Top public health doc says economy could be re-opened regionally, but testing must be expanded first

By Andy Gardner

A doctor at the front of St. Lawrence County’s fight against the coronavirus says a plan to re-open the state economy should be regionally based, but any re-opening would be risky without expanded testing.

On Friday, April 17, St. Lawrence County legislature chairman Joe Lightfoot and several state representatives called on Gov. Andrew Cuomo to use a regional approach to re-opening the state economy that treats the rural North Country somewhat differently than New York City. The letter was also signed by assembly members Mark Walczyk and Ken Blankenbush, and Sen. Patty Ritchie. Their respective districts include St. Lawrence County. All are Republicans.

“I agree that the reopening plan should be regionally based,” said Dr. Andrew Williams. He is president of the St. Lawrence County Board of Health, chief medical officer of Community Center of the North Country, and associate chief medical officer of St. Lawrence Health System.

“Interventions and time-frames for New York City are not relevant for our rural region,” the doctor said.

He said re-opening the economy while minimizing harm is not going to be easy.

“The immense energy we have spent preparing for and fighting this pandemic needs to be shifted to create a plan to safely reopen our region,” Dr. Williams said. “Our community needs a timely, thoughtful, regionally specific plan for reopening that balances socioeconomic needs with potential impacts on health.”

“Although our rural setting confers some advantages in a pandemic, our proximity to an international border and the anticipated seasonal influx of individuals from high transmission regions must be considered,” Dr. Williams said.

This all comes with a huge caveat.

“Reopening before expanded testing is available is associated with significant risk,” he said. “The short and long-term socioeconomic consequences of Public Health interventions must be carefully measured against the risk of increased illness and death when these mitigation strategies are withdrawn. Negative socioeconomic impacts can also have very real long-lasting consequences on the community’s mental and physical health.”

There will need to be a major expansion of testing capability, and public health will need to have the ability to rapidly isolate and trace contacts for all new COVID-19 cases, he said.

“Any plan for reopening would need to include robust testing for the disease, along with an intensive Public Health program that can rapidly identify cases, trace contacts and isolate as appropriate,” the doctor said.

He said that the current testing capability is not adequate, but other indicators suggest the local fight against the coronavirus is working.

“In the context of current testing numbers, less than 1% of the population, we cannot verify a low prevalence of the illness in our community, although our currently low COVID-related hospital census is consistent with a low number,” Dr. Williams said.

"As the curve continues to flatten and our state looks toward to reopening, we believe it is critical that we move forward with a regional approach that reflects the differences in population density and COVID-19 infection rates. In recent days, our offices have been inundated with concerns from those we represent about the devastating impact this pandemic is having on the economic vitality of our region," the letter from the four elected officials reads.

It points to over 123,000 COVID-19 confirmed cases in New York City and "just over 200" in St. Lawrence, Lewis and Oswego counties, all of which are in the three state reps' districts.

The full letter can be read at https://bit.ly/2KpZfy5 .