What Provincetown’s Gay Community Can Teach Us About Containing Covid

·9 min read
Provincetown Has Covid-19 Surge - Credit: Barry Chin/The Boston Globe/Getty Images
Provincetown Has Covid-19 Surge - Credit: Barry Chin/The Boston Globe/Getty Images

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

Evan Snavely moved to Provincetown full-time in 2020 and works at a brewery, so he is well-acquainted with the various communities that descend on the Cape Cod destination throughout the year. “Circuit Week is, like, more rave vibes. It’s a younger, more urban kind of muscly set,” he explains. “And then Bear Week is, I mean: Bears are literally older, heavier, hairy men. Bear week is also maybe a little queerer; a little more diverse in the kinds of people it attracts. But they’re both the two busiest weeks all year.”

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Donnelly’s been looking forward to returning to Provincetown this summer, as states lifted Covid-19 restrictions, and CDC guidelines at the time suggested his vaccine essentially rendered him ready to party. But with so much post-lockdown enthusiasm, lodging was sold out, and he and his husband couldn’t find a place to stay. So on July 10th, as Circuit Week wound down and the bear crowd arrived for their festivities, Donnelly, who’d been nursing FOMO all week, was texting New York friends who were leaving the Cape, excited to make plans for that evening when they’d all be back in town.

It had been a rainy week, so outdoor hangs and beach time had taken a back seat to sweaty indoor dance parties. There was an atmosphere of catharsis at the celebrations. “It really just seemed like it was busier than every other year,” Snavely says. “There were lines for some of the bars and clubs in town going blocks down the street. People were just so excited to get back together.”

As Donnelly was chatting with his friends on the road, one of them got word that someone they’d vacationed with had come down with Covid. The jubilant atmosphere evaporated. The group pulled over for a rapid test along the way. An hour later, Donnelly got another text: three of the five people in the car had tested positive. Evening plans canceled. Instead, Donnelly spent the rest fielding calls from an increasing number of friends telling him someone they knew had caught Covid. “It was really spooky,” he says. “All of these folks were fully vaccinated going into Provincetown and in most cases had been fully vaccinated for months.”

Having worked with city officials early in 2020 to advise on the New York pandemic shutdown, Donnelly knew these cases could be normal breakthroughs, but they seemed like more than that. He kept reaching out to people and began recording data on a spreadsheet. “I started contacting or following up with people and said, ‘Tell me what you really know,’ ” he says. ” ‘Have you gotten tested? What were your test results? When were you tested? What kind of test did you get? When were you vaccinated? What vaccine did you get? Who was in your house [in Provincetown]? Do you know for sure if they’ve gotten tested?’ “

Within 48 hours, he’d talked to around a dozen people, and had learned a total of 51 people’s test results. 21 were positive. All had been vaccinated. On Monday, July 12, Donnelly reached out to Dr. Demetre Daskalakis, a former New York City health official with whom Donnelly had communicated during early pandemic mitigation efforts and who had since been hired by the CDC to lead the agency’s HIV prevention efforts as well as helping out with Covid response.

Dr. Daskalakis got on the phone with Donnelly Tuesday morning. “Michael’s reaching out to me really put the rocket fuel in the engine to move it quickly,” Dr. Daskalakis says. “He had amassed an early sort of outbreak report.” Dr. Daskalakis routed that report through the ranks of the CDC’s Covid team, boosting the outbreak’s importance to the agency.

On July 10th, Sean Corbett arrived in Provincetown from Boston. A scientist who studies bioinformatics, Corbett was eager for the post-lockdown revival of his favorite theme week. “I’m mostly attracted to bigger, hairier guys, so it’s kind of like a fantasy for me,” he says. “As we were coming out of the spring this year and the vaccination rates started going up, particularly in Massachusetts, it seemed like everything was getting better.” He shared a rental house with friends, and split a bedroom with a pal from New York City. Almost immediately upon arrival, news reports and chatter on social media said there was Covid in paradise. By the end of the week, Corbett and his friends had stopped going out to parties and clubs, sticking mainly to beach-going. It was too late. When he was making coffee the next Monday morning, he realized he couldn’t smell it. “I was like, ‘Oh here we go,’ ” he says.

By early August, more than 1,000 infections had been traced to Provincetown, originating between July 3rd and 17th, most with mild or no symptoms. Local and county leaders responded to a post–July Fourth uptick in cases. Town Manager Alex Morse called for two mobile testing 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 the rise in positive tests around the Fourth of July. She and three other public health nurses started making phone calls; they handled contact-tracing for everyone who lived in Provincetown or who isolated there after their diagnosis. “Everybody cooperated,” she says, including people outside their jurisdiction. “We got the word out: If you were visiting and then got sick, please call us. And we got calls and emails. A lot of people let us know if they were visiting from out of state and ended up with coronavirus.”

The study the CDC released July 30th of a subset of the Provincetown outbreak found 90 percent of the infections they looked at were from the Delta variant and three quarters had been among vaccinated people. The findings led to reinstated mask recommendations for vaccinated people indoors, demonstrated the possibility that those with the shot can still spread the virus, and updated our overall understanding of the highly contagious Delta variant. None of this would have been possible without the extensive data provided to contract-tracers by the people who were infected. In that sense, the success story of this outbreak is how well it was documented and reported by the community of people, in large part gay men, who’d been in Provincetown at the time. “There was an enthusiasm with helping to facilitate the investigation that isn’t seen in a lot of other communities,” Dr. Daskalakis says. “Not only were people like ‘I had a sniffle and my taste was off,’ but they were like, ‘and let me give you my itinerary minute by minute so that you all can do your job.’ ”

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

Benwa Kramer, who lives in Provincetown year-round and works four jobs in the service industry during the summer, says he was disappointed he never heard from a contact tracer after his test came back positive on July 16th. He tracked down Arvidson’s Barnstable County office himself, however, thereby ensuring his case was recorded. “I was really concerned, like, am I getting counted or not?” he explains. (A representative from Arvidson’s office noted that sometimes a case can get categorized in a different jurisdiction, which might have explained why their department had no record of it.)

Disclosing details about your health, caring for one another in your community, and advocating for your own healthcare has been integral to gay culture since the HIV/AIDS pandemic began in the 1980s. “Many of us grew up before PrEP [a daily medication that prevents HIV], so in order to protect ourselves, we had to disclose our HIV status and get tested regularly and use condoms when we had sex with new partners,” Donnelly says. “No one wants to talk about medical stuff with somebody they’re going to hook up with, but we have now within the community support for those conversations.” He credits a pro-science attitude and a willingness to talk openly about health risks with making the tracing of this outbreak such a success.

“The queer community is really good at this,” Snavely says, meaning regularly talking about health topics with friends and partners. He thinks there’s something special about the town’s legacy in gay culture, too. “Provincetown is a place where people came during the HIV and AIDS crisis to be sick, to die, to take care of each other — so that the lineage lives in this place.”

Dr. Daskalakis isn’t surprised at all this group of gay men stepped up. “Gay and other men who have sex with men’s relationship with public health has been tempered by fire into a new kind of trust,” he says. “People’s lives in that community have been saved by science and fueled by their own advocacy…. They were delivering this [information] to public health, and they had no problem doing it, because there was trust in that interaction.”

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