State of Covid

Posted on March 24, 2023 by John Bailey

WPCNR QUARTERLY STATE OF LIFE SERIES # 1: STATE OF COVID. News & Comment by John F. Bailey. March 24, 2023:

The State of Covid will now be whatever our leaders say it is.

Because they who control the reports of covid spread or decline will now be only reporting results once a week on Fridays.

This is not a good development.

Those of you who make my weekly Covid Surveillance Reports developed from the daily trends of the communities in Westchester, Orange, Rockland, Dutchess, Ulster, Putnam and Sullivan Counties (the seven counties in the Mid-Hudson region) reported by the New York State Covid-19 Covid Tracker will not be worried any more or encouraged by lower numbers of new covid infections. You will understand whatever the state chooses to tell you.

Why? Any figures they will tell you will not reflect in real time the resurgence of the disease or the continued “diminution” of the disease. (What a lovely word! Diminution presents a very comforting feeling to the person who reads or hears it.

Once a week the authorities will analyze a week results, and who knows if they will level with us as to the real extend of the spread.

Why should they?

Because they have softened the real picture for a year and a half.

The state computerized data collection formats used the very questionable method of the Center for Disease breaking down the number of new cases reported per county by increments of 100,000 of population.

In order to know how many infections you have in a day, I the reporter, and you the person concerned about statistics must know the population of your county to know how many infections of covid are really happening a day.

Then multiply that out by week and 4 weeks of a month. The state could very easily report the infections by total population automatically without leaving us out here in queryland to do the math.

What this format has done is provide a false sense the disease is not as spreading a lot each day.

But unless you multiply it out according to 100,000 increments of population, the growth of cases is being reported with an error factor of as much as 50%.

Now the State as the Center for Disease Control announced a month previously, said Friday statistics are not going to be issued by the major stat providers. (I guess they are tired.)

This announcement by the state coincided with President Biden announcing the State of Emergency would end May 11.

Now Governor Hochul and the legislature currently controls covid policy and the right to announce a covid state of emergency again if needed.

To refresh your memory, the State Senators and Assemblypersons took this away from the Governor’s office during the sunset of the former governor (Andrew Cuomo). Now the senators and assemblypersons are now following suit.

The Governor’s updates on covid released to the press via email have basically stayed the same issuing new statistics based on the former day, sometimes on time and sometimes not — now are going to issue the stats for a week on new covid cases beginning this week. The day-by-day results will be on the New York State Covid Tracker dailyl

However the state is also looking at relaxing the amount of reporting hospitals have to provide on covid cases coming in, admissions.

It is unclear how detailed or curtailed the hospitalization figures will be. The statkeepers in the hospitals do not for the most part do hot treat patients.

I see no reason why that cannot still be reported the same way it is now. Hospitalizations broken down by daily covid cases compared to total hospitalization admissions.

My concern may be way off base, but the hospitalization stats you can get by hospital off the New York State Health Department Hospitalization site are hard to get a true picture because they are tough for the non-technical person to even access a hospital without knowing the hospital code. The hospitalization numbers are very difficult to access comparative information fast. (Perhaps that’s why few media report them in a comparative way that actually means something.)

Since the March 17 statistics came out, here is where Westchester County stands:

First the good news that the present daily statistics put out ended March 17

Westchester county had 35 positives if 1,211 tested 2.7%. The county over 7 days average 3.6 new cases a day per 100,000 population.

Westchester has completed a 13th week of decline in new covid cases with 175 cases compared to 254 last week. 989 for the 2 weeks and 3 days of March so far..

However, not so fast. At 3.6 new cases per 100,000 population a day over 7 days, you have to multiply that by 23.26 the number of 100,000 uncrements in Westchester population (1,040,000) to get the true daily figure.

The true daily number of cases for 1 day is 90 a day. Which is 634 for a week and over the month of March would give us 2,559 new cases in the month.

Perhaps this explains the high number of hospitalizations the 7 counties are experiencing the first three weeks of March

According to the report statistics on the hospitalizations graph for the Mid-Husdson Region of the 7 counties this is the hospitalizations were for the counties which have a total population of :

The population of the 7 counties in the Mid-Hudson Region is 2,326,000. That means there are 23.26 segments of 100,000 in the 7 county population. Multiply that daily figure of new covid patients hospitalized in 7 counties (55.56 per 100,000 people, you get 129 hospitalized patients with covid being hospitalized in 1 day March 16 in the 7 counties as of March 13.

Hospitalizations for 17 days in March for all 7 counties look like this:

MARCH COVID HOSPITALIZATIONS ICU INTUBATED COVID/DAY/100KPop DAY/WEEK/MONTH

17 117 11 5.56 129 /905 /3,621

16 129 10 5.56 129 /905/3,621

15 128 14 5.51 128 /897/3,588

14 129 13 5.56 129 /905/3,621

13 137 15 5.9 137 /960/3,842

10 136 12 5.86 136 /954/3,816

9 145 7 6.24 145 /1,015/4063

8 147 7 6.33 147/1,029/4,116

7 153 11 7 162/1,139/4,558

6 151 11 6.50 151/1,058/4,233

3 147 15 6.33 147/1029/4116

2 155 15 6.68 155/1,087/4,350

1 178 12 7.67 178/1,246/4,984

FEB 28 164 13 7.06 164/1,149/4,598

The above chart shows you what the probable hospitalizations will be across 7 Mid-Hudson Counties for the month of March– approximately 4,500 if the current average covid hospitalizations for covid continue

The hospitalizations for covid as you can see are going down from 164 as of February 28 to 129 last Friday..110but not by much. The average for the 7 counties for the 13 days is 144 for the 7 counties the new infections a day give you 1,015 infections a day, 4,000 cases in the month.

This covid is out there and we need to be aware.

How does this affect White Plains Hospital Center?

WHITE PLAINS HOSPITAL SITUATION

However, in White Plains alone, in the 30 days since February 15, White Plains Hospital Center has admitted 329 patients and 130 (40% of those admitted) were admitted for treatment of covid.

In the last week, White Plains has Hospital has seen some slowdown. Of 68 admissions, 42 were admitted for treatment of covid (62% of admissions) from March 8 to 15. March 1st through March 8, 42 persons of the 72 admitted (62%) were for treatment of covid.

Westchester County had 2,906 cases lab verified positive with covid in the month of February. But why all the hospitalizations across the 7 counties?

I worry there are just more covid positive persons out there who of antigen tested saw they were positive but have not gone to get lab verified becaus they need to work, need to take care of children and covid makes them sick and they eventually get so sick they have to have go to the hospital for treatment. This is just a hunch.

Significantly there is no data now telling the true nature of our covid situation.

If the state is thinking seriously about cutting data from the hospitals because they think it is no longer needed how with the State Senators and Assembly persons and county health officials decide if covid is under control or not.

We need more data not less.

If I was a health administrator I would demand, no, WANT to know:

How long each covid infected person is now staying in the hospital.
How many are reinfectees, so we can judge how many will come back. (They have to be coming back now)
How many have long covid
How much additional medications to they need.
Do our hospitals have enough medication to take in these persons so sick they need to be admitted to the hospital at a 40% rate of admissions a day?
We should stop worrrying bout keeping empty beds and worry about and find out aggressively what the disease is doing. Are we seeing new variants?
The schools should be told to report new cases of covid, flu so we can see how the new laissez fair State Education Department you do not have to report cases of covid policy is working out. We do not know. Let me repeat that, we do not know.
The disease roared back last July with 10,000 new cases in a month, and here after almost 7-1/2 months later we still seeing new cases over 7 counties at a 4,000 a month pace, what if this happens again, only on a larger scale, what will the leadership do?
Vaccine boosters for the fall, will county residents have to pay for them? The public is not getting their full compliment of shots when they are free. It is not their fault. They have been told it’s O.K. with no reason except hopeful optimism. If covid throws a 6th wave at us by summer, somebody has to think about how they are going to get the unvaccinated and not completely vaccinated vaccinated.
Restrictions have been completely relaxed. Leaders say we are getting back to a new normal. We’re told all about the wonderful things being done in Albany in the budget. Could do a little thinking about the covid situation please.

Thinking is something the leaders in Albany and Counties and cities and towns should do more of.

GREENBURGH MOVES AHEAD ON AFFORDABLE HOUSING AT THE 4 CORNERS

Posted on March 23, 2023 by John Bailey

WPCNR THE FEINER REPORT. By Geenburgh Town Supervisor Paul Feiner. March 23, 2023:

At Tuesday’s Greenburgh Town Board work session the Greenburgh Town Board spent some time meeting with our Albany lobbyist, John Emrick. We discussed seeking state funding to help the town implement one of Governor Kathy Hochul’s goals: more housing (including affordable housing) near train stations.

The 4 corners in Hartsdale (East Hartsdale Ave, Central Ave, West Hartsdale Ave) would be an excellent location for mixed use housing. But, we will need state financial help creating turning lanes and safety improvements on West and East Hartsdale Ave (to reduce traffic congestion) and will also need state funding to address flooding conditions on Central Ave.

Because housing near train stations is such a high priority for the Governor, we believe that this is a perfect opportunity to seek help from Albany. The discussion with John Emrick can be watched on the link below (first topic on work session agenda).

This is a link to the Hartsdale Neighbors Association posting about the four corners in Hartsdale: a nice history of community efforts to create mixed use housing at this site.

https://hartsdaleneighbors.org/wp/4corners/

https://greenburghny.new.swagit.com/videos/222432

The Greenburgh Town Board also supports a county grant that will help us move the 4 corner redevelopment initiative forward.

Westchester County has a Downtown Improvement Grant (if chosen the County provides a Consultant no cost to carryout market studies which we would use to focus on the redevelopment potential of Four Corners; if chosen the grant also provides $250,000 for use following the market studies – this is envisioned as funding for a consultant to prepare Zoning Code language to enable redevelopment at Four Corners).

2. A resolution approving a NYSDOT contractor to rent the Town owned site on West Hartsdale Avenue for a monthly fee for 3-6 months. This contractor will be carrying out a NYSDOT project to update the traffic signal and make new ADA compliant curb ramps at each 4C intersection.

PAUL FEINER

Greenburgh Town Supervisor

BOOSTERS. DO YOU NEED A SPRING COVID BOOSTER? NEW ANALYSIS BY YOUR LOCAL EPIDEMIOLOGIST

Posted on March 23, 2023 by John Bailey

Do we need a spring COVID-19 booster?

Katelyn Jetelina

and

Jeremy Faust, MD

2 hr ago

(Reprinted with permission)

It’s been close to 6 months since the initial rollout of the fall (bivalent) booster. A lot of people are wondering: Do I need a spring booster?

The answer hinges on more questions: What is the purpose of vaccines? Does that purpose change depending on age or health status?

The purpose of the vaccines

Last month, the FDA and CDC made it clear that the primary purpose of vaccines is to prevent severe disease and death. Decreases in infection and transmission are a bonus at this point, and unfortunately, protection against infection is only temporary.

This makes sense for younger and healthier people. They are staying out of the hospital from COVID-19 for three main reasons:

Hybrid immunity. Younger people are more likely to have been infected. People with both vaccination and infection history have protection that lasts longer.
Less likely to have comorbidities. Their immune systems are less taxed.
Robust immune memories, particularly T-cells. Their thymuses (the organs that give rise to T cells) haven’t gradually degraded into useless blobs of fat, yet.

This means that even if antibodies are waning after 5-6 months, this is okay because protection against severe disease isn’t waning yet.

The story is different for immunocompromised and other very high-risk groups, like older Americans with comorbidities. The purpose of the vaccines for this group should also be to prevent severe disease and death. However, one could argue that in order to do that, we also need to prevent illness.

There’s one big reason for this: SARS-CoV-2 infection can exacerbate potentially fatal underlying illnesses, like heart failure or diabetes. Protection against viruses and underlying illnesses relies on antibodies to act quickly before the immune system is pulled in multiple directions. If it is pulled in multiple directions, it can lead to hospitalization and death.

Immunocompromised

Of the COVID-19 hospitalizations today, 25% are among the immune-compromised. (Immune-compromised make up 3% of the general population). There are really two subgroups to think about:

Non-responders to vaccines. At this point, this is a very small group of people, like organ transplant patients. Some people who did not respond to 2 or 3 doses eventually did respond to 4 or 5 doses. For the remaining non-responders, one could argue that there’s no point in boosting them, but the downsides of trying seem low.
Protection wanes quickly. The majority of immunocompromised people belong in this second group. The vaccine works, but just not as well and not as long. For them, vaccine effectiveness against hospitalization with the fourth dose peaks at 51% at 0-2 months, then drops to 28% by 2-4 months. (The bivalent booster may increase protection and duration, but we don’t know yet.)

Figure from Chemaitelly et al., Long-term COVID-19 booster effectiveness by infection history and clinical vulnerability and immune imprinting. The Lancet Infectious Diseases. Source link here.

There are few downsides to boosting this group every 6 months. It’s actually possible that the immune-compromised are somewhat protected against imprinting by virtue of their sluggish immune systems.

Older Americans with comorbidities

Those 65 years and older are contributing more and more to the proportion of deaths over time. Among adults hospitalized for COVID-19, 96% had at least one underlying condition.

This is because 2 of the 3 defense walls have more holes than those of younger people. Comorbidities also increase with age, which means the immune response in general is a lot more taxed.

So this is another group in whom we want to prevent infection in order to prevent severe disease.

The latest data from the last ACIP meeting shows waning protection against infection among this group after 4-5 months.

The good news is that we clearly see that the risk of severe disease even in the very elderly dramatically declines with vaccination. In fact, very few people are in the hospital today who are up-to-date on vaccines. However, will this change with time? How much each booster helps (or does not help) incrementally is something that we really don’t have a good grip on prospectively.

What are other countries doing?

Canada and the U.K. have offered the bivalent vaccine to the following groups this spring. To our knowledge, this wasn’t based on any new data but rather a similar thought process as above.

Both countries used loose language: people “can” as opposed to “should” get a booster 6 months after the last dose:

U.K.:

People aged 75 years and older
Residents of care homes and other living settings for seniors
Those aged 5 years and older with a weakened immune system

Canada:

People aged 80 years and older
Residents of care homes and other living settings for seniors or those with complex medical care needs
People aged 18 years and older who are moderately to severely immunocompromised
People aged 65 to 79 years, particularly those with no history of SARS-CoV-2 infection

Will this be needed every 6 months until we start seeing predictable COVID-19 patterns? We don’t know. The WHO is meeting in Geneva this week to discuss global COVID vaccine recommendations going forward.

Bottom line

If you’re immunocompromised and/or an older adult with a comorbidity (and it’s been 6 months since an infection or last booster), a spring booster may be a good idea to stay ahead of the virus. Will it be official U.S. policy? We don’t know. There are rumors of FDA conversations happening behind closed doors. Hopefully, we will have an answer soon. But, as you can tell, it’s not a straightforward call.

BUDGET UPDATE MARCH 22,2023 11 A.M.– WHERE THE NEW YORK STATE BUDGET IS TODAY FROM ASSEMBLYWOMAN MARY JANE SHIMSKY

Posted on March 22, 2023 by John Bailey

Dear Friends,

New York State’s annual budgets are the product of a fast-moving, multistage process. When Governor Hochul presented her Executive Budget for the 2023-24 fiscal year on February 1, the Legislature had exactly two months to review the $227 billion Executive Budget, generate and present counterproposals, and negotiate with the Governor to develop the final State budget by the April 1 deadline.

Since February 1, the Assembly and State Senate have conducted 13 joint hearings on the Executive Budget, analyzed thousands of documents, and received information from seemingly countless State employees and private advocates. In the Assembly, individual and groups of Assembly members also sent hundreds of budget letters to Assembly Speaker Carl Heastie, making specific funding requests and suggesting specific means of raising revenue.

Late last week, the Assembly and the Senate reached a critical point in the process. By passing their respective One-House budget bills, each legislative house has put forward its suggested changes and revisions to the Executive Budget. At this point, negotiations will proceed among the “three people in a room” — Governor Hochul, Speaker Heastie, and Senate Majority Leader Andrea Stewart-Cousins — to come up with a final fiscal plan. Supporting those negotiations is a joint General Conference Committee process between both houses of the Legislature. (I am participating as an alternate on the subcommittee evaluating programs and funding for general government and local assistance).

The Governor and Legislature have voiced agreement on numerous major issues, including completing the Foundation Aid funding for our public schools, moving toward all-electric buildings, and raising the minimum wage. Other issues, such as the Governor’s housing proposals and her aid packages for SUNY and CUNY, have been rejected in major part by the Legislature. It remains to be seen whether there will be a comprehensive budget agreement, or if areas of disagreement will remain. The process for resolving any such disagreements is analogous to the process for other legislative disputes — the Governor can reject specific legislative appropriations and line items, and the legislature may override her decisions by a two-thirds vote of both houses.

Here is a list of some of the highlights from the Assembly’s One-House bill:

Public Schools and Childcare:

$2.6 billion for Foundation Aid (fully funding our public schools for the first time ever);
$280 million for free school meals for all students statewide;
No increase in the charter school cap;
$200 million for universal pre-K (Executive Budget proposed $125 million);
$198 million for child care funding, and two-year tax incentive for employer-provided child care

Higher Education:

No tuition hike at SUNY or CUNY;
$1.8 billion increase for SUNY funding (Executive Budget proposed an $879 million increase);
$1.3 billion increase for CUNY funding (Executive Budget proposed a $397 million cut);
Expansion of the Tuition Assistance Program income threshold from an $80,000 to $100,000;
4% increase in community college funding

Health and Mental Health Care:

$2.7 billion for Medicaid funding;
$1.32 billion for hospitals;
$266.5 million for nursing homes;
8.5% cost-of living adjustment for home care workers and direct support professionals

Housing and Development:

$1.5 billion for assistance programs for homeowners and tenants;
$500 million in housing creation incentives for villages, towns, and cities ex-New York City;
Exclusion of the Executive Budget proposals to override local zoning laws and mandate transit-oriented development within 50 miles of New York City

Environment:

All-Electric Building provisions, phasing out gas service in all new buildings by 2029;
$600 million for clean water infrastructure (Executive Budget proposed $500 million);
$435 million for the Environmental Protection Fund (Executive Budget proposed $400 million);
$400 million for energy affordability and home retrofit assistance programs

Transportation:

$1.33 billion to maintain and repair aging transportation infrastructure;
$275 million for PAVE-NY program (Executive Budget proposed $175 million);
$8.3 billion to the MTA, and no fare increase;
Exclusion of the Executive Budget’s MTA payroll tax increase for New York City and its suburbs; alternative funding proposals include an increase in the top corporate tax and fees on three remaining downstate casino licenses

Public Safety and Criminal Justice:

$275 million for discovery within the court system;
$198 million for the Office of Indigent Legal Services;
$69.3 for SNUG, GIVE, and other anti-gun violence initiatives

Workforce and Communities:

Increase in the minimum wage and indexing it to the inflation rate;
$102.5 million for the New York State Council on the Arts (NYSCA)

If you would like to do a deeper dive into this process, please see the Summary of the Assembly Recommended Changes to the Executive Budget.

Sincerely,

MaryJane Shimsky
Assembly member, 92nd District

THE WORLD READS WHITE PLAINS CITIZENETREPORTER — 8,324,077 VISITS IN ONE YEAR

State of Covid

GREENBURGH MOVES AHEAD ON AFFORDABLE HOUSING AT THE 4 CORNERS

BOOSTERS. DO YOU NEED A SPRING COVID BOOSTER? NEW ANALYSIS BY YOUR LOCAL EPIDEMIOLOGIST

Your Local Epidemiologist

BUDGET UPDATE MARCH 22,2023 11 A.M.– WHERE THE NEW YORK STATE BUDGET IS TODAY FROM ASSEMBLYWOMAN MARY JANE SHIMSKY