ALBANY COUNTY — In a week when 36 states are seeing an increase in COVID-19 infection rates, New York, once the epicenter of the disease, continues to have relatively low numbers of infections, hospitalizations, and deaths.

Governor Andrew Cuomo on Tuesday added to the list of states — now at 19 — from which travelers have to self-quarantine on arrival in New York. He also set up a task force to help local governments enforce protocols for social distancing and mask-wearing.

While Cuomo had earlier kept large indoor malls across the state shut because of concerns that air-conditioning systems spread COVID-19, he announced on Wednesday that malls can open Friday in regions, like the Capital Region, that have entered the fourth and final phase of reopening if those malls have installed the proper filtration system.

Systems are required to include filters with a Minimum Efficiency Reporting Value — or MERV — rating to filter out the coronavirus. Ventilation protocols include increased outdoor air, reduced air circulation, longer system run times, and frequent filter checks.

Following the governor’s announcement, Pyramid Management Group, which owns Crossgates Mall in Guilderland, announced it would open its malls across the state on Friday.

On Monday, the state’s Department of Health released a report that analyzed nursing-home deaths from COVID-19 across New York and attributed the deaths largely to a quarter of nursing-home workers being infected with the disease.

Also on Monday, Cuomo had announced the state fair in Syracuse has been canceled. On Wednesday, he said all county fairs would be canceled, too. The Altamont Fair, which serves Albany, Schenectady, and Greene counties, had already announced its closing last month.

Also on Wednesday, Cuomo sparred with President Donald Trump who has called for schools across the nation to reopen in the fall.

Opening schools

“School reopenings are a state decision, period,” said Cuomo at his Wednesday press briefing. “That is the law, and that is the way we’re going to proceed. It’s not up to the president of the United States.”

Cuomo likened it to Trump’s earlier declaration, which he later walked back, that he could reopen the nation’s economy.

 “And this is a redux because he poses a false choice, and that he’s posed the false choice that is one of the reasons this nation is now in the situation that it’s in,” said Cuomo.

While Cuomo said that the economy cannot fully reopen until schools do, he also said, “It was never a choice between reopen the economy or have more Americans die …  And the states that made that choice are the states that are now suffering. It was, ‘Of course reopen. But reopen the economy and be smart about the way you re-opening.’”

The governor said, “We will open the schools if it is safe to open the schools. Everybody wants the schools open — everybody,” said Cuomo, adding, “I am not going to ask anyone to put their child in a situation that I would not put my child in, and that’s how I make these decisions …,” he said. “So, we’ll get the data and we’ll make that decision in August.”

Cuomo had earlier required the more than 700 school districts in New York to each come up with a reopening plan. He said on Wednesday that the state will decide during the first week of August whether schools will reopen in the fall. Plans to reopen schools are due on July 31.

Cuomo also said on Wednesday, “Schools are important, not just for education, socialization of young people; we don’t even know what this means to have kids who are out of school for this period of time.”

Republican members of the New York State Assembly sent a letter on Tuesday addressed to Cuomo, the state’s health and education commissioners, and the Regents chancellor, calling for New York schools to open in the fall.

“Governor, from day one you have emphasized that facts matter. In an open memorandum by the American Academy of Pediatrics, which represents over 67,000 pediatricians, they rightfully urge states to provide in-person instruction this fall and emphasize the importance of doing so,” the letter states.

The letter goes on to outline protocols from the academy for reopening safely, such as wearing masks and placing desks six feet apart.

“Part of what makes our schools a nurturing experience for children are the social skills they develop, the mentors they find in teachers, and the camaraderie they experience from being in a safe, secure setting,” says the letter from the GOP assembly members. “It may be an unfortunate reality, but for many children, schools are a safe haven that provide safety, food, and shelter for a majority of each day.”

On Wednesday, Regents Chancellor Betty Rosa and Interim Education Commissioner Shannon Tahoe issued a statement, saying, “The rhetoric from Washington, D.C. calling on schools to be fully open with in-person classes this fall regardless of the status of the COVID-19 pandemic is a callous disregard for human health and safety, and puts the lives of those we have worked tirelessly to protect in jeopardy. Any decision on the reopening of school buildings should be made based on the best science, data, and guidance available from state and federal health professionals.” 

Their statement continued, “The coronavirus pandemic has laid bare longstanding, deeply embedded societal inequities. Simply put, COVID has had a disproportionately harmful impact on people of color and those that are economically disadvantaged, in terms of health, employment, and the ability to receive a meaningful education. This systemic injustice only strengthens our resolve to ensure educational equity for all students.”

Also on Wednesday, New York State United Teachers President Andy Pallotta released a statement, saying, “Health and safety of students, families, educators and other school staff, and equitable access to a high-quality education must be the top priorities in reopening schools. The federal government’s demands that schools reopen without concern for health, safety, and equity are simply out of touch.

“Thankfully here in New York, we know the governor, the Regents, and fellow education stakeholders are taking this seriously. Our work with them continues … .”

Pallotta went on to say that the intricate details of reopening may be complex and differ from school district to school district, but listed six points that need to be addressed: schools need to have adequate personal protective equipment for students and staff, cleaning protocols must be in place, six feet of social distancing must be maintained inside buildings, students and staff at high risk must have limited exposure, schools must have mental-health services to deal with the effects of the pandemic, and there must be equitable access to a well-rounded education for every student.

“We need two things to make all of this a reality,” said Pallotts. “First, parents and school staff must have a seat at the table locally to work out the details that are best for their communities. Second, we need the federal and state funding that absolutely will be necessary to do this safely and equitably. This isn’t a matter of whether we can do this right. We must.”

Nursing-home deaths

The majority of Albany County’s 121 COVID-19 deaths were of nursing-home residents.

Cuomo has come under widespread criticism for his March 25 executive order that allowed COVID-19 patients in nursing homes. Cuomo later required nursing-home residents who were sick with COVID-19 to remain in hospitals until they tested negative for the disease. At the same time, he required nursing-home workers to be tested for COVId-19 twice weekly, and then, later, once a week.

The July 6 report, “Factors Associated with Nursing Home Infections and Fatalities in New York State During the COVID-19 Global Health Crisis,” based on an analysis by the New York State Department of Health, says that the primary cause of the spike of COVID-19 cases in nursing homes was due to workers being infected.

The report says that one in four nursing-home workers were infected and also that visitors to the nursing homes, before a March 13 executive order forbade visitors, could also have unwittingly spread the disease.

The analysis, based on nursing-home reports, summarizes these findings:

— The timing of staff infections correlates with the timing of peak nursing home resident mortality across the state;

— Nursing home employee infections were related to the most impacted regions in the state;

— Peak nursing home admissions occurred a week after peak nursing-home mortality, therefore illustrating that nursing-home admissions from hospitals were not a driver of nursing-home infections or fatalities;

— Most patients admitted to nursing homes from hospitals were no longer contagious when admitted and therefore were not a source of infection; and,

— Nursing-home quality was not a factor in nursing-home fatalities.

“According to data submitted by nursing homes, in many cases under the penalty of perjury, approximately 37,500 nursing home staff members — one in four of the state’s approximately 158,000 nursing home workers — were infected with COVID-19 between March and early June 2020,” the reports says.

“Of the 37,500 nursing home staff infected, nearly 7,000 of them were working in facilities in the month of March; during the same period, more than a third of the state’s nursing home facilities had residents ill with the virus.,” the report says. “Roughly 20,000 infected nursing home workers were known to be COVID-positive by the end of the month of April. These workforce infections are reflective of the larger geographic impact of the virus’s presence across the state.”

On Monday, after the report was released, Stephen Hanse, president and chief executive officer of the New York State Health Facilities Association and the New York State Center for Assisted Living, a state-wide association representing over 450 nursing homes and assisted living facilities, responded, “At the onset of the COVID-19 virus, nursing homes and assisted-living facilities were not the top priority. The principal focus of policymakers was on bolstering hospital resources and ramping up hospital bed capacity. This strategy included the Department of Health’s March 25th advisory.

“As we learn more about the COVID-19 virus every day, policymakers now know that the men and women residing in nursing homes and assisted-living facilities are the most at risk to infection from the COVID-19 virus,” Hanse said in a statement, and went on to call for support from elected officials, including an end to Medicaid cuts.

On Tuesday, Assemblyman Chris Tague, a Republican from Schoharie, called for an independent investigation. “Once again the governor has avoided real accountability by declaring himself innocent after investigating himself,” said Tague.

On Wednesday, the Empire Center, a fiscally conservative independent government watchdog group, said the report ducked important questions. “Most glaringly,” wrote Bill Hammond from the Empire Center, “it relies on the Cuomo administration’s low-ball estimate of nursing home deaths, which excludes residents who were transferred to hospitals before passing away. No serious study of the pandemic would start by ignoring what could be thousands of victims.”

Hammond concedes, “Assuming the accuracy of that information, which is based on reporting by the homes, there is a plausible case that infections dating back to March, unwittingly introduced by staff and possibly visitors, account for the bulk of the spiking death toll in April.” But he raises doubts about the report’s conclusion that the March 25 order “could not be the driver of nursing home infections or fatalities.”

Hammond notes that the report finds that 24 to 29 percent of workers were infected, which is roughly double the Cuomo administration’s estimated rate for the state as a whole, and asks, “Did the homes themselves become vectors of infection? Given the fragile people in their care, how can they do a better job of infection control in the future?”

While he concludes that the health department’s first duty is to protect the public’s health, not the governor’s reputation, Hammond also notes, “Some of Governor Cuomo’s harshest critics have portrayed the March 25 order as the sole or dominant cause of coronavirus deaths in nursing homes, and it’s fair for the Health Department to rebut that argument.”

Hammond also notes that the order was made during a crisis when the fear was that hospitals would be overwhelmed with critically ill patients: “Only in hindsight is it clear that pushing people out of hospitals was not as necessary as officials believed.”

Travel

On Tuesday morning, in the midst of the county’s COVID-19 press briefing as the health commissioner was reading a list of states from which travelers must quarantine, Albany County Executive Daniel McCoy received a text that the governor had added three more states to the list.

Such is the ever-evolving nature of government regulations attempting to contain the coronavirus.

As COVID-19 spikes in other states, New York, along with New Jersey and Connecticut, have been requiring people traveling from those states to self-quarantine for 14 days on arrival here.

“Our entire response to this pandemic has been by the numbers, and we’ve set metrics for community spread just as we set metrics for everything,” Cuomo said in announcing that Delaware, Kansas, and Oklahoma are added to the list.

Cuomo went on, “New Yorkers did the impossible — we went from the worst infection rate in the United States to one of the best — and the last thing we need is to see another spike of COVID-19.”

The quarantine applies to anyone arriving from a state with a positive test rate higher than 10 per 100,000 residents over a seven-day rolling average or a state with a 10 percent or higher positivity rate over a seven-day rolling average.

There are now 19 states on a list that started two weeks ago with eight. Those states are: Alabama, Arkansas, Arizona, California, Delaware, Florida, Georgia, Iowa, Idaho, Kansas, Louisiana, Mississippi, North Carolina, Nevada, Oklahoma, South Carolina, Tennessee, Texas, and Utah.

On July 2, Albany County Health Commissioner Elizabeth Whalen had said, “We’ve already seen … cases coming into the Albany airport on the 25th and 26th of June and are now testing positive in Warren County. We can see evidence of cases being imported from these high-risk states so don’t travel there unless you need to.”

If someone travels to one of the high-risk states for a holiday, as opposed to essential travel, Whalen said, “You will not be given paid sick leave for a quarantine.”

While traffic at Albany International Airport dropped by nearly 95 percent in April, McCoy said on Thursday that he had recently spoken to Phil Calderone, the airport’s chief executive officer, who expected by August that 80 percent of flights would be restored.

Albany International Airport received a Department of Transportation grant totaling $4,150,000 through the CARES (Coronavirus Aid, Relief, and Economic Security) Act, which will be used to replace passenger boarding bridges to maintain the efficient movement of passengers at the airport.

Referring to the self-quarantine directive, McCoy said, “Now this will put a damper on aviation.”

Travelers arriving at Albany International Airport from targeted states are given a copy of the state’s COVID-19 Travel Advisory and the state’s Traveler Health Form, which they are asked to complete.

The form asks for the names and addresses of those arriving; whether they have traveled to states designated as having a significant community spread of COVID-19; if they have experienced fever, chills, cough or difficulty breathing; and their final destination in New York State.

“We’re going to track you down and make sure you’re identified,” McCoy said.

On the heels of the Fourth of July weekend, Whalen said the county has been receiving complaints of residents who are returning from visits to listed states. Whalen urged those residents to contact the health department, to follow the 14-day required quarantine, and to get tested.

McCoy also urged testing and noted that if residents do not have health insurance, the county will pay for COVID-19 diagnostic testing. Testing sites are listed on the county’s website.

McCoy said that “winter people” are now driving back from Florida and have to quarantine. “They owe it to the residents,” he said, urging, “Do the right thing when you come back.”

As of Wednesday morning, Albany County has 1,955 confirmed cases of COVID-19 with 281 residents under quarantine. The five-day average for new daily positive cases is now 7.2.

Currently, Albany County has 52 active cases of COVID-19. So far, 5,894 county residents have completed quarantine, with 1,903 of them having tested positive and recovered.

Two Albany County residents are hospitalized with COVID-19 and the hospitalization is at 0.1 percent.

There have been no new COVID-19 deaths reported since June 24, keeping the death toll for Albany County at 121.

While Whalen called the numbers encouraging and commended residents for wearing masks, washing hands, and maintaining social distance, she said, “I offer a warning that that work can be undone very quickly. We have seen exponential growth, starting from small numbers of cases in other states. And we don’t want to go there.”

Restaurants

On Friday, COVID-19 outbreaks at two restaurants in Albany County were announced by the county.

Delmonico’s on Central Avenue in Albany had three employees who tested positive for the virus, two from Schenectady County and one who lives in Albany County.

McCoy said on Tuesday that 63 Delmonic’s employees had been tested and five of the tests came back positive; two were for Albany County residents. “That’s on top of the three individuals that were identified last week,” he said.

Philly Bar and Lounge at 622 Watervliet-Shaker Road in Latham initially had three employees who tested positive for the virus, two from Albany County and one who lives in Rensselaer County.

Thirty-five Philly’s employees were then tested and four of the tests came back positive; three were Albany County residents, McCoy said. He noted that is in addition to the original three.

Most of the restaurant workers were in the 20-to-29 age group, McCoy said, warning, as he often has, that people with COVID-19 in that age group frequently have mild symptoms or no symptoms and so can unwittingly spread the disease.

Currently, the 20-to-29 age group has more cases than any other age decade in the county: 352.

“The concern again is that you can unknowingly transmit this infection to someone who could suffer much more severe consequences,” said Whalen  “We want to keep our numbers low. We want to keep our hospitals open to the public that needs them for other reasons. And we want to keep open.”

Whalen said that the owners of both Delmonico’s and Philly had been compliant. 

She made an appeal to all restaurant owners: “Mask-wearing is essential,” she said.

Whalen said the complaint hotline transmits many messages on masks being worn improperly. A mask, to be effective, must cover both mouth and nose.

“To have your nose hanging out is not wearing a mask. To have it under your chin is not wearing a mask,” said Whalen, noting she has seen this in restaurants herself.

She urged owners and managers to monitor their staff.

Whalen said she had recommended to the state’s health department that both Delmonico’s and Philly be closed for two weeks.

“We think the risk to customers was very low,” said Whalen. To spread the disease, “prolonged contact” is needed, she said.

Anyone who is concerned they were exposed, she said, should get tested.

McCoy said that most complaints about people not wearing masks are at the big-box stores or grocery stores.

“It’s up to the consumers to do the right thing. It’s up to the consumers to let us know when they’re not [wearing masks] and it’s up to workers to say, ‘Hey, look … I want to go home and not spread it to my family.’”

Whalen noted that the county’s health department is responsible for granting permits to restaurants.

“We’ve been responding to complaints and send out inspectors to offer education,” she said. If there are repeat problems, Whalen concluded, “We will be looking at enforcement.”