ALBANY COUNTY — As the United States is averaging close to 60,000 new COVID-19 cases a day, the most since early August, New York State continued this week to have one of the lowest rates of infection.

Governor Andrew Cuomo credits the state’s reliance on science — developing an approach to stamp out micro-clusters; listing states with high infection rates, now up to 43, on a travel advisory; and reopening slowly remaining activities with strict guidelines: movie theaters on Friday and ski resorts in November.

Cuomo noted in a press conference today that scientists had predicted rates would go up in the fall as schools reopened and activities moved indoors where the virus is more likely to spread.

Albany County is experiencing an uptick in cases. The county had two more residents die of COVID-19 this week, bringing its death toll to 138.

One patient was a woman in her seventies who lived in a nursing home; the other was a man in his eighties. Both of them had multiple underlying health conditions, said Albany County Executive Daniel McCoy.

“Unfortunately, our numbers continue to go up,” McCoy had said at last Thursday morning’s press briefing.

Between April 1 and 15, the county reported 297 cases; between Oct. 1 and 15, the tally was 291.

“The good news on this is, when we worked together in April, we were able to keep the numbers in Albany County such that we did not see a great deal of hospital surge capacity being tested,” said Elizabeth Whalen, the county’s health commissioner.

She urged, as always, mask-wearing, hand-washing, avoiding gatherings, and keeping six feet from others.

McCoy spoke of a birthday party in his own family, for his niece, and said that his sister, her husband, and their son have all contracted COVID-19.

“We feel, because we’re family or friends, we can let our guard down …,” said McCoy. “You can’t. You have to stay vigil. You have to stay on top of this. You have to know it’s there.”

Whalen also warned against family gatherings and stressed the importance of protecting the elderly and vulnerable.

“Although we all want to get together with our loved ones, it’s something we all look forward to this time of year, this year has to be different,” said Whalen. “It has to be different until we get to the point of having a safe, reliable, and widely available vaccine, which does not look to be on the table until the new year at the earliest and I think it will likely be spring.”

 

Vaccinations

Winter is going to be the season of the vaccine,” said Cuomo at Wednesday’s press conference. “That may very well be the most challenging operation government has had to perform all through COVID.”

Throughout the week, Cuomo has stressed the importance of a system to distribute a vaccine once it is available. 

“Dealing with COVID is not checkers. It’s chess,” said Cuomo in a conference call with reporters last Thursday. “So let’s start to think ahead.”

As chairman of the National Governors Association, Cuomo, a Democrat, along with Vice Chair Asa Hutchinson, the Republican governor of Arkansas, sent a letter to President Donald Trump, asking for  “guidance and clarification … on the roles and expectations of states in a successful COVID-19 vaccine distribution and implementation plan.”

Cuomo told the press, “The first question will be: Do the American people trust the vaccine?” 

He noted that New York State has put together a “committee of professionals that will review the protocol and efficacy of the vaccine.”

Cuomo said he believes there will be distrust of the vaccine because “there is distrust about this federal administration’s reliance or lack thereof on science.”

He said, if New York’s committee tells him the vaccine is safe, “I will tell the people of the state the vaccine is safe.”

The next move, he said, is, “How do we administer 20 million vaccines in the state of New York and how do you do that quickly and how do you do that safely? How do you do the vaccines all across the country?”

There has been speculation that the military would handle it or the Centers for Disease Control and Prevention, Cuomo said. 

So, said Cuomo, the letter sent to Trump on Thursday is requesting a meeting to delineate federal and state responsibilities, the funding needs associated with those responsibilities, and the planned supply chain management and vaccine allocation process.

On Friday, the White House responded.

With the looming presidential election, where Trump’s handling of the coronavirus pandemic has become a central issue, Douglas L. Hoelscher, assistant to the president and director of Intergovernmental Affairs, responded to Cuomo and Hutchinson’s letter, saying Operation Warp Speed “is accelerating safe therapies and vaccines at the fastest pace in human history thanks to President Trump’s leadership and American innovation.”

The letter says the Trump administration has hosted 39 governors-only briefings. “This ongoing dialogue is part of the most extensive Federal-State collaboration in our Nation’s history, a collaboration for which you have both personally thanked the President and Vice President,” writes Hoelscher.

He also calls out Cuomo, saying he has “missed the last 17 governors-only briefings.”

Rich Azzopardi, senior advisor to Cuomo, responded, through an email to The Enterprise, “We learned early on that the White House calls were a total waste of time and nothing more than political propaganda, using elected officials as props to heap praise on the President and deny the virus’ existence.  What the Governors of this nation actually require is a substantive operational discussion on policy and programming.”

Hoelscher concludes his letter to Cuomo and Hutchinson by saying the Health and Human Services team “has already reached out to begin coordinating a meeting between you both, Secretary [of Health and Human Services Alex] Azar and other relevant officials.”

Vaccination plans were due to the Centers for Disease Control and Prevention on Oct. 16.

New York released its plan on Sunday. “This is going to be a massive undertaking — hospitals, urgent-care facilities, primary-care facilities, pharmacies, local departments of health, mobile units, mass vaccination sites ….,” said Cuomo at Sunday’s briefing. “The federal government is in charge of producing the actual vaccines and distributing the vaccines so the state’s position is we have to wait for the federal government to provide us the vaccines, what is the schedule, how many, etcetera.”

Also on Sunday, the National Governors Association sent a letter to the White House compiling into 36 questions information governors across the nation are asking.

Summarizing the questions, Cuomo said, “How will the vaccine be allocated to states? What formula is used — in other words, are you going to allocate it by infection rate? Are you going to allocate it by number of cases of COVID? Are you going to allocate it by population? Who determines how many each state gets — what’s the basis that you are using?”

Cuomo also said it is important to know if there is a national strategy on prioritizing the shots — for example, vaccinating nursing homes, or nurses, or doctors, or people over age 70 ahead of others.

Coumo noted that some of the vaccines under development require two doses, which means New York State would have to administer 40 million shots. To put that number in perspective, he said, “Seven months it took us to do 12 million tests. How long is it going to take to do 40 million vaccinations? Or 20 million vaccinations?”

Cuomo also said, “There’s going to be trust issues about the vaccination, and there’s going to be conspiracy theories, and there are going to be rumors and there’s not a lot of trust, let’s be honest, in the federal health organizations right now, and, before people let you put a needle in their arm and inject something, there are going to be serious questions ….”

New York State has a task force of experts that are to review any vaccine before Cuomo recommends it to the public. “I think that will give people added surety in the vaccine,” he said.

Finally, Cuomo raised the issue of paying for the vaccines. “New York State is already $50 billion in debt between state and local governments,” he said. “And they have not passed legislation on the state and local relief. If the state has a deficit and the local governments have a deficit, we can’t fund essential workers.”

He said the vaccination program will require more, not fewer, essential workers.

Cuomo went on, “Who pays? Insurance companies? What happens for the uninsured people? How do I keep dosages cold, at negative 80-degrees? … That’s the difference between life and death in a situation like this. And that’s where we have to get.”

The state’s 90-page plan outlines five phases of administering vaccines. The first phase is for health-care workers in patient-care settings, long-term-care facility workers, and the at-risk long-term-care facility patients.

The second phase is for first responders, teachers and school staff, public-health workers; other essential frontline workers like pharmacists, grocery-store workers, and transit employees; other long-term-care facility patients; and people with high-risk health conditions.

The third phase is for people over age 65 or people younger than 65 with high-risk health conditions.

The fourth phase is for all other essential workers and the fifth phase is for healthy adults and children.

The plan also outlines measures to train, register, deploy and support providers to administer the vaccine and a data and technology infrastructure to coordinate and monitor all aspects of the procame.

Additionally, the state’s plan covers an education and community outreach campaign to build trust and inform the public as well as a budget and procurement process to get needed equipment and supplies.

 

Controlling COVID-19 in New York State

New York State is taking a two-pronged approach to controlling the virus: Quarantining people traveling to New York from places with high rates of infection, and identifying micro-clusters, small outbreaks of COVID-19, where restrictions are imposed and many tests are taken.

On Tuesday, Arizona and Maryland were added to New York State’s quarantine list, bringing to 43 the states on the travel advisory.

Pennsylvania, New Jersey, and Connecticut also meet the criteria but are not on the list. However, non-essential travel to those states is discouraged.

“There is no practical way to quarantine New York from New Jersey and Connecticut. There are just too many interchanges. There are too many interconnections,” said Cuomo in a conference call with reporters on Tuesday.

He went on, “There are too many people who live in one place and work in the other. It would have a disastrous effect on the economy and remember what we’re fighting, this public health pandemic, we’re also fighting to open up the economy ….”

“The way we basically enforce the quarantine is at airports when people fly in, because normally you fly in from another state,” said Cuomo at Wednesday’s press briefing. “Connecticut, New Jersey, Pennsylvania you don’t fly in, you drive in. There are numerous roads that are interconnections. You would have to do some theory of border checks all across the state ….”

Also on Tuesday, Cuomo released a list of the seven-day rolling average of COVID-19 positivity rates from Johns Hopkins. On May 12, the World Health Organization advised governments that, before reopening, rates of positivity in testing — that is, out of all tests conducted, how many came back positive for COVID-19 — should remain at 5 percent or lower for at least 14 days.

The Coronavirus Resource Center at Johns Hopkins charts each state with a line drawn at 5 percent. Currently, 34 states have a positivity rate over 5 percent.

The five states with the highest positivity rates are Nevada at 46 percent, South Dakota at 37 percent, Idaho at 29 percent, Wyoming at 21 percent, and Iowa at 21 percent.

The five lowest states are Maine at 0.36 percent, Massachusetts at 1.14 percent, New York at 1.17 percent, Vermont at 1.19 percent, and the district of Columbia at 1.23 percent.

The travel advisory requires anyone who has traveled to New York from areas with significant community spread to quarantine for 14 days. The quarantine applies to areas with a positive test rate higher than 10 per 100,000 residents over a seven-day rolling average or an area with a 10 percent or higher positivity rate over a seven-day rolling average. 

On Wednesday, Cuomo talked about the effectiveness of the “red zone” approach as “the most sophisticated COVID detection and elimination of any state.”

“You see an ember land in dry grass, ring the alarm, everyone runs, stamp out the ember. The embers are what we call micro-clusters,” he said. “We can identify them from the testing data from the hospitalization data and mapping software.”

The red zones had been largely in Orange and Rockland counties and in Queens and Brooklyn in New York City. Red zones have strict restrictions — schools must close, only essential businesses can stay open, and there can be no gatherings.

The red zones are surrounded by concentric orange zones with lesser restrictions and outlying yellow zones with still lesser restrictions.

On Wednesday, Cuomo presented a list of various red, yellow, and orange zones including some along New York’s border with Pennsylvania.

As always, he stressed the importance of following guidance and of local government enforcement.

“A cluster does not happen unless two things happen: a lack of compliance and lack of enforcement,” said Cuomo.

He also said, “Don’t get unduly alarmed by a micro-cluster. The infection rate in our micro-clusters is lower than the infection rate of most states.”

 

“COVID fatigue”

“COVID fatigue” was discussed on Monday at both the county’s press conference — where two college presidents reported no positive test results among 218 students in the Pine Hills neighborhood — and by the governor in a conference call with the press.

“This is not the time to be complacent … This is life and death,” said Marcia White, interim president of The College of Saint Rose.

Last Thursday and Saturday, 218 students from Saint Rose and the University of Albany took rapid tests for COVID-19.

Commissioner Whalen, always precise with her data, noted that four of those tests were indeterminate and would need to be conducted again. Nevertheless, she praised the partnership among the two schools, and the state and county health departments as well as Albany Medical Center and Saint Peter’s.

White, a Saint Rose graduate and former registered nurse, took on a leadership role at her alma mater just at the start of the pandemic.

“We don’t have walls,” she said. “Our sidewalks are the city sidewalks … During the pandemic, our location gives us even more responsibility.”

She considers Saint Rose students to be heroes because, she said, they have the values of Saint Joseph of Carondelet, one of which is “‘Care for your dear neighbor’ — and they’re doing that,” she said.

So far this semester, Saint Rose, with a student enrollment of about 4,000, has had only three cases of COVID-19, she said.

Rodríguez Havidán, president of the University at Albany, had similar praise for the partnership and said he was “very pleased with no positive test results.”

He noted that UAlbany continues to ramp up its campus testing and just passed “a major milestone with our pool surveillance testing program with over 11,500 saliva samples since September 1.”

Analysis showed a 0.56 percent positivity rate, he said. Next week, Rodríguez said, UAlbany is moving from bi-monthly to weekly tests for all students, faculty, and staff coming to the campus.

The public university, part of a sprawling state system, has three campuses serving about 18,000 students: an uptown campus in Albany and Guilderland, where free state testing for COVID-19 has been ongoing for months; a downtown campus in Albany; and a health-sciences campus in Rensselaer.

According to the SUNY COVID-19 Tracker, UAlbany has, as of Wednesday evening, an estimated 177 cases since COVID-19 tracking began on Aug. 28. Currently, 17 of the school’s 230 rooms set aside for quarantine are in use.

Rodríguez made two points about the first eight weeks of the UAlbany fall semester: The campus is not immune, and, he said, “We have the ability to manage the situation if we act responsibly and we work together.”

He noted there are just five weeks left in the fall semester as students will leave before Thanksgiving and not return until Feb. 1, for a delayed start to the spring semester. White said Saint Rose, like most local colleges, are looking at a similar schedule.

Rodríguez said the greatest challenge may be ahead with colder weather coming and “COVID-19 fatigue” setting in.

On Wednesday, Cuomo further explored the concept of COVID fatigue.

At first, he said, he heard “COVID fatigue” to “mean: ‘I’m tired of wearing the mask, I’m tired of doing the social distancing, I’m just tired and I don’t want to do it anymore.’ To that I said, you don't have the luxury of fatigue, because the virus isn’t fatigued and until the battle is over, you can’t take a nap.”

But, he went on, other facets of the fatigue include the stress on individuals and on society. “Yes,” he said, “we see it in the numbers, you see it in substance abuse, you see it in domestic violence, you see it in the number of people calling for mental health treatment.”

He recommended talking to friends and actually listening to what they have to say. “Nobody’s fine. You can’t be going through this and be fine,” said the governor.

Similarly McCoy, on Monday, without giving statistics, said that, since the start of the pandemic, the rate of suicides and deaths from drug overdoses in Albany County was “through the roof.”

McCoy again urged troubled residents to call the mental-health hotline at 518-269-6634, which is free and was set up by the county in March. The Mental Health Support Line is available seven days a week, from 8 a.m. to 5 p.m.

McCoy also urged, “Reach out to somebody … Let them know … you’re there for them.”

 

Newest numbers 

As of Wednesday morning, Albany County has 3,336 confirmed cases of COVID-19, an increase of 14 since Tuesday, according to a release from McCoy’s office.

Among the new cases, nine had close contact with someone infected with the disease, one is a health-care worker or resident of a congregate setting, and four did not have a clear source of infection detected at this time.

Currently, 1,001 county residents are under quarantine, down from 1,018 on Tuesday. The five-day average for new daily positives continued to decline to 12.4 from 13.8. There are now 92 active cases in the county, down from 100.

So far, 14,907 people have completed quarantine. Of those, 3,244 had tested positive and recovered.

Three county residents were hospitalized overnight, while the number of county residents currently hospitalized with COVID-19 climbed from 10 to 12; two patients remain in intensive-care units.

The county’s hospitalization rate ticked up from 0.3 percent to 0.35 percent.