Week CXXXII: Pandemic not over but being managed, task force proposes annual screening for depression

— Photo from the U.S. Preventive Services Task Force

On Tuesday, the U.S. Preventive Services Task Force, part of the Department of Health and Human Services, issued the draft of a proposal that would have adults younger than 65 screened annually for depression.

ALBANY COUNTY — “COVID is still with us,” Superintendent Marie Wiles told the Guilderland School Board last Tuesday. “We’re much better at managing it and keeping school going.”

That seems like a more accurate assessment than the one given by President Joe Biden, which aired on “60 Minutes” on Sunday: “The pandemic is over. We still have a problem with COVID. We’re still doing a bit of work on it, but the pandemic is over. If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape.”

Over 30,000 Americans are daily hospitalized with the virus and over 400 Americans a day are dying from it, which is dramatically fewer than a year ago when the Delta variant was raging and fewer than nine months ago when Omicron was surging.

But the roll-out of the first bivalent booster — targeting two Omicron subvariants, BA.4 and BA.5 —  has met with tepid uptake..

On Monday, Sept. 19, the day after Biden’s comments aired, U.S. Health and Human Services Secretary Xavier Becerra held a press conference at a clinic in New York City

He urged eligible Americans — those age 12 and older who got a primary series or a booster shot more than two months ago — to get a bivalent booster. He got one himself.

The updated COVID-19 vaccine protects against COVID variants that are currently dominant, as well as the original COVID-19 strain.

New Yorkers are being advised by the state’s health department to contact their regular health-care providers or county health departments for the boosters as well as making appointments through chain pharmacies. 

New Yorkers can also visit vaccines.gov, text their ZIP code to 438829, or call 1-800-232-0233 to find nearby locations.

In Albany County, as of Tuesday, 61.7 percent of eligible residents had received booster shots, according to the state’s dashboard, while 75.3 percent had completed a vaccination series.

Becerra, according to a release from his office, said the bivalent booster marks a shift in the pandemic that likely puts us on a path where the majority of Americans, without significant health risks, can be protected against serious illness with a single, annual vaccine, similar to what people do every year with the flu vaccine.

Meanwhile, as Superintendent Wiles pointed out, managing the virus is important. Her district, like many across the state, has adopted new guidelines following state and federal regulations (see related story).


Mental health

On Tuesday, the U.S. Preventive Services Task Force, part of the Department of Health and Human Services, issued the draft of a proposal that would have adults younger than 65 screened annually for depression.

The public will have a chance, until Oct. 17, to comment on the document before it is finalized. The task force had begun its work before the onset of the pandemic.

“​​Depression is a common mental disorder in the U.S., with substantial economic costs,” says the Kaiser Permanente report prepared last month for Health and Human Services. “In 2019, an estimated 7.8 percent of U.S. adults (19.4 million adults) experienced at least one major depressive episode and 5.3 percent of adults (13.1 million individuals) experienced a major depressive episode with severe impairment.”

Women have nearly double the risk of depression compared to men, though the mechanisms underlying this disparity are unclear, the report says. It has been hypothesized that social and economic circumstances, as well as biology may contribute to this gap.

Depression, especially untreated, is associated with increased mortality, higher risk of cardiovascular events, and may make comorbid conditions worse, the report says.

Screening for mental-health conditions involves administration of brief questionnaires to determine whether people have been experiencing mental-health symptoms. 

A trusting relationship with a clinician who is sensitive to cultural issues and free of implicit bias is an important part of effective mental-health screening and accurate diagnosis, the report says.

“Identification of mental health conditions alone is not always sufficient to ensure effective treatment in primary care settings,” the report says. “Rather, successful treatment requires a number of steps, including recognition that a patient is depressed, treatment initiation (often including referral and care coordination), and completion of an adequate course of treatment.”

The report also says, “Despite the USPSTF recommendation to screen for depression, data from a nationally representative survey of adults ages 35 and older conducted in 2014 and 2015 indicated that only 49 percent had been screened or assessed for depression at a routine health care visit in the past year (i.e., agreed that a health care professional had asked them about their mood, “such as whether you are anxious or depressed”).

The World Health Organization in March had released findings that, in the first year of the COVID-19 pandemic, “global prevalence of anxiety and depression increased by a massive 25 percent.”

These concerns, WHO said, caused 90 percent of countries surveyed to include mental health and psychosocial support in their COVID-19 response plans, but major gaps and concerns remain.

 “The information we have now about the impact of COVID-19 on the world’s mental health is just the tip of the iceberg,” said Dr. Tedros Adhanom Ghebreyesus, WHO director-general, said in a statement, releasing the report. “This is a wake-up call to all countries to pay more attention to mental health and do a better job of supporting their populations’ mental health.”

Stress factors included social isolation; lack of work; loneliness; fear of infection, sickness and death; and grief after bereavement.

WHO found that women were more severely impacted than men and that people with pre-existing physical health conditions, such as asthma, cancer, and heart disease, were more likely to develop symptoms of mental disorders.

WHO’s most recent Mental Health Atlas showed that, in 2020, governments worldwide spent on average just over 2 percent of their health budgets on mental health and many low-income countries reported having fewer than one mental-health worker per 100,000 people.

“While the pandemic has generated interest in and concern for mental health, it has also revealed historical under-investment in mental health services,” said Dévora Kestel, director of the Department of Mental Health and Substance Use at WHO, in a statement. “Countries must act urgently to ensure that mental health support is available to all.”


Albany County

The governor’s office reported, on Tuesday, Sept. 20, one COVID-related death of an Albany County resident this week, the county’s 132nd of dealing with the virus. The county’s dashboard on Tuesday showed a total of 582 deaths: 281 males and 301 females.

The CDC labels each county in the nation as having a “low,” “medium,” or “high” community level of COVID-19. In counties with a “high” level, masks are recommended when indoors in public regardless of vaccination status.

Albany County has been labeled with a “medium” level for 12 weeks.

As of Tuesday, just two of the counties in New York State — Tioga and Broome counties, next to the Pennsylvania border — are now labeled “high” with the rest either “low” or “medium.”

This is following a nationwide trend away from high to low levels. About 13 percent of counties are now labeled “high” while about 36 percent are, like Albany County, labeled “medium,” and about 51 percent are labeled “low.”

Although figures on infection rates are no longer reliable since tracing and tracking systems have been disbanded, the state dashboard shows that cases statewide and in Albany County are up from a week ago.

Albany County, as a seven-day average, now has 17.1 cases per 100,000 of population, up from 16.3 last week and 17.0 two weeks ago, but down from 17.3 three weeks ago, 17.9 four weeks ago, and from 19.3 five weeks ago, and 21.8 six weeks ago.

This compares with 22.2 cases statewide, which is also up from the count for the last two weeks of 18.6, and 21.09, but down from 23.0 four weeks ago, 25.6 five weeks ago, and 30.03 per 100,000 of population six weeks ago.

The lowest rate is still in the Finger Lakes at 14.29, which is up from 12.81 per 100,000 last week and 11.40 two weeks ago, 12.42 three weeks ago, 12.09 four weeks ago, 12.65 five weeks ago, and 12.92 six weeks ago.

The highest count is still on Long Island at 28.72, significantly up from  22.62 last week, which was slightly up from 22.46 two weeks ago, which was down from 25.07 three weeks ago.

As of Sept. 20, according to Albany County’s COVID dashboard, 30 patients were hospitalized with the virus for a seven-day average of 23.57, a marked increase from a week ago when the seven-day average was 15.14.


Sales-tax collection down in Albany County

Local sales tax collections statewide increased by 12.6 percent in August compared to the same month in 2021, according to an analysis that Comptroller Thomas DiNapoli released this week. Statewide local collections totaled $1.7 billion, up nearly $192 million from the same time last year.

In Albany County, sales-tax collections in August declined by about 4 percent, from $24.3 million last August to $23.3 million in August 2022. Albany County was the only Capital District county to show a decline for August.

However, from January to August this year, sales tax collection in Albany County increased by 11.6 percent over the same time period in 2021 — from $199.3 million in 2021 to $225.5 million in 2022.

“Overall local sales tax collections were strong in August, even with many counties participating in the gas tax holiday,” DiNapoli said in a statement, releasing the analysis. “With consumer spending softening in recent months, local governments should maintain vigilance when it comes to their finances.”

New York City’s collections totaled almost $751 million, an increase of 20.6 percent, or $128 million, over August of 2021. Most counties saw at least some year-over-year growth in August collections, with Sullivan County experiencing the largest increase at 15.7 percent, followed by Orange County at 12.9 percent, and Rockland County at 12.3 percent.

One county in Western New York had an August decline as did four counties in Central New York, four counties in the Finger Lakes, one county in the North Country, and three counties in the Southern Tier — including Schuyler County with the steepest decline at -24.8 percent.


Audit: NYS slow releasing fed funds

DiNapoli released an audit this week showing New York has been slow using some federal relief funds meant to alleviate the state’s affordable housing crisis.

The audit found that, under the management of Homes and Community Renewal and its local program administrators, the distribution of funds has been delayed, putting some of the millions of dollars of funding at risk. Because there is a deadline on using federal COVID-19 funds, delays in allocating it to specific housing projects or housing relief programs could result in funds being lost.

“The state continues to navigate the difficult waters of the post-pandemic housing crisis,” DiNapoli said in a statement releasing the analysis. “We need every dollar available for housing needs in our state, particularly those that can help bolster affordable housing. HCR must work more efficiently to ensure the unprecedented federal relief funds help New Yorkers in need and are not lost because of unnecessary delays and miscommunications.”

Two of the five local administrators that auditors spoke with said they could not meet HCR’s 12-month timeframe for completing projects because of supply-chain and contractor availability issues. HCR does offer extensions but the audit found not all local administrators were aware of that option.

The audit also concluded that HCR needed to increase oversight on some of the local administrators that did get funding to ensure they were monitoring contractors and subrecipients for compliance with federal requirements that govern the use of the funds.

Among its recommendations, DiNapoli’s audit called on HCR to work with local program administrators to make sure funds on a deadline tied to COVID relief are obligated and spent in a timely manner, by improving communication regarding performance completion requirements and by identifying and reducing delays in releasing funds for completed work; and to improve internal controls, including better monitoring of subrecipients and contractors used by local program administrators and strengthening controls over confidential information.

HCR generally agreed with the audit findings and officials stated that they had taken steps to improve allocation and distribution of funds and increase communication with local administrators about rules governing the completion of projects. The agency’s response is available in the audit.


More jobs

According to figures released Sept. 15 by the state’s labor department, the number of private-sector jobs in New York increased over the month by 27,600, or 0.3 percent, to 8,054,900 in August 2022. The number of private-sector jobs in the United States increased by 0.2 percent in August 2022.

Jobs in the Albany-Schenectady-Troy area increased by 2.6 percent from 442,500 jobs in August 2021 to 453,900 jobs in August 2022.

New York State’s private-sector jobs increased by 411,800, or 5.4 percent, over the year in August 2022, which exceeded the 4.4-percent increase in the number of private-sector jobs in the U.S.

New York State’s seasonally adjusted unemployment rate increased from 4.3 percent in July to 4.7 percent in August 2022. From August 2021 to August 2022, the unemployment rate (not seasonally adjusted) fell from 6.7 percent to 4.9 percent.

From July to August 2022, New York State’s labor force (seasonally adjusted) increased by 32,500. At the same time, the labor force participation rate went up from 60.3 percent in July 2022 to 60.5 percent in August 2022, its highest rate since March 2020.

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