To the editor:
Preventing epidemics require disease detections before infections reach critical mass — the epidemic threshold. New York City’s COVID-19 case detection was mid-March 2020. Mount Sinai Medical Center recently reported mid-February blood samples containing coronavirus antibodies — a month before detection, COVID-19 had spread through Mount Sinai’s patients.
Post-detection, Mayor Bill de Blasio dithered a week before taking action. Gov. Andrew Cuomo stopped all action another week. COVID-19 had reached epidemic thresholds in Queens, Brooklyn and Bronx areas before the mayor’s action.
All three levels of government had pandemic response plans, but jettisoned 2020 implementation. Donald Trump lied about COVID-19 contagion and virulence, and opposed interventions. Cuomo delayed action and tainted data with his hero-posing. de Blasio berated “disobedient” sectors, but failed to engage with vulnerable communities.
Disease transmission is minimized at community level. Pandemic response plans must fit communities and be created by community, health department, and other relevant agencies’ representatives. Workers, management and health departments must create worksite plans.
Health departments must hire “trusted messengers” from communities to convey information between government and community for plan implementation. Government, communities and workers must share power and leadership.
State and local health departments largely failed to establish long-term relationships with communities that state and local governments oppressed. New York state neglected and denigrated rural counties for decades. New York state and New York City failed poor urban neighborhoods for decades.
Discriminatory fire service, violence and corrupt discriminatory policing, underfunding of poor neighborhoods’ schools, failure to protect tenants and the like, generated animosity.
These communities rejected governmental COVID-19 rules. Why cooperate with contact tracers asking police-like questions? Why rat on neighbors, family and co-workers? Why follow orders developed by and for higher classes? Why get tested by authorities that discriminate against you and your community?
Disempowered communities exercise resistance in epidemics. Failed government cannot control contagious disease.
With the highest cumulative first-wave COVID-19 case and fatality rates of New York state counties, the Bronx became the epicenter of the metropolitan region, and the national epicenter. By May 31, 2020, cumulative fatality rates of 23 of 24 Bronx ZIP codes with at least 10,000 residents exceeded 150 for every 100,000.
In contrast, 18 of Manhattan’s 35 ZIP codes had less than 150 fatalities for every 100,000. Median ZIP code cumulative fatality rates were 174 for Brooklyn, 189 for Queens, 117 for Manhattan, and 222 for the Bronx.
Such socio-economic factors as median income, educational attainment and rent stress associated with fatality rates of three boroughs’ ZIP codes, but not the Bronx, which became one big first-wave, high-fatality conurbation — a broken borough vulnerable to contagious disease and risk behavior after decades of discriminatory public policies such as redlining, urban renewal, planned shrinkage, failed tenant protection, and underfunded overcrowded schools.
During the second wave’s crest, it had the highest borough ZIP code maximum, mean and median percent positive.
The second state wave came from counties bordering New York in Pennsylvania, New Jersey, Connecticut, and Midwest ports across Lakes Erie and Ontario. On Oct. 30, nine mainly border New York state counties exceeded the 3 percent positive test threshold. By Nov. 9, 29 counties did, and the second wave raged through the state — a second government COVID-19 failure.
Decades-long governmental failures opened the Bronx to consequences of short-term failures. The 1970s Bronx fire company cuts destroyed more than 50 percent of several neighborhoods’ housing, pouring refugees into adjacent neighborhoods. Socially, economically and politically disorganized and disempowered, the borough’s weakness attracted decades of attacks and neglect.
The Bronx needs socio-political reorganization, economic rebuilding, and adequate municipal services such as fire control, schools, public health, and housing regulation.