Health Commissioner says variants, vaccines in “tug of war”

Health Commissioner says variants, vaccines in

Governor Andrew Cuomo this week announced another exciting round of COVID-19 restrictions that will be lifted in the coming days.
While it is entirely possible to enjoy ball games outdoors and exercise in groups indoors safely, there is growing concern that the loosening of restrictions is sending the signal that New York is finally out of the pandemic.

What would you like to know

  • Despite vaccination efforts, COVID-19 cases are not decreasing in New York
  • A majority of the city’s coronavirus cases have been linked to new, more contagious variants
  • Health officials say New Yorkers must continue to wear masks and social distancing despite recent easing of some COVID-19 restrictions

There is certainly reason to be hopeful: Statewide positivity on Thursday fell below 3%, and hospitalizations and deaths also dropped significantly.

Problem is, there’s another story in New York City, where positivity rates continue to hover around 5% in all boroughs except Manhattan. New York is one of several northeastern states where the number of positive cases per capita continues to rise, albeit more slowly than at the start of the year.

“We look at all of our metrics together: test, positivity, cases, hospitalizations and deaths. The first two that I mentioned, we don’t see a major increase, but neither do we see a decline. They are essentially leveling off. Hospitalizations and deaths are starting to decline, ”said Dr. Dave Chokshi, New York City Health Commissioner, in an exclusive interview.

(Mary Altaffer / AP)

Chokshi says there is a showdown going on. Cases fell because New Yorkers were vigilant with public health precautions, bringing the seven-day average of new confirmed and probable cases to 3,524, from a high of 6,435 in January.

“On the one hand, we have everything we know to curb the spread of COVID-19. Public health precautions, like wearing masks and distancing, testing, isolating and quarantining when we need it, and now the best tool we have in our arsenal, which is vaccination . So all of these things have an effect, ”Chokshi said. “This particularly contributes to the decrease in hospitalizations and deaths that we are seeing. On the other side of the equation we also have several things, one is the new variants of the virus, especially here in New York.

Anna Bershteyn, PhD, is an assistant professor of public health and part of a team of infectious disease modelers at the Grossman School of Medicine at New York University. Bershteyn says the city faces one of two scenarios. The first: it is likely entering a prolonged “shoulder” period, or plateau, as the UK variant, B.1.1.7., Continues to spread.

“We will be stuck on this plateau longer than we want, even if we vaccinate very quickly. And the vaccination prevents that plateau from becoming a flare-up. But we’re going to be stuck on this plateau for a few weeks until we can vaccinate and then get it to decline again. So it’s kind of a slowdown in progress, ”Bershteyn said.

The second scenario is more complicated, in part because little is known about the rapidly gaining variant, the one discovered in town, B.1.526. It represents 45% of new cases. It is also not clear if there are other more dangerous variants lurking. Cases of other disturbing variants found in South Africa and Brazil are rarer in the city, but they have been shown to re-infect people who have had COVID-19 before. Vaccines offer some protection against them.

“The worst-case scenario is that people who are only immune to the virus and not because they have been vaccinated could easily get infected,” Bershteyn said. “We also looked in our model for a scenario where vaccines lose their effectiveness in the sense that you can catch the virus and pass the virus on, but if you are vaccinated you are still protected against hospitalization and death. What we found is that even then we would see another increase of a variant with these properties right now. ”

Bershteyn said this was because the virus may be able to spread undetected in people who have been vaccinated, with mild or no symptoms. ” [The virus] will find the vaccination gaps. So it really is a warning to unvaccinated people to be very careful right now to the spread of these variants. ”

Chokshi said the behavior of New Yorkers over the next two weeks will help determine the future trajectory of the pandemic.

“This is a critical time for New York. This is what I hope will be an inflection point where we can finally pass the pandemic course. But to get there, we cannot throw caution to the wind. We need to maintain the things that we know have worked for us over the past few months. This is what I call the “safe six”: mask yourself, distance yourself, wash your hands, stay home if you don’t feel well, get tested and get vaccinated when it’s your turn. “Said Chokshi.

(Mary Altaffe / AP)

Another thing New Yorkers can do? Keep getting tested for the coronavirus, as the newer variants can spread more easily. Chokshi says that while testing levels are still high enough in the city, the number of people going for testing has declined in recent days.

City labs have dramatically increased genomic sequencing for the coronavirus from a few hundred per week last year to the thousands of samples currently being sequenced every week. This allows health officials to monitor the spread of the different variants. Chokshi says that by next week the labs will be producing around 5,000 sequences per week.

“We’re one of the few places across the country – I think maybe the only one – that is able to get some insight into the proportion of cases associated with particular variants,” Chokshi said. “We announced last week that the majority of new cases are now linked to one of these new variants. And we’re seeing that proportion increasing over time, which is another reason we’re watching it very closely and with some concern. ”


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