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Help Wanted: COVID-19 Strains the Monroe County Health Department

Patti Singer

A sign in Genesee Valley Park in the spring urged people to practice physical distancing. As the pandemic surges, health officials remind people to continue distancing as well as wear a mask. File photo

Monroe County’s COVID-19 cases are up so much that the help wanted sign is out at the Department of Public Health.

To help with contact tracing and other aspects of the response to the pandemic, the county is adding 50 temporary positions that start at $15 an hour. The job description and application is at starting Nov. 20.

The need for help was among several COVID-19 topics discussed by County Executive Adam Bello and Commissioner of Health Dr. Michael Mendoza Nov. 19 at their weekly news conference.

Overall, their report was mixed.

Mendoza announced that the county would have another record-breaking day for new cases – 373. He said hospitalizations continued to go up and that middle-aged people make up about one-third of the patients.
On a better note, the rate of positive tests appears to have plateaued over the previous few days.

But Mendoza expressed concern over hospital capacity and the ability of stressed health care workers to care for patients with any condition.

“Hospital capacity isn’t just about beds,” said Mendoza, who is a practicing physician in the UR Medicine system.

“It’s about people,” he said. “Those people are our nurses, respiratory therapists, doctors. While they may be there in the same numbers as before, they are not there in the same spirit as before. We are burned out, we are tired and we want the community to step up and help us. Your words of encouragement, your flowers, your pizza are very nice. But what we really want is for you to do the right thing so you can help us do our job by taking care of you and your loved ones in your time of need.”

Here are highlights of the Nov. 19 news conference:

Hospitalizations: As of Nov. 19, the county had the highest number since the beginning of the pandemic. Mendoza said that of the 137 patients in the four hospitals, 31% are younger than 60, and 7% are younger than 40. Mendoza did not have exact numbers but said it’s his impression that more younger people are hospitalized than when the pandemic hit in the spring. He said that people younger than 40 tend to have fewer underlying medical conditions, so for them to be hospitalized means they are quite ill. “That represents a red flag in my view of how things may pan out in the weeks and months.” Deaths are not as frequent as they had been earlier in the pandemic.

Yellow zone designation: Parts of the county remain in the state-designated yellow zone micro-cluster. Restrictions are no more than 10 people gathering in a private residence; 50% capacity for houses of worship; no more than 25 people for indoor/outdoor gatherings; indoor/outdoor restaurant seating is limited to no more than four people per table. The zone status is reviewed after 14 days. Data such as the rate of positive tests, whether there is a demonstrable decline in the rolling average of new cases and testing capacity determine whether an area is placed in the yellow, orange or red zone.

Potential of a lockdown: If the Monroe County rate of positive tests rises to another threshold, more restrictions will be imposed by the state – what people refer to as a lockdown. Mendoza urged people to act as if one already is in place. He suggested people limit trips to the grocery store and consolidate errands for efficiency and to minimize exposure.

Enforcement: Bello said the consequences of not following COVID-19 guidelines isn’t the threat of a ticket from law enforcement but the risk to public health, the potential of overtaxing the health care system and the effect on businesses and jobs if more restrictions are imposed.

Testing: Bello said the state is expanding hours at the Monroe Community College testing site, which does the more accurate and precise PCR test. He said he is working with the state to receive more rapid tests kits, which would be deployed throughout the community. Exactly how that would happen and ensuring an equitable distribution still is being determined.

Thanksgiving: Mendoza said it would be very risky to have anyone outside your household. There have been recommendations that people open a window if they are gathering. “The part that makes me worry is when you blow in in air, these days it’s going to be cold,” he said. “Cold air is more dry, and dry air is more likely to disperse this virus (through aerosol). I don’t know that opening a window to cold dry air is necessarily going to be helpful. It’s not helpful enough for me to think it would be safer in a home to have a gathering more than the size of your own household.”

Where the virus is spread: Mendoza said schools are not being seen as problem areas for transmission. Neither are gyms, hair salons or barbershops, he said. Based on what contact tracers are being told, the virus appears to be transmitted in smaller gatherings where people are not wearing masks and are within close range.

Nursing homes: As of Nov. 19, about 17% of hospitalized patients were from congregate settings such as group homes, assisted living or nursing homes. Nursing homes were extremely hard hit early and visits were limited mostly for residents at end of life. As a result, residents were isolated and families reported concern over their physical and emotional health. The state oversees nursing homes, and since then has allowed some compassionate care visits for residents who are not receiving hospice care. Mendoza said his goal is to keep the community safe, which by extension eases the threat on residents and staff in nursing homes.