Monthly Archives: March 2020

Tuesday, March 31 update

NYS update: I admit that in recent days I have not been really tuning in to Cuomo’s briefings, particulary the photo-oppish ones. Today was not the day to miss out, however. Whether it was yesterday’s all-hospital planning meeting, or the alarming news that his brother has tested positive, Cuomo seems to have gotten religion, and he has gone into what the mainstream media calls “wonk mode” (i.e., talking about the particulars of governing a state rather than looking presidential).

So yes, now it’s gotten this bad: it’s now time to talk about inter-regional state unity, and smart ways of using upstate and downstate resources to create good outcomes for all, and the breaking down of silos, which is basically every effing thing that everyone upstate has ever wanted out of being part of this alleged Empire State, and basically every thing that every decent normal person anywhere in the state wants; but which the uber-rich and their petty Albany crapshooters have never given a thought about for the last thirty years. The same stuff that sounds so logical when you say it about a good, hardworking but distressed hospital in Queens not being helped by the wealthy private hospitals in Manhattan. That same stuff which sounds so golden coming out of President Cuomo’s lips these days.

“One coordinated system. It won’t be easy, but we have to do it.” We’re all ears.

Onondaga County update: I had a feeling this would not be as good a day as yesterday and it wasn’t. More than one hospital is running out of PPE (some worse than others). Although there were less new cases than the day previously, hospitalizations went from 20 to 31, and ICU admits also increased, a worrying sign about how severe the illness can get. Secure all the extra toilet paper you wish, but when a Wegmans employee tests positive, expect the community-Facebook s— to hit the fan. (In truth, you’re probably walking around with all sorts of COVID-positive people if you go out to Wegmans at this point.) With seven positive tests among employees of St. Joe’s, this could be the inflection point when we too start descending into the orange zone that our neighboring cities have been in for some time, and we’ll start hearing about these “institutional” transmissions more every day.

CE McMahon pointed out that Onondaga County, with its 467,000 official population and “up to 1 million” hospital-served population, currently has more COVID cases than at least eight other states. It’s strange to hear an upstate county official pleading the same case that we often hear when cities on the coasts ask for more money — we’re a population center! (That broader rural population is growing ever smaller, though.)

The irony on both ends is as thick as the COVID-fog these days, even if it still seems like needless “gotcha” to be pointing it out.

Tuesday, March 31: What a (data) dump

The first NY opinion poll of the post-pandemic era has been conducted by Siena College. President Cuomo’s approval ratings are sky-high, not just throughout the nation of New York, but the rest of the known world. Upstaters have high confidence in their local leaders and county health officials, and are wildly enthusiastic about Cuomo’s COVID-19 leadership (85%, virtually on par with other regions of the state), though not quite so enthusiastic about him generally (61%, although that figure seems way generous and must also be tilted by the current situation). 

If only we had as much neatly collated data on the actual COVID situation throughout the state, as we do about which politicians are perceived to be doing something about COVID.  This isn’t something we can pin on any individual, but it still sucks.  So there’s this basic stats tracker from syracuse.com, It can give you basic numbers, but when it comes to deciphering anything beyond “Lots of Tests Are a Good Thing,” we’re all out of luck. There isn’t even any regional consistency in who should, or even can, be tested. In a county like Onondaga, where everyone seems to be playing on the same team and testing is copious, the consensus on how to report the results subtly changes by the day. (We now have a new and improved metric, “Active cases”.)  Elsewhere, in places where county and city officials obviously don’t get along, there is controversy and bad blood that absolutely is not needed at a time like this.

Jamestown Mayor Eddie Sundquist is calling for transparency after Friday’s Chautauqua County press conference, which did not reveal where the latest coronavirus cases were located. On Saturday he issued this statement: “As more COVID-19 cases are confirmed in Chautauqua County, I recognize the need to provide accurate and timely communications to our residents. The health and well-being of our citizens is a top priority for my administration. I want to remind residents that the Chautauqua County Health Department, the lead agency for the COVID-19 response, has not publicly confirmed any positive cases in the City of Jamestown. My office is aware of social media posts and other conversations regarding potential cases.”

Chautauqua County officials were unimpressed. The New York Times speaks for many of these officials when pondering the privacy implications of more granular data.

We have so many fantastic data visualization tools now — like this one that (“anonymously”) tracks cell phone signals of Spring Breakers from one Fort Lauderdale beach as they spread plague across the rest of the country.  (Although not really up here, where students were told not to come back. Whew.)

But we’ve had decades of this beautiful gee-whiz from the tech bros — and now, in a crisis, we have nothing to show for it. Because there hasn’t been any culture of public health; no statewide standards that could fill in for guidance from the AWOL CDC; no coordination between cities and counties, no connection between neighboring regions, no commitment between upstate and downstate.   Maybe we should just issue smart thermometers to everyone and hope for the best. “Take everyone’s temperature, let God sort it out.”

Monday, March 30 update

NYS update: The major news from Cuomo’s briefing today was news of a statewide hospital conference call and a push to more closely coordinate private and public hospitals in NYC — and, it was implied, hospitals all over the state. The official press release is more clear:

The State Department of Health will work with the statewide healthcare system to create a command center to share information between hospitals about the supplies each hospital has in stock and the supplies each hospital is ordering. This central inventory system will help ensure purchasing and distribution of supplies is done strategically and efficiently.

At least for the duration of the COVID crisis, it seems that Cuomo would like to “federalize” (excelsiorize?) New York’s hospital ecosystem, which makes sense, but also opens a new can of worms. Who makes the decisions in the name of public health, and how? (We have to hope that there is better judgment in Albany about how to allocate resources than in Saratoga County.)

Saratoga County’s director of human resources who came up with the 50 percent pandemic pay raise for essential employees is both a beneficiary of the plan as well as a judge of its worthiness. Marcy McNamara, whom SeeThroughNY.org shows earning $119,000 in 2019, is taking in time-and-a-half pay for the first 35 hours she works each week. She also sits on the five-person committee reviewing its merits.

As with nearly everything else happening during this pandemic, the implications for the future of the U.S. health care and hospital “system” are tremendous. The extraordinary measures being taken in New York currently could be a harbinger of things to come for the other blue states.

Onondaga County update: Apparently it’s now safe for the county to publicly debut a new daily metric, “Active Cases.” There are 186 active cases of COVID here, the first decrease in daily actives noted. While there is a higher net number of hospitalized cases (23), the amount of critical cases has not risen, and there have been no new deaths. Question time moved on to the not-so-rosy reports of critically low PPE at St. Joseph’s and one local nursing home. Onondaga County officials are still enthusiastically testing any and all doctor-vetted comers, looking forward to the day when asymptomatic people can be tested affordably, buying PPE and equipment, and just in general sticking out like a plucky sore thumb while other upstate metros seem to be flailing.

Again, one can hardly criticize our county officials for their hard work. CE McMahon continues to handle the repetitive daily conferences skillfully. There is a real consciousness of Syracuse’s place in all this right now — and maybe in the new reality to come — that definitely comes through in each briefing. For now, we can give the benefit of the doubt to the county team, and try to not get too nervous over prudent questions about where the benefits of early preparation are actually being directed. (Where are these “small doctor offices” located, exactly?) But if, like the future-minded McMahon points out, “counties are miniature states,” we should be prepared to ask state-sized questions “today, not tomorrow.”

Monday, March 30: Upstate Has Fallen

Yesterday afternoon, Yates County — the last remaining stronghold against the spread of COVID-19 in New York State — finally fell. All 62 counties have now recorded at least one case. Seneca County was reportedly the second-to-last county to report a case (though this is not showing up on state-issued maps, perhaps because the positive was not a county resident?) In more leisurely times, it will be interesting to study the reasons why the shores of Seneca Lake, in the deepest Finger Lakes, were the last to be touched. I’m sure it’s due to spotty testing or the “You can’t get there from here” nature of traveling in the region… but a part of me wants to believe it’s because the lakes are magic.

Yates County is one of many rural vacation destinations that are anxiously warning travelers away while trying not to seem xenophobic:

“We don’t want to say Yates County is not welcoming to outsiders because we are, and we’re dependent on that but right now it’s not the time to come to Yates County,” Flynn said. Soldiers and Sailors Memorial Hospital in Penn Yan is Yates County’s only hospital…

Although [Yates and Seneca counties] discourage visitors from coming now, if they do so, Flynn says there’s very little county leaders can do in terms of enforcement.

I’m still annoyed at Cuomo’s dismissiveness of a reporter’s question a few days ago about rural communities’ concerns — and ironically these issues came back to bite him over the weekend. (Would it have been such a huge diversion from his very important other messages to take a few moments and say, “Hey, New Yorkers, please think of our rural New York communities and travel responsibly”?)

Despite early panic, most rural and small-town residents (and visitors) seem to be trying to do their part and react responsibly, but worries remain.

After Cuomo announced nonessential businesses had to be closed, Farmer saw restaurants rebound, at least a little, by offering take-out. But his take on the influx of people to Old Forge has changed day to day, and Thursday, he was worried about it. “Over the weekend, it was the first time our grocery store had been seriously depleted,” Farmer said. The worry grew as some restaurant owners approached him and said they were serving many people they didn’t know. “They were trying to stay in business, trying to stay open for take-out, trying to keep a percentage of their staff working, and they found out they were serving so many people that they had never seen before,” Farmer said. “They don’t know who they are, and they just can’t do it. They can’t, in good conscience, put their staff, their selves and families at that kind of exposure risk. And it’s a really tough call.”

It’s not just a New York problem. The elite and wealthy are “escaping” all over Europe, and these scenes are sure to unfold in the weeks to come in America’s other vacation spots. It also isn’t just a rural problem: college towns all over UNY are having to corral the very kids who help keep their sales tax revenues coming in. Oswego mayor William Barlow:

“We’ve already observed college students who were foolish enough to travel for spring break come back to our community and not practice social distancing by having house parties and other types of large gatherings. We also have students from downstate who have traveled here to seek refuge from the more dense areas experiencing more positive cases… The longer we do not properly social distance, the longer we will have to do it, and that is what people need to realize.”

Sounds like we need some of our own Italian mayor videos.

Sunday, March 29 update

NYS update: After spending yesterday evening fending off the Mouse That Roared (who backed down later), and pondering acts of “civil war,” Cuomo finally has got something to say about internal travel. (It would have been nice if he had just addressed this directly the other day, when asked, by a journalist from his own state asking about concerns of people from his own state. These are unprecedented times, but not that unprecedented I guess.)

Predictably, all nonessentials will remain at home until April 15.

Cuomo also brought up potential hospital load-bearing plans which, theoretically, would involve larger UNY hospital centers. (My guess: Albany, Utica-Rome, Syracuse if they came up this far; places like Olean certainly not). Although I’m not a health professional, I admit I struggle to understand what “overflow” means – would these be COVID patients? Would they be “regular” patients? Would it just be easier to send upstate equipment down south, and if so, would that raise the hackles of previously sanguine county leaders? (“They’re coming for your ventilators…”)

Suddenly, the physical distance between NYC and upstate seems farther than ever. (Never mind the social, political and financial distancing that, alas, didn’t just start last week.)

Onondaga County update: A large jump in confirmed cases, with 48 new cases for a total of 194. However, this is seemingly due to a large number of backlogged tests returning (something that Tompkins County may have also experienced this weekend). The other statistics seem more promising: No net increase in numbers of hospitalized (still 20). A net decrease in the number in intensive care (now 7). Four people have been discharged (still sick), and five have been classified as “recovered.” And no new deaths have been reported here.

Dr. Gupta was on hand to explain the (brand new) CDC and NYSDOH guidance on the ending of isolation/quarantine, where all three criteria must be met – 7 days since first appearance of symptoms; 3 days without fever (no fever reducing medicine allowed – if you took fever reducer, the 3 days has to reset); symptoms must continue to improve. This last criterion requires intensive and individualized evaluations. Once isolation/quarantine ends, things don’t go “back to normal”: strict social distancing must be maintained.

The “no more normal” theme continued regarding economic questions, with the open-endedness of this period of time stressed, and also that businesses who can come up with proposals (“evolve”) to adapt to uncertain conditions should receive help from the county. The only other major question concerned the possible transfer of downstate patients. I felt McMahon did a good job of explaining that critically ill medical transfers are not the same thing as AirBNB’ers running amok, and that, if Syracuse was managing the needs of CNY and NNY patients, it would be “ridiculous” not to accept downstate patients if necessary.

(One shudders at what the answers to these questions would have been if we lived in the home range of Republicanus trumpi, rather than the home range of the extinct R. rockefellerius and their as-yet-unclassified descendants.) May we all continue to evolve.