Gotham Gazette Sat, 28 Nov 2020 14:19:17 +0000 Joomla! - Open Source Content Management en-gb (Webmaster) Without Random Testing, New York City and State Address Covid Outbreaks with Blinders may covid19test

Mayor de Blasio gets tested (photo: Ed Reed/Mayoral Photography)

As New York City public health officials try to get a handle on a series of COVID-19 “hot spots,” they lack the tools to know exactly how the voluntary testing data they collect skews the true prevalence of the virus, both in communities of concern and city-wide. In the absence of randomized testing, public health officials rely on the results of voluntary testing, an especially challenging process given new evidence some New Yorkers are organizing to game the system against that weakness.

New York's covid positivity rate has been ticking upward in recent weeks, driven largely by surging rates in so-called "hot spots," which has led Mayor Bill de Blasio and Governor Andrew Cuomo to shut down schools and potentially non-essential businesses in impacted parts of Brooklyn and Queens, many of which are home to Orthodox Jewish communities and where the reported rate of confirmed cases outpaces the citywide rate fourfold.

The neighborhoods home to covid uptick “clusters” cover nine zip codes across the two boroughs where the seven-day average Covid positivity rate has exceeded 3% for more than seven straight days, while another 13 zip codes are now labeled “areas of concern” by city health officials. Cuomo announced Monday the state is taking control over local enforcement of covid guidelines like mask-wearing and limited gatherings, and the governor promised hard conversations with religious leaders and the possibility of closure of religious institutions. On Tuesday, he released a plan for tiered, localized shutdowns with the greatest restrictions closer to cluster epicenters and easing as the radius widens.

Despite tens of thousands of tests every day, the city and state have no widely applied randomized testing program and few ways to gauge what members of the population they are missing in their survey of the virus. Health + Hospitals, the city's public hospital network that is in charge of New York's test and trace corps, says testing protocols do not include a questionnaire about motivation for seeking a test, which in lieu of a random sample, could itself hint at gaps in the data. Getting a percentage of those seeking tests who are symptomatic, may have been exposed to a covid-positive person in close proximity, or are just being careful and getting a test based on public health guidelines can reveal finer contours in the official picture of the viral spread.

While key decisions during the city's precarious reopening are pegged to the positivity rate, dictating the opening and closure of schools and businesses, scientists question how well the city and state data captures the spread of the virus among those who haven't been tested.

In the lead up to the announcement about closures in the cluster areas, some residents in Hasidic neighborhoods in New York City received messages not to have their children tested if they have symptoms or to get tested if they are believed to be negative in order to drive the positivity rates down, Gothamist reported. Heavily Orthodox Jewish areas are not the only places seeing covid increases -- the map of recent outbreaks overlaps with areas of the city home to greater numbers of Trump supporters, as reported by Bklyner, including many Orthodox neighborhoods.

The positivity rate is a ratio of the number of positive cases out of the number of people who choose to get tested. Assumptions about that population of test-takers factor into the official assessment and response. In reality much is unknown about who is getting tested -- and who is not -- a variable that can downplay the extent of the virus, which is believed not to manifest symptoms at all in as much as 40 percent of cases.

Some form of randomized sampling, which is being advocated by epidemiologists and set to soon be used on a limited scale in New York City schools, could get at these missing figures and provide a better overall assessment of the virus’ spread.

"Any community anywhere where we're looking at test positivity, you have to ask, 'well, who's determining who's getting tested,'" said Irwin Redlener, a health policy expert and director of Columbia University's Pandemic Resource and Response Initiative, on WNYC radio’s The Brian Lehrer Show on Friday. "Are they just sick people? Are we doing a scientifically randomized study where we're taking a number of people whether they are symptomatic or not and doing testing?"

"If you don't have a good basis for collecting the samples and doing the testing in a randomized, scientific way it's not unexpected that we're going to have problems interpreting the outcome and making policies [inaudible] determining the outcome," Redlener continued.

One of the graphs the mayor uses at his daily press briefings is a product of this. The graph of the citywide seven-day average positivity rate, considered the most stable existing metric for measuring the spread and one that potential closures are pegged to, looks like a backward ski jump, a relatively smooth slope that fell from a peak of 68% in early April to about 1% in June and has remained mostly flat since. But in April, far fewer people were being tested and the criteria limited testing to people who were likely to test positive.

"There is something deceptive, a bit, about any number that we're talking about," Redlener said, because of the lack of randomization.

On September 29, the city's positivity rate was over 3%, the highest it has been since June, but was back below 1% the next day. Officials viewed the one-day spike as an anomaly and cautioned members of the public to focus on the seven-day average, which rose to about 1.65% as of this Monday’s test results, but it spotlighted questions about how the city is accumulating data and assessing spread in the midst of a targeted testing "blitz."

"It is imperative that community leaders, community institutions, and everyday New Yorkers heed the call and go out and get tested and send the message of how important it is to get tested," de Blasio said at a press briefing on October 1.

De Blasio has for days discussed the possibility of local shutdowns in areas seeing upticks in positivity, especially those deemed clusters, and on Sunday called for the closures of schools and non-essential businesses in the nine zip codes. The city has ramped up testing, mask distribution, and public awareness efforts in parts of Brooklyn and Queens, particularly in Orthodox Jewish communities where mask-wearing has reportedly lagged and social distancing rules often ignored. Last week, the mayor announced six "block parties" for mass testing, which they hope will conduct 3,000 tests per day when fully operational, on top of 11 mobile testing sites in covid cluster sites.

Governor Cuomo has attributed the upticks to a lack of compliance with social distancing protocols and has blamed local authorities for failing to enforce his ordinances. On Friday, he issued a directive to local governments to step up enforcement or face penalties of up to $10,000 per day in an effort to tamp down the outbreaks. On Monday, he said the state would take over enforcement of the relevant local law enforcement, though he said he would need local personnel.

The state is also deploying rapid testing in hot spots and coordinating resources with local health departments, and in some cases providing staff, according to Gareth Rhodes, an attorney at the state Department of Financial Services and a member of Cuomo's COVID-19 Response Task Force. The state conducts about 500,000 tests per week, a large portion of which are rapid, where the results are back within a day, allowing officials to monitor the virus in closer to real time. Of the 120,000 tests reported Friday, roughly one-third were completed within 24 hours, Rhodes told Gotham Gazette.

New York's approach to mapping the spread has been to provide opportunities for and in some places heavily encourage testing in the hopes of casting as wide a net as possible, and with it a more representative sampling. Short of a complete census, all testing models simply capture a snapshot that public health officials try to extrapolate to say something about the entire population and set policies to address it.

Officials are looking out for places where testing may be too low. "What is the testing per capita in that zip code?," Rhodes said by phone Friday. "Is it where we think it should be?"

But some testing strategies can have the effect of distorting the positivity rate, even as they are intended to more closely monitor key groups. At various moments during the pandemic, for example, the state has required certain populations to get tested, like health care workers, nursing home residents, or salon employees.

At this point, the best example of randomized testing could be the Department of Education's plan to randomly test 10 to 20 percent of the in-person student body at each school on a monthly basis. A team of NYU researchers recently released a report showing that the city may need many times that rate of testing, a sentiment Cuomo echoed Monday.

"I understand daily, I understand weekly, I don't understand random monthly," he said in response to questions about whether he wanted to see a more robust testing strategy in schools. "If you're saying it could possibly be a month between tests, that doesn't work for me. I would not accept that plan for my school."

The state has been testing wastewater in some state university (SUNY) dorms for COVID-19, as one way to get a random sample, and officials say they are working to expand that testing to other areas.

Randomized testing is difficult to perform. Even with the city's school testing program, parents must consent to their children being tested at random once a month. The children of parents who miss the notice among the flood of novel back-to-school instructions or who object on philosophical grounds will be left in the shadows.

Rhodes says the ideal testing environment would be one of rapid, on-the-spot results, that are affordable, widely available, and accurate.

"Obviously we are not there yet," he said. "I think the scientists and the people on the innovation side will say that's where we will get to eventually, but the question is are we all vaccinated before then?"

In July, Cuomo penned an op-ed to the New York Times, calling for federal funding for "broad community screening" to account for asymptomatic carriers. Rhodes echoed that call in a recent post to Twitter, responding to Gotham Gazette’s reporting about the city’s and state’s lack of randomized testing.

The state is looking at one testing model -- the BinaxNow, by the multinational medical device company Abbott -- that checks some of those boxes: it is quick, relatively cheap (about $5 per test), and does not need to be sent to a lab for results. Rhodes said state officials expect the Trump administration to distribute the new tests in the near future. But the BinaxNow is an antigen test, which is less effective for testing in people who are asymptomatic. The current cost of a rapid PCR test, which is better at detecting the virus in asymptomatic people, is $100 per test, which is "prohibitively expensive," Rhodes said.

Another metric officials rely on to track the spread of COVID-19 independent of testing is the hospitalization rate.

"If covid is spreading, it will result in people going to the hospital from that community," said Rhodes. "I'm looking at what addresses are hospitalizations coming from...It very closely tracks where we are seeing new cases."

If hospitalizations in a region are up, but the positivity rate doesn't reflect an uptick, the state would set up rapid testing there, Rhodes said. 

"It obviously is not ideal because you want to catch this long before people go to the hospital," he added.

But even this measurement isn't really randomized. Access (and admission) to an emergency room is not uniform across the population, and multiple factors influence whether a person receives treatment, especially during the pandemic's so-called "apex" in New York, and especially in predominantly Black and Latino communities.

The city's covid testing does not include a questionnaire about why a person is seeking testing -- because of potential exposure, proximity to testing sites, or being referred by a doctor or an advertisement -- questions that could give officials a sense of the profile of individuals who are getting tested and reveal potential blindspots in virus surveillance.

"We do not ask why they are getting a test," wrote Karla Griffith, a spokesperson for Health + Hospitals, the city’s public hospital system, in an email.

Individuals are asked some questions before receiving a test, like whether they've had COVID-19 previously, if they have symptoms, if they have upcoming surgery, if they are pregnant, and where they work. "These questions are for reporting purpose to the NYS Department of Health and to assist with contact tracing efforts should someone test positive," Griffith wrote.

In Borough Park and Williamsburg, two areas with large Hasidic populations, parents received robocalls urging them not to test their children and to remove them from school without getting tested if they are showing symptoms, as Gothamist reported. One religious leader urged members of his congregation who have already gotten the virus, and are believed to be less likely to still have it, to get tested in order to drive the official positive rate down. And some medical centers in the communities have refused to share test results with officials, according to Gothamist.

The city's Department of Health and Mental Hygiene did not say how or whether it was assessing the impact of this behavior.

Asked how the state accounts for potential distortions like the ones reportedly being machinated in certain Hasidic clusters, Rhodes said, "Let's say you don't test in certain areas, or test less. If covid is spreading, you're going to see an uptick in hospitalizations."

"In these areas we haven't seen what I would consider to be a testing desert," he added. "The message we've been saying is urging everyone to get tested."

by Ethan Geringer-Sameth, reporter, Gotham Gazette

Read more by this writer.

Without Random Testing, New York City and State Address Covid Outbreaks with Blinders Tue, 06 Oct 2020 04:00:00 +0000
Police Patrols Promised to Combat Anti-Semitism Arrived to Enforce Social Distancing, Orthodox Leaders Say de Blasio Orthodox Jews security

Mayor de Blasio & city officials in Borough Park in January (photo: Michael Appleton/Mayor's Office)

[UPDATE (5/19/20): After this story was published, an NYPD spokesperson told Gotham Gazette security cameras had been installed at 30 locations in Brooklyn as part of an effort to combat anti-Semitic hate crimes. The remaining 70 cameras planned to be deployed with the input of the community have likely been put on hold due to the coronavirus outbreak, the spokesperson said.]

Mayor Bill de Blasio in January announced 100 new police security cameras and more officers on the streets in Orthodox Jewish neighborhoods as part of an effort, embraced by officials across the political spectrum, to combat a rise in anti-Semitic hate crimes in New York City and State. But officials representing those communities say the cameras were never installed and the patrols never came, and that the spirit of protection has in recent weeks been replaced with one of suspicion and "retaliation," spurred on by the mayor himself in response to large public gatherings, as the pandemic has gripped the city.

"We were calling on the city to do more and to give us additional resources when Jews were being beaten, rocks thrown at them, on a daily basis in New York City. We were begging for more help. We were begging for additional resources...we were begging for manpower," said State Assemblymember Simcha Eichenstein, who represents Borough Park and is a former aide to de Blasio, in an interview.

"At the end of the day we were basically told, 'This is all we have, we don't have additional resources,'" he said of a period late last year after a series of violent attacks.

But Eichenstein and other local leaders say Orthodox Jewish communities have recently been flooded by police officers enforcing social distancing, especially in the days following the funeral of a rabbi in Williamsburg that saw thousands of mourners gathering in close quarters. The contrast in responses points to a complicated relationship between Orthodox Jews and city government.

"The number of cops that I saw floating around in Williamsburg in the last day or two of last week far exceeded the number of cops we were begging the mayor to send us last year and in January," said City Council Member Kalman Yeger, whose district overlaps Eichenstein's, of the period immediately following the April 28 funeral. The funeral gathering itself was met with a heavy police response, with even the mayor himself arriving on the scene to make sure the crowd dispersed. De Blasio then posted a highly controversial tweet, in which he singled out "the Jewish community" for violating rules established by executive order.

In the days that followed the leaders described what Eichenstein called a "ticketing blitz [of] people off the streets" for not wearing face coverings.

"Everyone should be wearing masks when you go out, people need to socially distance, of course we all want to stop the virus. But I wish we would've seen that same response when Jews were being beaten on the streets of New York on a daily basis. We did not see the response that we saw in retaliation to the funeral," Eichenstein said.

In January, in response to a surge in anti-Semitic crimes in 2019, including a stabbing at a Hannukah celebration in Monsey, a shooting at a kosher deli in Jersey City, and a series of verbal and physical attacks mostly in Brooklyn, de Blasio and Governor Andrew Cuomo said they were taking steps to "harden security" in Jewish communities.

Crimes targeting Jews accounted for 242 of the 420 hate crimes reported to the NYPD in 2019, a 26 percent rise over the previous year and an 86 percent increase since 2015.

In January, the mayor announced 100 new surveillance cameras would be installed in Williamsburg, Crown Heights, and Borough Park -- areas home to large Orthodox Jewish populations -- and that over 150 officers had been deployed there. The plan was for the first 30 cameras to be installed by March with the remaining 70 to be sited with the input of the community.

"I'm not aware of a single one of them that has actually been installed and turned on," Yeger said.

"I can tell you this, nobody has discussed it with me," said Eichenstein. "The only cameras that I know that were installed in my district in the last couple of weeks are speed cameras. That's the only cameras I know that were installed. They carry tickets, that's unfortunate.”

But the reality surrounding the cameras is unclear and it is possible some of them have been installed. A March 4 summary of the NYPD's proposed budget prepared by the City Council states that the installation formula of the 100 cameras had not changed and a spokesperson for de Blasio told Gotham Gazette their "gut recollection" is that the first tranche of cameras was installed and the city was aiming to begin the community engagement process for the second tranche around the time the COVID-19 pandemic hit New York. Neither the mayor's office nor the police department provided details on the cameras over the course of multiple conversations by email and phone spanning two weeks.

The camera plan was alarming to some civil rights advocates at the time, and the lack of public information about its implementation, especially in light of recent social distancing controversies, has heightened the concern.

"Once those cameras are in place in communities you are able to piece together people's entire daily movements, their comings and goings, in a way that is subject to really little oversight," said Michael Sisitzky, lead policy counsel at the New York Civil Liberties Union.

"There is very little control placed over how long the NYPD is retaining the footage, what other purposes they are using it for," he said. "So whether it is from the cameras that can be deployed as part of efforts to combat anti-Semitism, or just security and surveillance cameras in general, the same concern remains that they lend themselves to potential misuse as tools for criminal enforcement."

The police department has acknowledged using its network of cameras to monitor social distancing throughout the city. In early April, NY1 reported Chief of Department Terence Monahan saying, "We move from camera to camera to different parks around the city. We can see what the conditions are. If we see any overcrowding we will be able to send our teams out there."

There is no clear data on how many cameras, public and private, the NYPD has access to on a daily basis, including no accounting of how many existed in Orthodox neighborhoods before the mayor's announcement.

The NYPD's enforcement tactics have come under scrutiny since data was released on May 8 showing 81 percent of social distancing summonses and 90 percent of arrests related to COVID-19 have been of black and Latino people. Only 51 of the 374 summonses issued for social distancing violations between March 16 and May 5 went to white people, 42 of which were in Brooklyn, according to the data, with at least 15 of those on the night of the funeral and the morning after at synagogues in Williamsburg. And the mayor has been criticized for his decision to establish the NYPD, rather than public health officials and community groups, as the main agency responsible for ensuring people do not spread the virus in public.

In response to sweeping blowback and charges of “racist” policing, on Friday de Blasio announced a "reset" in enforcement with officers focused on breaking up groups of six or more people (who don’t live together) with warnings and summonses if necessary, and a heavier reliance on "civilian ambassadors" from other city agencies and community-based messengers to distribute face coverings and facilitate distancing.

Shea informed officers in a letter Friday that, "Moving forward...we will no longer issue summonses or make arrests for infractions related to face coverings — absent of a crime or other violation being committed."

The moves have been praised by a number of elected officials and advocates who had pushed for the reforms.

The night of the funeral of Rabbi Chaim Mertz and the day after, de Blasio said the city would be pursuing summonses for gatherings aggressively, and specifically called out "the Jewish community."

In the tweet just after the funeral, which was coordinated with the NYPD and reportedly drew over 2,000 people paying respects to the rabbi, who died of COVID-19, de Blasio wrote: "My message to the Jewish community, and all communities, is this simple: the time for warnings has passed. I have instructed the NYPD to proceed immediately to summons or even arrest those who gather in large groups. This is about stopping this disease and saving lives. Period."

The tweet received intense criticism from Jews and non-Jews alike. Eichenstein responded by condemning the gathering but stated: "Mr. @NYCMayor: it is also completely unacceptable to call out the entire Jewish community especially as a group that has been endlessly under attack in NYC."

Others called the comment insensitive but said it belied the many examples of targeted support Orthodox Jewish enclaves have received from de Blasio, who has been a strong ally throughout his career and represented parts of those communities in Brooklyn during his time in the City Council. The assertion that the mayor is anti-Semitic is "of course, absurd because the Mayor he’s been one of the most responsive Mayor’s to the entire spectrum of NY’s Jewish community," tweeted former City Council Member David Greenfield, who represented Borough Park before Yeger and is now head of The Met Council, a social service provider based in the Orthodox community.

"I spoke last night out of passion. I could not believe my eyes," the mayor said the next morning when asked by a reporter if he would apologize for his comments. "I spoke out of real distress that people's lives were in danger before my eyes and I was not going to tolerate it. So I regret if the way I said it in any way gave people a feeling of being treated the wrong way. That was not my intention."

"It was said with love, but it was tough love,” he continued. “It was anger and frustration and what I saw,'s not happened other places. Let's be honest, this kind of gathering has happened in only a few places and it cannot continue. It's endangering the lives of people in the community.”

According to the NYPD, the next morning on April 29 police issued three summonses at a synagogue in the 90th Precinct, which covers Williamsburg, after receiving a 311 call "in regards to violating New York City social distancing policy." One of the summonses was for disorderly conduct related to social distancing and two were for "doors being chained from the inside" in violation of fire code, said Sgt. Jessica McRorie, a department spokesperson. That afternoon, eight more summonses were issued at another synagogue in the same precinct by officers who didn't get a 311 call but who were "in the vicinity," McRorie said, of which six were again for having "chains on the doors" and two for "social distancing violations."

The NYPD did not provide specific information on enforcement in other heavily Orthodox Jewish neighborhoods.

"If the City of New York wants to send a thousand cops to the neighborhood to protect the people, it can do that. And if it wants to send a thousand cops to a neighborhood to terrorize people, it can do that," Yeger said. "The mayor's office has to decide which one it wants to do."

According to the Council's March budget summary for the upcoming fiscal year beginning in July, each precinct in Borough Park, Midwood, Crown Heights, Bedford-Stuyvesant, and Williamsburg "will have an additional 4 to 6 officers per tour. Police presence will also be increased specifically at houses of worship and local events." It also says six new NYPD light towers would be erected in Borough Park.

The mayor's office and NYPD have both refused to share communications and guidelines issued to officers around when people should receive a warning versus a summons for violating social distancing protocols. The police department did not answer questions about what specific tools it was using to monitor social distancing in Orthodox Jewish neighborhoods.

When asked about the potential for police security cameras to be used for targeted social distancing enforcement in Jewish communities, Eichenstein told Gotham Gazette: "I think that we should share a goal of what the purpose is of all of these security measures, be it cameras, be it whatever it is. These are measures to keep a community safe. These are not ‘big brother’ tools."

"It is true that if they start using it for other -- you know monetary fines, that would be a problem," he added.

Orthodox leaders are still seeking more protection from hate crimes, which they say are not past just because crime in general is down during the outbreak. Reported anti-Semitic hate crimes are down 40 percent between January and May compared to the same period last year, according to police data. In March, the month the city's stay-at-home order went into effect, the pace at which reports of anti-Semitic crime fell more than doubled.

"Over the course of a 365-day year, upwards of 350 of them, the police department works hand in hand with the community and does a good job," said Yeger. "Here and there there is a problem. On balance, the security cameras will provide security when they actually show up. Ask me how I feel when they actually show up."

But Sisitzky, of the civil liberties union, believes there is cause for concern for Orthodox Jews and for New Yorkers in general. "I think for particular communities and for people who are just passing through communities, the more cameras that are deployed the more potential there is to create a permanent record of people's daily lives, and just submit New Yorkers writ large to constant surveillance."

Yeger thinks the civil rights concerns are overstated: "The constitution does not ban surveillance cameras from being placed in public places. Cameras provide a necessary tool to combat violence in this city." 

"If I can't get a cop on every corner, I'll take a camera on every corner," he said.

by Ethan Geringer-Sameth, reporter, Gotham Gazette

Read more by this writer.

Police Patrols Promised to Combat Anti-Semitism Arrived to Enforce Social Distancing, Orthodox Leaders Say Sun, 17 May 2020 04:00:00 +0000