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Forced Quarantine An Option Under Contact Tracing Program, Says NYC H+H CEO
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David Cruz
Published May 16, 2020
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Michael Appleton/Mayoral Photography Office
By
David Cruz
Published May 16, 2020
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At a committee hearing exploring the contact tracing program under the New York City Health and Hospitals Corporation in response to the COVID-19 outbreak—a controversial move since the program consistently fell under the purview of the city Department of Health and Mental Hygiene —the CEO of the public hospital system warned that mandatory quarantines will be utilized for infected patients who don’t voluntarily self-isolate.
It’s an option reserved for worst-case scenarios, according to Dr. Mitchell Katz, CEO of NYC Health and Hospitals, in testimony he delivered at the New York City Council’s Health + Hospitals Committee hearing on Friday, which sought greater details on the program. That decision, Katz said, will be made through collaboration with DOHMH since the agency has the sole legal authority to issue that order.
“We have not ruled out using any of the powers of DOHMH. Of course, they will be issued by DOHMH by, as a commissioner order; it would not be by [Health and Hospitals]," said Katz at the Friday hearing. "Our hope is not to have to use them."
Katz, who served as director and health officer of the San Francisco Department of Health for 13 years, said he was confronted with this type of issue with patients suffering from multi drug-resistant tuberculosis. There, patients were placed in mandatory self-isolation. Over the years the decision to force self-isolation has been met with legal challenges that question whether personal freedoms outweigh public safety.
Globally, forced isolation has been known to happen during the pandemic, often with controversial results. In China, among the first nation to experience an outbreak, authorities had forced families into homes, sealing or barricading entrances at buildings during the height of their wave.
Understanding that self-isolation may be problematic for some New York City residents unable to do so at home, the public hospital system will reserve 1200 hotels by June 1st for those ordered to enter self-isolation. Those under quarantine will be provided with any needed medications or food for their families at their home as they ride out the quarantine period. Social workers and counselors will also be available to visit patients staying in hotels, said Dr. Ted Long, vice president of ambulatory care at the municipal hospital system.
Katz, meantime, expects 99 percent of infected COVID-19 New York City residents to comply with the self-isolation order.
Long said the hospital has already hired 500 contact traces–employees designed to track down the persons a COVID-19-positive patient came in contact–with another 500 expected to be hired. The hires have been made in collaboration with community-based organizations with a caveat of hiring tracers whose ethnicity reflects the majority demographics of low-income neighborhoods they’ll be assigned to carry out the work, according to Dr. Demetre Daskalakis, deputy commissioner with DOHMH, who testified at the hearing.
The decision for NYC Health and Hospitals to serve as the lead also took center stage at the hearing as reports of a strained relationship between DOHMH Commissioner Dr. Oxiris Barbot, who was not at the hearing, and Mayor Bill de Blasio, prompting NYC Health and Hospitals to become the lead.
Council Speaker Corey Johnson, in attendance at the committee hearing convened via Zoom, asked for clarity on the city’s decision for such a move, with Katz responding it was purely operational and a collaboration with DOHMH. With the city-funded hospital already having the hotel option in place while having the ability to hire contact tracers quicker than DOHMH, Katz justified the decision. He also downplayed reports of infighting between Barbot and de Blasio, prompting de Blasio to appoint NYC Health and Hospitals as the lead, adding that not all health experts agreed.
"I have not read any attacks on me that were by Dr. Barbot or Dr. Daskalakis nor have I made any attacks on DOHMH that have been–of anyone at DOHMH. So I can't ignore the same things you've read. I've seen the same things that you've said. I think we can all agree that not everybody is happy about this particular structure. There's no reason to pretend that everybody is happy with it," said Katz. "But I do think that at the end one of the great things about having the hearing is what I keep hearing is the most important thing is that this project succeed."
Katz also responded to a report by the New York Times that showed Katz was resistant to toward a complete shutdown of New York City, arguing over the economic impact that would bring upon the city.
"At first we thought that the pandemic was propelled by people only those were symptomatic. It's now clear that people who were asymptomatic can transmit or maybe are some of the most transmissible people who could most easily transmit. In January there was concern about flights coming from Asia. Turns out that the concern should have been about flights coming from Europe. We earlier on, all of us, agreed that the risk of the virus being transmissible from surfaces was close to non-existent. We weren't right about any of those things," said Katz. "So I think humility is a really key feature that all of us should take from this pandemic."
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health
David Cruz
David is a former WNYC and Gothamist editor.
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