ALBANY — Three years after the COVID-19 pandemic, some normality has returned to everyday life in New York; schools and businesses are catching up, case counts are no longer tracked, and pandemic-era restrictions are long gone.
But health experts say many New Yorkers are still becoming 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 to For better or for worse, the state’s health care infrastructure is fundamentally changed.
Marking the third anniversary of the statewide shutdown, policymakers and state Department of Health officials spoke with the Times Union about the state’s progress in combating COVID, lessons learned from the pandemic and how the state can respond. prepare for the next health crisis.
Is COVID over?
While the state hasn’t seen a major spike in COVID in over a year, daily hospitalization numbers have stabilized at a worrying level, placing an ongoing burden on hospitals across the state, according to Bryon Backenson, who heads the Department Bureau of Communicable Diseases.
Approximately 1,350 New Yorkers were hospitalized with COVID as of March 15, compared with just over 1,000 admissions a year earlier, state data shows. About 79,000 New Yorkers have died from the virus since March 2020, according to CDC data.
“COVID has been like a bad flu season every day for three years. And that puts tremendous strain on the healthcare system… and there are still a lot of people out there who are getting sick and, in some cases, dying from COVID” Backenson said. “I’m thrilled that we’re where we are, but it’s not like that has gone away.”
The vast majority of New Yorkers have had at least one vaccine, which has been shown to reduce the severity of COVID-19 symptoms. But the virus continues to evolve, and health leaders say they are closely monitoring new mutations. A new variant that has the ability to bypass immunity and cause serious illness could easily delay these efforts.
There are still mysteries about the disease, such as the causes of the “long COVID”. Often defined by symptoms lasting more than three months after infection, the condition continues to irritate doctors, and for many patients, the relief is indescribable.
the road ahead
Burnout has taken a toll on the state’s public health workforce. More than half of the state’s county health workers have resigned or been forced out since March 2020.
The state’s Department of Health has also seen an exodus of some of its most senior staff and has rotated three health commissioners in three years.
Now that things have stabilized, the agency is working to rebuild its workforce and institutional experience. Nearly 40 percent of the Health Department’s 4,500 employees are new or recently promoted, according to data provided by the department.
“It can be challenging to bring new people up to speed,” Backenson said. “A lot of people in health departments across the state have been hired during COVID and this is the only thing they’ve done.”
The pandemic has also spurred scientific and technological innovation. Developments in vaccine research, at-home testing and the provision of virtual healthcare have transformed the medical landscape.
New capabilities such as wastewater testing and genome sequencing have generated new excitement in the field of public health.
State partnerships with the Wadsworth Center and CDC laboratories have allowed state health officials to do cutting-edge genomic analysis, according to Daniel Lang, who heads the department’s Center for Environmental Health.
“It’s one thing to test (COVID) … but with the ability now to sequence genetic material from clinical or environmental samples, we can get ahead of mutations and variants that occur in these viruses.”
Lang, who also oversees the state’s wastewater surveillance system, said the sewage testing program will be a “game changer” for disease control going forward.
Some of the diagnostic systems established during COVID, including wastewater testing, have been used again during the state’s recent smallpox and polio scares.
The health crisis brought greater cooperation between state and local health agencies, hospitals and community organizations who worked closely to establish mass testing sites and get information to the public. Those relationships, if they can be maintained, will serve the future of the state, Lang said.
lessons learned
Figuring out how to combat the new pathogen was a clumsy process. Early efforts to limit travel from critical countries or contain the disease to Westchester County were largely ineffective against the rapidly spreading virus. In mid-March, businesses and schools were closed.
The state has established temporary hospitals to absorb the influx of patients and has built mass testing sites across the state.
Most schools tentatively resumed part-time face-to-face learning in the fall of 2020, and the state has established metrics 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 withstood criticism from both sides of the political aisle, some arguing that the state’s 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 as it tried to absorb an immense amount of data emerging from other parts of the world.
“Obviously this particular disease has shown us a lot of things 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’re doing too little and more and more people get sick, or you’re doing too much and you think you it took away rights and freedoms. It’s really hard to find the right line.”
There were some clear mistakes. Early in the pandemic, the administration of Governor Andrew M. Cuomo was criticized for ordering nursing homes to accept coronavirus-positive patients in order to ease the shortage of beds in emergency rooms and intensive care units. About 9,000 infectious patients were referred to long-term care facilities before the policy was reversed.
A 33-page Department of Health report that concluded the change did not result in a higher death toll was undermined after Cuomo’s team admitted to manipulating details in the report, including the number of nursing home residents who died from COVID.
Cuomo and former health commissioner Howard Zucker resigned in 2021. Some critics say they have not been held sufficiently accountable for nursing home policies that they say have accelerated the spread of disease.
Rep. Ron Kim, a Queens Democrat and vocal critic of Cuomo’s asylum policies, said the state must own up to its mistakes.
“We need 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 we don’t repeat them.”
Under the new leadership, health experts say they have worked to improve transparency and communication, with the aim of releasing as much real-time data as possible and worrying less about how that data could be interpreted or misinterpreted to political purposes.
“Science doesn’t operate on the same time scale as politics,” Lang said. “Our goal is to make sure we keep improving the science and getting information out there for people to digest and respect in different ways.”