No, you are wrong Cuomo

 

Gothamist

In New York and beyond, the coronavirus pandemic has ushered in an unusual new conversance with public health metrics, with government officials now using testing and hospitalization data as a gauge for the severity of the virus and important policy decisions.

No metric has drawn more attention—or controversy—than the positivity rate. The number, which measures the percent of tests that turn up positive and serves as a proxy for infection rate, has been used to justify economic reopenings as well as business and school shutdowns.

For example, Governor Andrew Cuomo has said that he would order schools to close should local positivity rate rises above 9 percent, an increasingly likely possibility given the surge of infections.

In spite of the high stakes, New York state officials have been calculating positivity on a flawed basis, according to several experts. The criticism stems from the state's decision to fold in a type of rapid test known as antigen tests, which are less sensitive than polymerase chain reaction (PCR) tests.

"That's not what the professional guidance is," said Dr. Jay Varma, Mayor Bill de Blasio's top health adviser. "It's not what the WHO does or the CDC or the Council of State and Territorial Epidemiologists does."

The Council of State and Territorial Epidemiologists, which advises the Center for Disease Control and Prevention and other health agencies, has said that a positive antigen test should be considered a probable case of COVID-19, not a confirmed case. In turn, the CDC has defined its positivity rate as based on PCR tests only.

Despite the limitation of antigen tests, their benefits are clear: the tests can provide results within 15 minutes and can cost as little as $5, whereas PCR tests cost around $100 at national labs. Antigen testing has proliferated across the country in nontraditional testing centers, like schools and nursing homes, especially as the demand for testing increases.

In New York City, the tests are now available at pharmacies, CityMDs and doctor's offices. Drawn by their quick turnaround time, many people are unaware of the caveats.

During a recent seven-day period, there were nearly 88,000 antigen tests performed in one week, although city health officials cautioned that not all antigen test results are being reported to the city.

According to Cuomo, the state performs “hundreds of thousands" of antigen tests per week.

Dr. Ian Lipkin, a renowned epidemiologist at Columbia University and testing expert, agreed with Varma that antigen tests should be separated from PCR tests. The latter are currently considered the gold standard in terms of accuracy.

"You need to distinguish those clearly," he said. "It's reasonable to say these are PCR, these are antigen, but I don't think you should mix the two."

Southeast Queens is at the bottom of available COVID-19 testing sites

Queens Chronicle 

When Gov. Cuomo designated Ozone Park as a yellow zone, it served as a warning sign to the borough that the virus was traveling into the area south of Forest Park.

But while positivity rates of the yellow zone in the whole Central Queens area have stayed relatively low — hovering below 3 percent for the past seven days — another problem has revealed itself, which precedes the recent rash of positive cases.

South Queens has exceedingly low rates of COVID testing. Five neighboring ZIP codes in South Queens are among the 10 areas with the lowest rates of COVID testing in the whole city. Lawmakers and community leaders say their efforts to set up more sites in the area have met bureaucratic resistance.

“This is nothing new,” said Councilwoman Adrienne Adams (D-Jamaica). “The whole phenomenon around the lack of testing in Southeast Queens has gone on since the onset of the pandemic.”

The absolute lowest amount of testing per 100,000 people in the city is bound by a ZIP code bisecting Richmond Hill and South Ozone Park, stretching mostly over Adams’ district. Only 4,837 per 100,000 people have been tested there – nearly half of the city’s average rate of testing per ZIP code.

The next lowest ZIP code covers most of Woodhaven, just a little farther north. The rates of testing in ZIP codes stretching over South Ozone Park, Ozone Park and South Jamaica are not far behind.

While still below the citywide average, Howard Beach’s test rates are not as low as the aforementioned neighborhoods.

None of that information surprised Felicia Singh, a neighborhood advocate and District 32 City Council candidate, who has been calling for more and longer-lasting testing sites in the area for more than three weeks.

“I told [NYC Health + Hospitals, the mayor and governor] that COVID would travel here and sadly I was right,” Singh tweeted.

When she saw lines wrapping around the two-week rapid testing site at the Ozone Park Library on its final day on Oct. 2, Singh filled out a request for a city-run site on the border of the neighborhood and East New York. It was not approved, even though at the time the number of confirmed positive cases per 100,000 people had skyrocketed 650 percent over the two-week period, according to the city’s data.

“Still, getting the testing sites for all of our districts has been a battle,” Adams told the Chronicle over the phone. “We’ve still got communities of color slighted when it comes to testing. There is a lot of bureaucracy that astounds when it comes to maneuvering through this.”