Week CLXV — WHO: ‘Time to transition to long-term management of the COVID-19 pandemic’

— Graph from from NYSOSC
Even before the pandemic, there was a disparity between the number of registered nurses in New York City and in the rest of the state.

ALBANY COUNTY — The pandemic — or at least the government declarations of emergency it engendered — is ending not with a bang but a whimper.

In June 2021, fireworks lit the sky at the Empire State Plaza in Albany the day then-Governor Andrew Cuomo announced COVID-19 restrictions were lifted.

New Yorkers had met the mark he had set earlier of 70 percent of adults being vaccinated. “You know who beat COVID? The people of New York beat COVID. The courage of New Yorkers beat COVID. The individual strength beat COVID,” said Cuomo at the time.

Despite the bang of fireworks, COVID, of course, had not ended. The virus evolved and the Delta surge followed, and after that came the giant Omicron surge.

But gradually, as mask requirements and travel restrictions were lifted, and as more people got shots with a vaccine tailored to current strains, life began to return to normal.

We’ve seen it locally as last week the Guilderland library director told us foot traffic is back to 95 percent of pre-COVID levels. “Story times are full … A lot of the kids’ events are full ….,” he said. “Patrons seem to have overcome their fears.”

And this week we have a letter — responding to one last week lamenting the end of an old-fashioned celebration of our common heritage: sit-down church and firehouse meals — inviting everyone to “an eat-in breakfast with shared tables” as the North Bethlehem volunteers celebrate 75 years of fighting fires.

On Friday, more than three years after the World Health Organization declared a public health emergency of international concern, it said COVID-19 no longer qualifies as a global emergency although thousands are still dying weekly from the virus and millions are suffering long-term effects.

“The WHO Director-General concurs with the advice offered by the Committee regarding the ongoing COVID-19 pandemic,” said a statement released by the Emergency Committee. “He determines that COVID-19 is now an established and ongoing health issue which no longer constitutes a public health emergency of international concern (PHEIC).”

 While acknowledging the remaining uncertainties posed by potential evolution of the virus, the committee advised that “it is time to transition to long-term management of the COVID-19 pandemic.”

The director-general, Tedros Adhanom Ghebreyesus, made seven recommendations, that countries: prepare for future events; integrate COVID-19 vaccination into regular programs; maintain reporting and surveillance systems; prepare for medical countermeasures; “continue to work with communities and their leaders to achieve strong, resilient, and inclusive risk communications and community engagement”; lift COVID-19 international travel-related health measures based on risk assessments; and continue to support research to improve vaccines, to understand the full impact and evolution of the virus, and to develop relevant integrated care pathways.


State disaster emergency

Meanwhile, today, May 11, the COVID-19 public health emergency declared by the Trump administration in 2020 — and extended several times since — is ending .

But on May 9, New York’s governor issued an order declaring a state disaster emergency.

In last week’s COVID roundup, The Enterprise detailed at length what is changing for United States residents with the end of the public health emergency.

Besides changes in domestic policies, a wave of asylum seekers is expected as Title 42 expires along with the public health emergency.

In January, the White House said, “The end of the public health emergency will end the Title 42 policy at the border. While the Administration has attempted to terminate the Title 42 policy and continues to support an orderly lifting of those restrictions, Title 42 remains in place because of orders issued by the Supreme Court and a district court in Louisiana.”

The White House statement went on, about the Biden administration, “The number of migrants crossing the border has been cut in half, approximately, since the Administration put in place a plan in early January to deter irregular migration from Venezuela, Cuba, Nicaragua, and Haiti. The Administration supports an orderly, predictable wind-down of Title 42, with sufficient time to put alternative policies in place.”

On Tuesday, Governor Kathy Hochul issued an Executive Order to help provide aid to asylum seekers expected to arrive in New York as federal Title 42 immigration policy ends.

She declared a state disaster emergency as of May 9, in effect through June 8, for the entire state.

Her order “will provide the State with greater flexibility to procure the resources necessary for municipalities to support asylum seekers while also allowing the State to increase the number of National Guard service members providing logistical and operational support,” according to a release from the governor’s office.

The order says that New York City alone is currently providing temporary housing for 36,738 migrants from the southern border, a number that has increased by 12,279 since January and an additional 1,578 in just the last week.

“The arrival of increased numbers of migrants seeking shelter in the City and State of New York  is expected to exacerbate an already large-scale humanitarian crisis and create a disaster emergency to which local governments are unable to adequately respond, creating a threat to health and safety, which could result in the loss of life or property,” the executive order states.

The order will allow New York state to mobilize an additional 500 members of the National Guard, who are currently providing support at the Port Authority and shelter sites, bringing the total mobilization to approximately 1,500 service members, the release said. It will also allow the state and localities to “quickly purchase necessary supplies and resources, including food and equipment.”


Nurse shortage

A report released this week by the state’s comptroller, Thomas DiNapoli, says the pandemic worsened a nursing shortage in New York City hospitals and health facilities, leading to an increased reliance on temporary nurses and higher staffing costs.

“The COVID-19 pandemic put stress on the health care workforce across the United States, particularly in New York City, the initial epicenter of the pandemic,” the report says. “While nurse staffing shortages are not a new problem, the issue was greatly amplified by the pandemic. This resulted in high turnover and employee burnout, increasing reliance on temporary staff to handle demand and driving up the cost of labor, and increased competition for nurses.

“In addition, faculty shortages at nursing schools across the country are limiting the number of available nursing candidates. New York City Health + Hospitals (H+H) was hard hit by these challenges, with a decline of nurses critical to H+H’s mission to provide quality care to City residents. To manage staffing pressures and service demand, H+H has continued to rely on temporary staff.”

Between February 2020 and September 2022, temporary staffing at H+H grew by 83 percent to offset the loss of staff nurses while managing demand. This resulted in unexpected costs of $125 million in 2023, which the State Comptroller’s office anticipates will remain elevated through at least 2024.

“For many NYC residents, NYC Health + Hospitals is a lifeline to quality health care, but it is a public health system struggling to get fully back on its feet after the stress of the pandemic,” DiNapoli said in a statement, releasing the report. “Hospitals and their staff were pushed to the brink during the pandemic. H+H lost hundreds of nurses, forcing them to hire temporary staff to manage demand due to the pandemic and its fallout, which increased salary costs and created training and other challenges.”

At H+H facilities, the number of registered nurses declined by 6 percent and the number of licensed practical nurses declined by 31 percent from February 2020 to September 2022. As the pandemic persisted, RN staffing levels in H+H facilities declined at a greater rate than they did in the city overall and statewide.

Between 2019 and 2022, RN employment also declined in New York City by 1.1 percent and in the rest of the state by 5.3 percent. Currently, H+H’s vacancy rate for nurses is 15 percent.

Hiring temporary staff to deal with the pandemic and its fallout on hospital staff is driving up hospital costs across New York City, including at H+H. It is estimated that in New York, contract labor costs across health-care systems and hospitals have increased by more than 110 percent of pre-pandemic levels, with average temporary nurse salaries increasing from about $1,800 per week pre-pandemic to about $3,300 per week in March 2022.


Sales tax collections up

Local government sales-tax collections in New York state totaled $5.5 billion in January through March of 2023, an increase of 7.1 percent, or nearly $369 million, compared to the same quarter last year, according to a report released by DiNapoli.

“Sales tax collections were quite strong in the first quarter,” he said in a statement, releasing his report. “New York City’s ongoing recovery from the pandemic, as well as high inflation, continues to bolster statewide numbers. For the rest of the state, collections growth has generally returned to the rates seen before the pandemic.”

Albany County saw a 9.9-percent increase for the first quarter of 2023 compared to the first quarter of 2022, going from $79 million last year to $87 million this year.

The county saw its biggest hike in February — a whopping 49-percent increase — going from $18 million last February to $26 million this February.

The jump for January was 12 percent, from $27 million in 2022 to $30 million in 2023.

For March, there was a decrease of 12 percent from $34 million in 2022 to $30 million in 2023.

“Albany County would have seen almost no growth at all were it not for the addition of nearly $7.8 million in technical adjustments,” the report says.

It explains, “Tax and Finance regularly makes prior period corrections and late filing changes – referred to in our reports as ‘technical adjustments’ — to correct for earlier sales tax distribution inaccuracies.”

On a monthly basis, statewide sales tax collections increased by 9.2 percent in January and 14.1 percent in February, but the growth slowed to 0.3 percent in March.

Fifty out of 57 counties experienced year-over-year sales tax increases during the quarter, with some seeing double-digit growth. Schuyler County had the strongest growth at 11.7 percent, while Dutchess County experienced the steepest decline at 7.4 percent.

Fourteen of the 18 cities outside of New York City that impose their own sales tax instead of receiving a portion of county collections also experienced growth in the period. Saratoga Springs led the way with 13.4 percent growth, while Auburn experienced the steepest drop at 4.8 percent.


Albany County COVID numbers

For the third week in a row, the entire state of New York is colored green by the Centers for Disease Control and Prevention, meaning that all 62 counties have a “low” community level of COVID-19.

It’s the seventh week in a row that Albany County has been so designated.

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.”

Nationwide, following a positive trend over the last three months, under half of a percent — just 15 counties — are labeled “high.” Less than 1 percent of counties are labeled “medium,” while those labeled “low” make up a whopping 99 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 13 per 100,000 of population, down from 20 last week, a nearly steady decrease from 120 fifteen weeks ago;

— For the important COVID hospital admission rate, Albany County has a rate of 6.4 per 100,000, up from 5.8 last week, 4.6 two weeks ago, 4.4 three weeks ago, 6.2 four weeks ago, and 5.6 five weeks ago, but down from 9.6 six weeks ago and dramatically down from 22.2 fifteen weeks ago; and

— Albany County now has 2.5 percent of its staffed hospital beds filled with COVID patients, down from 2.8 last week, 3.1 two weeks ago but up slightly from 2.4 three weeks ago although down a bit from 2.9 four weeks ago, and also down from 4.3 five weeks ago, 5.1 six weeks ago, which had hovered near the same mark for about a month, down from the percentages for the previous thirteen weeks, which ranged from 6 to 8.

This week, Albany County’s 165th 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, May 9, showed a death toll of 635, the same as for the last two weeks, with 305 males and 330 females dying of COVID-related causes since the start of the pandemic.

Also as of May 9, according to Albany County’s COVID dashboard, 12 patients were hospitalized with COVID, the same as last week, which is one more than the previous two weeks, but down from 16 five weeks ago, 22 six weeks ago, 26 seven weeks ago, 30 eight weeks ago and 31 patients the week before, which was down from 39 ten weeks ago, near the same mark for a month but steadily down from 46 sixteen weeks ago.

In New York state, according to the health department’s most recent figures, from April 9 to 22, the Omicron variant continued to make up 100 percent of new cases.

The Omicron sublineage XBB.1.5 dominates at 56 percent, in decline since March 12 to 25, when it made up 87 percent of new cases, which before that had been increasing steadily from 39 percent for the twelve weeks prior.

The next most frequent sublineage is XBB at 13 percent, which peaked at 19 percent a fortnight ago. That is followed by XBB.1.16 and XBB.1.9, each making up about 11 percent of new cases.

BA.2 makes up 9 percent of new cases while BA.2, BA.5, BQ.1, and BQ.1.1 are now reported at zero.

Nationwide, according to the CDC, from April 23 to 29, the XBB.1.5 sublineage still dominates at 67 percent of new cases. But its percentage is declining since peaking at 88 percent five weeks ago after steadily rising from 49 percent fifteen weeks ago.

This is followed by XBB.1.16, a newcomer four weeks ago, now at 13 percent, still rising; XBB.1.9.1, still at 9 percent, up from 5 percent five weeks ago; and XBB.1.9.2, a newcomer last week, still at 4 percent of new cases.

XBB.2.3 is next at 3 percent followed by XBB.1.5.1 at 2 percent and finally FD.2 at 2 percent.

Meanwhile, in our region, which includes New York, New Jersey, the Virgin Islands, and Puerto Rico, 66 percent of new cases are caused by the XBB.1.5 sublineage of Omicron; the percentage had grown steadily to 99 percent six weeks ago but then began declining.

Also in our region, XBB.1.16 still makes up 13 percent of new cases followed by XBB.1.9.1, at 10 percent, which was 3 percent five weeks ago.

Next in our region is XBB.1.9.2 still at 4 percent of new cases followed by XBB.2.3 at 4 percent and XBB.1.5.1 at 3 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 February, 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, now has 2.0 cases per 100,000 of population, up slightly from 1.9 last week, but down from 3.2 two weeks ago, the same as 2.0 three weeks ago, which has been in a more or less steady decline from 12.4 seventeen weeks ago.

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

This compares with 2.5 cases per 100,000 statewide, the same as last week, 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 rate continues to be in Central New York at 1.6 per 100,000 of population, up from 1.3 last week.

Two regions have the same highest rate at 3.0: Long Island and Mid-Hudson, which was the highest last week at 4.1 cases per 100,000.

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, 22.3 percent percent of Albany County residents were up to date on vaccines, a gradual increase from 17.9 twenty-one 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, 76.4 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 14.5 percent being up to date with vaccinations, up from 10.6 twenty-one 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.

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