Ulster’s curve is flattening

Ulster County Executive Pat Ryan and HealthAlliance of the Hudson Valley Executive Director and Chief Medical Officer Michael Doyle at the latest testing site on Grand St in Midtown Kingston. (Photo by Dion Ogust)

It’s as plain as the nose on your face. This wave of the COVID-19 pandemic is slowly receding locally. It is no disservice to the cause of public health to say so.

The relief we all feel is palpable. But we will soon face equally difficult circumstances on the way down the slippery slope of this pandemic as we have been experiencing on the way up.

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The data for coronavirus at Ulster County’s testing sites has shown a slowing cumulative increase in total positive cases in recent days. Back on April 11, there had been 655 positive tests, and 2566 had come out negative. As of April 28, there were 1294 positive cases and 4856 negative ones. The doubling had taken two weeks and three days – a promising signal because it took so long.

The curve does seem to be plateauing. But Ulster County is by no means out of the proverbial woods. As the public will find out as actual numbers emerge from more counts at local nursing homes, much of that progress has been due less to a weakening of positive findings than to a statistical skewing in the largely self-selected population tested.

Considering the number of variables affecting the numbers, the ratio of positives to negatives findings hasn’t changed much. By April 28, the number of Ulster County positives deemed to have recovered after sufficient quarantine had increased to 280. This was a pandemic which most people who had tested positive were going to survive. The virus-caused Ulster County fatalities – their definition a matter of some dispute – had risen to 24.

It had seemed around Easter that the rate of tested positives might be increasing above ten percent per day, meaning an approximate doubling of the reported infected population every week. The news stories were all about the lack of ventilators and the inadequate personal protections of the overworked healthcare providers.

But the worst-case scenario didn’t materialize. The hospitalization rate is now flat. The story has shifted.

HealthAlliance’s Mary’s Ave. campus. (Photo by Dion Ogust)

If the predicted weekly doubling had occurred, there would now have been a projected 2365 positive findings for Ulster County to deal with, a thousand more than there actually are. Social distancing, the wearing of masks, the avoidance of crowd events, and the thorough washing of hands appear to have had their cumulative positive impact on the results after all. We’ll analyze below how different patterns of behavior and circumstance in three areas of Ulster County appear to have resulted in markedly different infection rates.

Quite properly, officials warn of overconfidence. A premature relaxation of the present restrictions could backfire. Ulster County executive Pat Ryan says he’s been told that there are probably ten asymptomatic carriers of the virus for every positive diagnosis – a very high ratio, but one aligned with an extensive recent state study of the presence of antibodies to the novel coronavirus in New Yorkers. The reopening of the economy needs to be deliberate, measured and regulated. Testing is key.

To be tested for COVID-19 in Ulster County until recently, you needed a car, a physician’s note, and an appointment at a testing site. Last week the county government and HealthAlliance of the Hudson Valley collaborated on a new site on a parking lot on Grand Street in Midtown Kingston. You still needed an appointment to be tested, but you could walk in.

Statistics are kept on the results at the three Ulster County COVID-19 test sites: the Grand Street one, the one at a TechCity parking lot in Ulster, and outside the hospital in Ellenville. The people tested say where they live, and the numbers are recorded by municipality on the county’s COVID-19 website. The dashboard on the site provides the number of people tested (6150 as of April 27), the number of positives (1294) and negative (4856) tests, the number of people quarantined long enough to have been judged recovered (280), and the number of fatalities (24).

Cases by municipality, as of April 29

The pattern of infection incidence differs among three major different sections of Ulster County. It’s been the highest from the beginning in the exurban towns in the southern and eastern sections, Wawarsing, Shawangunk, Plattekill, Marlborough and Lloyd, which are more oriented toward the economies of Orange and Dutchess counties. The data shows that the northeastern part of the county, centered on Kingston and consisting of the Esopus-to-Saugerties corridor, has recently experienced a surge in its infection rate. Meanwhile, the western part of the county, which consists of towns of smaller population with a generally higher proportion of seasonal and second-home residents, have recorded much lower per-capita infection rates than the rest of the county.

The three sections vary very little from each other in terms of population (56,000, 57,000 and 59,000 per the 2010 federal census). The southern section had 525 positive cases, the northeastern section 434, and the remainder of the county 243. Whoever advanced the theory that New York City second homers would come to the area to party and infect the locals seemed to have been dead wrong.

Earlier in the pandemic, the Kingston corridor had trailed southern Ulster in infections by a considerable margin. On April 25, however, the Town of Ulster reported 55 new COVID-19 cases at the Ten Breock Commons nursing home. According to Ryan, test results on the occupants of eleven of 13 major nursing homes in the county (Wingate in Lloyd reported 20 new cases on April 19) are still awaited.

Six thousand tests in Ulster County represent a considerable effort, but the fact the tests don’t tell us as much as we need to know is troubling. These tests don’t tell us much about the population as a whole. Even though they’re the best we’ve got, that’s extremely troubling.

As the economy opens up, it will be essential for government to be able accurately to track virus transmission not passively by waiting for people to show up for appointments at parking lots but actively by being able to identify and isolate asymptomatic carriers of a disease that can kill. That’s going to be very hard work under menacing circumstances.

Government is in a tough position. It’s going to take more than a few well-intentioned committees to build an effective new economy on top of the ashes of the old one.

“As we continue to address the day-to-day public health challenges of COVID-19, we must simultaneously prepare for and respond to the longer-term economic and social ramifications of the pandemic,” Pat Ryan said in a recent statement. “Our recovery efforts must be coordinated, compassionate and equitable. It’s more important now than ever that we renew our commitment to leave no one behind.”

The execution is even more important than the intention.

There are 7 comments

  1. Ed

    We did well here in Ulster County and we should be proud our citizens are an inspiration to others with our empathy and commitment to caring for others. The antibody testing is ramping up and will facilitate the reopening and after that testing, rapid antigen testing will help contain any hotspots. We went from “it will be just like Italy” and “you can’t stop it it’s like stopping the wind” to “we can control this virus” without having to suffer the worst of the virus yet. Now it’s time to accelerate the autopsy of this virus. There are some who oppose an expansive investigation into this virus and would prefer we just treated and not cured. This can’t be morally or ethically justified and won’t stand. We’re looking under the hood on this thing no matter where culpability leads us. Covid 19 met its end when it attacked NY. We are committed to eliminating the threat.

  2. TIM HUNTER

    .Why did you write in this week’s paper that “Ulster’s curve is flattening”…That is demonstrably false and a dangerous narrative. Each and Every day the number of infected here in the County rises. We have NOT YET his the statistical Peak

    Positions such as this only serve to encourage people to act recklessly, and if we do not take care,
    more will be infected, and more will die.

    I applaud optimism, but it needs to be fact and science based, otherwise it is perilous!

    Yesterday from Jane Freiman Schanberg, formerly of The NY Daily News “Positive cases have grown steadily for the last 5 weeks. We are up to 1294. The graph looks like the Alps! Maybe you want to do a little mitigation and stop the growth for two weeks before you talk about reopening? People are not wearing masks or social distancing as much as they could. Otherwise, we might as well be in Georgia.”…and today we are up to 1338

        1. wowjustwow

          Wow, a graph.

          What are the ages? Co-morbidities?

          What about the deaths? Are they U07.1s (confirmed) or U07.2s (inconclusive or presumed)?

          Yes, science matters.

  3. Ellston Gunn

    You reported that the numbers are highest in the southern part of the County (closest to NYC), second highest in the northern part (second closest, as measured in time, miles and/or Thruway access), and lowest in the rest of the county (furthest from NYC). How do you then draw the conclusion that the NYC second-homer theorists are dead wrong?

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