Week XXXVIII: First vaccines expected December 15 for health-care workers and nursing homes

“We’re still waiting on guidance,” said Albany County Deputy Executive Daniel Lynch on Wednesday, referring to how the new metrics for micro-cluster zones will play out for Albany County.

ALBANY COUNTY — The county’s 38th week of dealing with COVID-19 was a week of broken records — for daily new cases of the virus, for hospitalizations, and for deaths.

Albany County Executive Daniel McCoy announced two deaths last Wednesday, another death on Thursday, six deaths on Saturday, two more deaths on Tuesday, and another death this Wednesday. Albany County’s COVID-19 death toll now stands at 161.

“November was a dark month and it has positioned us unfortunately very poorly for the upcoming holiday season …’” Albany County Health Commissioner Elizabeth Whalen said on Saturday. “People need to know this could get a lot worse before it gets better.”

Some bright news broke toward the end of the week — about the potential reduction of quarantine length and about imminent delivery of the first doses of a vaccine. The governor said the first 170,000 doses are expected in New York State on Dec. 15, to be used by health-care workers and nursing homes.

At the start of this week, county officials predicted a yellow zone would soon be imposed on all or parts of Albany County. But that was upended later in the week with a change in state strategy.

On Oct. 6, the state had started a micro-cluster system to tamp down on outbreaks of COVID-19 without closing regional economies. Red zones have the most severe infection rates and the most limiting restrictions followed by orange warning zones and yellow precautionary zones.

Under the original formula, Albany County would have had to have 10 consecutive days with a seven-day rolling average of an infection rate of 3 percent or higher.

Throughout the week, McCoy and Whalen urged residents to follow protocols to wash hands, wear masks, and not gather so that the number of new cases wouldn’t continue to climb.

They both noted that the ascent began with Halloween, and worried what Thanksgiving gatherings, Black Friday shopping, and holiday parties would do to the numbers.

“We’re pleading with you,” McCoy said last Wednesday. “Please help us get through this.”

“My concern really is about capacity of the system ...,” said Whalen at Friday’s press conference. “The system does not have infinite capacity.”

She said this includes capacity for testing, for case investigation, for contact tracing, for hospitalization, for ventilators, and for beds in intensive-care units.

“Think about what might happen if you get sick and there isn’t a system to help you ...,” said Whalen. “People really need to be concerned.”

The majority of infected people don’t know where they got the disease, said Whalen.

She also stressed, “If you have a positive case, tell the truth.” She noted that the virus is spread by someone two days before symptoms show up. So someone who attended, say, a Thanksgiving gathering and later tests positive should name all the people at the gathering.

Throughout the seek, at both the county and state levels, residents were warned that small at-home gatherings were now driving the high infection rates. Governor Andrew Cuomo on Wednesday released a video highlighting the dangers of “living-room spread.”

At his Monday morning press briefing, McCoy leapfrogged over warnings about a looming yellow zone to say the more severe orange zone is bound to be declared in the county.

“We’re probably going to pass yellow, people, and go right to orange at the rate we’re headed,” he said.

But later on Monday, Cuomo upended those predictions when he detailed his winter plan for battling the coronavirus. Micro-clusters are still central to the winter plan but a fourth zone, more stringent than red, has been added and, at the same time, both the metrics for entering a zone and the restrictions applied to the zones are being modified.

As of Wednesday morning, neither the metrics nor the protocols were yet clear to county officials.

“We continue to monitor the data ahead of the possibility of Albany County or parts of it entering into a micro-cluster zone,” said McCoy on Wednesday morning. “We’re still waiting for the state to release more information on the new matrix that they’ll be using to decide which areas enter the micro-cluster zones.”

At the control-room meeting on Tuesday, where Capital Region municipal leaders talk with state officials, it was confirmed that Albany County’s seven-day rolling average went low enough to reset the 10-day count, McCoy said.

“We started a new count on Nov. 26 as Day One,” he added.

Daniel Lynch, the deputy county executive, specified that what broke the 10-day chain, which would have led to a yellow-zone designation, was the seven-day rolling average for Nov. 25, which was 2.98 percent. The state’s New York Forward dashboard had rounded that up to 3.0 percent although it was actually slightly below the threshold.

“So we’re on Day Five as of Nov. 30,” said Lynch, noting that the last two days would qualify the county for an orange zone, under the old system, if the streak holds.

He was referring to infection rates, on a seven-day rolling average, over 4 percent: 4.1 percent on Dec. 29 and 4.4 percent on Nov. 30. The dashboard posted a rate of 4.7 percent for Dec. 1 later on Wednesday.

Lynch agreed with McCoy that, under the original metrics, it was “inevitable” that Albany County or parts of it would be declared a micro-cluster zone.

The new system, he said, will include metrics on hospital bed and intensive-care-unit capacity as well as on hospital staffing and death rates.

Fred Venditti, executive vice president for System Care Delivery and Albany Medical Center’s hospital general director, is in touch with 12 area hospitals and filled in officials on a recent control-room call, Lynch said.

“The hospitals have good capacity,” Lynch said that Vendetting had reported. He also said, “The hospitals are working in unison.”

McCoy also referred to the conversation with Venditti and reported, “Our hospital and ICU bed capacities are in a good place.” He said of local hospitals, “They’re seeing more patients but less people on ventilators.”

Still, the officials have no sense yet on how the new metrics will play out for Albany County. “We’re still waiting on guidance,” said Lynch.

“We’re still waiting for guidance on what it means, how it affects schools, how it affects businesses ...,” said McCoy. “It gets a little tricky trying to figure out through the weeds, which where we’re going.”

When The Enterprise sought clarification on metrics defining zones from the governor’s office, Erin Silk with the state’s Department of Health, responded on Monday, “The governor’s office forwarded your request to DOH to handle” followed only with this: “NYS DOH and Albany DOH are in close coordination regarding the increase in viral spread in the county and appropriate restrictions including zone designations will be implemented as necessary as part of State’s aggressive targeted action to contain the virus.”


Vaccine imminent

New York State’s first delivery of the vaccine, from Pfizer, will be 170,000 doses, expected on Dec. 15, Cuomo said at a press conference in Albany on Wednesday.

“The federal government distributes the vaccine by percentage of population of that state. So, the state’s population divided by available dosages is what the state gets,” said Cuomo. “There’s no discretion in how much the state gets. It’s purely a percent of population, which is what they say at least. We expect, if all safety and efficacy approvals are granted, those doses will arrive on December 15.”

By the end of December, Cuomo said, the administration suggests there will be enough to vaccinate 20 million people with two dosages, which is 40 million dosages.

“That means 6 percent of Americans — gives you an idea of where we’re going to be coming into January, and those 6 percent will be prioritized as the health care workers, seniors in congregate facilities, et cetera. But 6 percent of Americans, having available dosages by the beginning of January, you see how far we have to go.”

Later in December, Cuomo said, New York State expects additional allocation of the Pfizer vaccine and the Moderna vaccine, which has also been approved.

“We’re going to have to take two operations simultaneously. One is the hospital management situation, which is critical. We have to reduce the spread …,” said Cuomo. “At the same time, you have the vaccine management program …  we need the federal funding, we need a real aggressive outreach effort, we need social acceptance and confidence to take the vaccine.”

Cuomo reiterated that the state has set up a panel to review the Food and Drug Administration approval of the vaccine. “Why?” he asked, answering himself, “Because we know we have existing skepticism about the vaccine.”

He also noted that on Tuesday “the CDC’s advisory committee on immunization practices issued four more prioritization recommendations. They recommended front line health-care workers and elderly people living in long-term care facilities. That recommendation coincides with the priorities that we had established already so the CDC’s recommendation reinforces the priorities we established.”

The state’s 90-page plan, released in October, 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.

Cuomo concluded on Wednesday, “The good news is the goal line is in sight. And the goal line is a vaccine that we administer that people accept. That could happen as early as June, could happen as late as September. It depends on us. Depends on us, how many people go into the hospital; depends on us, how many people get vaccinated, how quickly.”


Letter to Azar

Cuomo sent a letter on Tuesday to Alex Azar, the Trump administration’s secretary of Health and Human Services, reiterating three concerns he has raised since October on distribution of COVID-19 vaccines: lack of federal funds for cash-strapped states; the need for outreach to Black, brown, and poor communities without adequate health-care facilities; and problems with requiring identifiers that could lead to deportation.

When The Enterprise, in late October, asked the White House about these concerns, spokesman Michael Bars responded just to the last one.

“As we’ve already explained to Governor Cuomo, such information would only be used to support the unprecedented private-public partnership continuing to harness the full power of the federal government, private sector, military, and scientific community to combat the coronavirus and save lives,” Bars wrote in an email to The Enterprise.

Thursday’s letter, signed by 52 people besides Cuomo — largely leaders of minority organizations — was also sent to President-Elect Joseph Biden, New York State’s congressional delegation, and to members of congressional caucuses for Blacks, Hispanics, and Asian Pacific Americans.

In a conference call with reporters on Tuesday, Cuomo said that experts predict the vaccination won’t hit critical mass until late summer or September.

He went over the three problems itemized in the letter to Azar and said that, unless all communities are served with the vaccine, it will “impede the effectiveness of the entire vaccination program because the vaccination program only works if everyone is vaccinated.”



On Tuesday, Lynch noted, the Centers for Disease Control and Prevention had adjusted the parameters for quarantine, which had been 14 days.

The new guidance, he said, is “you can test out at Day Seven with a negative test.” Without that test, the quarantine is 10 days if the person does not show symptoms like a cough or fever.

“It helps employers, it helps parents, it helps right down the line of getting folks back to their normal responsibilities,” he said.

McCoy added that he hopes Cuomo and the state’s Department of Health adopt that guidance for New York State.


Newest numbers

Statewide, the positive testing rate, based on Tuesday’s results, was 4.63 percent, Cuomo reported, which includes the 5.88 percent rate for all micro-cluster zones.

The seven-day average for the Capital Region of which Albany County is a part, was 3.84 percent. Of the state’s 10 regions, the Southern Tier continues to have the lowest rate at 2.39 percent while Western New York continues to have the highest rate at 7.34 percent.

As of Wednesday morning, Albany County has 6,038 confirmed cases with 167 new cases since Tuesday, McCoy announced.

Of the new cases, cases, 15 had close contact with someone infected with the disease, one reported traveling out of state, 148 did not have a clear source of infection identified at this time, and three are health-care workers or residents of congregate settings,

The five-day average for new daily positives increased to 117.6 from 112.2.

There are now 904 active cases in the county, down from 910 on Tuesday. The number of people under mandatory quarantine dropped to 2,181 from 2,370. So far, 24,085 people have completed quarantine. Of those, 5,134 had tested positive and recovered.

There were 17 new hospitalizations reported overnight, and there are 84 county residents currently hospitalized from the virus – a net increase of eight. Twelve patients are in intensive-care units. The hospitalization rate is now 1.39 percent.

A man in his nineties who lived in a nursing home died overnight. 

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