Week XLV: Deaths and infection outpace COVID-19 vaccine distribution

The Enterprise — Michael Koff

Eligible: On Wednesday morning, a line of socially-distanced people forms outside the state-run point of dispensing, or POD, at the University at Albany uptown campus. COVID-19 vaccines are administered by appointment only.

ALBANY COUNTY — Deaths and infection outpaced COVID-19 vaccine distribution during Albany County’s 45th week of coping with the pandemic.

Meanwhile the Centers for Disease Control and Prevention have sounded the alarm on the highly transmissible variant of COVID-19 first identified in the United Kingdom, hastening the urgency for vaccination distribution.

New York State, as of Wednesday morning, was up to 22 confirmed cases of B.1.1.7.

Governor Andrew Cuomo, at his Wednesday press conference, expressed support for President Joe Biden’s $1.9 trillion economic package that offers relief to local governments and to people and businesses hurt by the pandemic; that plan includes $400 billion to fight COVID-19 and speed vaccine distribution.

“It’s what the nation needs,” said Cuomo.

Since last Thursday, Albany County Executive Daniel McCoy has announced 24 new deaths from COVID-19. The county’s death toll now stands at 283.

On Tuesday, as the nation passed the grim milestone of 400,000 deaths from the disease, McCoy urged residents to join in “lighting candles and ringing bells in remembrance.”

While the county’s infection rate, as with the rest of the state, is leveling off after a post-holiday high, Albany County broke its record for hospitalizations several times this week.

As of Wednesday morning, 185 county residents were hospitalized with COVID-19, one fewer than the record-setting tally on Tuesday.

Throughout the week, among the state’s 10 regions, the Capital Region had the worst rate for available intensive-care-unit beds and had among the worst rates for available hospital beds.

As of Wednesday evening, the Capital Region had administered 78 percent of the 78,550 vaccine doses it has received, according to the state’s COVID-19 Vaccine Tracker. Statewide, 84 percent of doses have been administered.

A state vaccination site opened on Friday morning, Jan. 15, at the University at Albany’s uptown campus, one of 20 being opened throughout New York.

 

“Through the point of a needle”

Based on federal guidelines that the state is following, more than 7 million New Yorkers are now eligible for the COVID vaccine, but the state had been receiving only about 300,000 doses per week from the federal government.

This past week, New York received just 250,000 doses and Cuomo said on Wednesday that just 250,000 doses are expected in the upcoming week. Both the federal government and the state distribute doses based on population.

“At this rate of supply, it takes seven-and-a-half months to get enough vaccine for the currently eligible population,” Cuomo said on Wednesday.

New York, based on original guidance from the Centers for Disease Control and Prevention, had been giving vaccinations to residents in two tiers: 1a, largely for at-risk health-care workers and for residents of and workers at nursing homes, and 1b for essential workers and people aged 75 and older.

Last Tuesday, the CDC expanded eligibility to include people 65 and older, and people with underlying health conditions.

Sites that are faster giving vaccines will get more doses, Cuomo said on Friday. “Why? Because they get it out the door faster, and this is about getting needles in arms,” he said. “No one gets all they need.”

Cuomo was critical of the federal decision last week to add people 65 and older to the category of eligible vaccine recipients.

“What they did was like opening the floodgates of eligibility and you have a rush of 7 million people, ‘I want a vaccine. I want it now. I was told I’m eligible.’ And that entire flood has to go through a syringe,” said Cuomo. “All this volume and it has to go through the point of a needle literally and figuratively, that’s the situation that the federal government created.”

On Monday, Cuomo wrote a letter to the chief executive officer of Pfizer, Albert Bourla, asking for New York State to purchase vaccine doses directly from the company. Pfizer developed its vaccine with a German company, BioNTech.

In the letter, the governor points out that Pfizer is a New York company and that it did not participate in the federal Operation Warp Speed program. The other vaccine given emergency approval from the Food and Drug Administration, Moderna, was part of Warp Speed.

“Because you are not bound by commitments that Moderna made as part of Operation Warp Speed, I am requesting that the State of New York be permitted to directly purchase doses from you,” Cuomo wrote.

Cuomo said at his press conference on Wednesday he had learned that, by law, neither Pfizer nor Moderna could sell to a state because their emergency use authorization from the Food and Drug Administration does not allow them to sell to states or to private individuals.

Cuomo also wrote a letter on Monday to Alex Azar, the outgoing Secretary of Health and Human Services, blasting Azar for causing “damage, anxiety and confusion among the American public” by intimating vaccine doses that had been held in reserve — presumably for the required second shot — would be dispersed to states.

“You told reporters on January 12, 2021 that the federal government would increase the supply of vaccines by shipping ‘all of the doses that had been held in physical reserve’ when in reality, according to news reports, the federal government had already distributed all of those doses and supply would not be increasing,” Cuomo wrote.

Cuomo cited comments of outrage from six other Democratic governors and asked, “When were these additional doses released? Were you aware at the time you made these public comments that there were not additional doses in reserve? When will vaccine supply increase? Will the second doses we have been promised actually arrive? Why was New York's Week Six allocations cut at a time when we were promised an increased supply?”

New York State started vaccine distribution by naming a hospital to be a hub for each of the state’s 10 regions. Albany Medical Center is the hub for the Capital District, which serves eight counties including Albany.

Cuomo is continuing to push to get hospital workers vaccinated, both to keep hospital beds available and to prevent spread of the virus. He said on Monday that only 60 percent of doctors and nurses statewide have been vaccinated.

Albany Med, Saratoga Hospital, Glens Falls Hospital, Ellis Hospital, and St. Peter’s Hospital — all in the Capital Region — are among the health-care centers that have distributed 100 percent of allocated vaccine doses, meaning they administered all first-dose vaccines they have been given.

Approximately 81 percent of Albany Med’s and 85 percent of Glens Falls Hospital’s health-care workers have received the vaccine; according to a release from Albany Medical Center; the percentage of hospital workers who declined a vaccine in the Capital Region is 11.7 percent — the lowest rate in New York State.

On Friday, Cuomo outlined the expanding network for administering vaccinations. “We have about 5,000 pharmacies; about 194 hospitals; you have about 2,500 private doctor networks; city departments of health, county departments of health: 58, and then we have state mass vaccination sites, which were just very high-volume vaccination sites,” said Cuomo.

Also on Friday, the state launched a program to bring vaccination sites into places without doctor’s offices or pharmacies. “A health-care desert is a health-care desert because it doesn’t have traditional distribution. So we’re supplementing that …,” said Cuomo. “That’s public housing, churches, and community centers. We're setting up mass vaccination sites.”

Cuomo said that city and county health departments are to prioritize police, firefighters, and public-safety workers while hospitals prioritize nurses and doctors, and pharmacies and private practices focus on people 65 and older.

The state is still waiting for clear guidance and which categories of people are now eligible, under the federal expansion, for underlying health conditions, Cuomo said.

 

B.1.1.7

The Centers for Disease Control and Prevention on Friday sounded the alarm on the dangers of the B.1.1.7.

“Modeling data indicate that B.1.1.7 has the potential to increase the U.S. pandemic trajectory in the coming months,” said the CDC’s Morbidity and Mortality Weekly Report, issued on Jan. 15.

“The modeled trajectory of this variant in the U.S. exhibits rapid growth in early 2021, becoming the predominant variant in March,” says the CDC paper.

The report also said, “The increased transmissibility of the B.1.1.7 variant warrants universal and increased compliance with mitigation strategies, including distancing and masking. Higher vaccination coverage might need to be achieved to protect the public.”

While the variant does not produce different “clinical outcomes” — in other words, symptoms and severity of the disease are the same — B.1.1.7 has a higher rate of transmission, the report says.

The higher transmission “will lead to more cases, increasing the number of persons overall who need clinical care, exacerbating the burden on an already strained health care system, and resulting in more deaths,” the CDC report says.

The CDC calls for “strategic testing” of people without systems as well as for “rigorous implementation of public health strategies” to buy “critical time to increase vaccination coverage.”

The identified cases of B.1.1.7 are mounting quickly in New York State. New York’s first case was identified by Albany’s Wadsworth laboratory in December.

Friday, Cuomo said that another case had been confirmed in New York State, in Nassau County, bringing the state’s known total to 16.

On Sunday, Cuomo announced that, for the second day in a row, New York State has another case of B.1.1.7 — in Westchester County, bringing the state’s total of B.1.1.7 cases to 18.

On Wednesday, he announced four more cases — in Saratoga, Warren, and Suffolk counties — bringing the state’s total to 22.

“There’s a South African strain that may or may not be more lethal. There’s a Brazilian strain that may or may not be more lethal. We’re seeing the U.K. strain spread,” said Cuomo on Wednesday. “We have two more cases linked to the Saratoga Springs spread and two cases in Suffolk County. Wadsworth is testing, we have not found the South Africa strain, or the Brazilian strain, in New York. I believe it’s just a matter of time.”

On Wednesday evening, the CDC webpage tracking B.1.1.7 cases in the United States said New York had 17 cases and the nation had 144 — with the most in Florida, at 46, followed by California, at 40.

Earlier in the week, Cuomo had stressed, “Hospital capacity is still the red line, danger zone, shut-down mechanism in this entire situation. California is what we’re afraid of. Italy is what we’re afraid of. U.K. is what we're afraid of … If the hospitals are overwhelmed, you close down. Period. End of story. You close down, everyone closes down. Every restaurant. Every office. We go right back to full shutdown.”

He noted that hospital capacity depends both on the number of available beds and the staff to attend to the patients in those beds.

 

Teachers seek waiver

The New York State United Teachers, the state’s largest teachers’ union, on Monday called on the State Education Department to request a federal waiver of testing requirements in grades 3 through 8 and in high school.

Such a waiver was granted for the last school year.

“Throughout this school year there has not been a standardized mode of instruction across the state,” wrote Jolene DiBrango, NYSUT’s executive vice president, in a letter to Betty Rosa, the state’s action commissioner of education.

“Schools have varying degrees of in person, hybrid, and remote instruction. Without standardized instructional modes there should not be a standardized test at the end of the year,” DiBrango wrote.

She went on, “On top of this, teachers are trying to address the social emotional needs of students caused by the pandemic and racial unrest caused by the death of George Floyd.”

Further, the union is calling on the state to delay until the 2023-24 school year implementing the Next Generation Learning Standards, not giving the new tests based on those standards until the spring of 2024.

 

Erie County judge relaxes dining rules

Last Thursday, Kumiki Gibson, counsel to the governor, released a statement on Wednesday’s Supreme Court decision by Erie County Justice Henry J. Nowak, which allowed some restaurants in an orange zone to follow the less stringent indoor dining rules for yellow zones.

Cuomo had set up a micro-cluster system to tamp down on COVID-19 outbreaks. In yellow precautionary zones, indoor and outdoor dining are permitted with a maximum of four people per table.

In orange warning zones, only outdoor dining — with no more than four diners per table — along with take-out or delivery is permitted.

Across the state, all bars and restaurants must close by 10 p.m.

Most of Erie County has been an orange zone since Nov. 18.

“We are reviewing the decision,” Gibson said. “While that process is ongoing, to ensure uniformity and fairness, all restaurants operating in orange zones can now operate under rules governing yellow zones.

“We disagree with the court’s decision and its impact on public health as federal CDC data clearly demonstrates indoor dining increases COVID-19 spread. From the start of this pandemic, the state has acted based on facts and the advice of public health experts, and we will continue that approach.”

The Supreme Court is the lowest run in the state’s three-tiered system.

 

Newest numbers

On Wednesday morning, McCoy, in a release, announced four more COVID-19 deaths of Albany County residents: two men in their fifties, a man in his eighties, and a woman in her nineties.

As of Wednesday morning, Albany County has had 16,236 confirmed cases of COVID-19, including 173 announced on Wednesday.

Of the new cases, 117 did not have a clear source of infection identified, 39 had close contact with someone infected with the disease, and 15 are health-care workers or residents of congregate settings.

The five-day average for new daily positives has decreased to 201.6 from 225.4. There are now 1,748 active cases in the county, down from 1,796 on Tuesday.

The number of county residents under mandatory quarantine decreased to 2,792 from 2,842. So far, 48,497 residents have completed quarantine. Of those, 14,488 had tested positive and recovered. That is an increase of 215 recoveries since Tuesday.

There were 21 new hospitalizations overnight, and there are 185 county residents currently hospitalized from the virus with 14 in intensive-care units.

According to Cuomo’s Wednesday release, the Capital Region is tied with the Mohawk Valley for the worst rate of available hospital beds, at 25 percent. Currently 553 of the Capital Region’s hospital beds are filled with COVID-19 patients, which is 0.05 percent of the region’s population.

Statewide, 0.05 percent of New Yorkers are hospitalized with the virus, leaving 32 percent of the state’s hospital beds available.

The Capital Region continues to have the worst rate of available ICU beds at 19 percent. Currently 218 of the region’s 263 ICU beds are filled with COVID-19 patients.

Statewide, 26 percent of the ICU beds are available.

Three regions — the Mohawk Valley, Long Island, and the North Country — have a higher infection rate, as a seven-day average, than the Capital Region, at 7.08 percent.

Statewide, the infection rate is 6.27 percent.

As of Jan. 19, the most recent date reported on the state’s dashboard, Albany County had a seven-day rolling average of 6.3 percent for its infection rate.

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