Delays, shifting measurements obscure Covid’s toll in Ulster

The dead in eleven of 13 Ulster County nursing homes are dead, all right. When they’re officially counted, their numbers will be added to the Ulster County total Covid 19 fatalities, 44 as of this Tuesday. They just haven’t been all counted yet. They’re the undead waiting to become dead.

Of all Ulster County nursing homes, only those deceased from the virus at Ten Broeck Commons and Wingate at Ulster in Lloyd have been tested so far and included in the county data. New York State that this week it will be providing kits to test residents and staff at all the nursing homes in Ulster County. County executive Pat Ryan on Monday applauded the state support. On Tuesday afternoon, Ryan announced that testing will take place this week at a third Ulster County nursing home, and that tests will be conducted at all of them by the end of May.

A chart showing declining hospitalizations was presented yesterday at Ryan’s latest virtual town hall

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The exclusion from the county data of a considerable number of nursing-home Covid 19 deaths has been difficult for the public to understand. Perhaps that was one of the reasons that Ulster County government decided to focus its efforts to publicizing not the rising number of positive cases but the falling number of hospital beds occupied by novel coronavirus cases.

If you don’t like how people are interpreting the results, just change the game. That’s what Ulster County seemed to do this Monday when without notice it made this major revision in its calculations. Ulster County’s town-by-town statistics now counted “active cases” instead of “positive cases.” There were 1401 positive cases on Sunday and 735 active cases on Monday.

The active cases chart shown on Monday, May 4.

That day, I called deputy county executive Dan Torres, who handles media matters at the county executive’s office, a couple of times. He didn’t call me back. Colleagues at HV1 asked him what had prompted the change. “We are currently looking at new ways to help residents better understand where we are,” was the reply.

Then poof! Monday’s new counting method was gone by Tuesday, as silently as it had arrived. The Tuesday numbers showed 193 new negatives since Sunday and only 15 new positives. Two fatalities had been reported on Monday and none on Tuesday.

A change in counting method was defensible, though it could easily have been accompanied by a period of overlap with the old system. The positive cases included everybody who had tested positive for the virus, regardless of whether they might have recovered from it or might have died from it. As the pandemic evolved, the number could only go up. People who watched it rise day after day got scared. It was common sense that they would feel more comfortable with a number that was falling instead.

Active (as of 5/4) vs. confirmed (as of 5/5) cases by town

And that’s what they got, if only for a single day. Adding the newly infected while deducting the number of recovered and dead souls (except for those who had died at the eleven as-yet uncounted nursing homes) from the total, officials were able to come up with a number that would be expected first to flatten and then to decrease: exactly what is now occurring.

It is happening, though it has not yet for the length of time that state health standards require.

The positive case count on April 28 was 1309. Twenty-four residents were reported to have died from the virus, and 370 had recovered. The number of active cases, 1309 minus 394, was 915.

By a week later, this Monday, May 4, the positive count had increased to around 1410. Forty-four persons were reported deceased and 578 had recovered. The number of active cases had decreased to somewhere around 798 (Because there’s delay in assigning positives to particular municipalities, the county data lags by a day or two).

There seemed to have been visible progress. The pandemic was losing ground. Public-health safety measures were having their intended effect.

Of course, that’s not the whole story. The local health authorities seem to have an incomplete idea of how many actual Covid 19 fatalities there have been, and how many may have been attributed to complications such as strokes, respiratory infections and organ failures. Perhaps because of fears that healthcare facilities will get overwhelmed by the pandemic, those seeking help are generally told to stay home unless their symptoms require hospitalization. And the needs of the most vulnerable populations – the aged, the asthmatic, the incarcerated, the homeless and the first responders – take a back seat in an overworked system that in a crisis seems to respond best only to emergency.

Ulster County testing take place at three designated locations: TechCity, a HealthAlliance parking lot on Grand Street in Midtown Kingston, and Ellenville Regional Hospital. The customers are to a degree self-selected and unrepresentative of the county population as a whole.

No good deed goes unpunished.

“Ulster Covid deaths nearly double from a week ago” was the Daily Freeman headline to the story on Monday. And indeed “bringing the total number of county residents to die from the virus to 44, nearly double the 24 deaths the county had seen only a week earlier,” was true.

The total number of deaths, certainly the bottom line in social statistics, had increased 83 percent in a week. And it’s of little solace to point out to the bereaved that deaths are a lagging indicator. In a pandemic, the number of newly infected people fall first, then the number of hospitalizations fall, and finally the number of deaths fall. New cases have been declining in Ulster County. Hospitalizations have been dropping for over a week.

As the article correctly stated, the majority of the most recent week’s deaths were in nursing homes. That was an ominous sign. The Ulster County death toll could well surpass 100 before this viral wave is over.

Recovery will come next, and if Pat Ryan’s playbook is followed it will be followed by reopening and realignment of the county economy. “As we continue to battle the public-health risks of Covid 19,” said Ryan last week in a press release, “we must also move aggressively with all the tools at our disposal to ensure we are ready to safely reopen our businesses and get our economy going again.”

That’s the plan.