As the Vineyard enters the second Covid-19 summer, lessons learned over the last year can help us move forward. Over the last 15 months, we certainly didn’t escape the pandemic: at least 1,500 islanders have been infected, businesses have been shuttered, many have lost jobs or income, and treasured summer events were canceled. But the Vineyard’s case load was substantially lower than the rest of the country, the economic losses were less than feared last spring, and many cultural events were able to continue (albeit with the help of Zoom). Perhaps equally importantly, unlike so many other communities, the Vineyard didn’t tear itself apart over shutdown and masks. All of that, together with widespread vaccinations, better understanding of the risks, and the return of warm weather provide hope for the summer of 2021.
How does the Vineyard’s Covid-19 experience compare to other areas? Based on figures compiled by the Island boards of health as well as the New York Times, 1,555 cases have been reported on the Vineyard, most confirmed by PCR test. Per capita, this is about 20 per cent lower than the U.S. or Massachusetts. Taking into account that the population “at risk” is substantially higher than the census estimate of 17,000 due to summer visitors (some of whom stayed on into the fall), and that the Vineyard’s extensive testing and contact tracing efforts were probably better at finding cases than other communities, the Island case load over the last 15 months is well below national expectations. More surprisingly, and thankfully, the Island has seen no Covid-19 deaths; if national or state rates applied, we might have expected three or four dozen.
The vast majority of Island cases, about 90 per cent, occurred in the winter and spring. Since Nov. 1, around 250 cases per month have been reported, compared to 13 per month from March to October. In the spring and summer, most cases were linked to off-Island travel. Since November, there have been substantially more clusters and chains of transmission extending beyond two individuals. And the Brazilian community has been especially hard hit, accounting for 40 per cent or more of the cases. Although Island cases have been falling since the peak in early April, they remain persistently above zero.
Why the change? First, as the winter weather returned, people spent more time indoors. Second, more highly transmissible variants have arrived on the Island. Finally, many in the Brazilian community have jobs that put them at higher risk of infection and tend to live in larger households. The combination of these factors naturally leads to the clusters and transmission chains that we’ve seen since last fall.
Despite the good news, the current outbreak continues, and the Vineyard now has the highest positivity rate in the state. With the return of warm weather, and the increasing proportion of Islanders who are vaccinated, the number of new cases is likely to continue to fall. But as long as some people remain unvaccinated, and summer travel continues to introduce new infections to the Island, the virus remains a threat on the Vineyard. d
When the threat of the pandemic became clear last spring, the Island responded, following state guidelines, by closing non-essential businesses and schools and canceling many summer activities. Social service agencies rallied to support vulnerable residents put out of work. And concerned by credible projections about case loads that could overwhelm a hospital staffed for the off-season, the Martha’s Vineyard Hospital urged summer residents to stay away.
At the same time, the Island’s public health system rallied to manage the crisis. The hospital started testing everyone with symptoms, and Island Health Care set up a contact tracing operation under contract to the separate town boards of health. They all collaborated to issue daily epidemiology reports for the whole Island that provided a clearer picture than the town-by-town reports from the state health department. Later, these reports were expanded to include results from all the Island’s testing operations.
As the spring progressed the focus shifted to re-opening in time for the summer season, but doing so safely. For sure, tensions emerged between the business community and health authorities implementing state guidelines, but they were resolved reasonably quickly. The Community Ambassador Partnership Program was formed during this period to work with the Brazilian community.
The creation of TestMV at the regional high school (with the assistant of a summer resident who is the CEO of Quest Diagnostics) was a critical element in the Island’s response to the pandemic. Offering free testing to all, the program helped protect the front-line workers who serve us all, relieved the hospital’s testing operation with an option for people without symptoms or who didn’t want to go to the hospital, and provided peace of mind to many. Later in the summer, TestMV provided a convenient opportunity to avoid the required 14-day quarantine for visitors from other states.
During the summer, the focus shifted to enforcing social distancing policies, balancing public safety with the requirements of the hospitality industry. Although some felt that the island should have a uniform mask requirement, policies were developed town-by-town, depending on conditions. Fortunately, visitors kept coming longer into September and October than in previous years, allowing the business community to recoup some of their losses.
The fall brought concerns about reopening schools, especially in the face of growing outbreaks on the Island. A surveillance testing program, which started in January, helped to reassure parents and staff that transmission was still rare in the schools. The new year also heralded the arrival of Covid-19 vaccines. Although appointments originally were as challenging to get on the Island as anywhere in the country, the hospital, Island Health Care, and the state coordinated their efforts and now a greater fraction of Vineyarders are vaccinated than most communities in the country.
Thus, although we faced many challenges, the Vineyard managed to balance the health risks, business costs, personal sacrifices, and social consequences reasonably well. That’s remarkable, especially considering how mask and vaccine wars have torn apart communities around the country that were already reeling from pandemic deaths and disruption. Many worked hard within their own organizations and coordinated well with others, but surprisingly this happened without the leadership of a single person, such as Vermont Gov. Phil Scott or New Zealand Prime Minister Jacinda Ardern. Social scientists label this intangible but still very real concern for the whole community as solidarity or social capital. Here, it’s just the Island spirit that has helped us through.
As we head into the summer of 2021, we have many things going for us. Scientists have developed safe and very effective vaccines, and many Vineyarders have or soon will receive them. Yet some are still not vaccinated. Filling this gap is challenging, but we could begin by ensuring that everyone has easy access, regardless of immigration status. Employers could also require or encourage vaccination, and give their workers paid time off to be vaccinated and recover from adverse reactions. The more vaccinated, the better off we are all.
We now know that transmission outdoors is unlikely. As much as possible, let’s gather on our decks rather than indoors. Let’s keep in place the outdoor dining options that were developed last summer. And why not make as much use of tents and the Tabernacle as possible?
As long as some are not vaccinated, and with the emergence of more transmissible variants, the primary risks are being indoors and in close quarters. So, better that the West Tisbury Farmers Market stays at the Ag Hall, where we can spread out more. And although CDC now says that vaccin
ated people don’t need masks indoors, let’s support shops that still require them. It’s a good way to protect those still vulnerable to infection, to show respect for the workers who risk their health to serve us, and to remind ourselves of the shared sacrifice that is still required.
Finally, we must build on the Island spirit that got us through the last 15 months. The pandemic is still with us, no matter how much we would like to have it in the rear-view mirror. The situation is far less difficult this summer, but challenges remain. Knowing that we’ve been through a lot worse should make them easier to face. And let’s not forget that we need to support those in our community who are still suffering with the pandemic.
Michael Stoto, an epidemiologist and public health researcher at Georgetown University and the Harvard T.H. Chan School of Public Health, is a longtime summer resident of Vineyard Haven.
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