In the three years since Covid, NY health care has fundamentally changed.

ALBANY — After three years of the COVID-19 pandemic, some normalcy has returned to daily life in New York. Schools and businesses are being rebuilt, case counts are not being tracked and pandemic-era limits are long.

But health experts say too many New Yorkers are still seriously ill and suffering from COVID — the virus kills more than 100 New Yorkers a week, according to the latest numbers from the Centers for Disease Control and Prevention — and, for better or worse, the state’s health care infrastructure has fundamentally changed.

Marking the third year of the statewide shutdown, policymakers and state health department officials spoke with The Times Union about the state’s progress in fighting Covid, lessons learned from the outbreak and how the state should prepare for the next health crisis.

Is covid over?

Although the state hasn’t seen a significant increase in COVID-19 cases in more than a year, the daily number of hospitalizations has reached alarming levels, creating an ongoing burden on hospitals across the state, said Brion Beckenson, director of the state’s health department. Infectious diseases.

As of March 15, about 1,350 New Yorkers were hospitalized with the virus, compared to more than 1,000 hospitalized a year ago, state data show. As of March 2020, some 79,000 New Yorkers have died from the virus, according to CDC statistics.

“Covid is like a bad flu season every day for three years. It puts a huge strain on the health system … and there’s still a lot of people out there getting sick and in some cases dying from Covid,” Bakson said. “I’m glad we’re where we are, but it’s not like it’s gone.”

Most New Yorkers have received at least one vaccine, which has been shown to reduce the severity of Covid-19 symptoms. But the virus continues to evolve, and health leaders say they are closely monitoring new mutations. A new variant that sidesteps the immune system and causes chronic disease can easily set back efforts.

There are still mysteries about the disease, such as the causes of “long COVID”. Symptoms usually last more than three months after the illness It continues to annoy the doctors And for many patients it is difficult to find relief.

The road ahead

It has burning. He took a price on the public health workers of the state. More than half of the state’s county health officials have resigned or been laid off since March 2020.

The State Department of Health has seen the exodus of some of its most experienced staff and has been replaced by three health commissioners in three years.

Now that things have stabilized, the agency is working to rebuild its workforce and institutional expertise. About 40 percent of the Department of Health’s 4,500 employees are new or in the process of being promoted, according to the department’s figures.

“Bringing new people up to speed can be challenging,” Buckson said. “There are a lot of people in the health departments who came during the COVID period in the region and that’s the only thing they did.”

The pandemic spurred scientific and technological innovation. Advances in vaccine research, home diagnostics, and virtual healthcare delivery have changed the medical landscape.

New capabilities such as wastewater testing and genome sequencing have created new excitement in the field of public health.

Daniel Lang, who directs the department’s Center for Environmental Health, said the state’s partnership with the Wadsworth Center and the CDC labs has allowed state health officials to conduct state-of-the-art genome analysis.

“Testing for (Covid) is one thing…but with the ability to sequence the genetic material from clinical or environmental samples, we can get ahead of the mutations and variations that occur in these viruses.”

Lang, who oversees the state’s wastewater control system, said the sewage testing program will be a “game changer” for disease control in the future.

Some of the diagnostic systems established during Covid, including wastewater testing, have been reused in the state’s recent monkeypox and polio scares.

The health crisis has led to greater collaboration between state and local health agencies, hospitals and community organizations, which are working closely to establish mass testing sites and provide information to the public. Those relationships, if they can be sustained, will benefit the state moving forward, Lang said.

Lessons learned

Figuring out how to combat the new pathogen was a complex process. Efforts to limit travel from hotspot countries or to Westchester County have been largely ineffective against the fast-moving virus. By mid-March, businesses and schools were closed.

The state has set up temporary hospitals and built mass testing centers across the state to absorb the influx of patients.

Most schools have tentatively continued in-person learning through the fall of 2020, and the state has set benchmarks to help them determine when to transition to distance learning.

The state has implemented a cluster strategy that restricts businesses and schools to counties or geographic areas with high infection rates.

Health officials have faced criticism from both political stripes, with some saying state powers are too rigid, others too lax.

Bakkensen explained that the department is dealing with unknown pathogens while trying to absorb the vast amount of information coming from other parts of the world.

“Obviously, this particular disease has shown us many things over time,” he said. “Public health always has the problem of trying to do the right thing … I often talk about Goldilocks and the Three Bears – you’re doing too little and a lot of people get sick, or you’re doing too much and you think you’ve taken away rights and freedoms, finding the right line is very difficult. It’s hard.

There were some obvious missteps. During the outbreak, Gov. Andrew M. Cuomo’s administration took heat for ordering nursing homes to admit coronavirus-positive hospitalized patients to ease a shortage of beds in emergency rooms and intensive care units. Before the policy change, about 9,000 infectious patients were admitted to long-term care facilities.

A 33-page health department report that said the move did not lead to higher death rates was discredited after Cuomo’s staff admitted to manipulating the report’s details, including nursing home residents who died from Covid.

Cuomo and former Health Commissioner Howard Zucker both He resigned in 2021. Some critics say they are not being held accountable enough for nursing home policies that they believe are accelerating the spread of the disease.

Rep. Ron Kim, a Queens Democrat and critic of Cuomo’s nursing home policies, said the state must own up to its mistakes.

“We have to hold them accountable for bad decisions,” Kim said in an interview. “Not because we want to demonize and insult them, but because we want to learn from our mistakes so we don’t repeat them.”

Under the new leadership, health professionals have worked to improve transparency and communication, aiming to release as much up-to-date information as possible and with less concern about how that information could be interpreted or twisted for political purposes, he said.

“Science doesn’t work on the time scale that politics does,” Lang said. “Our goal is to make sure we continue to improve science and digest it in different ways for people to integrate and respect.”

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