Capital Region

State adjusts COVID vaccination plans as counties protest diminished role

ERICA MILLER/THE DAILY GAZETTE A drive-through COVID test at the Saratoga Spa State Park.
PHOTOGRAPHER:

ERICA MILLER/THE DAILY GAZETTE
A drive-through COVID test at the Saratoga Spa State Park.

ALBANY — Gov. Andrew Cuomo again addressed the slow and imperfect rollout of the COVID vaccine in New York state Tuesday, and said the campaign will transition away from hospitals in later stages, when the general public is receiving shots.

Leaders of some of the state’s 62 counties also spoke out Tuesday, sharing their distress at being sidelined instead of being allowed to implement the mass public vaccination plans they’ve been rehearsing for years.

Cuomo made only brief passing reference to county health departments in a news conference devoted largely to vaccination, but the leaders of the New York State Association of Counties said they saw some hope in the latest message from Cuomo and his top officials.

Cuomo said there are two key elements, supply and distribution, and neither is adequate at this point.

New York is getting about 300,000 doses a week, he said, at which rate it would take two years to vaccinate 75% of the nearly 20 million New Yorkers and achieve potential herd immunity.

“We hope, pray and expect the supply from the federal government will be increasing,” said Cuomo, who on Monday threatened to fine hospitals up to $100,000 if they didn’t administer every dose provided to them within one week of receiving it.

Looking forward, Cuomo said, the state will lead an effort to bring the vaccine into poor and minority communities and a network of thousands of other providers (pharmacies, hospitals, urgent care clinics, doctors, county health departments) would simultaneously vaccinate the mass public.

Dutchess County Executive Marc Molinaro, president of the state County Executives Association, asserted at a news conference Tuesday that counties should be leading the vaccination campaign — they are responsible for public health under state mandate and have been preparing for this type of crisis since the Sept. 11 attacks, using state and federal resources to plan and rehearse mass vaccination.

Cuomo has earned heavy praise and heavy criticism for his central leadership of the state’s response to the COVID-19 crisis, which hit New York first and hardest among the 50 states.

Some have called it dictatorial — at one point Cuomo threatened to send the National Guard to upstate hospitals and seize their respiratory ventilators for use in downstate hospitals.

The changes to the vaccination campaign have followed a similar model, the counties say: They were informed of the changes very late in the process and given no explanation for the changes.

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Now, instead of a single central leadership in each county, state and regional task forces were recently set up to plan distribution and ensure equitable treatment of poor and minority communities, and no fewer than 3,762 vaccination sites are already enrolled in the network to carry it out.

So the process is being significantly re-invented amid the worst public health crisis in a century.

The County Association compared it Tuesday to building an airplane after takeoff.

Chemung County Executive Chris Moss said his county received 400 doses and was prepared to distribute them Tuesday but Arnot Medical Center heard the threat of a fine from Cuomo on Monday and did a cattle call to distribute all of its vaccine allotment in rushed fashion into the evening.

On Tuesday, the county discovered after the fact that some of its 400 intended recipients had already gotten their first dose the day before. There is no central database to easily determine this, Moss said.

“Our hospital network is not set up for what’s going on here,” he said. “They’re making the best of a bad situation. It’s a shame that we have to duplicate our resources like that.”

All of the county executives who spoke Tuesday were Republicans. Molinaro in fact was Cuomo’s opponent for re-election in 2018.

Leaders of some other counties are on radio silence, refusing to criticize the state on the record or even discuss the situation off the record.

Montgomery County Executive Matthew Ossenfort told The Daily Gazette on Tuesday that he doesn’t think a state as diverse as New York would be best-served by a one-size fits all policy.

He said his county is prepared and eager to start administering the vaccine to its 49,000 residents but has yet to receive any doses — only St. Mary’s Healthcare is providing vaccine in the county.

The county plans to run three points of distribution for the vaccine: Fonda and one satellite each in the eastern and western reaches of the county. He’s confident in the county’s ability to manage and achieve mass vaccination, but thinks more is better when it comes to number of providers and access points — especially with the number of residents who can’t drive or don’t have reliable transportation — and he’s OK with the state stepping in.

Schoharie County Public Health Director Amy Gildemeister said the state’s decision to redesign the mass vaccination plan was unexpected and disruptive.

“They did pivot in a way that initially was not helpful and did not take into account the considerable expertise we’ve developed at the county level,” she said.

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However, she said, the state very recently has shifted its stance to restore a greater role to the counties. She credits the state Association of County Health Officials for bringing about the change.

Gildemeister said more is better when it comes to vaccination — “this needs to be an all-hands effort.”

What Cuomo and his aides may not have appreciated, she continued, is that departments of health already have partnerships and already target the vulnerable populations who haven’t fully benefited from modern health care and medications.

Schoharie County had vaccination partnerships in place with Bassett HealthCare, Family Medical Care, SUNY-Cobleskill and public school district nurses, she said.

The problem remains availability of the vaccine for the 31,000 county residents.

Not only has the county not received any doses, it doesn’t know when or how many it will get, so planning is difficult.

One final challenge after public access to the vaccine is secured: Public acceptance.

Rensselaer County Executive Steven McLaughlin noted that Cuomo himself for months bashed the approval process for the vaccine that the state and county must now convince skeptics to have injected into their shoulders.

A reporter Tuesday asked Cuomo if he could mandate vaccination, even if only among a critical subpopulation — healthcare providers. Cuomo said there’s a legal question whether a vaccine can be mandated if it is being used under federal emergency authorization, as both COVID vaccines are.

MOHAWK VALLEY

The Mohawk Valley region now has the highest positive test rate in the state: 12.3% Monday and 10.7% average over the preceding seven days.

The Finger Lakes region is now second-highest and the Capital Region remains third-highest on both metrics.

The Mohawk Valley — Fulton, Herkimer, Montgomery, Oneida, Otsego and Schoharie counties — is also conducting fewer tests than the other regions, which can skew the results, depending on how the tests are allocated.

Schoharie County health officials said Tuesday that test capacity is insufficient locally, so the priority is to test those who are showing symptoms or are otherwise likely to be sick.

Only 75 Schoharie County residents, for example, were tested Monday, while 2,046 residents of neighboring Albany County were tested.

Albany County’s seven-day positive rate is 10.4%, while Schoharie County’s is 12.1%.

The Mohawk Valley is faring poorly on other COVID metrics, as well:

  • On Monday, 309 COVID patients were hospitalized across the Mohawk Valley, nearly five times more than on the worst single day in the spring.
  • Percentages of available hospital beds and number of ICU beds were second-lowest among the state’s 10 regions.
  • New hospitalizations per-capita were highest among the 10 regions.
  • New infections per-capita were second-highest among the 10 regions.
  • Thirteen of the 149 COVID deaths reported in New York state were in the Mohawk Valley region: one in Fulton County, four in Montgomery County and eight in Oneida County.

The seven-day average positive test rates for the six Mohawk Valley counties are:

  • Fulton, 8.6%
  • Herkimer, 12.5%
  • Montgomery, 12.2%
  • Oneida, 10.8%
  • Otsego, 6.3%
  • Schoharie, 12.1%

GAZETTE COVID-19 COVERAGE

The Daily Gazette is committed to keeping our community safe and informed and is offering our COVID-19 coverage to you free.

Our subscribers help us bring this information to you. Please consider a subscription at DailyGazette.com/Subscribe to help support these efforts. Already a subscriber? Thank you!

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