How 3 years of COVID hit N.Y.
State’s public health experts, policymakers reflect on the lessons and next crisis ahead
ALBANY — Three years into the COVID-19 pandemic, some normalcy has returned to daily life in New York. Schools and businesses are rebounding, case counts are no longer tracked and pandemic-era restrictions are long over.
But health experts say too many New Yorkers are still getting seriously ill and dying of COVID — the virus kills more than 100 New Yorkers per week, according to the latest numbers from the Centers for Disease Control and Prevention — and for better or 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 talked to the Times Union about the state’s progress in fighting COVID, lessons learned from the pandemic and how the state can prepare for the next health crisis.
Is COVID-19 over?
Though the state hasn’t seen a major COVID spike in more than a year, daily hospitalization numbers have leveled out at a concerning pace, placing a continuing burden on hospitals throughout the state, according to Bryon Backenson, who heads the Department of Health’s Bureau of Communicable Diseases.
About 1,350 New Yorkers were hospitalized with COVID on March 15, compared to just over 1,000 hospitalizations one year earlier, state data shows. Since March 2020, 79,000 New Yorkers have died of the virus, according to CDC figures.
“COVID has been like a bad flu season every day for three years. And that puts a tremendous strain on the health system ... and there still are an awful lot of people out there who are getting sick and in some cases, dying from COVID,” Backenson said. “I’m thrilled that we are where we are, but it’s not like it’s 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 muta
tions.
A new variant that has the ability to sidestep immunity and cause severe illness could easily set back those efforts.
There are still mysteries about the disease, such as the causes of “long COVID.” Often defined by symptoms that last longer than three months after infection, the condition continues to vex doctors and for many sufferers, relief is elusive.
The road ahead
Burnout has taken a toll on the state’s public health workforce. More than half of the state’s county health officials quit their jobs or were forced out since March 2020.
The state Department of Health also saw an exodus of some of its most experienced staff and has rotated through three health commissioners in three years.
Now that things have stabilized, the agency is working to rebuild its workforce and institutional expertise. Nearly 40 percent of the Department of Health’s 4,500 employees are new or recently promoted, according to figures provided by the department.
“It can be challenging to bring new people up to speed,” Backenson said. “There are a lot of people in health departments across the state who were brought on during COVID and that’s the only thing they have done.”
The pandemic has also spurred scientific and technological innovation. Developments in vaccine research, at-home testing and virtual health care delivery have transformed the medical landscape.
New capabilities like wastewater testing and genome sequencing have generated new excitement in the public health field.
State partnerships with the Wadsworth Center and CDC labs have enabled state health officials to do cutting-edge genome analysis, according to Daniel Lang, who heads the Department’s Center for Environmental Health.
“It’s one thing to test for (COVID) ... but with the ability now to sequence the 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 surveillance system, said the sewage testing program will be a “game changer” for disease control in the future.
Some of the diagnostic systems established during COVID, including wastewater testing, were used again during the state’s recent monkey pox and polio scares.
The health crisis has brought greater cooperation between state and local health agencies, hospitals and community organizations, which worked closely to establish mass testing sites and get information to the public. Those relationships, if they can be maintained, will be useful to the state moving forward, Lang said.
Lessons learned
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. By mid-March, businesses and schools were shut down.
The state established temporary hospitals to absorb the influx of patients and built out mass testing sites statewide.
Most schools tentatively resumed in-person learning on a part-time basis by fall of 2020 and the state established metrics to help them know when to shift 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 weathered criticism from both Republicans and Democrats. Some argued the state’s mandates were too rigid, while others thought they were too lax.
Backenson said the department was dealing with an unknown pathogen that was constantly evolving while trying to absorb an immense amount of data emerging from other parts of the world.
“Obviously this particular disease has showed us a lot of things as time went on,” he said. “Public health always has this problem of trying to do what’s just right ... I often talk about Goldilocks and the Three Bears — you are either doing too little and more and more people get sick, or you are doing too much and you think you have taken away rights and freedoms. It’s really hard to find that right line.”
There were some clear missteps. Early in the pandemic, Gov. Andrew M. Cuomo’s administration took heat for ordering nursing homes to accept coronavirus-positive hospital patients in order to ease bed shortages in emergency rooms and intensive care units. The policy was reversed after 9,000 infectious patients were directed to long-term care facilities.
A 33-page Department of Health report that concluded the move did not result in a higher death toll was undermined after Cuomo’s staff admitted they manipulated details of the report, including the number of nursing home residents who died of COVID.
Cuomo and former Health Commissioner Howard Zucker both resigned in 2021..
Some critics say they have not sufficiently been held accountable for nursing home policies that they believe accelerated the spread of the disease.
Assemblyman Ron Kim, a Queens Democrat and vocal critic of Cuomo’s nursing home policies, said the state must own up to its mistakes.
“We need to hold them accountable for the bad decisions,” Kim said. “Not because we want to demonize them and vilify them but this is about learning from our mistakes so we don’t repeat them.”
Under new leadership, health experts say they worked to improve transparency and communication, aiming to release as much real-time data as possible and worrying less about how that data could be interpreted or misconstrued for political purposes.
“Science doesn’t operate on the same time scale that politics does,” Lang said.
“Our goal is to make sure we continue improving the science and get information for people to digest and respect that they will digest it in different ways.”