Week CII: County looks at health equity in light of the pandemic

— Photo from Albany County Executive’s Office

“Most folks come to the clinic when they’ve exhausted all options, when they’re almost at the point of death, which is why we saw a higher number of deaths,” said Nosa Aigbe Lebarty, M.D.

ALBANY COUNTY — This week, as COVID-19 infection rates and hospitalizations continued to decline from the Omicron peak both statewide and in Albany County, the county’s executive, Daniel McCoy, hosted a forum to consider issues around Black health and equity.

At the same time, the governor and the state’s health commissioner backed off the mandate that health-care workers get booster shots by Monday since so many haven’t yet complied and the industry is already short-staffed.

And, a Siena poll released on Tuesday showed a strong majority of New Yorkers — 58 percent — favor Governor Kathy Hochul’s plan not to lift mask mandates at school until data is analyzed after students return from their mid-winter break in early March.


Health equity

McCoy opened his Feb. 21 Black History Month forum by saying he was proud that the county had brought COVID-19 testing into minority communities and also partnered with an ambulance company to bring vaccines to residents.

“Working together, we can solve anything,” he said.

According to the county’s records, a disproportionate number of white, rather than Black or Hispanic, residents died of COVID-19.

The United States Census Bureau reports that 75.8 percent of Albany County’s population is white, 14.1 percent is Black, and 6.3 percent is Hispanic.

Albany County has tracked COVID-19 cases, hospitalizations, and deaths, according to race among other factors. (Nearly a quarter of the cases are tallied as “unknown” when it comes to the patient’s race.)

As of Feb. 22, whites had 50.6 percent of the county’s reported COVID cases, 62.3 percent of its hospitalizations, and 80.3 percent of its deaths (423 dead). So, while fewer than the percentage of white population were hospitalized, a disproportionately higher number died of the disease.

Blacks had 12.2 percent of reported cases, 25 percent of the county’s hospitalizations, and 13.9 percent of its deaths (73 dead). So, the hospitalization rate for Black county residents was nearly double the population percentage while fewer than the population percentage died of the virus.

Hispanics had 6.4 percent of reported cases, 4.8 percent of hospitalizations, and 2.4 percent of the county’s COVID deaths (13 dead). So, many fewer Hispanic residents were hospitalized and died of the virus than the population percentage.

“It’s been difficult at times but we take pride in what we do,” said Nosa Aigbe Lebarty said at the start of Monday’s forum. He is one of two doctors who opened CentralMed Urgent Care on Central Avenue in Colonie in 2020 in the midst of the pandemic.

Lebarty, who was born and raised in Nigeria and has his medical degree from Poznan University School of Medical Sciences in Poland, is also the founder and president of Project Health Africa, which provides health-care supplies to Africa.

Simone Keisha Guest, a doctor of osteopathic medicine with St. Peter’s Health Partners Medical Associates, said that, during the pandemic, routine screenings — such as those for diabetes, heart disease, breast cancer, and colon cancer — have fallen off.

“The Black community has had a high incidence of these medical problems,” she said.

Both doctors spoke of the apprehension people had of seeking medical treatment during the pandemic.

“The offices are safe,” Guest stressed.

“We had to improvise,” said Lebarty. He said televisits and testing patients for COVID in their cars were some of the methods used to help people who were apprehensive.

He also said that he got vaccinated himself to show his patients that it was safe, and that he worked to counter the many myths around vaccination. “I did not die … It’s safe,” he would tell his patients.

“In our community, there’s definitely been vaccine hesitancy and that comes just from the country’s past and different dynamics and how minorities have been treated,” said Guest.

She has heard many times that the vaccination program is “some kind of social experiment,” Guest said, and countered, “Patients should really trust the science.”

Guest said there are programs in place to meet the needs of patients who are uninsured or under-insured although she conceded there are barriers besides finances, such as education and transportation issues.

“Most folks come to the clinic when they’ve exhausted all options, when they’re almost at the point of death,” said Lebarty, “which is why we saw a higher number of deaths.”

Citing the World Health Organization’s definition for health, Lebarty said it is “a state of physical, mental, and social well being.”

 Health equity, he said, is the process “whereby an individual, regardless of sex, race, sexual orientation, or disability, are able to achieve their highest health potential.”

As a nation, the United States falls short, said Lebarty, stating that the Black community was hardest hit by COVID “because of the health inequity we have in this country.”

Lebarty cited a Harvard Business Review article that reported 13 percent of the United States population is Black yet only 4 percent of its doctors and 7 percent of its medical students are Black.

The Harvard report notes that Black men have the lowest life expectancy of any demographic group in the nation, living an average of 4.5 fewer years than white men.

Research has found that physicians of color are more likely to treat minority patients and practice in underserved communities,” the report says. “And it has been argued that sharing a racial or cultural background with one’s doctor helps promote communication and trust.”

The article goes on to report on a California study, showing that Black men with Black doctors were more likely to take important preventative steps, such as screenings and vaccinations, than Black men with white doctors.

Lebarty also spoke of the price differences of drugs — insulin, for instance — in communities with different racial compositions.

“Education is pretty big,” said Guest in discussing equity. “We have to make sure patients are aware of what programs are available.”

She, too, said there is price-gouging with different pharmacies and different groups charging for insulin and other medications.

Like Lebarty, Guest said that establishing trust with patients is essential and stressed the importance of talking to them “to know what stands in their way,” and then letting them know what programs are in place for them to get the lab work, imaging, or medications they need.

“We have to be able to get to those patients who do not come to us,” said Lebarty.

“The pandemic has revolutionized how we can access our patients and how they can access us …,” said Guest. “We’ve seen where we’ve done televisits from almost Day One of the pandemic.”

For patients without access to a computer, she said, talking to them on the phone can also work although, she conceded, “Nothing beats the patients coming in.”

Lebarty concluded by saying, “When COVID is over, it’s time to double our efforts.”



Hochul has said she will consider lifting the school mask mandate after she reviews data in early March when students return to school from their mid-winter break. She had allowed the mask-or-vax rules for businesses to expire on Feb. 10.

Governors in nearby states have already announced plans to lift school mask mandates, including in Massachusetts and Connecticut on Feb. 28, in Rhode Island on March 4, in New Jersey on March 7, and in Delaware on March 31.

As of Tuesday, the Centers for Disease Control and Prevention listed 10 of New York’s 62 counties as having a “substantial” rate of community COVID transmission: Niagara, Orleans, and Monroe countries in Western New York, and Rockland, Westchester, Dutchess, Kings, Queens, Nassau, and Suffolk counties downstate.

New York’s other 52 counties, including Albany County, continue to have a “high” rate of transmission.

CDC guidance specifies that, in places with substantial and high rates of transmission, people should wear masks indoors in public regardless of vaccination status.

On Monday, the Siena Research Institute released a statewide poll showing 58 percent thought the state should wait for early March data before deciding whether to lift the school mask mandate, compared to 30 percent who say the school mask mandate should have ended already, and 10 percent who want to see it end after this week’s school break.

On New York’s indoor public mask mandate, a plurality, 45 percent, says the mandate should still be in place, compared to 31 percent who say it should have ended earlier than it did, and 20 percent who say it ended at the right time.

“Waiting to see data from early March before deciding to lift the school mask mandate — as opposed to lifting that mandate as schools reconvene next week or wishing it had been lifted previously — is how the majority of New Yorkers would like to proceed,” said Siena College pollster Steven Greenberg in a statement when the data was released. “The majority of virtually every demographic group agrees, though not Republicans and conservatives, who wish the mandate had ended already.

“While nearly two-thirds of voters without children at home support waiting for March data to decide on the school mask mandate, state and school officials face a ‘lose/lose’ proposition with their constituents most closely affected by this decision — regardless of the decision — since voters with children under 18 in their household are closely divided between waiting for data to decide and masks should have been off already,” Greenberg said.

“There is no clear consensus on mandating masks in indoor public spaces. Half of voters want the mandate finished — 20 percent said Feb. 10 was the right time to end it and 31 percent said it should have ended earlier,” Greenberg said. “Still, a plurality of voters, 45 percent, say the indoor mask mandate should remain in place.”


State funds to help mentally ill

Addiction and mental health problems have both surged during the pandemic.

On Friday, Hochul announced funding and plans that would address both issues.

She and New York City Mayor Eric Adams held a press conference at the Fulton Street subway station to announce their plans.

“We have a common objective: We have to bring this city, this state, back from this pandemic,” said Hochul.

She urged New Yorkers to join the 3 million who have gotten back on the subways — still only about half of the 6 million New Yorkers who rode the subways daily before the pandemic.

“We will accomplish what New Yorkers deserve, and that is a safe ride on our subway system, at the same time recognizing the very real humanitarian crisis that has been unfolding before our eyes for far too long,” said Hochul. “Individuals who deserve better as well.”

She went on to say that the state will use “involuntary commitment for the highest need individuals.”

Hochul called this long overdue. “People who are suffering from the extreme symptoms can be a danger to themselves and a danger to others,” she said.

“We see New Yorkers clearly suffering in plain sight,” Hochul said, calling it “a cry for help.”

The new multi-pronged plan includes $27.5 million a year for in-patient psychiatric beds, $9 million annually to recruit psychiatrists and psychiatric nurse practitioners; and $12.5 million a year for 500 more beds to house homeless people in their communities.

Current Medicaid reimbursement for psychiatric beds is lower than for medical or surgical beds so the plan would increase Medicaid by 20 percent for psychiatric beds.

“You can have all the beds you want, but if they’re not staffed by professionals, it serves no purpose,” said Hochul, touting her $10 billion plan to shore up New York’s healthcare workforce.

She also said $10 million is “on the table for recruitment and retention” of psychiatrists and psychiatric nurses, including $150,000 for student loan forgiveness.

The 500 supportive housing beds are to get homeless people off the streets and out of subways and shelters into stable housing. 

The governor is planning Safe Options Support teams to start functioning in the spring to complement the 10,000 units of supportive housing she announced in her $25 billion housing plan. The 20 new SOS teams are to be made up of eight to 10 mental-health specialists to work one-on-one with homeless people.


Federal funds for addiction treatment

Up to $1.5 million in federal funding under the Substance Abuse Prevention and Treatment Block Grant will be used to allow providers to expand telehealth services for addiction treatment.

These are services where patients talk to their healthcare providers through computer screens or smartphones.

The COVID-19 pandemic accelerated the adoption of telehealth services throughout the state, which has made it easier for people to access the care that they need without traveling to a doctor’s office, according to a release from the governor’s office. This has been especially important in addiction treatment settings, which often require continuous, uninterrupted care.

This funding will help support providers who face challenges in meeting the increased demand for telehealth services and will further expand access to important resources across the state.

Each provider can receive up to $15,000 through this initiative. The application deadline is March 11.

Last June, Albany County Executive McCoy said of the pandemic, “One of the things hit the hardest …. was people with addiction.”

Halfway through 2021, there had been 37 confirmed opioid deaths in Albany County with another 13 suspected cases awaiting toxicology reports, which McCoy termed “alarming.” Fentanyl, he said, was present in 89 percent of the deaths.

He noted that in 2020, with the economic shutdown, Albany County suffered 99 opioid deaths, up from 62 in 2019 and 50 in 2017.

“We’ve gone backwards,” said McCoy, stating “Our opiate task force will be regrouping at the end of the month.”


Albany County

This week, Albany County’s 102nd of coping with the coronavirus, one resident — a woman in her fifties — died of COVID-19, bringing the county’s death toll from the virus to 527.

The county’s numbers of new cases and of hospitalizations also continued to decline from the Omicron peak. In his Wednesday morning COVID release, McCoy reported 53 new cases of the coronavirus.

The county’s seven-day average of new daily positive cases is now down to 58.2. Albany County’s most recent seven-day average of cases per 100,000 is down to 16.8 and its infection rate is 3.4 percent.

Statewide, also as a seven-day average, the cases per 100,000 of population are down to 15.1 and the infection rate is 2.1 percent, according to the state tracker.

On Wednesday morning, McCoy reported five new hospitalizations since Tuesday and there are now 29 county residents hospitalized with the coronavirus — a net decrease of one. Of those hospital patients, three are currently in intensive-care units, down from four on Tuesday.

As of Tuesday, 81.0 percent of all Albany County residents have received at least a first dose of vaccine, and 73.6 percent are now fully vaccinated. The first-dose vaccination rate for county residents 18 and older is 89.5 percent.

Statewide, 88.6 percent of New Yorkers have received at least one dose as have 95.0 percent of New Yorkers 18 and older, according to the state vaccine tracker; also, 75.2 percent of New Yorkers are fully vaccinated as are 85.4 percent of New Yorkers 18 and older.

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