ALBANY COUNTY — People living in nearly 7,000 group homes across New York state were at risk during the pandemic, according to an audit of the Office for People With Developmental Disabilities released this week by the state’s comptroller, Thomas DiNapoli.

From March 2020, when the pandemic started in New York state, to April 2022, OPWDD reported 657 people died from COVID-19, and more than 13,000 contracted the virus in its residential programs.

“Group homes are supposed to offer people with developmental disabilities safe places to live as independently as possible,” said DiNapoli in a statement as he released the audit. “Our audit found the Office for People With Developmental Disabilities did not issue timely, consistent guidance to the vast majority of their certified group homes. Inconsistent emergency management coordination and oversight put residents, families and staff in harm’s way. I urge OPWDD to implement our recommendations before the next public health emergency.”

The audit did not establish a causal relationship between OPWDD’s actions and COVID cases, but it found the office did not provide consistent guidance.

The office coordinates services for people with intellectual and developmental disabilities, known as IDD, a lifelong disability that involves limitations in learning, language, and behaviors.

People with IDD face “significant health issues that render them more vulnerable in an emergency,” the audit explains. They have a higher prevalence of comorbidities and are more susceptible to infection diseases like COVID-19, which is highly contagious.

Also, OPWDD clients often receive services as part of a group and their living situations can make social distancing difficult.

In the first three months of the pandemic, OPWDD reported a 15-percent death rate among its residential clients (400 deaths among 2,593 cases), which was nearly double the 8-percent rate for the state overall, according to the Centers for Disease Control and Prevention.

“OPWDD has the responsibility to protect this vulnerable population through proper emergency planning,” says the audit.

New York has 6,921 certified facilities run by not-for-profit organizations and just eight facilities run by the state. The not-for-profits take care of all but 1 percent of the state’s 34,117 group-home residents.

While OPWDD developed guidance to cover COVID-19 emergency planning and response, it was distributed only to the eight state-run facilities.

The audit found that, while many not-for-profit group homes had emergency response plans, they did not account for pandemics or emerging infectious diseases, while others referred staff to follow OPWDD’s guidance.

Among the 16 homes the auditors visited, seven were state-run and nine were operated by voluntary agencies. Only one of the 16 had expressly considered pandemics in its emergency plans.

The audit noted OPWDD’s stockpile of personal protective equipment was exhausted early in the pandemic, and group homes had trouble getting masks and gowns on their own due to overwhelming demand. Masks were crucial to stopping the spread of COVID-19 and especially important in group homes, where clients often have multiple medical issues and staff typically cannot socially distance when helping them bathe, dress, and eat.

The pandemic led to staff shortages at many group homes and, the audit says, 81 group homes were closed between March 2020, when the pandemic started, and November 2021. Also, employees would work across several homes or work longer-than-normal shifts, increasing fatigue and the risk of contracting COVID-19.

Every three years, group homes have to be recertified by OPWDD but, the audit says, inspectors did not review plans for infection-control practices or public health emergency response.

When OPWDD, in May 2020, began surveying group homes to better assess response to COVID-19, only 22 percent of homes were visited by inspectors, the audit says.

The surveys often lacked meaningful observations, the audit says, and staff at certified group homes were not required to take refresher courses on infection controls.

“For almost a year, OPWDD officials were uncooperative with the audit team — questioning OSC’s authority to conduct the audit, requesting initial data requests as unduly broad, and ultimately taking 8 months … to provide data and access to key personnel,” the audit says, noting this later improved.

The audit concludes with four recommendations:

— Review and update the Emergency Management Operations Protocol and supplemental documents to ensure all group homes implement current policies and procedures in the event of another public health emergency;

— Develop procedures to ensure that group homes’ emergency plans encompass planning for and responding to public health emergencies;

— Ensure that monitoring and review protocols address well-developed infection control practices and are consistently applied when conducting reviews at homes; and

— Establish effective communication with staff responsible for infection control policies and procedures when deficiencies are identified.

OPWDD agreed with some of the recommendations but expressed concern with the audit’s methodology.

In its response, OPWDD noted the “enormous challenges” COVID-19 posed for agencies across the nation. The office also noted “evolving guidance” from the CDC and other federal agencies, and said it was proud of the “extraordinary efforts of staff to keep people safe, often at risk to their own health and safety.”

Albany County COVID numbers

For the third week in a row, Albany County has been designated by the Centers for Disease Control and Prevention as having a “low” community level of COVID-19.

This follows two months of being labeled “medium,” which followed a month with a “high” designation after just two weeks at “low” preceded by a month of “medium” after 13 weeks of being labeled “high.”

This week, 58 of New York’s 62 counties are, like Albany, designated as having a “low” community level. Four counties in the Finger Lakes region are again labeled “medium”: Yates, Ontario, Seneca, and Wayne counties.

Nationwide, following a positive trend over the last two-and-a-half months, less than half of a percent —just 13 counties — are labeled “high.” Counties labeled “medium” are down from 9 percent last week to just 5.5 percent while those labeled “low” make up a whopping 96 percent.

The weekly metrics the CDC used to determine the current “low” level for Albany County are:

— Albany County now has a case rate of about 28 per 100,000 of population, down from 35 last week, 30 two weeks ago, 42 three weeks ago, and a steady decrease from 120 eleven weeks ago;

— For the important COVID hospital admission rate, Albany County has a rate of 6.2 per 100,000, up from 5.6 last week but down from 9.6 two weeks ago and dramatically down from more than triple that, 22.2, eleven weeks ago; and

— Albany County now has 2.9 percent of its staffed hospital beds filled with COVID patients, down from 4.3 last week, 5.1 two weeks ago, which had hovered near the same mark for about a month, down from the percentages for the previous ten weeks, which ranged from 6 to 8.

This week, Albany County’s 161st of dealing with COVID, numbers are continuing in the right direction with fewer new cases documented. The same is true statewide and nationwide.

Albany County’s dashboard, as of Tuesday, April 11, showed a death toll of 634, which was one more male, at 305, and the same number of females, at 329, as last week.

Also as of April 4, according to Albany County’s COVID dashboard, 11 patients were hospitalized with COVID, down from 16 last week, 22 two weeks ago, 26 three weeks ago, 30 four weeks ago and 31 patients the week before, which was down from 39 six weeks ago, near the same mark for a month but down from 42 ten weeks ago, 43 eleven weeks ago, and 46 twelve weeks ago.

In New York state, according to the health department’s most recent figures, for samples collected between March 12 and 25, the Omicron variant continued to make up 100 percent of new cases.

The Omicron sublineage XBB.1.5 dominates at 87 percent, up from 79 percent in the last fortnight, Feb. 26 and March 11, which had been increasing from 39 percent for the eight weeks prior; 8 percent were still XBB, while another 3 percent were BQ.1.1., down from 8 percent during the previous fortnight. The other sublineages made up less than 3 percent of new cases.

Nationwide, according to the CDC, from April 2 to 8, the XBB.1.5 sublineage made up 88 percent of new cases, the same as last week, which had been steadily rising from 49 percent eleven weeks ago.

This is followed by XBB.1.9.1, at 5 percent, the same as last week, XBB.1.5.1 still at 2 percent, and BQ.1.1, which made up 3 percent of new cases two weeks ago, at 1 percent.

Meanwhile, in our region, which includes New York, New Jersey, the Virgin Islands, and Puerto Rico, 90 percent of new cases are caused by the XBB.1.5 sublineage of Omicron; the percentage had grown steadily to 99 two weeks ago but has declined slightly from 91 last week and 94 percent two weeks ago.

Also in our region, XBB.1.9.1, is at 4 percent, up from 3 percent last week while XBB.1.5.1 continues at 3 percent of new cases followed by XBB at 2 percent.

Although figures on infection rates are no longer reliable since tracing and tracking systems have been disbanded, the state dashboard shows that cases in Albany County as well as statewide have continued to decline in recent weeks.

Three months ago, rates for both the state and county had jumped after having leveled off in November following two months of climbing.

Albany County, as a seven-day average, has 3.1 cases per 100,000 of population, down from 4.0 last week, 5.2 two weeks ago, 4.1 three weeks ago, 6.5 four weeks ago and 8.7 five weeks ago, which has been in a more or less steady decline from 12.4 thirteen weeks ago.

Numbers hovered between 8 and 11 before that, which was a fairly steady decrease from 21.8 cases per 100,000 thirty weeks ago.

This compares with 3.5 cases per 100,000 statewide, down from 4.4 last week,  5.1 two weeks ago, and markedly down over the last month-and-a-half in the twenties following a fairly steady decrease from 30.03 per 100,000 of population five months ago.

The lowest rates are in New York City at 2.7 per 100,000 or population.

The highest count is still in the Finger Lakes at 5.1 this week, which is down from last week’s 6.0 cases per 100,000 as a seven-day average, and further down from 8.3 two weeks ago for the Finger Lakes.

The numbers for vaccination in Albany County have hardly budged for several months. The state’s dashboard now reports on these two categories:

— People with a primary series, for those who have completed the recommended initial series of a given COVID-19 vaccine product — two doses of Pfizer or Moderna vaccine or one dose of Johnson & Johnson vaccine; and

— People who are up to date, for those who have completed all COVID-19 vaccinations, including the bivalent booster, as appropriate per age and clinical recommendations.

As of Tuesday, 21.9 percent percent of Albany County residents were up to date on vaccines, a gradual increase from 17.9 seventeen weeks ago, as opposed to the 61.5 percent of eligible residents who had received booster shots, as reported in prior weeks.

At the same time, 76.3 percent of county residents have completed a primary series, nearly the same as the last several months.

This compares with 76.6 percent of New Yorkers statewide completing a vaccination series, and 14.2 percent being up to date with vaccinations, up from 10.6 seventeen weeks ago.

New Yorkers are still being encouraged by the state’s health department to get bivalent COVID-19 vaccine boosters from Pfizer-BioNTech for anyone age 5 or older and from Moderna for those 6 or older.

To schedule an appointment for a booster, New Yorkers are to contact their local pharmacy, county health department, or healthcare provider; visit vaccines.gov; text their ZIP code to 438829, or call 1-800-232-0233 to find nearby locations.