Three years into COVID, NY healthcare has fundamentally changed
ALBANY — Three years into the COVID-19 pandemic, some normality has returned to daily life in New York City; schools and businesses are bouncing back, case numbers are no longer being tracked, and pandemic-era restrictions are long gone.
But health experts say too many New Yorkers are still getting seriously ill and dying from COVID — the virus kills more than 100 New Yorkers a week, according to the latest figures from the Centers for Disease Control and Prevention — and for the better or worse, the state health care infrastructure is fundamentally altered.
On the third anniversary of the statewide shutdown, policymakers and state Department of Health officials spoke to The Times Union about the state’s progress in the fight against COVID. , lessons learned from the pandemic and how the state can prepare for the next health crisis.
Is COVID over?
Although the state hasn’t seen a major COVID spike in more than a year, the number of daily hospitalizations has stabilized at a concerning level, placing a continued burden on hospitals across the state, according to Bryon Backenson, who heads the Office of the Department of Health. Communicable diseases.
About 1,350 New Yorkers were hospitalized with COVID on March 15, up from just over 1,000 hospitalizations a year earlier, according to state data. Some 79,000 New Yorkers have died from the virus since March 2020, according to CDC figures.
“COVID has been like a bad flu season every day for three years. And that’s putting a huge strain on the healthcare system…and there’s still an awful lot of people out there getting sick and in some cases dying of COVID,” Backenson said. “I’m glad we’re where we are, but it’s not like it’s gone.
The vast majority of New Yorkers have received at least one vaccine, which has been shown to reduce the severity of COVID-19 symptoms. But the virus continues to evolve, and health officials say they are watching new mutations closely. A new variant capable of bypassing immunity and causing severe disease could easily set back those efforts.
There are still mysteries about the disease, such as the causes of “long COVID”. Often defined by symptoms lasting more than three months after infection, the disease continues to vex doctors and for many sufferers relief is elusive.
The road ahead
Burnout has taken its toll on the state’s public health staff. More than half of the state’s county health officials have quit their jobs or been expelled since March 2020.
The state Department of Health also saw an exodus of some of its most experienced staff and rotated three health commissioners in three years.
Now that things have stabilized, the agency is working to rebuild its workforce and institutional expertise. Nearly 40% of the Health Ministry’s 4,500 employees are new or recently promoted, according to figures provided by the ministry.
“It can be difficult to bring new people up to speed,” Backenson said. “There are a lot of people in health departments across the state that have been brought in during COVID and that’s the only thing they’ve done.”
The pandemic has also spurred scientific and technological innovation. Developments in vaccine research, home testing, and virtual healthcare delivery have transformed the medical landscape.
New capabilities such as sewage testing and genome sequencing have generated new excitement in public health.
The state’s partnerships with the Wadsworth Center and CDC labs have enabled state health officials to perform cutting-edge genomic analysis, according to Daniel Lang, who directs the Department’s Center for Environmental Health.
“It’s one thing to test for (COVID)…but with the ability now to sequence genetic material from clinical or environmental samples, we can get ahead of the mutations and variants that occur in these viruses.”
Lang, who also oversees the state’s wastewater monitoring system, said the wastewater testing program will be a game-changer for disease control in the future.
Some of the diagnostic systems established during COVID, including sewage testing, have been used again during the recent monkeypox and polio scares.
The health crisis has prompted greater cooperation between state and local health agencies, hospitals and community organizations who have worked closely together to establish mass testing sites and inform the public. Those relationships, if they can be maintained, will help the state move forward, Lang said.
Figuring out how to fight the new pathogen was a clumsy process. Early efforts to limit travel from hotspot countries or contain the disease to Westchester County were largely ineffective against the fast-moving virus. In mid-March, businesses and schools were closed.
The state created temporary hospitals to absorb the influx of patients and built mass testing sites across the state.
Most schools tentatively resumed part-time in-person learning in the fall of 2020, and the state has established measures to help them know when to switch to remote learning.
The state also implemented a cluster strategy, which only restricted businesses and schools in counties or geographic areas with high levels of infection.
Health officials resisted criticism from both sides of the political aisle, with some saying the state mandates were too rigid, while others thought they were too lax.
Backenson notes that the department was dealing with an unknown pathogen that was constantly evolving while trying to absorb an immense amount of data from other parts of the world.
“Obviously this particular disease has shown us a lot over time,” he said. “Public health always has this problem of trying to do the right thing… I often talk about Goldilocks and the Three Bears – either you do too little and more and more people get sick, or you overdo it and you think you’ve taken away rights and freedoms. It’s really hard to find the right line.
There were obvious missteps. Early in the pandemic, Governor Andrew M. Cuomo’s administration rushed to order nursing homes to accept hospitalized coronavirus-positive patients to ease emergency room bed shortages. and intensive care units. Some 9,000 infectious patients were referred to long-term care facilities before the policy was rolled back.
A 33-page Health Department report that concluded the move did not lead to a rise in the death toll was undermined after Cuomo staff admitted to manipulating details in the report, including the number nursing home residents who died of COVID.
Cuomo and former health commissioner Howard Zucker both resigned in 2021. Some critics say they weren’t held accountable enough for nursing home policies they say accelerated the spread of the disease .
Assemblyman Ron Kim, a Democrat from Queens and a vocal critic of Cuomo’s nursing home policies, said the state must own up to its mistakes.
“We have to hold them accountable for bad decisions,” Kim said in an interview. “Not because we want to demonize and vilify them, but it’s about learning from our mistakes so that we don’t repeat them.”
Under new leadership, health experts say they have worked to improve transparency and communication, with the goal of releasing as much real-time data as possible and worrying less about how that data might be interpreted or misinterpreted. interpreted for political purposes.
“Science doesn’t operate on the same time scale as politics,” Lang said. “Our goal is to make sure that we continue to improve science and get information that people can digest and respect that they will digest it in different ways.”