Dear John,

One big challenge of this crisis is keeping up with the shifting collective actions it demands of us. So I want to take a minute today to let you know where we are at the moment with testing, contact tracing, and social distancing -- and what we need to do in the days ahead.

At the beginning of the crisis, we lacked clear and rapid guidance from federal, state, and local leaders. The hard truth: if we had shut down more quickly, we might have saved tens of thousands of lives (and also if we hadn’t sent thousands of virus patients into vulnerable nursing homes). 

Then, with our hospital system overwhelmed, and our testing capacity utterly failing to keep up with the virus, we were forced to move into the aggressive shelter-in-place regime. For most of the past 70 hard days, the guidance has been: Stay at home as much as you can. Don’t even get tested unless you’re sick enough to be admitted to the hospital.

But now, the guidance has changed: We want people to get tested, so we can know who’s carrying the virus, trace who they’ve been in contact with, and then help a narrower set of people remain isolated to slow the spread. With hospitalizations down and testing finally available, we can start, finally, slowly, to open up some activities. But we still must maintain social distancing and wear masks as we go back out in public. And that will take new, creative, collective strategies. Here’s a little more on what that means for the hard but hopeful days ahead.

Testing:

New Yorkers are encouraged to get a diagnostic test if they 1) have COVID-19 symptoms (cough, fever, shortness of breath, loss of appetite or smell), regardless of age, chronic conditions, or occupation, 2) believe they have been exposed to the virus (and really, who doesn’t?), or 3) work in a congregate residential setting (nursing home, shelter, or adult care facility), regardless of symptoms. 

So, when in doubt, get tested. The City now has 29 testing sites across every borough. Community testing sites operated by NYC Health + Hospitals offer free and convenient testing on a walk-in basis, with no appointment necessary. CityMD urgent care facilities are also doing walk in testing, including for free for those who are uninsured. In addition, testing for essential workers and vulnerable populations is available for free with an appointment through a partnership with One Medical, a national digital health and primary care provider. The state has said that pharmacies will be able to provide testing, though that’s not happening yet. More information and testing locations can be found here. 

Antibody tests are also becoming more widely available. While diagnostic tests tell you if you have the virus at the point in time you are tested (and therefore must remain in isolation for 14 days, and help with tracing contacts to prevent spread), antibody tests tell you if you had the virus at some point in the past. There is still no conclusive evidence that having had the virus would make you immune, so a positive test shouldn’t change your behavior (i.e. wear a mask and keep your distance still). But getting tested can help researchers and policymakers better understand the spread of the virus. If you have sufficient antibody levels you could be eligible to donate plasma to help those still struggling against the virus. Antibody tests are now available at most urgent care facilities, and the City has set up one site per borough to provide free testing by appointment, visit here to see if you qualify and make an appointment.

(Regardless of whether you have antibodies, please consider donating blood. NYC’s blood supply is dangerously low right now).

Tracing: 

With expanded testing, the City is ramping up contract tracing as well, so we can help people isolate if they’ve been exposed. This is a huge and critical effort, the foundation of our ability to open back up. So I wish that we were several weeks further along (Massachusetts got started several weeks before we did). And I wish New York City would have avoided the unnecessary and counterproductive level of sniping and ego-driven conflict around setting up the program, and let the Health Department run it. 

But despite my skepticism, last Friday’s City Council oversight hearing (chaired by Council Members Mark Levine and Carlina Rivera) actually gave me some reason for optimism in the City’s Test & Trace Corps. The team that is leading the effort is full of public health and operations professionals, who are committed to working together in a thoughtful way across agency lines. At the hearing, NYC Health + Hospitals President Mitch Katz was refreshingly honest in admitting that he made a mistake in not advising a shutdown earlier; that kind of honesty inspires more confidence that we can learn and improve. The operations director for the Test & Trace Corps is Jackie Bray, who I’ve worked with in the past, and found to be one of the best at cutting through bullshit and setting up government operations (you can watch their answers to my questions here at 2:16; I especially appreciated Jackie’s great answer about smartly navigating the snarl of databases needed to make this work at 2:21).  

The City’s team has committed to have 1,000 contact-tracers on board by June 1st, with the training & equipment they need, and the 2,400 by the end of June. More on this gargantuan effort here.

Social Distancing: 

So, with testing and tracing nearly in place, we can start to move into the next phases of opening back up. That’s a good and utterly necessary thing, for our economy, and for our physical and mental health. We all need to be outside, to breathe fresh air, to interact with others, to play (especially our kids).

But that’s going to require new ways of approaching social interactions in the long and hard months ahead. We already know a lot about what won’t work: Aggressive and discriminatory enforcement by the NYPD won’t achieve this public health task. Haranguing by elected officials aren’t likely to persuade everyone either. And we’ve all seen too many examples, across communities, of people engaging in too-risky behavior. It’s not easy to stay so far apart from our friends. Plus the rules are weird and sometimes confusing.

So what will work?

This week, the New York Times editorial board joined me and others calling for a NYC Public Health Corps, to do public health outreach and encourage compliance with physical distancing rules. We need people from every community, in our communities, speaking our languages, understanding our values, the public health, and the guidelines, to help us collectively comply with new norms for how to interact safely. This kind of “harm reduction” approach has a lot better chance of getting us to all take better care than selectively punishing those who aren’t complying (or that Twitter lectures). Here are some helpful tips for taking a harm reduction approach to your interactions. 

The City Council is holding an oversight hearing on social distancing this morning, both to account honestly for some of the mistakes so far in the NYPD’s enforcement efforts, to learn more about the Mayor’s plan for “social distancing ambassadors,” and to strengthen our plans for collective compliance. You can tune in here at 11 am to watch).

The months ahead are going to be hard ones. But there is some reason for hope too.

Brad

In this email:
City and State Updates
Upcoming Events

City and State Updates

Upcoming Events

Tuesday, May 26 from 6-8 PM: Small Business Townhall with Councilmember Lander and Assemblymember Carroll. Register here. 

Join us to discuss the challenges facing small businesses. We will be talking about the PPP and EIDL programs, our new interest-free loan program, and are eager to hear from you about other ideas to support small businesses. 

Thursday, May 28 from 4:30 to 6:30 PM: IntegrateNYC D15 Middle School Youth Council. Sign up here.

All 5th, 6th, 7th, and 8th grade students in D15 (Boerum Hill, Carroll Gardens, Cobble Hill, Fort Greene, Gowanus, Kensington, Park Slope, Sunset Park, Red Hook, or Windsor Terrace) are invited to join IntegrateNYC D15 Middle School Youth Council for their first virtual youth-led meeting on Thursday, May 28 from 4:30 to 6:30 PM. Also, encourage middle schoolers in your life to take Integrate’s D15 middle school student survey: bit.ly/INYCd15survey.

456 Fifth Avenue, 3rd Floor
Brooklyn, NY 11215
718-499-1090
[email protected]

    

unsubscribe
Was this forwarded to you? Sign up here.