ALBANY — New York may be on the brink of breaking the log jam in COVID-19 testing that has stymied efforts to contain the highly contagious and potentially deadly disease.
Even with the limited testing capacity available in New York, confirmed cases of the coronavirus in the state jumped nearly 25 percent from Tuesday to midday Wednesday, when Gov. Andrew Cuomo gave an update on the situation. He said the state had bypassed federal regulators and would contract with 28 independent laboratories in the state to test patients for the disease.
As of Wednesday afternoon, 216 New Yorkers were confirmed to be ill with COVID-19. All but three of them (two in Saratoga County, one in Ulster County) are downstate, in New York City and its closest neighboring counties.
Cuomo said after the state had already decided to contract with the 28 labs, it sought and received approval for the move from the federal Centers for Disease Control, which at the onset of the crisis had declared that only the CDC would be conducting tests.
“We’re not in a position where we can rely on the CDC and FDA,” Cuomo said.
U.S. Sen. Charles Schumer, D-N.Y., also lit into the U.S. government’s response to the worldwide COVID-19 pandemic Wednesday. The proven way to contain a highly communicable disease is to test anyone with symptoms then track down everyone who had contact with a confirmed patient and test those people. That is not possible in New York, which has become the first or second hardest-hit state, he said.
“I’ll level with you: No one knows why it has taken so long,” Schumer said during a call with reporters.
Tallies provided by government agencies in South Korea and the United States show South Korea has performed 2,100% more tests than the U.S. despite having only 16% as many citizens.
South Korea has been fighting the disease longer than the United States and has one of the highest confirmed case counts outside of China, where COVID-19 originated.
The Trump administration is stuck in the mud, Schumer charged, having failed to prepare for the inevitable spread to American soil. The United States now must mount a come-from-behind defense, he added.
ON THE GROUND
The list of events, activities and gatherings canceled in the Capital Region grows longer by the hour, from sporting events to chamber of commerce dinners to in-person classes at college.
Late Wednesday afternoon, for example, Schenectady County officials closed the county-run Glendale Nursing Home to all visitors, because the elderly are as vulnerable to COVID-19 as they are to the flu — 19 of the 29 COVID-19 deaths in the United States are linked to a single Washington state nursing home.
Health care providers are seeing heavy call volumes from patients concerned about COVID-19. The fact that testing has been rationed — people who show up seeking a test without prior approval of their primary care provider or local county of health have been turned away — has only exacerbated the worry.
One of the largest medical groups in the region has had to temporarily suspend some primary care walk-in hours as a result.
Dr. Ron Musto, executive vice president of clinical affairs for Community Care Physicians, said the problem is that symptoms of COVID-19 are similar to those of cold and flu, which are very common this time of year.
“Not everyone with a respiratory illness needs to be examined,” he said Wednesday via email. “Most patients with mild to moderate respiratory illness can be managed by our physicians and our care managers by phone at home. We have special procedures for the evaluation and treatment of patients with more serious symptoms but we need to know in advance that they are coming so we can protect other patients in our offices and, of course, our staff.”
Glens Falls Hospital has had to take preparatory steps of its own, according to spokesman Ray Agnew. “We actually are getting a lot of calls and we’ve set up a hotline. What we also did is we put an FAQ on the website. Everybody’s been concerned.”
Other Capital Region hospitals have set up multidisciplinary teams and run drills with mock COVID-19 patients without telling the staff first.
And all the major hospitals in the region, from Columbia Memorial to Nathan Littauer, said Wednesday they’ll be strengthening their normal flu-season restrictions on visitors, screening them at entry for COVID-19 risk factors.
County departments of health also are on the front line, working to prevent spread of the disease and preparing contingency plans if it reaches crisis proportions. For example:
- The Schenectady County Public Health Services has emergency preparedness and communicable disease teams that provide guidance to schools and other organizations, conduct surveillance, confer with the state and federal health agencies and monitor quarantined residents. (There currently are 12 people in mandatory quarantine and nine in precautionary quarantine countywide.)
- Saratoga County’s Public Health Services is supervising mandatory quarantine of five people and precautionary quarantine for 46. Registered nurses are checking them daily for changes in their condition, either in person or electronically. Like hospitals, Public Health Services is receiving increased call volumes from worried residents as the number of confirmed cases rises.
- The Montgomery County Department of Health, meanwhile, is monitoring just one person, and that person hasn’t shown any symptoms. It said the risk of contracting COVID-19 is fairly low at this point but recommended the commonsense and low-cost precautionary measures such as handwashing, covering mouth and nose to cough or sneeze, and staying home with a fever. Montgomery County residents experiencing symptoms or who have been exposed to someone who’s tested positive for COVID-19 should call the Department of Health.
Schenectady-based health insurer MVP Healthcare has the dual responsibility of facilitating care for its 700,000-plus members and keeping its over-1,700-person workforce healthy.
“We have an obligation to our members to make sure they have access to the health care they need,” said MVP Regional Medical Director Dr. Kim Kilby.
One goal is to ensure that sick people get care but not expose healthy people to their germs in the process. “So telemedicine is one of the great opportunities we have in that regard,” she said.
Kilby, a specialist in family medicine and public medicine, was director of communicable disease control for the state Department of Health in 2009 during the H1N1 swine flu pandemic, so this is familiar ground for her.
For COVID-19, MVP has assembled a task force with multiple areas of expertise, from government affairs, risk management and information technology to claims, marketing and clinical operations. It has been a stretch of long work days with attention diverted from other tasks.
“We’re all in this task force that’s meeting daily,” Kilby said. It’s quite an effort.”
THE LARGER PICTURE
The true scope of COVID-19 remains to be seen. Some people infected with the disease almost certainly have gone undiagnosed because of the shortage of tests.
“The more testing you have, the more cases you’ll have,” Kliby said, adding that the rapid spread shows the importance of a global view of health. “It can be humbling for people day to day and what we take for granted.”
Cuomo noted that while the death toll so far from COVID-19 is a terrible number — over 4,600 worldwide — it is far from the greatest health threat. The seasonal flu has killed 20,000 to 50,000 people from Oct. 1 to March 1 just in the United States, by the CDC’s estimate.
“The facts here do not justify the amount of fear,” the governor said. “I understand it’s a virus, I understand it sounds like a bad science fiction movie. This is not the Ebola virus, we’ve dealt with that. That was a much more dangerous, frightening virus. The facts here actually reduce the anxiety. We have  cases in the state of New York; 32 are hospitalized. Well, how about everyone else? They’re home. They’re recovering at home or they have recovered. But only 32 out of the  require hospitalization.”