State officials may wrestle with expanding quarantines as coronavirus cases spread
ALBANY — Gov. Andrew Cuomo made it clear Wednesday: At some point, the state may struggle to contain coronavirus through quarantines of New Yorkers.
New York last week indicated there were at least 700 voluntary quarantines of people feeling sick and concerned whether they might have the flu or coronavirus.
But now the quarantine is rapidly spreading after a Westchester County family has contracted the virus and a neighbor who drove the father to the hospital. Later Wednesday, another family of five in New Rochelle tested positive.
In total, 10 people in Westchester have contracted the virus and one woman in Manhattan.
The growing concern led the Westchester health department to put an estimated 1,000 people associated with the family's synagogue under a 14-day quarantine.
Cuomo said the goal is to try to track the coronavirus cases and try to limit the exposure in any community, as well as being cautious.
The same sentiment is being expressed by local health departments across the state and in neighboring states as they all wrestle with how to manage the virus' spread.
"At one point, you can’t trace the cord back anymore," Cuomo said at a coronavirus briefing at the state Capitol.
Quarantines, where infected people are ordered to stay home or do so voluntarily, have long been disputed as to whether they are an effective way to curb a virus. Isolation — where an infected person is separated from other humans — has often been deemed more effective.
Last month, passengers on the Diamond Princess cruise ship were quarantined in Japan, but it ultimately appears to have led to more people becoming infected, roughly 700 in total.
And the massive quarantine effort in China, where the virus originated, failed to contain it.
“There are reasons to be skeptical of the efficacy of quarantine, for respiratory diseases [like coronavirus] in particular,” Wendy Parmet, director of the Center for Health Policy and Law at Northeastern University Law School, told the website FiveThirtyEight.
Cuomo and state Health Commissioner Dr. Howard Zucker said a self-quarantine is simply people deciding to stay home if they are sick, which health officials encourage.
"What is self-quarantine? Self-quarantine is stay home if you’re not feeling well or if you have symptoms," Cuomo said. "In this case, or if you had close contact with an individual who you know tested positive, err on the side of caution. Stay home."
Cuomo said the state is focused on containment, even as the virus is likely to spread.
Yeshiva University, for example, closed Wednesday because a son of the Westchester man who contracted coronavirus now has tested positive. It will be closed through Friday.
The family's temple also shuttered, as did his daughter's school, and several other local schools.
Cuomo called it the "concentric circles" — first focus on the inner core group of people who were close to the infected person.
That is what the Westchester family's temple is doing. About 1,000 congregants at Young Israel of New Rochelle are being quarantined.
"A quarantine means that both adults and children, should remain at home at least until March 8," Westchester Health Commissioner Dr. Sherlita Amler wrote to congregants late Tuesday.
"This means they should not go to work, attend school, go shopping or attend religious services or gatherings anywhere and should have no guests, visitors or staff in their homes during this period."
She encouraged anyone who feels sick to first call their healthcare provider before going to the doctor "so that appropriate precautions can be taken."
Coronavirus tests on Wednesday of people in Buffalo and Oneida County came back negative, Cuomo said.
“The system we have in place in Oneida County worked,” said Oneida County Executive Anthony Picente Jr.
What governments are doing
Westchester County is monitoring quarantined residents, contacting them through Skype or video conference, Amler said.
For people that are voluntarily quarantined, the county depends largely on an honor system, but if it’s mandatory, county officials are “ensuring that they're absolutely where they need to be," Amler said.
County officials couldn't tell The Journal News/lohud.com how many residents are under a mandatory quarantine. But Amler said everyone has cooperated so far.
"I think most people understand we wouldn't do this unless it was necessary," Amler said.
If quarantined residents need food, Amler said they should reach out to family and friends. Any food delivered should be left on the doorstop, she stressed. Residents can also contact the county if they need food deliveries, Amler said.
In neighboring Vermont, the state health department is asking all travelers who are returning to the state from China, Italy, Iran, Japan and South Korea to contact them.
The department will then be in contact with those people for 14 days to monitor for symptoms. It is currently monitoring 116 people.
In Pennsylvania, health officials are building a a COVID-19 plan based off its pandemic influenza response plan.
"If social distancing measures were required in Pennsylvania, they would be taken to prevent the spread of the disease," said Nate Wardle, the state's health department spokesman.
Counties develop action plans
Dr. Anil Vaidian, commissioner of the Dutchess County Department of Behavioral and Community Health, said the county has an “all hazards plan,” which is required of every state health department, and covers the isolation and quarantining of those with a transmissible disease.
He said the protocols begin “with least restrictive measures first. Most individuals comply with home self-isolation.”
However, if someone does not comply, the department can recommend initiating legal steps, “including a Commissioner’s Order for Quarantine which would then be executed by law enforcement.”
Vaidian said isolation and quarantining individuals are effective “when the numbers are small and it is still early in the outbreak.” After there is “sustained transmission in the community, mitigation strategies,” such as washing hands and disinfesting, work best.
“Once there are multiple cases in a community, isolation and quarantining are of little public health value as Governor Cuomo correctly noted today during his briefing at the state Capitol,” he said.
in Canandaigua, FF Thompson Hospital said it is following both state and federal guidelines to prepare for coronavirus potentially hitting the community.
"Our multidisciplinary team is continually monitoring the situation and making sure that — in accordance with guidance from federal and state health officials — we are well prepared for any patients or residents who may test positive for this virus," said Kristen Bloom, the director of infection prevention at UR Medicine Thompson Health.
Cuomo continued to urge New Yorkers to not panic, reiterating that 80% of cases will be mild.
For example, the first woman diagnosed in New York — a health-care worker who visited Iran — is resting at home in Manhattan with mild symptoms and her husband's test came back negative for the virus.
"The more you test, the more positives you will find," Cuomo continued. "If you never tested then, yes, it would increase and it would run its course. What the testing does for you is it allows you to reduce as much as possible the exposure."
Includes reporting by Julie Sherwood of Messenger Post Media; Sam Ruland of the York Daily Record in Pennsylvania; Amy Neff Roth of the Observer-Dispatch in Utica; Elizabeth Murray of the Burlington Free Press in Vermont; and Katelyn Cordero of the Poughkeepsie Journal