Citing rising COVID-19 hospitalizations and deaths, packed emergency departments, and the specter having reinstate a shutdown of elective surgeries for the second time since the pandemic began, Monroe County Executive Adam Bello today declared a state of emergency.
For now, Bello says, the county is in the first phase of a three-phase emergency plan to deal with the new surge of COVID cases. Along with area health system officials and county Public Health Commissioner Michael Mendoza M.D., Bello is calling for unvaccinated individuals to get COVID vaccine shots.
“We have a situation here in our hospitals where the numbers are going up at an alarming rate and it’s being driven largely by people who are unvaccinated,” Bello says. “I think the more people hear that message (and) understand the benefits of vaccination, not just for them but for the people around them, we’re going to continue to have more and more vaccinations,”
As part of the Phase I effort, Bello adds, the county has secured 750,000 rapid COVID tests, which it will hand out free to county residents. Exact plans for distribution of the test kits are still being worked out.
Under the first, voluntary phase of the emergency plan, Bello is calling on county residents to wear masks outside the home and at public gatherings, and for businesses to require on-site employees to mask up and let workers who can do jobs remotely to work from home, steps the county is requiring of its own workers.
Phase II would usher in mandates including protocols requiring employees and residents to show proof of vaccination and proof of negative COVID tests to attend certain gatherings and events.
What would the plan’s third phase look like?
“Phase III becomes a lot more restrictive,” says Bello. “But we can’t get to that phase; we don’t have to get to get to that phase.”
Prompting the state-of-emergency declaration are disturbing numbers of area COVID hospitalizations and deaths.
In the Finger Lakes region, 31 out of every 100,000 residents is hospitalized due to COVID. By contrast, five of every 100,000 New York City residents is hospitalized for COVID. The Finger Lakes region now accounts for 20 percent of the state’s total COVID cases.
In Monroe County today, says Mendoza, more patients being treated in hospitals for COVID are critically ill than those during the pandemic’s earlier surges. The roughly 25 percent of COVID patients requiring treatment in local ICUs represents a nearly 50 percent increase over the ICU-COVID cases at the same point in 2020. Today, there are 108 area COVID patients in ICUs. Last year at this time, the number was 68.
Mendoza, Bello and hospital officials pin the blame for the gap between this region’s and New York City’s numbers on the percentage of vaccinated residents and the region’s differing numbers of those masking in public and at gatherings and events.
Of the 256 local individuals who have died of COVID since March, more than 90 percent of those under the age of 65 were not vaccinated, Mendoza says. Nearly 70 percent of the over-65 cohort of local residents who succumbed to the virus in that span were unvaccinated.
Sixty-five percent of Monroe County’s currently hospitalized COVID patients are unvaccinated. Nearly 80 percent of the county ICU patients with COVID are unvaccinated. Eighty-two percent of county COVID patients on a respirator are not vaccinated.
Unvaccinated individuals on average are eight times as likely to be hospitalized with COVID and eight times as likely to land in an intensive care unit as those who have taken a shot, Bello says. Unvaccinated hospitalized COVID patients are nearly nine times as likely to be on a ventilator as vaccinated patients.
While the county could face an unknown level of additional threat from the recently identified Omicron variant, says Mendoza, it has not yet been identified to have hit here. The current surge is largely a product of the Delta variant, a strain that has shown itself to be at least partially tamed by vaccines.
Citing a wide discrepancy between downstate and upstate hospitals’ ability to cope with the Delta variant surge, Gov. Kathy Hochul announced Monday that she is sending the National Guard to upstate areas, deploying troops with EMT training to help move hospital patients to nursing homes to free up space.
The governor also has issued an executive order that would let the state bar non-elective procedures at overburdened hospitals. The order calls for limits to be applied to hospitals whose capacity falls 10 percent below a specified limit. The 10 percent threshold applies to hospitals that don’t have enough beds as well as those that have adequate bed capacity but are too short staffed to service them.
“We’re riding that 10 percent number,” says Michael Apostolakos M.D., UR Medicine chief medical officer. Rochester Regional Health’s situation is similar, says Robert Mayo M.D., chief medical officer.
Rochester hospitals’ capacity had been stretched for years before the pandemic hit, with major hospitals like UR Medicine’s Strong Memorial and RRH’s Rochester General routinely at more than 100 percent capacity.
“We had staff shortages well before the pandemic began,” Apostolakos says. “The pandemic has gotten a number of people in health care to rethink where they want to be. It’s led to people retiring or leaving the profession because it isn’t what they want to do.”
RRH’s Mayo again echoes Apostolakos.
Still, says Apostolakos, both health systems are working closely with the state to try to avoid a shutdown of elective procedures, a move that could cause patients awaiting surgeries like non-urgent cancer procedures considerable distress.
“If the rule becomes hard and fast, we’ll go along with what the state says,” Apostolakos says. “But thus far, we’ve been working with the state very closely and they have been accepting of how we’re moving forward.
“With that said,” he adds, “whether the state mandates it or not, if we don’t feel we can safely care for our patients because of a surge of COVID patients, we will call them, we will talk with them about what the options are, but we will only postpone surgeries if we can safely do so.”
In the end, Mayo says, how the county fares will not be up to the state or local government or hospital officials. Our collective fate will depend on individuals’ decisions and choices.
The difference between the current surge and what we faced a year ago, says Mayo, is that now we know that strategies like masking, vaccines and social distancing work to bring the pandemic under control and so “now personal choice more than ever is the solution to this pandemic. Personal choice by being vaccinated is the ultimate tool to overcome the pandemic and to bring it to its conclusion.”
In declaring a state of emergency, says Bello, he is not imposing mandates or burdens on residents but is “asking for the public’s help to avert additional mandates and restrictions that no one wants to see implemented here again. Simply put, this pandemic is with us until we approach a more fully vaccinated population.”
Adds Bello: “We can do this because we’ve done it before, and I have faith and confidence in this community that we can flatten this curve.”
Will Astor is Rochester Beacon senior writer.