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68% Have Antibodies in This Clinic. Can a Neighborhood Beat a Next Wave? 68% Have Antibodies in This Clinic. Can a Neighborhood Beat a Next Wave?
(about 1 hour later)
At a clinic in Corona, a working-class neighborhood in Queens, more than 68 percent of people tested positive for antibodies to the new coronavirus. At another clinic in Jackson Heights, Queens, that number was 56 percent. But at a clinic in Cobble Hill, a mostly white and wealthy neighborhood in Brooklyn, only 13 percent of people tested positive for antibodies.At a clinic in Corona, a working-class neighborhood in Queens, more than 68 percent of people tested positive for antibodies to the new coronavirus. At another clinic in Jackson Heights, Queens, that number was 56 percent. But at a clinic in Cobble Hill, a mostly white and wealthy neighborhood in Brooklyn, only 13 percent of people tested positive for antibodies.
As it has swept through New York, the coronavirus has exposed stark inequalities in nearly every aspect of city life, from who has been most affected to how the health care system cared for those patients. Many lower-income neighborhoods, where Black and Latino residents make up a large part of the population, were hard hit, while many wealthy neighborhoods suffered much less.As it has swept through New York, the coronavirus has exposed stark inequalities in nearly every aspect of city life, from who has been most affected to how the health care system cared for those patients. Many lower-income neighborhoods, where Black and Latino residents make up a large part of the population, were hard hit, while many wealthy neighborhoods suffered much less.
But now, as the city braces for a possible second wave of the virus, some of those vulnerabilities may flip, with the affluent neighborhoods becoming most at risk of a surge. According to antibody test results from CityMD that were shared with The New York Times, some neighborhoods were so exposed to the virus during the peak of the epidemic in March and April that they might have some protection during a second wave.But now, as the city braces for a possible second wave of the virus, some of those vulnerabilities may flip, with the affluent neighborhoods becoming most at risk of a surge. According to antibody test results from CityMD that were shared with The New York Times, some neighborhoods were so exposed to the virus during the peak of the epidemic in March and April that they might have some protection during a second wave.
“Some communities might have herd immunity,” said Dr. Daniel Frogel, a senior vice president for operations at CityMD, which plays a key role in the city’s testing program.“Some communities might have herd immunity,” said Dr. Daniel Frogel, a senior vice president for operations at CityMD, which plays a key role in the city’s testing program.
The CityMD statistics — which Dr. Frogel provided during an interview and which reflect tests done between late April and late June — appear to present the starkest picture yet of how infection rates have diverged across neighborhoods in the city.The CityMD statistics — which Dr. Frogel provided during an interview and which reflect tests done between late April and late June — appear to present the starkest picture yet of how infection rates have diverged across neighborhoods in the city.
As of June 26, CityMD had administered about 314,000 antibody tests in New York City. Citywide, 26 percent of the tests came back positive.As of June 26, CityMD had administered about 314,000 antibody tests in New York City. Citywide, 26 percent of the tests came back positive.
But Dr. Frogel said the testing results in Jackson Heights and Corona seemed to “jump off the map.”But Dr. Frogel said the testing results in Jackson Heights and Corona seemed to “jump off the map.”
While stopping short of predicting that those neighborhoods would be protected against a major new outbreak of the virus — a phenomenon known as herd immunity — several epidemiologists said that the different levels of antibody prevalence across the city are likely to play a role in what happens next, assuming that antibodies do in fact offer significant protection against future infection.While stopping short of predicting that those neighborhoods would be protected against a major new outbreak of the virus — a phenomenon known as herd immunity — several epidemiologists said that the different levels of antibody prevalence across the city are likely to play a role in what happens next, assuming that antibodies do in fact offer significant protection against future infection.
“In the future, the infection rate should really be lower in minority communities,” said Kitaw Demissie, an epidemiologist and the dean of the School of Public Health at SUNY Downstate Medical Center in Brooklyn.“In the future, the infection rate should really be lower in minority communities,” said Kitaw Demissie, an epidemiologist and the dean of the School of Public Health at SUNY Downstate Medical Center in Brooklyn.
Dr. Ted Long, the executive director of the city’s contact-tracing program, said that while much remained unknown about the strength and duration of the protection that antibodies offer, he was hopeful that hard-hit communities like Corona would have some degree of protection because of their high rate of positive tests. “We hope that that will confer greater herd immunity,” he said.Dr. Ted Long, the executive director of the city’s contact-tracing program, said that while much remained unknown about the strength and duration of the protection that antibodies offer, he was hopeful that hard-hit communities like Corona would have some degree of protection because of their high rate of positive tests. “We hope that that will confer greater herd immunity,” he said.
Neighborhoods that had relatively low infection rates — and where few residents have antibodies — are especially vulnerable going forward. There could be some degree of “catch up” among neighborhoods, said Prof. Denis Nash, an epidemiology professor at the CUNY School of Public Health.Neighborhoods that had relatively low infection rates — and where few residents have antibodies — are especially vulnerable going forward. There could be some degree of “catch up” among neighborhoods, said Prof. Denis Nash, an epidemiology professor at the CUNY School of Public Health.
But he added that even if infection rate were to climb in wealthier neighborhoods, “there are advantages to being in the neighborhoods that are hit later.” For one, doctors have become somewhat more adept at treating severe cases.But he added that even if infection rate were to climb in wealthier neighborhoods, “there are advantages to being in the neighborhoods that are hit later.” For one, doctors have become somewhat more adept at treating severe cases.
Some epidemiologists and virologists cautioned that not enough data exists to conclude that any areas have herd immunity. For starters, the fact that 68.4 percent of tests taken at an urgent care center in Corona came back positive does not mean that 68.4 percent of residents had been infected.Some epidemiologists and virologists cautioned that not enough data exists to conclude that any areas have herd immunity. For starters, the fact that 68.4 percent of tests taken at an urgent care center in Corona came back positive does not mean that 68.4 percent of residents had been infected.
“For sure, the persons who are seeking antibody testing probably have a higher likelihood of being positive than the general population,” said Professor Nash. “If you went out in Corona and tested a representative sample, it wouldn’t be 68 percent.”“For sure, the persons who are seeking antibody testing probably have a higher likelihood of being positive than the general population,” said Professor Nash. “If you went out in Corona and tested a representative sample, it wouldn’t be 68 percent.”
So far, the federal government has released relatively little data from antibody testing — making the CityMD data all the more striking. The Centers for Disease Control and Prevention, for instance, has published limited data that suggested that 6.93 percent of residents in New York City and part of Long Island had antibodies. But that survey was based on samples collected mainly in March, before many infected New Yorkers might have developed antibodies.So far, the federal government has released relatively little data from antibody testing — making the CityMD data all the more striking. The Centers for Disease Control and Prevention, for instance, has published limited data that suggested that 6.93 percent of residents in New York City and part of Long Island had antibodies. But that survey was based on samples collected mainly in March, before many infected New Yorkers might have developed antibodies.
New York State conducted a more comprehensive survey on antibody rates, which involved testing some 28,419 people across the state. That survey suggested that roughly 21.6 percent of New York City residents had antibodies. But it also revealed a much higher rate in some neighborhoods. While the state has released little data from Queens, its numbers showed that in Flatbush, Brooklyn, for example, about 45 percent of those tested had antibodies.New York State conducted a more comprehensive survey on antibody rates, which involved testing some 28,419 people across the state. That survey suggested that roughly 21.6 percent of New York City residents had antibodies. But it also revealed a much higher rate in some neighborhoods. While the state has released little data from Queens, its numbers showed that in Flatbush, Brooklyn, for example, about 45 percent of those tested had antibodies.
The CityMD data provides similar conclusions. At a location in Bushwick, a Brooklyn neighborhood which has a large Hispanic population and where the median household income is below the citywide average, some 35 percent of antibody tests were positive, according to Dr. Frogel.The CityMD data provides similar conclusions. At a location in Bushwick, a Brooklyn neighborhood which has a large Hispanic population and where the median household income is below the citywide average, some 35 percent of antibody tests were positive, according to Dr. Frogel.
Dr. Frogel said that across the Bronx, which has had the city’s highest death rate from Covid-19, about 37 percent of antibody tests were turning up positive.Dr. Frogel said that across the Bronx, which has had the city’s highest death rate from Covid-19, about 37 percent of antibody tests were turning up positive.
Updated July 15, 2020
The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
The CityMD in Corona, on Junction Boulevard, serves a predominantly Hispanic neighborhood whose residents include many construction workers and restaurant employees. Many had to work throughout the pandemic, raising their risk of infection.The CityMD in Corona, on Junction Boulevard, serves a predominantly Hispanic neighborhood whose residents include many construction workers and restaurant employees. Many had to work throughout the pandemic, raising their risk of infection.
Angela Rasmussen, a virologist at Columbia University, called the high positive rate in Corona “a stunning finding.” Epidemiologists said the rate showed the limits of New York’s strategy in curtailing the virus: While public health measures may have slowed the spread in some neighborhoods, they did far less for others.Angela Rasmussen, a virologist at Columbia University, called the high positive rate in Corona “a stunning finding.” Epidemiologists said the rate showed the limits of New York’s strategy in curtailing the virus: While public health measures may have slowed the spread in some neighborhoods, they did far less for others.
There are reasons parts of Queens were hit so hard. Homes in Elmhurst and parts of Corona are especially crowded — the highest rate of household crowding in the city, according to census bureau data from 2014. Given that transmission among family members is a leading driver of the disease’s spread, it is unsurprising that crowded households have been associated with higher risk of infection.There are reasons parts of Queens were hit so hard. Homes in Elmhurst and parts of Corona are especially crowded — the highest rate of household crowding in the city, according to census bureau data from 2014. Given that transmission among family members is a leading driver of the disease’s spread, it is unsurprising that crowded households have been associated with higher risk of infection.
For residents of Corona, the main sources of employment are jobs in hospitality, including restaurants, as well as construction and manufacturing, according to a 2019 report by the Citizens’ Committee for Children of New York. Many construction workers and restaurant employees showed up to work throughout the pandemic, elevating their risk of infection.For residents of Corona, the main sources of employment are jobs in hospitality, including restaurants, as well as construction and manufacturing, according to a 2019 report by the Citizens’ Committee for Children of New York. Many construction workers and restaurant employees showed up to work throughout the pandemic, elevating their risk of infection.
“Our plan did not really accommodate essential workers as it did people privileged enough — for lack of a better word — to socially distance themselves,” Professor Nash said. He said that one lesson of the past few months was that the city needed to better protect essential workers — everyone from grocery store employees to pharmacy cashiers — and make sure they had sufficient protective equipment.“Our plan did not really accommodate essential workers as it did people privileged enough — for lack of a better word — to socially distance themselves,” Professor Nash said. He said that one lesson of the past few months was that the city needed to better protect essential workers — everyone from grocery store employees to pharmacy cashiers — and make sure they had sufficient protective equipment.
Epidemiologists have estimated that at least 60 percent of a population — and perhaps as much as 80 percent — would need immunity before “herd immunity” is reached, and the virus can no longer spread widely in that community.Epidemiologists have estimated that at least 60 percent of a population — and perhaps as much as 80 percent — would need immunity before “herd immunity” is reached, and the virus can no longer spread widely in that community.
But scientists say it would be a mistake to base public health decisions off antibody rates across a population.But scientists say it would be a mistake to base public health decisions off antibody rates across a population.
“Just looking at seroprevalence alone can’t really be used to make actionable public health decisions,” Dr. Rasmussen, the virologist at Columbia, said.“Just looking at seroprevalence alone can’t really be used to make actionable public health decisions,” Dr. Rasmussen, the virologist at Columbia, said.
One reason is that the accuracy of the antibody tests is not fully known, nor is the extent of immunity conferred by antibodies or how long that immunity lasts. Dr. Rasmussen noted that the “magical number of 60 percent for herd immunity” assumes that everyone infected has complete protection from a second infection. “But what about people with partial protection?” she asked. “They may not get sick, but they can get infected and pass it along.”One reason is that the accuracy of the antibody tests is not fully known, nor is the extent of immunity conferred by antibodies or how long that immunity lasts. Dr. Rasmussen noted that the “magical number of 60 percent for herd immunity” assumes that everyone infected has complete protection from a second infection. “But what about people with partial protection?” she asked. “They may not get sick, but they can get infected and pass it along.”
“It is premature to discuss herd immunity, since we are still learning what the presence of Covid-19 antibodies means to an individual and whether, or for how long, that conveys immunity; and we don’t know how the level of immunity in a single community translates into herd immunity,” said Jonah Bruno, a spokesman for the state Department of Health.“It is premature to discuss herd immunity, since we are still learning what the presence of Covid-19 antibodies means to an individual and whether, or for how long, that conveys immunity; and we don’t know how the level of immunity in a single community translates into herd immunity,” said Jonah Bruno, a spokesman for the state Department of Health.
He said he was unsurprised by the high rate in Corona, and senior officials with the city’s contact-tracing program and public hospital system agree. “We know this area was disproportionately affected,” said Dr. Andrew Wallach, a senior official in the city’s public hospital system, “so this just confirms what we’ve seen clinically.”He said he was unsurprised by the high rate in Corona, and senior officials with the city’s contact-tracing program and public hospital system agree. “We know this area was disproportionately affected,” said Dr. Andrew Wallach, a senior official in the city’s public hospital system, “so this just confirms what we’ve seen clinically.”