Coronavirus: Vulnerable Seniors
“We’re going to protect our senior centers,” Mayor Bill de Blasio said during his latest briefing on the spread of the new coronavirus, also known as COVID-19, adding that city health department officials are visiting all of the city’s 600 such centers to ensure proper protocols amid the virus outbreak that has now led to 20 confirmed cases in the city, with more expected.
According to the federal Centers for Disease Control (CDC), older adults are at higher risk for contracting the new coronavirus that is spreading across the globe and here in New York City, and “early data suggest older people are twice as likely to have serious COVID-19 illness.”
During his Sunday briefing on the new coronavirus, Governor Andrew Cuomo also again stressed that seniors are among the most vulnerable populations to COVID-19. “Most people have mild symptoms, most people don't get hospitalized,” Cuomo said. “The dangerous aspect again is people in that vulnerable population -- senior citizens, the elderly, et cetera. So we are trying to contain it.”
Also on Sunday, the city’s health commissioner, Dr. Oxiris Barbot, pointed to the additionally dangerous combination of age and underlying conditions. “We want to make sure that elderly folks who have chronic underlying illnesses, we do everything that we can together as a community not to increase their risk,” Barbot said alongside the mayor. The underlying conditions that have been identified to exacerbate the risk of coronavirus are chronic lung disease, cancer, diabetes, immuno-compromised, heart disease.
“As our senior New Yorkers, as you've heard today, are especially vulnerable to the effects of this virus, we are also working very closely with the Department for the Aging and our other human service partners to ensure our senior centers, adult care centers, nursing homes, receive up to date guidance on how to limit the spread of the disease,” said Deanne Criswell, head of the city’s Office of Emergency Management, also during Sunday’s press conference on how the city is trying to contain and combat the new coronavirus.
Amid rising worries about older New Yorkers and senior care facilities, on Friday the New York City Council’s Committee on Aging held a regularly-scheduled budget hearing with representatives of the city’s Department for the Aging (DFTA) where coronavirus concerns were front and center in the discussion. It was one in an ongoing series of hearings on de Blasio’s $95.3 billion preliminary budget plan that the Council is holding over the course of weeks, with some taking on new importance relative to the spread of coronavirus and its impact, which could include undermining revenue sources for the city’s budget while creating new city government expenses.
City government is developing a plan to try and ensure New York City’s seniors stay healthy as the coronavirus concerns continue, although no additional funding has been requested by DFTA to provide further protections.
DFTA currently has a $434 million budget and oversees “230 neighborhood senior centers, 16 innovative senior centers, and 39 sites affiliated with senior centers” across the city and has 1,393 contracts with agency providers to deliver services, according to budget documents.
DFTA Commissioner Lorraine Cortés-Vázquez, along with the department’s chief financial officer, Jose Mercado, outlined the agency’s work and budget, and responded to questions from Council members, especially Margaret Chin, a Manhattan Democrat who is chair of the Council Committee on Aging and whose lower Manhattan district includes several senior centers.
Cortés-Vázquez was asked multiple times by Council Member Ruben Diaz, Sr. if DFTA is asking for or plans to ask for any additional funding to address coronavirus.
“I have the utmost confidence that the mayor is going to do all he can and has made it very clear that this is a priority and that resources will be made available to combat this disease,” Cortés-Vázquez responded.
Pressed further by Diaz Sr. about limited testing for coronavirus and what DFTA is going to do if the virus begins to enter senior centers.
“Our Department of Health and our commissioner of health has been having tabletop meetings on a daily basis with the mayor around this same issue,” Cortés-Vázquez said. “We have the utmost confidence that this administration and this health commissioner made all the provisions necessary if it were to reach that level. It has not reached that level and we do not want to cause chaos or alarm in our senior centers or in the population as a whole.”
Council Member Chin brought the mayor's plan to have city workers visit senior centers to the attention of Cortés-Vázquez, who then provided further information on the plan.
“We have been given incredible amounts of guidance and information,” Cortés-Vázquez said. “The mayor wanted to ensure the information was being implemented, so we have an emergency plan that we have devised that involves DFTA staff as well as additional staff to visit the congregate sites throughout the city precisely to ensure they are posting the information, that the information is being distributed to the consumer population and the population staff is responsible for; to ensure that the professionals have the guidance to know what to do should any incident occur and also to inform the staff, the nonsensical staff, know what the protocols are. It’s a widespread effort to ensure everyone is taking the proper precautions and using the guidance that has been distributed to them.”
Cortés-Vázquez said the effort will reach over 600 senior centers, including those not funded by DFTA.
“To ensure that older New Yorkers are staying informed about coronavirus, starting today, DFTA staff will be visiting over 600 congregate sites to check that Department of Health and Mental Hygiene (DOHMH) COVID-19 informational fliers are on display and share DOHMH resources,” said Suzanne Myklebust, Deputy Director of Public Affairs for DFTA, in a Friday email to Gotham Gazette just after the hearing, answering follow-up questions.
“DFTA is working closely with its partners to distribute information and guidance on coronavirus. As a preventative measure against the spread of COVID-19, we have asked providers to continue to follow standard cleaning protocols and be extra diligent in their disinfecting practices,” Myklebust said.
Council Member Mark Treyger, a Brooklyn Democrat, also inquired about DFTA’s preparedness for the spread of coronavirus, citing the example of the city Department of Education asking for additional funding to provide the resources to deep clean the city’s schools and to contract with more nurses so that every school building has at least one nurse.
“My concern is that if we don’t have a health care professional at the front end and proactively helping the population, the worst thing that can happen is that seniors end up in emergency rooms and hospitals which are very dangerous because of the spread of other very serious diseases and can really compromise their health. I think it is wise for us to proactively provide health care professionals,” Treyger said.
Cortés-Vázquez responded that providers have enough resources and to the best of her knowledge no senior service providers have asked for additional funding. She also emphasized that this is an ongoing conversation in conjunction with the Department of Health and the Mayor’s Office, and that maintenance and sanitary conditions are always a priority given that senior centers provide meals, so it is not a new area of concern.
DFTA congregate sites also have a procedure if seniors begin to show symptoms or are found to have the virus.
“If a senior center member displays symptoms of sickness while at that center, senior center staff has been instructed to immediately restrict the movement of that person within the facility, by isolating the suspected case and minimizing interaction with staff and other members, and from leaving the facility,” Myklebust said by email. “The senior center staff should then call 311 to contact the nearest healthcare provider who can provide additional guidance. If an individual is found to be confirmed for COVID-19 infection, the individual should follow the recommendations of healthcare professionals and refrain from visiting any congregate sites altogether.”
Some emergency action was triggered when it was learned that a health care worker who has tested positive for coronavirus had been in contact with residents of a nursing home in southern Brooklyn.
Brooklyn City Council Member Justin Brannan tweeted on Sunday an update that the healthcare worker, who lives in New Jersey but works at King David Nursing Home, had come into contact with eight residents of the home, but that none of them were showing as symptomatic of COVID-19. Each family has also been notified, Brannan said.
At Mayor de Blasio’s press conference on Sunday, he was asked about the King David Nursing Home case, and Commissioner Barbot responded that each of the individuals who were exposed “are all in private rooms and being monitored daily. So they're in the appropriate level of isolation.” De Blasio also added that all were asymptomatic.
Also Discussed at the Hearing
Other topics that were brought up during the budget hearing with DFTA representatives included increased funding for the home delivered meals program, and what DFTA is going to do about the growing waitlist for homecare and case management.
The Council committee report in response to DFTA’s preliminary budget highlighted that there has been “persistent over-serving against the home-delivered meals target,” which presents higher demand than has been accounted for. Council members raised concerns about this in addition to rising food costs, advocating for higher funding for home delivered meals to preemptively address the concern so they can meet demand.
Cortés-Vázquez said of the home delivered meals that they will consider budgetary changes to address rising food prices, and said that saying there’s a waitlist for home delivered meals is misleading.
“We triage it and those with the greatest needs get priority. Everyone gets a phone assessment so we can assess. If someone needs a meal, that meal gets turned on immediately. So it is not a waitlist in a traditional way you think of a waitlist. Is it a problem, is the need growing? Absolutely. But it is not a problem that is not being managed,” Cortés-Vázquez said.
Cortés-Vázquez emphasized multiple times during the hearing that combating social isolation and geriatric mental health, and confronting ageism as a whole are also priorities for DFTA.