Week XL: First COVID-19 vaccinations given as cases surge

Albany County Executive Daniel McCoy

The Enterprise — Michael Koff
Albany County Executive Daniel McCoy signs an emergency executive order, effective on Friday, that will cap fees for food delivery at 15 percent. 

ALBANY COUNTY — The joy of the first COVID-19 vaccines being administered this week was tempered with stern warnings from both state and local officials that safety from enough people being vaccinated is months away and protocols must be followed in the meantime.

On Monday, the same day the first shots were given, Governor Andrew Cuomo did not discount an entire shutdown of the state if numbers don’t improve. “If we do not change the trajectory, we could very well be headed to shutdown,” he said.

On Wednesday, Cuomo announced regional vaccination hubs, led by local hospital systems, to work with community leaders in developing vaccination networks.

Albany Medical Center is the hub coordinator for the Capital Region.

After nursing-home residents and workers along with frontline health-care workers are vaccinated first, the next phase, under New York’s plan, is to vaccinate essential workers and people most at risk.

On Wednesday, health insurers regulated by the state were sent a letter, directing them to immediately cover, without cost-sharing, approved COVID-19 immunizations.

In its 40th week of battling the coronavirus disease 2019, Albany County broke records it didn’t want to break, said County Executive Daniel McCoy.

For two weeks in a row, the county’s daily rate of new infections has been in triple digits; it hit 205 on Wednesday.

Deaths of county residents were announced every day for a week: two on Thursday, three on Friday, five over the weekend, one on Monday, and one on Tuesday. The COVID-19 death toll for Albany County stands at 183.

More residents were under mandatory quarantine than ever before — the county hit a high of 3,317 on Tuesday.

McCoy termed it “another record we weren’t happy to hit” and said the county’s health commissioner, Elizabeth Whalen, had called on the volunteers in the Medical Corps, often retired  nurses or doctors, to help. He renewed that call on Wednesday.

“Anyone that has medical skills, please volunteer your time,” he said.

McCoy noted that, when New York was hard hit in the spring, people from other places offered help but now the entire nation is experiencing a surge. He noted a parking garage in Reno is being used as a hospital and tractor trailers in El Paso are being used as morgues

“We’re putting more tracers and people into play, assigning more people to the health department,” McCoy had said on Monday as he announced the record-breaking number of residents under quarantine. “It’s overwhelming … Bear with us. It’s a lot of people to deal with.”

Whalen reiterated that residents, while they wait to hear from health-department staff, can consult the department’s website for guidance on isolation if they have tested positive for COVID-19 and on quarantine if they have been exposed to someone with the disease.

She also pointed to an online graphic to illustrate how someone can unwittingly spread the disease — a topic on which some confusion remains, she said.

In the illustration, a woman is exposed to COVID-19 on Day 0, tests negative on Day 5, then goes to work and to a family gathering on Day 8, unwittingly exposing 22 people, before testing positive on Day 10.

“This is why COVID is tricky,” said Whalen.

This week, Cuomo released data from contract tracing statewide that showed the vast majority of COVID-19 spread — 74 percent — is from small at-home gatherings, which he calls “living-room spread.”

On Wednesday, Cuomo told reporters that to deal with the surge, “Hospitals have to shift to crisis-management mode. Crisis hospital management is a different state of mind for hospitals.”

Hospitals that are used to working individually, Cuomo said, have to work as part of a system so that patients can be transferred as needed. Earlier in the week, Ferdinand Venditti from Albany Medical Center, had said just such a system is already in place locally.

The state’s health commissioner, Howard Zucker, sent a letter to hospital administrators  on Wednesday, saying, “As you know, we are in a difficult situation again with COVID. The largest spread is from small gatherings and we expect that to increase over the holidays. Small gathering spread is very difficult for government to control.”

The letter goes on to require hospitals to work together to balance patient load and says hospitals must be prepared to achieve 15-percent staffed bed capacity growth within 72 hours if a significant COVID surge occurs.

“If a hospital is, or would be, unable to achieve this ‘flex up’ of beds if necessary, they must cancel elective procedures or expand bed capacity to ensure they always can have an additional 15% staffed bed availability within 72 hours,” Zucker wrote.

“Bed capacity” is defined as an available bed with available staff and equipment for purposes of patient care within 72 hours.

Also on Wednesday, Cuomo reiterated that New York’s infection rate, compared to the rest of the nation is low. “We’re still lower than anyone besides Maine, Hawaii, Vermont, which is extraordinary,” he said at Wednesday’s press conference.


Micro-cluster zones

Last Friday, Cuomo outlined much-anticipated guidance for the new metrics that will define micro-cluster zones as part of his winter plan to combat COVID-19.

Data was calculated over the weeknd with new zones announced on Monday.

“If you are a yellow zone or if you are an orange zone, this is all determined on the facts and what it is saying is, in your community you have a problem,” said Cuomo during a lengthy press conference on Friday. “It’s not somewhere else. It’s your community. It’s your grocery store, it’s your church, it’s your temple, it’s your mosque, it’s your block, and you can make a difference in your community and it means you have to take it seriously.”

On Monday, Albany County escaped being named a yellow precautionary zone. Cuomo announced that new yellow zones were established in Genesee and Oneida counties and the yellow zone in Niagara County has been expanded.

Last month, based on the state’s metrics for COVID-19 infection rates, Albany County had been on the cusp of being named a yellow zone when Cuomo outlined his winter plan for micro-cluster zones, which shifted the focus to hospital capacity.

COVID-19 rates have risen across the state and across the nation with the onset of cold weather and holiday travel and gatherings.

New York, rather than shutting down regional economies, has adopted a micro-cluster approach, defining red zones, with the heaviest outbreaks of the virus and the most severe restrictions, followed by orange warning zones and yellow precautionary zones.

These are the new metrics outlined outlined by Cuomo:

— A red zone will be implemented in a region where hospital capacity is within 21 days of reaching 90 percent, even after the cancellation of elective procedures and a 50 percent increase in bed capacity in hospitals in the region;

— An orange zone will be declared if an area has a 4-percent positivity rate (seven-day average) over the last 10 days and it is located in a region that has reached 85 percent hospital capacity. Alternatively, a geographic area may also become an orange zone if the state’s health department determines the area or region’s rate of hospital admissions is unacceptably high and a zone designation is appropriate to control the rate of growth; and

— A yellow zone will be designated if an area has a 3-percent positivity rate (seven-day average) over the past 10 days and is in the top 10 percent in the state for hospital admissions per capita over the past week and is experiencing week-over-week growth in daily admissions.

Also on Friday, the state’s health department issued a directive for hospitals to take steps to remain below 85 percent capacity by either adding an additional 25 percent of capacity, eliminating elective surgeries, or by taking a combination of both steps.

Beginning on Monday, indoor dining was suspended in New York City restaurants, and the rules for gyms and health-care venues, like hair salons and barber shops, have been changed.

Because state data shows businesses that have been following guidance from the state’s health department have reduced the spread of the virus, gyms and personal-care shops in orange zones may operate, with restrictions, which started on Monday.

Gyms will be allowed to operate at 25-percent capacity. Personal-care businesses can perform services as long as workers are tested weekly for COVID-19 and obtain negative test results before opening.

Cuomo said that New York State, unlike many other states that either entirely open or close activities, is using “a constant calibration.” The goal is to balance economic and social activity with public health, he said, following the data and metrics.



Last Thursday, a panel of experts formally recommended that the Food and Drug Administration authorize the vaccine developed by Pfizer and BioNTech for people 16 and older.

Cuomo had set up an advisory panel in New York to review the FDA’s process, which he thought would instill confidence in New Yorkers to take the vaccine.

The state has set up a website to inform New Yorkers about the vaccine and its administration.

New York’s health commissioner, Zucker, met with the state’s panel on Thursday night, Cuomo said at Friday’s press conference.

“The New York State clinical advisory task force has approved unanimously the FDA decision to go forward with the vaccine, so that’s good news, and we notified the FDA of that,” Cuomo said. “Obviously there was no delay whatsoever in the timing, and New Yorkers will have more confidence.”

The first of New York’s initial 170,000 doses, based on state population, are to go to nursing home residents and staff and to high-risk health-care workers.

McCoy said at his press conference on Friday morning that the first injections of the vaccine will be given at Shaker Place, the county’s nursing home, on Dec. 21. To be fully effective, two shots are needed.

A second dose will be given to the first Shaker Place group on Jan. 11 when a second group will be inoculated for the first time, with final shots on Feb. 1.

The vaccinations will be administered by Walgreens.

The first vaccines for COVID-19 were administered on Monday, including locally to high-risk health-care workers at Albany Medical Center.

McCoy said at his Monday morning press briefing that the state hopes to get 350,000 doses of vaccine from Moderna by the end of December, which Cuomo confirmed at his press conference later in the day at 346,000 doses.

McCoy noted, though, that it will take months to vaccinate enough of New York’s 19 million residents to  have life return to normal.

Cuomo made a similar point, estimating it would take six to nine months to get a critical mass inoculated.

“The big ‘if’ is, you need 75 to 85 percent critical mass and you have 49 percent of the people who are skeptical about taking it ..,” said Cuomo. “We have to educate the public. We have to outreach to all communities, Black, Latinos, poor communities, that have paid the highest price for this virus, and we have to get it out. We have to distribute it; it is a logistical operation like you’ve never seen before, which we’re already working on.

On Monday morning, Sandra Lindsay, a frontline health-care worker at Long Island Jewish Medical Center in Queens, got the first vaccination in New York State and, Cuomo speculated, perhaps the nation.

Lindsay said she felt hopeful and relieved. “I feel like healing is coming and this marks the beginning of the end of a very painful time in our history,” she said. “I want to instill public confidence that the vaccine is safe.”

“It’s very heartening to know we have a vaccine,” said Whalen on Tuesday.

Counties have participated in conference calls with the Centers for Disease Control and Prevention, she said, to learn about the vaccine now being deployed from Pfizer and BioNTech. It is being given to frontline workers and to residents and workers at nursing homes.

The vaccine is given in two doses, 21 days apart, and usually takes a week to two weeks before full inoculation is achieved, said Whalen. 

The Pfizer vaccine has been shown to be 95 percent effective, said Whalen.

“We know that it is safe. We know that it is our most important tool so far to stop this pandemic,” she said.

Albany County has planned for more than 10 or 15 years,  Whalen said, to administer vaccinations in the event of a pandemic.

“We stand ready to partner with the federal government in the deployment of this vaccine ...,” she said. “However, it is important for the public to know this is not an imminent option for members of the public. It will likely be months before this is rolled out to the general public.”

She again urged people not to participate in the usual holiday gatherings. “That sacrifice … could save lives,” Whalen concluded.


Newest numbers

As of Wednesday morning, Albany County has had 8,315 confirmed cases of COVID-19, McCoy announced.

Of the 205 new cases, 25 had close contact with someone infected with the disease, 166 did not have a clear source of infection identified at this time, and 14 are health-care workers or residents of congregate settings.

The five-day average for new daily positives increased to 181.6 from 176. There are now 1,549 active cases in the county, down from 1,691 on Tuesday.

The number of county residents under mandatory quarantine decreased to 3,279 from 3,317. So far, 29,144 residents have completed quarantine. Of those, 6,766 had tested positive and recovered.

There were 15 new hospitalizations reported overnight, with 13 COVID-19 patients discharged. Currently, 96 county residents are hospitalized from the virus – a net increase of two. There are now 15 patients under intensive care, unchanged from Tuesday.

Eleven of the hospitalized patients are between the ages of 25 and 49 while 46 are between the ages of 50 and 74 and 39 are 75 or older, McCoy said. 

Statewide, the infection rate, based on Tuesday’s test results was 6.21 percent, Cuomo announced. The Capital Region, of which Albany County is a part, had a rate of 6.23 percent.

The Capital Region currently has 306 patients hospitalized with COVID-19, which represents 0.03 percent of the region’s population and leaves 24 percent of its hospital beds available. Statewide, 0,03 percent of New Yorkers are hospitalized with COVID-19, leaving 24 percent of hospital beds available.

The Capital Region has 257 ICU beds of which 179 are currently being used, leaving 39 percent available. Statewide, 33 percent of ICU beds are available.

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