Presented to the Senate Aging Committee
May 3, 2022
Senator Serino invited me to address this meeting because of my research and commentary on the state’s pandemic defenses and how they can be strengthened. This is a matter of special urgency for the state’s older residents, who are typically more vulnerable to infectious diseases and were the predominant victims of COVID-19.
One of the bills on today’s agenda (S. 8585) would create a new agency, the Office for an Age-Friendly New York, with the purpose of helping older New Yorkers “remain healthy and active in the communities of their choice.”
It’s a worthy goal. But the state cannot hope to achieve it – or consider itself “age-friendly” – until it properly reckons with the events of the past two years.
The novel coronavirus hit New York – particularly the downstate area – harder than almost anywhere on Earth. If New York City were its own country, its mortality rate of 4,776 per million would rank as the fifth worst in the world. That’s largely based on a few harrowing weeks in the spring of 2020 when hospitals overflowed with critically ill patients and bodies piled up in refrigerator trucks.
The virus struck people of all ages, but it was the elderly who bore the brunt. Of the almost 71,000 New Yorkers who have died, two out of three were over 70 years old, and eight out of nine were over 60.
Many if not most of those losses could have been prevented if New York’s state and local governments had been better prepared and responded more effectively.
A study from Columbia University estimated that imposing the statewide lockdown just one week earlier could have saved 17,500 lives. If New York’s public health system had performed as well as South Korea’s, its death toll today would be closer to 9,000 instead of 71,000.
There were many serious failings in Washington, too. But under our federal system, state governments bear primary responsibility for safeguarding public health.
The key to being better prepared is to learn from hard experience. The state needs a careful and comprehensive investigation of its pandemic response – ideally conducted by a commission of independent experts. Otherwise, there is a danger that the invaluable lessons of this once-in-a-century catastrophe will go to waste.
The investigation should not be about pointing fingers or shaming officials past or present. It should be about understanding what went wrong and devising systems to get things right in the future. It should be done in the spirit of the National Transportation Safety Board, whose methodical studies of air disasters have helped make aviation an especially safe mode of travel.
The review should also focus primarily on truly public parts of the public health system – the preventive measures aimed at protecting whole populations rather than treating individuals one at a time. If New York’s upstream public health systems had functioned better, the pandemic might never have become so severe for the downstream parts of the health system, such as hospitals and nursing homes.
A recent comptroller’s audit of the Health Department offers a model of this constructive lesson-learning approach. The auditors showed that the state’s system for viral outbreaks in nursing homes, known as NORA, failed to provide an early warning about COVID because of widespread non-compliance by facilities. The audit made plain that NORA should be repaired or replaced. Now is the time of have that discussion.
It has also come to light that the state’s pandemic stockpile was full of materials that were years past their expiration date when New Yorkers needed them most. The public deserves to know what is being done to prevent that from happening again.
These examples merely scratch the surface. There are dozens of issues across multiple agencies and multiple layers of government that are crying out for analysis and reform. Now is the time to get that done, while memories are fresh and money is available.
The governor could form a pandemic study commission on her own authority under the Moreland Act. In the absence of action on her part, it falls to the Legislature to lead the way on this necessary effort.
As long as the state’s leaders leave this crucial job undone, any promise to make New York “age-friendly” will ring hollow.