The Barnstable County outbreak in July is a great example of how effective the COVID-19 vaccines are. They show us what an outbreak of the Delta variant of COVID-19 looks like in a highly vaccinated population.
Barnstable is a county of 213,000 people in the 2nd most densely populated state in the country. It is a popular tourist location, especially during the Summer. It just suffered an outbreak triggered by a super-spreader event. This resulted in only about 500 cases of COVID-19 (in residents; we don’t have data, including vaccination data, on the other half who were from out-of-state), 5 hospitalizations, and 0 deaths. About 79% of the population is fully vaccinated, with many more partially vaccinated. The various disinformation purveyors cite the fact that 74% of those who got COVID-19 during this outbreak were vaccinated as a shocking counterpoint to literally all of the data pouring in from all over the country, as though it proves that the vaccines don’t work… When really, it is exactly what we should expect even if they do work. It’s a bit like saying “the people who lived there are the ones who got it while living there”; unvaccinated Texas and Floridians couldn’t have gotten COVID-19 from the outbreak in Barnstable County Massachusetts; they weren’t there. We know many people who were just visiting did get COVID-19 during the outbreak, we just don’t have information on their vaccination rates because they went back home and added to their county’s COVID-19 statistics after the event; they aren’t included in Barnstable’s.

The misinformation would have you believe that 5 hospitalizations in Cape Cod are more statistically meaningful than 1,003 hospitalizations in Baton Rouge.
All of the evidence we have from the other 3,005 counties (and 64 Parishes) in the US strongly suggests that if Barnstable had had this outbreak with, say, a 36% vaccination rate like we have here, this would not be a mere 500 person outbreak with just 5 hospitalizations and 𝐳𝐞𝐫𝐨 deaths. Less densely populated counties without super-spreader events are seeing worse numbers than these every day, and their hospitals and ICU’s are filling up rapidly as patients continue to die. To put it another way, when I worked as a full-time hospitalist in a small town I considered it a “light day” when I personally had 8 or 9 patients to care for by myself; I felt busy once that number was above 14 or 15 (and some hospitalists routinely see 18 or more). The entire Barnstable outbreak resulted in a burden on their hospital system that required 1/3 of the time and effort of 1 doctor each day. And they all lived.

My home state of Louisiana is. Texas will be soon (parts of it already are). We both have vaccinations rates that are about half of Barnstable County. That’s the difference in our case trends.
This is what might have been. This is what Texas could be experiencing right now if we had a higher vaccination rate: a minor surge, entirely within our capacity to handle, and quickly contained and improving. Instead hospitals all over the state are cancelling elective surgeries and operating beyond surge capacity, and the ER, hospital, and ICU doctors and nurses are so overwhelmed with COVID-19 that other patients can’t get access even when they are very ill or injured.
I live in a similarly sized county to Barnstable with half the population density, excellent local leadership, and no recent super-spreader events; yet we have 866 active cases, 173 new cases from just Friday (I diagnosed some of those personally), and over 100 hospitalizations. Most of those cases- and almost all of those hospitalizations- are unvaccinated patients. Our numbers just leave Barnstable county standing- because we have such a low vaccination rate. And we aren’t even calling it an outbreak; this is just what the COVID-19 Delta variant looks like anywhere without adequate vaccination rates to prevent widespread transmission.
- McLennan County, Texas (This Week)
- Population: 256,623
- Population Density: 227 People/Sq. Mile
- Current Active Cases: 866
- Current COVID-19 Hospitalizations: 106
- Barnstable County, Massachusetts (July Outbreak)
- Population: 212,990
- Population Density: 562 People/Sq. Mile
- Total Cases in July: 560
- Total Covid-19 Hospitalizations in July: 5
Vaccines don’t put a forcefield around us that keep us from coming in contact with the virus; they prime our immune system to fight the virus effectively when we do come into contact with it by teaching us how to build antibodies and a targeted immune response. No vaccine can keep every person from becoming symptomatic when they are exposed to COVID-19. But they do substantially reduce infections and thus transmission, and most importantly they greatly reduce the risk of severe illness and death; that has been their purpose since they were invented in the late 1700’s, and that was the purpose of vaccination’s predecessor, inoculation, which we inherited (one could argue, stole) from African, Indian, and Asian traditional healing practices.
Right now, hospitals all over the country are drowning in almost entirely unvaccinated COVID-19 cases that are absolutely overwhelming our medical infrastructure, and many of those patients are dying tragically- as are those who don’t have COVID-19 but can’t get medical access because the healthcare system is stretched so thin. They didn’t have to die. The Barnstable outbreak is indeed a warning about just how contagious the Delta variant really is- and how even vaccinated people need to continue exercising caution and wearing masks. But it also shows us how much better off we would be right now as a nation if all of our counties- and parishes- had vaccinated at the rate of Massachusetts.
The vaccines are incredibly safe and super effective; please go out and get one.

He’s not an anti-vaxxer, just a huge nerd.