saved by science and fueled by their own advocacy…. They delivered that [information] to public health, and they had no problem doing so, as there was confidence in this interaction. “

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