By Josefa Velasquez, Ann Choi, Claudia Irizarry Aponte, Ese Olumhense, Yoav Gonen, Originally published in THE CITY.New York City neighborhoods home to public housing developments logged a 30% higher rate of recent coronavirus hospitalizations than surrounding areas, according to THE CITY’s analysis of new state data.
On average, 14 people per 100,000 residents were hospitalized in ZIP codes with public housing, compared to 11 hospitalizations per 100,000 in other neighborhoods, at some point between May 2 and May 5.
As hospitalizations from COVID-19 decrease in New York, state and city officials have begun to focus on where New Yorkers are still getting sick from the virus and how.
Public health researchers say longstanding disadvantages that include poverty and limited access to health care, coupled with the city and state’s belated moves to safeguard residents, made the city’s roughly 400,000 public housing residents especially susceptible to the virus.
“NYCHA housing is almost a petri dish,” said Beverly-Xaviera Watkins, an epidemiology professor at NYU School of Global Public Health. “Everything about the NYCHA population makes them more vulnerable.”
During the three-day period in early May, residents of East Flatbush and Brownsville in Brooklyn, the South Bronx and East Harlem landed in the hospital because of the virus at rates twice as high as the city’s average, the newly released data shows.
These neighborhoods are home to a heavy concentration of NYCHA residents — a total of 62,000.
The state this month began to require hospitals to report more detailed information about patients, including their addresses and occupation.
The resulting snapshot of hospitalizations that occurred between May 2 and May 5 offers the first glimpse of where the virus still has a foothold — and where health officials will need to target efforts as they seek to stamp out COVID-19.
Four residents of Tawana Myers’ building in Brooklyn’s Linden Houses passed away from COVID-19 in mid-April, Myers said. All but one of the people who died were in their 50s.
“It’s really devastating. These are residents that you know and you can’t even pay your respects,” said Myers, who is 58. “And it’s scary. We’re fighting an army we can’t see and it’s gunning people down.”
Roadblocks to Testing
On a typical day before coronavirus, Kingsbrook Jewish Medical Center saw about 10 new patients admitted to its East Flatbush campus, according to a physician there who spoke to THE CITY on the condition of anonymity.
By mid-April, the hospital had 90 patients backed up waiting for a bed, virtually all for confirmed or suspected COVID-19 cases. In retrospect, the physician noted, that was the likely apex of the illness in the community.
“It was very chaotic. There were admitted patients all over,” the doctor said. “We had double rows in the hallways, a row of beds on each side.”
The hospital would log 340 deaths that month — an average of 11-plus per day — with roughly 95% of those related to COVID-19, he said. Under ordinary circumstances, the hospital would record 25 deaths in a month.
Kingsbrook — which had begun moving to shut down several of its non-emergency services this summer only to stop as the pandemic hit — primarily serves residents of East Flatbush and Brownsville, home to two of Brooklyn’s largest black and West Indian communities.
The doctor noted that many of his patients lived in multi-generational homes, large-scale private apartment buildings and public housing complexes.
Residents of the area’s close-knit public housing communities were devastated last month when 10 people died in a single week at the Van Dyke Houses. Around that same time, six seniors died at the nearby Woodson Houses.
Councilmember Alicka Ampry-Samuel (D-Brooklyn), whose district includes Kingsbrook, said that longtime neglect of the community paired with a lack of accessible testing ignited a tinderbox. Until mid-April, only hospitals were testing for the virus in the area, and even then, only admitted patients had access, she said.
“In the beginning, only people with a fever or difficulty breathing were admitted to the hospital, and only people who were admitted could get tested — so you basically had to be dead or near death to get tested,” Ampry-Samuel said.
“And even though the city was telling people without serious symptoms to stay home and tell their doctor, the reality is that the emergency room is the primary care for a lot of our neighbors. So of course we are seeing these numbers,” she added.
Testing sites sprung up in mid-April, with the opening of a controversial state-run drive-through testing operation in Flatbush on April 14. Two days later, an additional testing site opened in the Brownsville Multi-Service Family Health Center operated by the state.
As testing sites opened, so did “roadblocks” — such as not having a car for drive-through testing — “that didn’t lend to it being a very accessible experience,” said state Assemblymember Latrice Walker (D-Brooklyn).
Since Brownsville Multi-Services Family Health Center opened its site a month ago, 20% of the 1,100 people swabbed there have tested positive for COVID-19, according to a spokesperson for Metro IAF, a nondenominational social justice advocacy group working with the state to open testing centers. That’s lower than most testing sites have seen until recently.
Hospitalizations and deaths in his facility have been steadily declining, said the Kingsbrook physician. Internal hospital data shows that just 10% of newly admitted patients this week are in care for confirmed or probable COVID-19 related illness, he said, compared to 95% at the apex.
A Vulnerable Population
More than one-fifth of NYCHA’s residents are 62 or older — and so particularly vulnerable to COVID-19’s lethality. But that’s far from residents’ only risk factor.
“When you just think about the population in public housing, like every other low income community, you have a lot of comorbid disease that’s already associated with COVID,” said Watkins.
“High rates of asthma, you have cardiovascular disease, you have diabetes. The things that would increase susceptibility. But then low-income communities of color also have a lot of environmental exposures, and this is particularly true around NYCHA complexes,” Watkins said.
Residents of public housing are more likely to be in the service industry as hourly workers who are not able to work from home during the pandemic and rely on public transportation to get to work, Watkins added. In addition, people need disposable income to buy things like masks and hand sanitizer to protect themselves from the virus.
New York State distributed gallons of hand sanitizer in late April, in a manner that left residents feeling inhuman. Residents had to line up and wait as tenant leaders poured the allotted amount for each person.
“I hate the way they gave out sanitizer,” said Karen Blondel, a Red Hook public housing resident of 37 years, “After waiting that long to get it, it was almost like — we didn’t count.”
Beverly MacFarland, the tenant association leader at Taft Houses in East Harlem, said she and a few others pooled together some money in early March to buy supplies for the “vulnerable seniors” in the complex just as news of the virus’ landfall in New York was beginning to spread.
The roughly 100 “Corona to go bags” distributed contained Lysol, hand sanitizer, gloves, soap and masks, MacFarland told THE CITY while distributing food to residents.
Taft Houses recently received an infusion of masks and hand sanitizer for its residents from Cuomo’s office, she said. The resident association also purchased gloves to distribute.
MacFarland said two residents of the development have died from COVID-19. “Not a high number of people in Taft” were affected by the virus that she knows of — but with testing difficult to reach, it’s hard to get a handle.
Taft Houses residents seeking testing can travel to a hospital, or to two other area NYCHA complexes, St. Nicholas Houses or, in East Harlem, the George Washington Houses. “Each is a bus ride away,” MacFarland said.
‘We All Knew it was Gonna Get Hit’
The East Harlem ZIP codes of 10035 and 10029 — home to 20 public housing developments and more than 30,000 NYCHA residents — reported more than six times as many hospitalizations as the 10128 and 10028 ZIP codes on the Upper East Side.
And within the 10459 ZIP code in the Longwood area of the South Bronx, home to eight NYCHA developments, residents were hospitalized at one of the highest rates in the borough, at 36 per 100,000 residents.
“The larger issue remains the decades-long inequities in the borough, specifically in the South Bronx,” said Councilmember Rafael Salamanca (D-The Bronx), who represents the area. “Underlying health issues, disparate access to health care, density and poverty play a crucial role.”
Add to this years of disinvestment in the city’s public housing stock and the consequences were predictably disastrous, said Tomas Ramos, former program director at NYCHA’s Bronx River Houses and current candidate for Congress.
Before the pandemic struck, visits to NYCHA apartments in the area brought Ramos face-to-face with mold, peeling paint and other “uninhabitable” conditions.
“On top of that,” he told THE CITY, “we’re talking about poverty. NYCHA was gonna get hit regardless — we all knew it was gonna get hit. Why didn’t people act accordingly? We’ve been let down for so long.”
In mid-February, the union that represents roughly 8,000 NYCHA employees had already begun discussing with management how to prepare for the virus.
“We knew about the virus coming. We had many meetings with NYCHA pertaining to social distancing, how to perform the job, how to send maintenance into apartments, what type of (personal protective equipment) would be needed. We met with them about many things,” said Carl Giles, the housing director for Teamsters Local 237.
“Long and the short — NYCHA works on crisis, so they ignored us,” he said. “They didn’t pay attention to anything we stated. By mid-March now people are getting sick. NYCHA is not prepared.”
Residents of NYCHA complexes have noted that staff at their complexes have been calling out sick, making it hard to properly sanitize communal spaces adequately.
Giles said more than 100 of his members have contracted COVID-19 and five have died.
Representatives for NYCHA said its most recent verified data shows staff attendance rates at 71% between the April 5 and April 18 pay period. It referred all other questions to the city Department of Health and Mental Hygiene, which did not respond.
Counting Every Case
On Saturday, Cuomo announced a plan to set up additional testing sites “in churches in lower income communities and communities of color,” which will help with community outreach.
“As the governor has said since the beginning, it is the poor and minority communities that are suffering the most. it’s unfair, it’s unacceptable, and has been an issue of great concern for us,” said his senior aide, Rich Azzopardi. “We’ve been and will continue to take any action we can to correct this inequity and fight back this virus wherever it rears its head.”
East New York’s St. Paul Community Church, nestled between NYCHA’s Linden Houses and Boulevard Houses, will reopen on Monday as a walk-in testing site for the community.
Rev. David Brawley, the church’s pastor, declined to say how many of his congregants have passed away from the illness, noting simply that the virus “has taken a toll on the community.”
St. Paul’s is among churches that pitched themselves as potential testing sites to the Cuomo administration, with help from Metro IAF.
“We knew we had space, so we asked ourselves, ‘What can we do to contribute this space and do our part in this fight?’” Brawley said. “I’m just delighted to know that the governor saw the validity of this plan and has been willing to strategize and partner with us.”
As officials figure out how to relax restrictions and begin opening up sectors of society, getting hospitalizations and new infections down is a crucial part of the reopening equation, in which every case matters.
As of Thursday, New York City had only met four of the seven criteria set by the state to begin reopening. The five boroughs haven’t gotten the number of new hospitalizations down to under two per 100,000 residents, nor do they have the required 30% availability for hospital and ICU beds.
The chief of the city Department of Health and Mental Hygiene on Wednesday emphasized the overall decline in the number of new infections, rather than areas with rising cases or hospitalizations. On Tuesday, the department reported 886 new cases, the lowest daily increase since March 16.
“What we’re seeing recently isn’t particularly different than what we have been seeing all along in terms of the distribution of cases,” said Commissioner Dr. Oxiris Barbot.