COVID-19 TOWN HALL III
June 16, 2020
Updates on COVID-19: New York City Health Department's Response
Download a copy of the NYC DOHMH Bureau of HIV's presentation from the June th town hall.
Policy Presentation Additional Questions
Whats happening with the public charge rule?
AG Leticia James will file suit but Adrian will follow up with additional info.
Info on stimulus checks for people on SSD and SSI?
To check the status of your COVID-19 Economic Impact Payment (i.e., stimulus check), visit https://www.irs.gov/coronavirus/get-my-payment. Yesterday, the IRS announced that it's adding 3,500 telephone representatives to answers questions re: Economic Income Payments. The phone # is 800-919-9835. For more information on the new phone service, see: https://www.irs.gov/newsroom/irs-adds-phone-operators-to-answer-economic-impact-payment-questions.
Seven regions of NY have been approved to re-open: Capital Region, Western New York, Central New York, North Country, Finger Lakes, Southern Tier and Mohawk Valley Regions.
Metroplus Wellness Check/Outreach Program
By consumer request, Metroplus presented on their outreach program. Metroplus is wholely owned by Health + Hospitals. Network includes over 30,000 health care providers. Wanted to conduct assessments of clients to ensure that people were connected to critical services – such as food. Food insecurity has been the largest issue for members. A lot of anxiety, uncertainty, and isolation. Began delivering counseling over the phone. Currently in 7th week, and have reached over 7,000 members. Challenges around 90 day refills – had to work with individual pharmacies to ensure that everything could be filled. Peers have been central to the outreach work – this has worked very well. To enroll, go to: https://www.metroplus.org/plans/marketplace
Consumers Town Hall Q&A:
Medical
I have been wiping down whatever packages that come into my home. I wash my fruits and vegetables with a vegetable brush (I do this on the regular). My question is- How safe are packages (it's surfaces) and how long does the COVID-19 virus survive on surfaces!? There was an article that I read that it (virus) can survive on stainless steel surfaces for 24-48 hrs.?
A lot that we don’t know. For solid services – we can use a wipe. Wiping soft surfaces -like an envelope – has its own challenges. When bringing packages, can wash fruits and vegetables. Wipe down packages, and wash hands before and after handling them. Be careful about touching your face as that is how infection largely occurs.
Consumers are having issues accessing the 90-day supply for medication prescriptions, This has happened, not only, to me but other consumers attempting to get scripts for 90-days of their meds. My situation involved Medicaid insurance; however, it is unclear how this would affect other insurance providers. The guidance document for this issue is titled "Medicaid Pharmacy Guidance Regarding the Declared Disaster Emergency in the State of New York - COVID-19". I have attached the document and am sharing the online link at: www.health.ny.gov/health_care/medicaid/covid19/docs/2020-03-19_guide_med_pharm.pdf.
Medicare was denying the request. Each month had to be put in individually -commercial pharmacies may not make this effort. Additional guidance and info can be found here: https://health.ny.gov/health_care/medicaid/covid19/2020-03-19_guide_med_pharm.htm
Can you talk about antibody tests?
Testing has not been widely available in the USA for a long period during the pandemic. Social distancing has helped mitigate infections, but is a very blunt instrument. Contact tracing – or partner notification – is used for infectious diseases – contacting partners/contacts of exposed persons, to trace the path of the illness and also encourage isolation With HIV, can test or offer PrEP – with coronavirus, the option is to restrict a person’s movement. Testing, contact tracing and then movement restriction are the tools we have. Antibody testing – FDA allowed emergency authorizations without submitting complete documentations – so no testing on the market now for antibody testing has been approved. There are over 200 coronavirus tests – more than any other disease – are on the market or in the pipeline. Only ¾ antibody tests are giving reliable results – many false positive and false negative results – not helpful. Currently very little public information – may take a long time for the disease to pass and an antibody test to be accurate. Not everyone produces antibodies – with SARS – not everyone produces antibodies. The science currently suggests that people who have no/light symptoms – do not produce antibodies. There is also the question of whether the antibodies will offer protection to re-infection or a future mutation of the virus.
Is HIV testing being conducted?
Agencies have been directed to stop providing services in the community. 3-4 weeks ago made HIV testing available for agencies that can conduct the counseling virtually/over the phone, and then set out codes for free home testing kit. Have sent out over 500 kits, with 80% of the codes being redeemed. State link to free home testing kits: https://www.health.ny.gov/diseases/aids/consumers/testing/
Looking at integrating at home specimen collection for STI testing. (Planning Council will follow up).
For organizations deemed essential – will they be able to conduct testing when they re-open? Many organizations are open and deemed essential is there a timeline.
No guidance on this yet. Not enough info currently to put in place a timeline for the development of guidance. Currently the NYC DOHMH is paying out contracts based on time, not fee for service – health department wants agencies to succeed, but cannot endanger people’s lives.
Are STI clinics open?
Chelsea and Fort Green are currently open for limited services, but the Bureau of STI is doing virtual consultations and offering treatment without testing. Click this link https://www1.nyc.gov/site/doh/services/sexual-health-clinics.page for detailed information on what services are available.
What supplements should we be taking? Vitamin D?
Should be eating whole foods – presence of vitamins and minerals, but also other building blocks, like enzymes that help with our health. Doing meditation and yoga – so helpful – with reducing stress. Physicians don’t have a great background in nutrition. Because coronavirus is novel – it is unclear as to what would be effective.
Social Distancing/Face Masks
When taking off masks...
Take masks off from ears – try not to touch the front of the masks. After taking off the masks, really important to make sure you wash your hands for 20 seconds – can inadvertently introduce the virus to your face.
Since face masks or face coverings are now recommended to all NYC residents for regular use, please give a detailed explanation of what this use means.
Recently, governor recommended face coverings in public where social distancing is not possible. Face coverings help protect each other. People who don’t have symptoms are still able to transmit symptoms – purpose of face coverings is to reduce this transmission. If you are more than 6 feet away, unlikely you need a mask – but indoors you definitely do.
Is wearing a mask or face covering necessary if you are practicing social distancing and are 6 feet or more from others?
No, but 6 feet isn’t always enough distance. Read more here: https://www.vox.com/science-and-health/2020/5/22/21265180/cdc-coronavirus-surfaces-social-distancing-guidelines-covid-19-risks
What is the difference between N95 masks, surgical masks, and face coverings?
N95 and surgical masks are regulated by the FDA – these can protect people from very small particulates. Surgical masks are less effective- they allow air to come in from the sides. In healthcare facilities – a fitting is required to ensure a proper seal. N95 should not really be worn by the general public. But a face covering is essentially to protect others.
How long can masks be worn without causing harm from inhaling your own carbon dioxide?
Masks should not be worn for extended times – if you’re feeling like you aren’t getting enough air, take them off.
When buying, how can you determine if a mask or face covering is genuine and adequately effective?
No way to know if masks being sold are genunine. Continues to be a shortage of masks for front line workers.
Are there any recommended guidelines for DIY (do it yourself) making your own face coverings?
Something as simple as a bandana can be worn.
Surgeon General’s DIY face covering guidance: https://www.youtube.com/watch?v=tPx1yqvJgf4
CDC DIY face covering instructions: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html
Can masks and face coverings be sanitized and/or washed, and then reused?
For N95, should be single use. Providers are now wearing them for longer than intended.
How often should it be washed?
Wash your face covering after each use.
When should a new one be used?
This depends on the covering being used, but whenever a mask becomes soiled or worn and cannot maintain its structural integrity if cleaned, a new one should be used.
In buildings with elevators are you seeing social distances enforced in common areas and elevators?
Important to supplement social distancing with a face coverings – especially in confined areas.
Are people ever exempt from wearing coverings due to a medical issue?
From Interim Guidance on Executive Order 202.16: Employees who are unable to wear face coverings and are susceptible to COVID-19 based on the “Matilda’s Law” criteria (i.e. individuals who are 70 years of age or older, individuals with compromised immune systems, and individuals with underlying illnesses) should consult with their employer to consider reasonable accommodations, including but not limited to different PPE, alternate work location, or alternate work assignment with fewer interactions with the public. Employers should work with their employees to see if they can be accommodated to ensure the employee can continue to deliver essential services in the safest manner possible.
From Interim Guidance on Executive Orders 202.17 and 202.18 Requiring Face Coverings in Public During the COVID-19 Outbreak: If a face covering would inhibit or otherwise impair an individual’s health or if an individual is not older than two (2) years of age, an individual is not required to wear or use such a covering. Further, essential business operators and enforcement authorities are prohibited from requesting or requiring medical or other documentation from an individual who declines to wear a face covering due to a medical or other health condition that prevents such usage.
People who have underlying conditions should take as many precautions as possible, within reason. Stay home (if you can)!
Housing (questions largely answered by Yvonne Katallage of HASA)
How many cases of COVID have been found among staff and residents in HASA?
NYC DOHMH is responsible for tracking clients and staff – waiting for the data. We have had several losses. Both staff and clients, but need the data from the NYC DOHMH.
How are social distancing violations being handled in HASA?
Give staff weekly supplies of PPE – give clients that come in the center masks if they don’t have any. Try to set up chairs in all areas at least 6 feet apart. Have had good compliance.
Do HASA staff have enough protective gear?
In the beginning it was difficult, but are now getting enough supplies.
How are cases handled in residential shares where one resident has COVID and the other does not?
In some situations, place clients in emergency shelters, but if we are having an issue, work with the NYC DOHMH, who has secured rooms in hotels.
Do you have info about Stonewall House?
Working to continue to conduct inspections – can go in there alone when we have codes. We are working with stores to deliver furniture when they are open.
Rent arrears:
HASA has closed some centers, can help with rent arrears. Case managers will help to keep people housed.
Can people get apartments?
If brokers are working, this can happen, but a large concern about how safe it is to seek out an apartment.
Info on evictions and tenants rights?
Court systems are closed – so not evictions should be happening. Have special liaisons at the courts to ensure that HRA clients are protected.
Home inspections?
Home inspections – wellness checks are happening
If HASA is denied entry – will client be penalized?
We don’t penalize for that – client can say at any time they do not want visits.
Will stimulus checks impact HASA benefits?
Have not had any clients receive stimulus checks so far. It is unlikely, but no guidance has been issued for this issue. (Planning Council will follow up).
Client moving to Stonewall House, looking for how to get connected to medical services etc.?
HASA locations have been consolidated – current information on open service locations: https://www1.nyc.gov/site/hra/locations/job-locations.page
Congregate housing in the Bronx – multiple cases in the residence, including the director – seems they need to be in hotels, to ensure safeguards. A lot of stigma as well.
Have monthly congregate meetings with the vendors – will ensure that director of housing addresses this.
Consumers living in assisted living facilities – have not been reporting cases.
When people are not following policies and recommendations, Mayor has asked for people to call 311. Report these violations.
Have you heard about an increase in cases in supportive or congregate housing?
Haven’t seen a rise in cases among these facilities. Staff are working ardently to ensure this.
Having a lot of challenges with the 15-15 program – common kitchen and common bathroom in multiple bedroom apartment. Finding a lack of social distancing – how can HASA help?
New director of housing at HASA, will bring this question back to them. (Planning Council will follow up)
Home inspections?
Home inspections – wellness checks are happening
If HASA is denied entry – will client be penalized?
We don’t penalize for that – client can say at any time they do not want visits.
From the NYC DOHMH Housing Unit:
- The DOHMH Housing Services Unit is collaborating with SHNNY and the NYC Emergency Preparedness Management department to offer hotel services free of charge to residents residing in congregate facilities.
- If a resident residing in a congregate facility has COVID-19 Like Illness (CLI), the resident is moved to a vacant room/unit, if available, within the organization’s housing portfolio.
- If residents share an apartment and one become COVID infected, the housing program will arrange for the resident to be relocated to a vacant room/unit within the organization, if available. If both residents in a shared apartment have COVID, the housing program will take the necessary steps to self-isolate both residents.
- Where necessary, program staff have worked with clients to set up specific bathroom schedules or identify bathrooms specifically for symptomatic residents.
- If a congregate facility has sleeping areas with multiple floors, one floor is designated for residents with COVID and one floor for residents with symptoms.
- Program staff who test positive for COVID-19 have isolated themselves under self-quarantine within their home.
- If a symptomatic resident is still struggling to self-isolate after implementing all strategies (including physical and behavioral), the agency may be able to request a hotel room as a last resort, subject to City approval. The agency is required to provide continuous support services to the resident for the duration of their stay in the hotel.
- We are currently tracking who gets COVID and what strategies to take in collaboration with each respective housing program.
Ryan White Services
From the grantee:
Have worked to change how we are conducting billing, ensuring data security and how service are delivered. We anticipate future changes as well.
How are recertifications being handled? Are they secure over the phone?
Recertifications and assessments are being conducted over the phone – we recognize that many people are working from home. Each agency is required to maintain confidentialy according to law – and ensure that current protocols meet this requirement.
What happens if worker/staff step away and someone else lots on and views or deleted information unknowingly. Do they have Job use only laptop/tablets?
Data security is the responsibility of each agency – if a client has a concern, should ask agency how they are ensuring confidentiality. All devices must be password protected.
How are recertifications being handled? Are they secure over the phone?
Recertifications and assessments are being conducted over the phone – we recognize that many people are working from home. Each agency is required to maintain confidentialy according to law – and ensure that current protocols meet this requirement.
Have laptops been distributed to ensure these devices aren’t being shared?
That’s at the discretion of the agency.
Contact Tracing
What safety precautions will be made for people with HIV?
Same precautions will apply to all persons.
Wellness/Mental Health
If you are struggling – with depression, anxiety, uncertainty, etc. Please reach out to NYC WELL, your connection to free, confidential mental health support. Speak to a counselor via phone, text, or chat and get access to mental health and substance use services, in more than 200 languages, 24/7/365. https://nycwell.cityofnewyork.us/en/
Find additional resources at Thrive NYC https://thrivenyc.cityofnewyork.us/mental_health_support_while_home