NCH Update on Island COVID-19 Cases and Testing

April 2, 2020

Nantucket Cottage Hospital has now confirmed nine positive cases of COVID-19 on the island, and while this may seem like a relatively small number, we want to emphasize that the coronavirus threat is still very real, vigilance is imperative, and we must continue to stay home, practice physical distancing, and adhere to all the measures put in place to protect our community.

For most of the COVID-19 cases we have confirmed, we know of presumed positive family members and social contacts, all of who are appropriately quarantined but not counted in the total number of confirmed cases. In a household with a COVID-19-positive patient, they have likely already spread the virus to those in close contact, before their symptoms developed. So if those people develop symptoms a few days later, or not at all, they are presumed to be infected and not necessarily tested. The entire family of a COVID-19 patient is ordered to remain quarantined together for 14 days after exposure, and receives extensive CDC-issued instructions and guidance to prevent further infections.

In addition to being quarantined, contacts of positive patients are instructed to monitor their symptoms and seek help if needed. These individuals are educated on the most current testing indications and that in their particular situation there is not always clear guidance, but clinical judgment plays a large role. We also understand there is a false negative rate to consider with the COVID-19 testing, and not only do we recommend to those who have tested negative to maintain isolation, we have decided to retest some of those individuals in which there is a strong suspicion of a COVID-19 diagnosis.

The bottom line is that the coronavirus is here on our island, and there are almost surely more cases than have been confirmed. NCH and other Massachusetts hospitals are making every effort to expand testing capacity and our turnaround time for the island has improved, but widespread or voluntary testing is unlikely in the short term. While the community spread of the virus on Nantucket that we are aware of to date has not been extensive, that is only because our town and hospital leaders acted early and decisively to protect Nantucket with emergency orders and guidelines around physical distancing. So we urge the community to continue adhering to these critical measures to prevent any further spread on Nantucket in the days and weeks ahead. Please stay home, wash your hands, and limit trips to the grocery store as much as possible. Everyone in the community is making sacrifices during this challenging time and we appreciate the collective efforts of our island.

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General News

4 / 2 / 2020 by

Comments

Please explain about 1 patient transferred. To where? Is that patient worse?
Also, of these 9 positives, were any of these interacting with any of the others who later tested positive or is it just 9 random people!

I would like to thank the management of NCH for extremely effective and timely communications. You are honest, straightforward and calming but firm. Shame that your example isn’t being followed at the national level. My husband and I are not on island but our children are, so these updates give us a lot of peace of mind.
I would also like to congratulate you on your level of planning and preparedness. I have no doubt that NCH and the Nantucket community at large will weather this storm in the best possible way.
I agree with Joyce that a bit more granularity with respect to the information on the confirmed cases would be useful.

Hi Joyce and Anne – the patient was transferred to a higher level of care on the mainland. We are bound to protect patient privacy so we are not releasing further information about individual patients who are covid positive. No hospitals are releasing this type of demographic information, and NCH has not done so. Town health departments can release limited demographic information, and the level of disclosure varies from town to town. There was guidance from the Mass DPH to town health departments asking them not to disclose this information, and there has since been a lot of confusion and debate about this. I understand the desire to know as much information as possible and while it might be interesting to know the ages or genders or contacts, disclosing that information does nothing to protect you or the community. It shouldn’t change anything you are doing to protect yourself and the measures that have been put in place to protect the island. We should all be assuming that everyone is infected, and act accordingly.

HI Jason,
Joyce’s questions have nothing do do with “demographic information”. Her questions were aimed at better understanding if we are seeing the results of transmission in the group of confirmed cases. A perfectly rational and intelligent question. People are pretty clear on privacy issues and don’t expect “demographic information”.

Hi Jason, will there eventually be a “recovered” #? It might helpful for people to know this too.
Thank you.

It’s a complicated question and difficult to determine, but yes at some point we would like to be able to include that in our reporting. Thank you Lynn.

Hi Robert – if this test is needed and your physician has directed you to come in, our lab is open and able to care for you. All patients are screened and masked when entering the hospital. We have taken every infection control precaution to keep our patients safe when they need to come to the hospital for care.

Would you agree that once the season starts and New Yorkers arrive, your cases will rise quickly?

Is NCH performing their own Covid tests or sending off island ( if so where?) please respond for rna pcr test and antibody test. And which test is being used- wherever. (Eg rapid or high throughout, manufacturer) Thanks

Hi Candice. NCH is doing both. Specimens collected at our drive-through evaluation site are sent to the MGH lab with a 24-hour turnaround time for results. We also have an in-house Cephied analyzer capable of PCR testing with a 45-minute turnaround time. However, due to the lack of availability of test kits, the in-house testing is reserved for cases in which our physicians deem are time-sensitive and would improve patient care. We are not yet conducting any antibody tests but are pursuing a large-scale study to test a significant percentage of the island, but there are hurdles including approvals and funding before we could pursue this.

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