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Have Drug Overdoses Spiked During the Coronavirus Crisis? It Depends Who You Ask


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Mayor de Blasio makes an announcement (photo: Ed Reed/Mayor's Office)


As the coronavirus ravaged New York, hospitals were flooded with patients and city services ground to a halt. Activists and elected officials worried that in the fray of the pandemic, with New Yorkers ordered to mostly stay inside and millions losing work, the already prevalent opioid epidemic in the state could be further exacerbated. But city and state health officials don’t have full grasp on the scope of the problem, and may not know for months, because of a lag in how drug overdose data is tracked and classified.

The NYPD, on the other hand, reports that while overdoses have fallen overall in the first half of 2020, overdose deaths appear to have significantly increased during that period, according to preliminary reports.

Reports from across the country indicate that overdose deaths have likely increased as a result of COVID-19. In a brief report, updated June 18, the American Medical Association’s Advocacy Resource Center noted, “More than 30 states have reported increases in opioid-related mortality as well as ongoing concerns for those with a mental illness or substance use disorder in counties and other areas within the state.” Among the examples the report cited were reports from New York.

But city and state officials say it’s too soon to tell if there has been a spike in overdose deaths or hospitalizations. “Fatalities may still be pending classification and more data is needed for a reliable comparison to previous years,” said Michael Lanza, a spokesperson for the city’s Department of Health and Mental Hygiene, in an email earlier this month. According to Lanza, since March, just before the coronavirus outbreak in New York, there has not been a larger increase in overdose-related hospital intensive care unit (ICU) visits than what was expected based on historical data. At the state level, a Department of Health spokesperson said the most recent confirmed data is from 2019, even as the calendar shows 2020 nearly halfway over.

Asked about overdose data from this year so far, Edison Albany, a spokesperson for the state Office of Addiction Services and Supports, said in an email, “Official data regarding relapses and/or overdoses for this period is not available at this time. OASAS recognizes the potential consequences of isolation during the pandemic, and how it relates to the possibility of increased alcohol and substance use. To combat this and other risk factors, all OASAS providers remain open during the pandemic, and we are committed to ensuring that all of our services remain available.”

A New York City health department spokesperson said it’s hard to definitively say whether overdose deaths have gone up since classifying them takes time because of the need for additional investigations and to conduct toxicology reports. The department monitors several metrics, including ICU visits, for this data.

The lag in data production is evident from past reports. It was only in August 2019 that the city health department released a full picture of overdoses in 2018 and the first three months of 2019. The report found that drug overdose deaths fell for the first time eight years, to 1,444 from 1,482 in 2017. In the first three months of 2019, there were 45 fewer overdose deaths than in the same period in 2018.

The NYPD’s overdose squads, created in 2016, investigate all overdose deaths in the city and also respond to hospitals to interview people who have survived overdoses. The department also holds quarterly RxStat meetings, which involve about 35 different law enforcement and public health agencies, to discuss data on overdoses.

According to an NYPD spokesperson, preliminary data shows that overdoses overall are slightly lower, even during the months of the pandemic peak, but overdose deaths have increased over last year. The numbers will likely change after further investigation but there does seem to be an indication of a spike.

The Queens and Staten Island District Attorney offices have also noticed local spikes in overdoses. Queens District Attorney Melinda Katz’s office, in a June 1 press release, pointed to 86 suspected overdoses in the first five months of 2020, a 56% increase compared to the same time in 2019, it said. The data is sourced from the NYPD and the city Office of the Chief Medical Examiner.

“We are living through an extraordinary time. We are fighting battles no one would have expected, but still we push forward with hope and unrelenting resolve to succeed,” Katz said in a statement at the time. “Unfortunately, the coronavirus pandemic has made the opioid epidemic even worse for those fighting for their sobriety.”

Ryan Lavis, a spokesperson for Staten Island District Attorney Michael McMahon, said that through June 18 there has been an apparent year-over-year increase in overdoses in the borough, from 35 to 47, based on data collected by the office’s Overdose Response Initiative which collaborates with the NYPD. Lavis emphasized that data for 2019 and 2020 is “preliminary, incomplete, and subject to change as additional information is collected, including completed toxicology reports from the Medical Examiner, which have been delayed due to the effects of COVID-19.”

The confusion in the data is part of a persistent problem, said Jasmine Budnella, drug police coordinator at Vocal-NY, an advocacy group. Budnella said that activists like herself have seen anecdotal evidence that suggests an increase in overdoses across the state. “What that looks like in actual numbers, I don't think we'll know for a long time,” she said.

The pandemic, she said, has illustrated the need to track overdoses in real-time, just as the city is tracking covid infection rates on a daily basis. “I think if we can get covid numbers out that fast, then we should be able to get overdose numbers out that fast,” she said.

Budnella noted that the pandemic has posed particular challenges for those struggling with addiction. The state and city lacked a clear plan for dealing with the coronavirus outbreak, let alone specifically for those with a substance use problem. “Covid kind of goes against everything that we tell people, like don't use alone…don't isolate,” she said. If the city had a better system to track overdoses, they could have “responded in real time to a public health crisis on top of a public health crisis,” she said.

The city did eventually respond in May, just over two months after the lockdown, rolling out a program to deliver methadone to people sick with COVID-19 or a similar illness and those at high risk of contracting the virus. The program was first piloted at certain city-run isolation hotels. Additional measures were also taken to expand eligibility for the home delivery program, which was possible after the federal government eased certain regulations for the medication.

A separate issue that Budnella raised concerns about, particularly at a time when protests to defund the police have taken place across the country, is the NYPD’s involvement in overdose investigations. Treating overdoses as a police issue, she said, could discourage people from calling 911. Budnella’s group, Vocal-NY, is among those leading the advocacy for establishing safe injection sites for people suffering from addiction. Though Mayor de Blasio has outlined a plan to create four such “Overdose Prevention Centers,” with a strong police presence around them, the city has yet to receive permission from the state to follow through.

City Council Member Mark Levine, a Manhattan Democrat who chairs the Council’s health committee, noted that the city has seen a staggering 5,000 more deaths above normal that haven’t been attributed directly to COVID-19 but have been caused by the conditions created by the pandemic.

“We were losing a New Yorker approximately every six hours prior to the pandemic,” he said of the overdose crisis, while noting that since then, people have lost access to primary care and addiction treatment services. “We have every reason to fear that the number of overdose deaths has only increased over the last three months.”

Levine said he is considering holding an oversight hearing to press the administration on its response to the overdose crisis, though the Council and his committee have a full docket because of the outbreak and its many impacts. Levine said he has also submitted a request to draft legislation that would require monthly reporting by the health department on the number of overdose deaths in the city.

As the Council negotiates the budget for the next fiscal year with the de Blasio administration, Levine said the city will need to invest more funds in services for people struggling with addiction. “We have to respond now by ramping up our efforts,” he said.

For those who need help, the state’s “HOPEline” is at 1-877-8-HOPENY or text 467369.

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by Samar Khurshid, senior reporter, Gotham Gazette
     

Read more by this writer.

The 2021 New York City Mayoral Race, One Year to the Primary


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City Hall on inauguration day (photo: mayor's office)


It’s election day, and all eyes on the 2020 party primaries in New York, though the results won’t be clear for at least one week. But one year from now, New Yorkers will cast their ballots in another primary election, one that will likely determine the slate of leadership of New York City for the next four years, including the next mayor. With Mayor Bill de Blasio term-limited, the stage is set for a fierce competition, which may not really take off until just after this year’s presidential election but has already begun.

With the economy in shambles and the streets echoing with the exasperated cries of a city disillusioned with current leadership, political analysts say New Yorkers will look for a steady hand to guide them through the city’s many crises, whether it’s the lingering effects of the COVID-19 pandemic, structural and systemic racism, economic devastation, perennial unaffordability, entrenched homelessness, crumbling public housing, and more.

Observers admit that there are no easy predictions to be made about the 2021 mayoral race, particularly at this early stage while the city is still trying to overcome what has proved to be the greatest public emergency in its modern history. Candidates, some of whom have spent years preparing to run to become the city’s chief executive, are eyeing the future of the campaign while continuing to make their aspirations clear to voters. Now with just under a year to the primary, fundraising urgency will pick up, as will the need to hold house parties where candidates interact with small groups of voters, even if they must be virtual for the time being. Campaign teams must be built, volunteers recruited, labor leaders schmoozed.

There are so far six Democratic candidates who have declared or are actively exploring runs for mayor: City Council Speaker Corey Johnson; Comptroller Scott Stringer; Brooklyn Borough President Eric Adams; Loree Sutton, former commissioner of the city’s Department of Veterans’ Services; Dianne Morales, a former nonprofit executive in the Bronx; and Shaun Donovan, who served as HUD Secretary under President Barack Obama and was previously an aide to Mayor Michael Bloomberg.

There are several other individuals either rumored to be considering a run or being pressed to do so, including Public Advocate Jumaane Williams, former counsel to the mayor Maya Wiley, former City Council Speaker and mayoral candidate Christine Quinn, and Citigroup executive Ray McGuire. With Democrats holding a 7-to-1 voter enrollment advantage over Republicans, it seems all but assured that the winner of the Democratic primary will win the November general election, but nothing in politics is ever guaranteed.

On the Republican side, there has been little movement so far. Billionaire supermarket magnate John Catsimatidis has raised speculation that he may run, announcing he is formally exploring another campaign. He ran unsuccessfully in the Republican primary in 2013, losing to Joe Lhota, and was reportedly considering doing so again in 2017 but chose not to jump into the race. Perhaps the best-known Republican in city government, Staten Island Borough President James Oddo, has ruled out a run. There are few other Republicans who hold elected office in the city, though Queens City Council Member Eric Ulrich also toyed with a 2017 campaign but decided not to run.

What remains to be seen is how the political winds will blow. Will today’s anger on the streets carry through to poll sites next year? Will voters choose experienced leadership from those who have long served in elected office or will they look outside for fresh faces and perspectives? Are they more focused on the city’s economic recovery or will social justice be the driving force behind their votes? What specific issues will emerge as paramount? Which policy proposals will gain the most momentum? What impact will labor unions have?

What role might “identity politics” play -- will voters choose an openly gay white man (Johnson) or an openly gay white woman (Sutton) or a Black man (Adams) or a Black Boricua (Morales) after nearly three decades of a heterosexual white man running City Hall and no Latino or woman or openly gay peson ever elected mayor? How will the new ranked-choice voting system for primaries (and special elections) play out?

As the Democratic field currently stands, and perhaps even with additions, Johnson and Stringer will likely compete for the most progressive parts of the Democratic Party, with other candidates also trying to make headway there. Johnson, the first openly gay and openly HIV-positive City Council Speaker (and only open HIV-positive elected official in the state), has focused heavily on the social safety net in his time as speaker, promoting populist policies to lift up the city’s most vulnerable. Stringer, as the city’s top fiscal officer, has acted as a foil to the mayor’s spendthrift policies, released a long list of policy proposals, and shrewdly cultivated allies in labor and among insurgent Democrats at the state and local levels.

Adams, a former NYPD captain, tends to appeal to the more moderate viewpoints among Democrats but does not easily fit descriptors, and has reportedly proclaimed that he wants to “out-white” Stringer, an apparent plan to appeal to white ethnic voters key to the elections of Rudolph Giuliani and Michael Bloomberg. The borough president has tried to walk the fine lines of promoting law and order with police reform and real estate development without displacement. He has already outlined his platform for instituting “real-time governance,” pledging to modernize how city government operates.

As the calendar has inched toward 2021, and as de Blasio ran for president leaving more of a leadership vacuum and the coronavirus crisis hit, Johnson, Stringer, and Adams have been staking out more positions on major issues and through their official jobs auditioning for the role of mayor.

Morales is a proponent of strong social justice policies that said she will reduce the “inequality and inequities” that have been exacerbated in the last few months and which “I've been talking about forever.” She pointed out that her campaign has been built on the very issues that have inspired the recent mass protests. “I am a reflection and representation of the communities that have been disproportionately harmed or left behind,” she said. 

Morales hopes that the electorate will have its eyes open to the failures of the city’s political leadership. “There is an increasing recognition that while the COVID-19 pandemic was unprecedented, that we weren’t prepared,” she said. “There are so many things that were done the way things have always been done, that left us unnecessarily vulnerable, not just from a health perspective but from an economic perspective. And my hope is that people will come out of this ready for a different kind of leadership with a new lens on what we really need.”

Sutton skews more centrist and promises “seasoned leadership,” which she says has been sorely lacking during the current crises (and those preceding them) and that she can bring after a career in the Army then her time in city government. She admits she has a big hill to climb to raise her profile and build her campaign coffers. And she also differentiates herself from de Blasio, her former boss. “In a Sutton administration, you will see a very different dynamic,” she said, “between the mayor and the media, between the mayor and corporate leaders in New York, between the mayor and communities of color, between the mayor and my own administration and the types of leaders that I will bring in and will build upon.”

She would also welcome the unenviable challenge of running the city during this pandemic, a task that would test even the most effective leaders. “I would give anything to be the mayor right now...This is my burning building. This is what I run towards,” she said.

Donovan’s resume lends him a credible campaign platform, particularly during the recovery from the pandemic since he was intimately involved in the federal response to the Great Recession and the recovery effort from Hurricane Sandy. Rick Fromberg, a spokesperson for his campaign, said he can easily make a compelling argument to voters. “Shaun’s experience and bio are so far and away better than anybody else in this race that it's just a matter of us telling people,” he said. “Nobody who has ever run for this office has this kind of experience in dealing with such analogous kinds of situations.” 

“Shaun’s not a politician,” Fromberg continued. “He never has been. He's always been a public servant. And I think that is something that we will certainly hang our hats on.”

Most observers agree that the election will inevitably be tinged with resentment of de Blasio, an increasingly unpopular mayor who, despite his progressive accomplishments, has only cemented his status as a lameduck in his struggles to respond to COVID-19 and the mass protests against police brutality and racism.

“New York is a progressive city and is one that has been dealt an enormous body blow over the last four months, and is looking for someone who is progressive but who has a vision on how to manage and lead this city at this really dark period,” said Chris Coffey, a veteran of the Bloomberg administration, consultant with Tusk Strategies, and ally of Speaker Johnson but not working on his campaign. 

“I think New York needs a cheerleader and wants a cheerleader,” Coffey said, alluding to what many have observed as de Blasio’s apparent lack of interest in celebrating the many particularities of New York as well as Johnson’s apparent penchant for such enthusiasm. “I think every mayor is in some ways a reaction to the last mayor...being a progressive who can govern and manage the city and be a cheerleader and give people some hope and confidence in their mayor is what I believe this election will be about.”

George Arzt, a Democratic political consultant who has previously worked for Stringer, echoed that view. “I expect a lot of de Blasio-bashing and I don’t expect anyone to come out and say that [they are] the successor to the policies...that de Blasio espoused,” he said.  

Over the next year, who emerges on top will depend in part on which of the largely unknown candidates can garner the necessary name recognition as well as the fundraising to get their message across to New Yorkers. To an extent, the fundraising field can be levelled by the city’s voluntary public matching funds program, which matches small-dollar donations at high rates through the New York City Campaign Finance Board.

On name recognition, the sitting electeds do already have an advantage by virtue of their positions in government. They have each been in the limelight and continue to be during the pandemic and its fallout. The other candidates may have to work harder for it, though their respective messages -- of competent leadership challenging the very people in power that are responsible for the state of the city -- could resonate. 

Fordham professor Dr. Christina Greer said the next few months will be crucial as the city heads through summer, a season that is usually accompanied by an uptick in crime (a trend that has already begun). Rampant unemployment and a prolonged recession could only exacerbate that, she noted, and could determine the type of candidates and campaigns that gain traction. Then there’s the presidential election in November, which will likely have its own impact on local races. 

“Will we see someone who is very progressive, say a ‘defund the police’-type candidate? Let's just say there's an uptick in crime in the next few months, will we see someone who is a little more centrist in their thinking? Will we see someone who wants to be a little more of the Bloomberg model, which is fully economic, trying to get the city back on track financially, or will we see someone who is more of a social justice candidate who's trying to bring all these things together in a more holistic way?” 

A key known wild card in the election will be ranked-choice voting, which will be implemented for the first time next year. The system allows voters to cast votes in order of preference and a candidate must cross a certain threshold of first-preference votes to win. It’s hard to predict the effect it will have in a crowded field as New Yorkers vote their values. 

As Greer noted, if moderates come together behind one candidate and progressives go for another, a more consensus second-choice candidate could end up claiming victory. 

“In 2021 we need a Mayor who will meet the imposing challenges in New York City that 2020 has exposed,” said Maya Wiley, now a New School professor and MSNBC commentator, in an email. “New York City needs a Mayor who will see that the twin pandemics of virus and brutality require history-making, not deal-making. We need a Mayor who will get us off the treadmill of incremental reform and command an all-of-government response to structural disparities. We need a Mayor who gets that New York doesn’t work in isolation and that we need an urban policy humbly led by the chief executive of the greatest city of the world.” 

She did not address the candidates directly, however. “It’s not for me to say whether the current crop of candidates includes that Mayor. That's for New Yorkers to decide.”

Wiley also did not respond to the question of whether she is considering a run.

“It’s a free-for-all right now,” said J.C. Polanco, a Republican attorney and strategist who ran for New York City Public Advocate in 2017. He noted that the closed primary process will affect who comes out to vote. In both parties, that is usually the most active, motivated and “ideologically purist” voters, he said. The Democrats, he said, will “fight hard to see who can captivate that ultra, uber-progressive wing of the party because those are the voters that come out for sure.” 

The one almost certain bet is that Republicans will have a hard time running a competitive campaign against a Democrat. “Our numbers are dwindling a great deal. It’s difficult for a Republican to have a fair shot at winning a citywide election,” Polanco said. “As you know I could attest to that.”

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by Samar Khurshid, senior reporter, Gotham Gazette
     

Read more by this writer.

What's The [DATA] Point? 70 million, with Kathryn Garcia and Cas Holloway


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What's The [Data] Point? Episode 92 -- 70  million, with Kathryn Garcia and Cas Holloway [You can download What's The [Data] Point? wherever you get your podcasts, including on iTunes]

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70 million is the number of free meals distributed by New York City government since mid-March, when the COVID-19 pandemic took hold. We spoke to key individuals in the public and private sector teams that made this success happen: New York City Sanitation Commissioner and "Food Czar" Kathryn Garcia, and former NYC Deputy Mayor Cas Holloway, now of Unqork, the enterprise software company that developed an app virtually overnight.

Listen to the conversation and let us know what you think: Ben Max of GG (@TweetBenMax), Maria Doulis of CBC (@MariaDoulis). Listen below or download wherever you get your podcasts!

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by Ben Max, Gotham Gazette
     

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