Dr. Raul Vazquez closed his Urban Family Practice clinic last week on the lower West Side. Now, he is employing mobile care units offering 13 Covid-19 rapid tests at one time.
The spread of Covid-19, Vazquez felt, left him little choice.
Meanwhile, Jericho Road Community Health Center, which sees a large number of low-income immigrant and Black patients in its clinics on the city's West and East sides, also is seeing a dizzying rise in Covid-19 cases.
"The last seven days have been crazy," said Myron Glick, Jericho Road's founder and chief executive officer. "Normally our isolation units, if you combine them, see 100 patients. This week, it's well over 200."
Glick said he expects his patients' overall positive rate will be 15% to 20% when he sees the data.
"Something is definitely happening in the community, and we're feeling it the last two weeks," Glick said Friday.
They're not imagining. While state data showed that conditions in the yellow zone that now exists in much of Erie County improved somewhat on Saturday, with the rate of positive tests dropping to 6.62% from 8.17% on Friday, that was still the second-worst among all the yellow and orange zones around the state. It is also still far worse than the 2.86% reported for the Erie zone in late October.
Erie County also led the state in the number of Covid-19 deaths reported Saturday, with 5.
All of that has businesses worried about what Gov. Andrew M. Cuomo might say in the announcement he planned for Monday, as Erie County and Western New York have seen dramatic spikes in the number of Covid-19 cases. State data show Western New York's positivity rate was 5.6% on Saturday, up from 4.6% on Friday and 3.9% on Thursday. The World Health Organization recommends a rate of 5% or lower.
An elevation of Erie County from its current yellow zone designation to an orange zone would bring closure of non-essential and higher-risk businesses – such as gyms, salons, tattoo parlors, personal-care businesses and movie theaters – while restaurants would revert to just outdoor dining, takeout and delivery. Schools would return to fully remote learning.
Anthony Scioli IV, co-owner of My Tomato Pie restaurant in Amherst, said he expects the state to raise the zone level on Monday.
"I'm actually shocked it hasn't happened yet," he said, citing the data. "I'm expecting a closure for sure, and I feel like we're going to skip right over that orange and go to red. We've already noticed a major uptick in takeout, as people are not dining in as much already because of the news. So we're gearing ourselves for going back to the curbside."
Kelly Davis, owner of Elite Hair Creations, a Buffalo salon with five employees, has a strong clientele and was able to pick up its business again after the first closure. Now, he's trying to be optimistic, but also realistic.
"I'm thinking it may sway that way, but hoping and wishing it doesn't go that route," he said of an orange designation. "It would hurt bad, because I still haven't received my unemployment benefits from the first time, so the second time would probably be more devastating."
'Things are getting worse'
Health care providers are already seeing the devastation as Erie County's seven-day rolling average of 7.3% was the third-worst of the state's 12 focus zones, behind only Tioga's yellow and Westchester County's orange zones. The damage hits hard especially for providers who serve low-income neighborhoods and people of color, whose underlying health and socioeconomic conditions make them especially vulnerable.
Positive tests were close to 20% midweek among Vazquez's largely Latino patients, including nine of 10 group home members. Five employees contracted the coronavirus, making it dangerous to keep the clinic open, he felt. Vazquez thought the remote units, along with the ability to see some of his patients online, was the safest way to go.
Vazquez is a big proponent of using telehealth to reach patients. He said the pandemic is helping to normalize this form of care quicker than would have occurred otherwise.
"What you find is we do great inside the building, but in communities like ours, you really have to change your model to go outside and have a bigger impact," he said. "We have to get mobile. Everything is mobile in life. I see a shift in health care the same way."
Glick said the increase at Jericho Road has to do with higher rates among refugees and immigrants, including Bengali, Rohingya and Burmese. But the clinic also is seeing high rates in people from other parts of Western New York.
"Last week we tested attorneys, doctors, policemen, immigrants, and too many of them were positive," Glick said. "I'm definitely worried about what happens next. Between now and New Year's is not looking good."
Jericho Road has tested more than 13,000 people to date, with close to equal numbers of white and Black people, as well as refugees and immigrants, he said. The average rates of infection, he said, are 3% for whites, 13% for Blacks, and 29% for refugees and immigrants, particularly Asians.
About half of the 1,150 people who tested positive for Covid-19 have been refugees and immigrants.
"We clearly show a disproportionate affect on people of color, and there is no question about that," Glick said. "That is consistent across the country.
"People ask me why and I say it's partly because a lot of the people in the communities we serve don't have the luxury of sitting this out," Glick said. "They are frontline workers, they live in homes that are multigenerational and bring it home, and they maybe don't have as much access to care."
Glick said the scarcity of places to test for Covid-19 on the East Side is also a problem.
He added that Jericho Road is remaining open because many of his patients don't have the option of seeing health professionals online, especially as the pandemic gets worse.
"Things are getting worse," he said. "We have to as a community limit our gatherings. Some of the positive rates we saw even this week were from Halloween parties or a bunch of people watching the Bills game.
"We have to step up as a community and sacrifice for the good of the overall health of the community. A vaccine's going to come, but we have to hang in there another four to six months. We'll get through it, but we have to work together."
Virus is 'everywhere,' and spreading
That's the message County Executive Mark C. Poloncarz has been trying to drive home as Erie County's and Western New York's numbers reach alarming heights.
The 5.6% positivity rate for the Western New York region – Erie, Niagara, Chautauqua, Cattaraugus and Allegany counties – was the highest of any region in the state on Saturday.
Erie County tallied 277 new cases – fourth-highest in the state – while Niagara County noted 30. Allegany County added another 16, while Chautauqua County posted 5 and Cattaraugus County listed 3.
Erie County data for last week shows that the 14075 ZIP code in Hamburg remains the flash point, with 180 current cases, followed by 14221 in Amherst and Clarence and 14086 in Lancaster, which are tied at 114. All other ZIP codes are under 100.
"As you can see, it is everywhere in Erie County, and it is growing," Poloncarz tweeted Sunday afternoon.
Meanwhile on Sunday, Lackawanna became the latest local municipality to announce changes in its operations because of the dramatic rise in the number of cases in the area.
Mayor Annette Iafallo said that beginning Monday and until further notice, "all public business conducted at City Hall will be done by appointment only and the Lackawanna Senior Center located at 230 Martin Road will be closed to the public."
She said those wishing to make an appointment can contact the appropriate department using the phone and email directory found on the city website at lackawannany.gov/contact/. Anyone entering City Hall for an appointment must comply with mask, social distancing and other precautionary measures.
During the temporary closure of the Senior Center, no lunches, activities or van services will be provided, except for the Meals on Wheels program, she said, while encouraging residents to regularly check the city's website and Facebook page for updates.