Multiple cases confirmed in Westchester
Many Highlands residents began preparations this week for what appears to be the inevitable arrival in Putnam and Dutchess counties of the coronavirus.
On Tuesday (March 3), officials confirmed that a Westchester County lawyer in his 50s was the second person in the state known to have 2019 Novel Coronavirus, or COVID-19. Two days earlier, a 39-year-old health care worker in Manhattan who recently returned from Iran was the state’s first confirmed case.
By Tuesday, the state had confirmed 108 cases in Westchester, six in Rockland, two in Saratoga, one in Ulster and 20 on Long Island.
■ Last week Gov. Andrew Cuomo requested an emergency appropriation of $40 million from the state Legislature for the Department of Health to hire staff and purchase equipment to battle the pandemic.
The request was quickly approved, passing 53-4 in the Senate with support from Sue Serino, a Republican whose district includes the Highlands, and 122-12 in the Assembly with Democrats Sandy Galef, whose district includes Philipstown, and Jonathan Jacobson, whose district includes Beacon, voting in favor.
However, Serino and other legislators from both parties protested provisions in the initial proposal that would have greatly expanded the governor’s ability to declare states of emergency and suspend legislative oversight. That provision was peeled back to limit each state of emergency to 30 days and give lawmakers the ability to overturn them.
“While I am incredibly disappointed by the process that unfolded last night, ensuring that the state has the funding and the tools necessary to effectively combat this pandemic needs to be a top priority,” Serino said in a statement on Tuesday. “I will remain vigilant to ensure that the intent behind the new law — protecting New Yorkers in the wake of a health emergency — is followed closely and the powers that come along with it are not abused.”
■ Cuomo announced a directive that New York health insurers must waive co-pays for in-network testing related to COVID-19 at medical offices and urgent care centers, or at emergency rooms. Residents receiving Medicaid will also not be required to make co-payments.
■ The Wadsworth Center at the state Department of Health said it would expand its testing from 200 to 1,000 samples per day by instructing hospitals how to replicate its test and providing funds to purchase equipment. The federal Food and Drug Administration on Feb. 29 approved a test for the virus developed by Wadsworth that can be completed within five hours. The state had been sending samples to Atlanta for testing by the Centers for Disease Control.
■ The state instituted new cleaning protocols for schools, and the MTA announced it would disinfect its buses and train cars, including on Metro-North, every 72 hours. Turnstiles, handrails and ticket machines will be disinfected daily.
■ Cuomo said he planned to amend the sick paid leave law, which took effect in 2014, to allow people who are quarantined because of the virus to continue to be paid by employers.
■ Study-abroad programs run by SUNY and CUNY in China, Italy, Japan, Iran and South Korea have been suspended, and the universities are bringing home students, faculty and staff in those countries to begin 14-day quarantines. On Feb. 29, Marist College suspended its program in Florence.
The first Westchester patient, who lives in New Rochelle and works in Manhattan, had no known exposure from global travel. By Thursday, officials announced that his wife, son (a student at Yeshiva University in Manhattan) and teenage daughter had contracted the virus, along with a friend of the man, the neighbor who drove the man to a Bronxville hospital, and the neighbor’s wife and three children.
“While we should treat this as a serious public health issue, please keep in mind that there is no reason to panic,” said state Assemblywoman Sandy Galef, whose district includes Philipstown, in a March 4 statement. “The vast majority of people who have contracted the virus have not become seriously ill and only a small percentage require intensive care.”
CDC: What May Happen
In a post on its website dated Feb. 29, the federal Centers for Disease Control offered this forecast:
“More cases of COVID-19 are likely to be identified in the coming days, including more cases in the U.S. It’s also likely that person-to-person spread will continue to occur, including in communities in the U.S. It’s likely that at some point, widespread transmission of COVID-19 in the U.S. will occur.
“Widespread transmission of COVID-19 would translate into large numbers of people needing medical care at the same time. Schools, child care centers, workplaces and other places for mass gatherings may experience more absenteeism. Public health and health care systems may become overloaded, with elevated rates of hospitalizations and deaths.
“Other critical infrastructure, such as law enforcement, emergency medical services and transportation industry may also be affected. Health care providers and hospitals may be overwhelmed. At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Non-pharmaceutical interventions would be the most important response strategy.”
“New Yorkers should focus on facts not fear as we confront this evolving situation, and the facts do not merit the level of anxiety we are seeing,” said Gov. Andrew Cuomo in a statement on March 5. “The number of cases will increase because it’s math — the more you test, the more cases you find.”
COVID-19 is believed to have originated in Wuhan, China, in December and has spread around the globe and infected tens of thousands of people. Thousands of people have died, including 10 in the U.S. as of Thursday evening.
Symptoms of infection include fever, cough, difficulty breathing or shortness of breath, and gastrointestinal problems or diarrhea. Milder cases may resemble the flu or a cold, but serious cases cause lung lesions and pneumonia, and the virus appears to be more deadly than the seasonal flu. It is estimated that symptoms occur 2 to 14 days after exposure.
A Voice from China
Residents of Cold Spring and Beacon over the past two weeks stocked up on hand sanitizer, antibacterial wipes and groceries as they anticipated extended periods of isolation. Some also purchased medical-grade respirator masks, although the U.S. surgeon general has dismissed their effectiveness for the general public and warned of a shortage for medical professionals.
In Dutchess County, the Department of Behavioral and Community Health issued a public health alert on Jan. 24.
In Putnam County, health officials say they are ready for any outbreak. Three weeks ago, on Feb. 11, Dr. Michael Nesheiwat, the health commissioner, briefed legislators on his agency’s preparations. He said that, like other counties in the state, Putnam follows the guidance from the state Department of Health in Albany and the federal Centers for Disease Control and Prevention (CDC) in Atlanta.
An Ounce of Prevention
Health officials recommend these steps to stop the spread of COVID-19:
■ Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
■ Avoid touching your eyes, nose and mouth with unwashed hands.
■ Avoid close contact with people who are sick.
■ Stay home when you are sick.
■ Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
■ Clean and disinfect frequently touched objects and surfaces.
At the time, he noted that travelers from mainland China entering the U.S. were allowed to continue on their travels if they showed no symptoms after screening at the airport by the Port Authority and CDC. Those authorities contacted local health departments to make them aware of travelers from China.
In Putnam, Nesheiwat said his agency in early February placed two individuals under 14-day “restricted movement isolation,” or “active monitoring,” during which health officials visited twice a day to check for fever. He said both patients were “very cooperative” and understood the need for the restrictions.
Nesheiwat said his agency was attempting, through social media, the county website and the news media, to educate residents about the virus. His staff also was meeting with hospitals and health care providers to discuss how to handle patients who presented symptoms of what might be COVID-19.
New York Numbers
as of March 10
137 positives outside NYC
108 in Westchester
20 on Long Island
6 in Rockland County
2 in Saratoga County
1 in Ulster County
36 positives in NYC
Dr. Valerie Cluzet, an infectious disease specialist with Nuvance Health, which owns Putnam Hospital Center and six other facilities, said in a statement that the company was “working closely as a multidisciplinary team to ensure we are prepared for this quickly evolving outbreak.”
Nesheiwat told legislators on Feb. 11 that he had briefed County Executive MaryEllen Odell, department heads, sheriff’s and corrections officers and first responders about the virus. He said the county also had “reached out to facilities in case, God forbid, we need to house” a large number of patients.
“Putnam County is prepared,” he said. “The staff at the Department of Health is doing an outstanding job, working seven days a week around the clock.”
Local school officials have reassured parents that they are prepared to respond to an outbreak of the COVID-19 virus.
At Haldane, Superintendent Philip Benante wrote on Feb. 27 that the district has been in contact with health officials for guidance, and noted that the custodial staff cleans and disinfects classrooms, offices and bathrooms daily. He asked that parents keep home any child with a fever or cough until they are fever-free for at least 24 hours without medication.
At Garrison, interim Superintendent Debra Jackson wrote on Feb. 27 that the staff has been cleaning surfaces as recommended by the state Department of Health and federal Centers for Disease Control. On March 6 she added that, as part of an e-learning Preparedness Plan, that parents of students in kindergarten through second grade have been given Google accounts already in place for grades 3 to 8 to connect with teachers remotely; all teachers have been trained in using the virtual learning space; a videoconferencing account has been established for staff meetings; and the business office is setting up a virtual network to operate remotely.
In Beacon, Superintendent Matt Landahl wrote on March 2 that the district has been in contact with the Dutchess County Department of Behavioral and Community Health and that the school staff has been cleaning all “high-touch” surfaces and disinfecting bathrooms on a daily basis. He also said the district had increased its “custodial coverage” of all buildings, and that school nurses and teachers were reminding students to wash their hands.
Legislator Nancy Montgomery, whose district includes Philipstown, asked Nesheiwat if the county could also coordinate with NewYork-Presbyterian/Hudson Valley Hospital in Cortlandt because most residents on the western side of Putnam go to the Westchester County facility rather than Carmel. “These viruses don’t know borders,” she noted.
She also asked Nesheiwat if the county had enough supplies, such as respirator masks. He assured her that the hospital in Carmel is “well-equipped” and that the Health Department “has plenty of N95 masks. I don’t believe there’s a shortage.” He said the county Bureau of Emergency Services has protocols in place to respond to an outbreak and that “most of the volunteer firefighters” in the county are equipped with medical-grade masks.
Kim Wilson, the owner of Hollowbrook Travel in Fishkill, said she had her first cancellation on Tuesday (March 3) that could be attributed to the coronavirus, by a couple planning a summer trip to Italy. She said that airlines are not waiving cancellation penalties for June and July flights, which cost the couple $900.
Gov. Andrew Cuomo said on March 6 that travel insurance companies and travel agents will offer residents and businesses travel insurance that includes coverage for cancellations due to COVID-19. Six insurers have agreed to offer “cancel for any reason” coverage — Allianz, Nationwide, Starr Indemnity, Berkshire, Crum & Forster and Zurich — which had not been available in New York State. Standard travel policies usually exclude coverage for pandemics. “Cancel for any reason” policies are substantially more expensive than standard insurance and typically only cover 75 percent of expenses.
On Feb. 27, Montgomery asked Nesheiwat if he could attend a March 5 Philipstown Town Board meeting to provide an update; Odell responded that Nesheiwat would not be available because he was attending a meeting of the New York State Association of County Health Officials.
Montgomery also had asked about the availability of N95 masks; Odell wrote that the Health Department “is not required to have supplies on hand for all residents. I have researched myself and verified with Dr. Nesheiwat that these supplies are available on Amazon; also local drugstores should have them on hand.”
Last week, Philipstown Supervisor Richard Shea said: “I found her advice to go on Amazon and get masks to be completely outrageous. This response does not instill confidence in our top elected officials to lead us through a large public health threat.”
Shea also said the town had not been informed of a meeting organized by the county in Carmel on Monday (March 2) for first responders and stakeholders to discuss the response to the virus.
The Dutchess County Health Department can be reached at 845-486-3402 from 9 a.m. to 5 p.m. weekdays or 845-431-6465 otherwise, or see dutchessny.gov.
The Putnam County Health Department has posted information at putnamcountyny.com.
New York State has created a coronavirus hotline at 888-364-3065, or visit health.ny.gov. The CDC is posting updates at cdc.gov.
When these virus cases so far have occurred — generally around the world — in clusters, it appears they are most often associated with one of the following categories of environments and/or their respective connected activities: buildings used for religious purposes of various denominations, nursing homes, cruise ships, airplanes, indoor concerts, and hospitals.
One condition all these types of environments typically have in common – for their own various logical or traditional reasons – is a relatively small amount of natural and/or forced ventilation of fresh air from outside, coupled with a relative high density of people in proximity to others for an extended period of time. Possibly these conditions apply as well to student dormitories, and to trains, although clusters in these cases have so far not been much discerned or reported.