SARATOGA SPRINGS — An increasingly dangerous sign of the coronavirus lockdown has come to light in recent weeks in communities across the country where there is a marked increase of people delaying seeking care when they are sick or hurt.

The issue has grown from a reluctance of people willing to go to hospitals or urgent care facilities for fear of contracting the COVID-19 virus. 

Last week, the Washington Post reported on the international phenomenon of the pandemic producing a silent sub-epidemic of people who need care at hospitals but are frightened to go to the ER. Titled “Patients with heart attacks, strokes and even appendicitis vanish from hospitals,” the article described how people with everything from inflamed appendixes to those suffering chest pains and stroke symptoms were avoiding seeking medical treatment out of fear of physically seeking care, resulting in illness and mortality concerns among the medical community. This has also played out on the local stage. 

“If you’re having a medical problem that concerns you and goes beyond what a physician in their office can manage then you should really come to the emergency department, or Urgent Care and let us take care of you. People should not wait until things can go very bad for them,” says Dr. Timothy Brooks, chair of the Department of Emergency Medicine at Saratoga Hospital. 

“Since this started, we’ve watched our volume drop off 40 to 50 %. The number of people who would normally come in by ambulance or by foot have disappeared. Our perception is that people are terrified about coming in because they have the belief they could catch COVID-19.

 “This drop in volume really concerns us, because the disease progression that people have for all the other medical problems continues on, and what we’re seeing is people waiting far too long to come in. Instead of having a problem that might require a brief hospitalization, they are critically ill and end up on a ventilator in the ICU. And that’s happened multiple times,” says Dr. Brooks, who was born in Detroit, studied at medical school at the University of Michigan and relocated to Saratoga Springs in the late 1980s

Saratoga Hospital assures that precautions are in place to take care of all patients, and everyone admitted to the hospital is tested for COVID-19. “At the hospital and at Urgent Care – we have mechanisms in place to keep people separated and to take care of them safely. There’s not a single person in the building where we don’t know their status relative to being covid-positive or covid-negative. That way we can separate people out with COVID-19 infections,” Dr. Brooks says. “They are isolated on a separate floor and are taken care of by specific nurses, and other parts of the hospitals do not have those types of patients. Once a patient leaves our department, their room is completely sanitized with the appropriate cleaners and virus-cides.” 

Inside the hospital, the work goes on. “The day has changed in the sense that when you approach patients who may be infectious it takes a little more time and preparation before you go into each room, as well as when you leave that room,” Dr. Brooks says. “I have to say I am so proud of the staff in this emergency department. Everybody stepped up to the line.” 

Regardless of when an un-pausing or reopening occurs, Brooks says until a vaccine is introduced, he anticipates the virus will circulate among the population, and that the hospital is prepared to deal with ongoing public issues. 

As for hospital occupancy, there is ample space for people to address issues both in the emergency room and the rest of the hospital. This week, Gov. Cuomo announced he will sign an Executive Order allowing some hospitals – Saratoga Hospital among them – to resume conducting elective surgeries, a practice which he had ordered halted in March as the virus was spreading across the state.   

Saratoga Hospital currently describes three working criteria for beginning what is broadly termed “elective” surgery. The procedures are defined as: medically necessary, time-sensitive surgeries for patients with significant symptoms or serious illness, and a predicted negative health impact without the surgery. 

“Cases that needed to be done and should be done, we’re in the process of bringing those back and getting them going. We’re still holding off on some areas that I would call discretionary – cosmetic plastic surgery is a good example,” says Saratoga Hospital President and CEO Angelo Calbone. “People who are in pain, conditions that may worsen if we don’t get to them. This is work that needs to be done.”

Approximately 3,000 people work under the Saratoga Hospital banner. At the hospital, there are approximately 170 licensed beds. 

“This has been a learn-as-you-go situation. We know how to run a hospital. We know how to respond to emergencies. This has been a new struggle challenge for all of us. I can tell you the staff here have been beyond remarkable, gearing up, understanding the new protocols. They’ve done a wonderful job,” Calbone says. “Frankly what has been a challenge has been the lack of testing materials, getting access to personal protective equipment for our staff and the bottleneck supply chain that emerged. That really threw a wrench into every institution’s ability to respond to this. But how our staff managed COVID in the building isn’t that different to how they managed every infectious disease. I think the entire industry was startled as to short supplies and access to supplies and how limited testing was at the time we needed it most. That’s what made this unusually challenging.

“We have had our heads down, seven days a week, making sure this hospital is well-positioned and capable of taking care of the community. Hospitals and health care providers are very used to taking care of infectious diseases – we know how to do that. And we’ve taken great strides making this a very safe environment. We’re confident and comfortable saying to our entire community: if you need to access health care, this is as safe of an environment as you will enter anywhere in the community. Being afraid to come in, isn’t a good reason to avoid care,” Calbone says. 

“We get concerned when we see patients end up in our ER with conditions that have worsened and potentially even threatened their lives that could easily have been managed if they sought care – as they would have – three months ago. That’s a message we’re been trying to get out there.”

SARATOGA SPRINGS — Assemblywoman Carrie Woerner, who represents the 113^th Assembly District, issued a statement Thursday morning arguing against Gov. Andrew Cuomo’s “instinct to cancel” the Saratoga meet, and recommending the region prepare to move forward planning to hold the summer card at Saratoga Race Course.     

 The portion of the statement pertaining to Saratoga Race Course is as follows:

“I couldn't possibly disagree more with the Governor’s instinct to cancel this year’s meet at Saratoga Race Course, even without fans. The equine industry is a core component of New York State agriculture, the largest sector of the state's economy. Opening the rest of the economy while keeping the track closed disrupts a major economic driver and the livelihood that thousands of people rely upon.

 The Governor has lumped together various forms of entertainment and referred to them as 'attractive nuisances.' I would like to stress that horse racing is unique and needs to be approached differently than concerts and sporting events.

 We need to move forward planning to hold this year’s race meet. Maintaining the schedules and operations of the dozens of different sectors of agriculture including foaling farms, stables, hay farms, equine veterinarians, and tack shops all necessary to making a race season possible.

 Our region, state and nation are continuing a trend that points to a resilient and healthier society and economy by July and August.  

Cancelling now would leave us no ability to decide to race later. However, continuing to prepare for a meet will allow for a variety of potential opportunities including but not limited to social distancing, limited viewership, and personal protective equipment. “

SARATOGA SPRINGS — Caffe Lena’s Stay Home Sessions, which take place every night at 8 at caffelena.org, continues with Friday with The Suitcase Junket, captured in this image on stage at Caffe Lena 55th anniversary concert at The Zankel in 2015.  The Stay Home Sessions feature Jontavious Willis on Saturday, April 25, and Sloan Wainwright and Cosy Sheridan on Sunday, April 26. 

• The council during its Tuesday meeting unanimously approved by a 4-0 measure a 30-day extension of the city’s State of Emergency declaration, initially declared in March. That State of Emergency now goes through May 12. City Mayor Meg Kelly was absent from Tuesday’s meeting. 

• Public Safety Commissioner Robin Dalton updated the latest known status of the summer meet at Saratoga Race Course, which is slated to begin July 16. 

“My understanding is that NYRA is following the governor’s recommendations and they are preparing to be open and to run if they have the opportunity to do so - meaning the restrictions on mass gatherings and events will have to be lifted,” Dalton said. “If indeed that happens then they will be ready to run in July.” 

Accounts commissioner John Franck added that there also is a possibility that the Saratoga meet may be staged with no fans present. “This is what I heard from various representatives and racing people; I guess the reason being there will still be gambling online, so there would still be revenues coming in to NYRA and the state. We just don’t know yet.” 

Last year, the meet at Saratoga Race Course generated more than $700 million in all-sources handle for the first time in NYRA history at The Spa, despite losing one full racing day to a weather cancellation. The $705.3 million all-source handle bested 2018’s total by more than $46 million. 

• Late Fees for City, County and Delinquent School Taxes: Finance Commissioner Michele Madigan said the city had looked into the potential waiver of fees and penalties as they relate to tax bills. “Last week the late notices went out to anyone who was late paying their taxes and that really kicked off quite the firestorm,” Madigan said Tuesday, during a meeting of the City Council via Zoom. “Unfortunately, legal research shows that the city has no authority to waive these fees. The only person who can do so during the State of Emergency is the New York State governor.” The New York Conference of Mayors legal team reports that local governments do not have unilateral authority to extend the interest-free period with respect to the payment of property taxes, she added. 

Regarding other types of fees or late payments that are established via local law - such as water, sewer, garbage - local governments do have the ability to extend or modify late penalties and payments dates by promulgating an emergency order that suspends the relevant local law. 

• Funds: Given anticipated revenue losses due to the COVID-19 emergency, Madigan asked each department to submit by April 29 suggestions on where to potentially cut or trim non-mandatory expenditures. 

All city employees - full-time and part-time – had been paid full wages through April 17. “As of April 18, part-time employees have been furloughed, unless their departments deem them essential and they are actually working,” Madigan said. A temporary hiring freeze went into effect April 10. Until that order is rescinded, new hires may only be made on an emergency basis. 

Options under consideration include payroll reductions, layoffs, securing loans, and using the city’s cash fund balance, the latter of which is already underway, according to Madigan. 

• Land Use Board meetings will resume this week and will be held virtually with board members and applicants and may be viewed via live stream on the city’s website. Consult the city website for dates and times for meetings of the Planning Board, Design Review Commission, and Zoning Board of Appeals.

ALBANY — There has been a noticeable shift among lawmakers during the past 10 days that points to a scheme of an eventual reopening plan for New York that may take the shape of a region-by-region easing of restrictions, as opposed to the state reopening in its entirety, all at the same time.   

“There are regional economies within the state. Let’s talk about reopening economies in a regional context. Coordinated regionally. And that’s what we’re going to be doing,” state Gov. Andrew Cuomo said this week, naming Lt. Gov. Kathy Hochul in charge of overseeing the Western New York region public health and reopening strategy, and former Lt. Gov. Robert Duffy as special advisor on public health and reopening in the Finger Lakes region. 

Nearly two months since New York registered its first COVID-19 case, and three months since the first case in the U.S. was discovered, Cuomo surveyed the daily charted number of infections, hospitalizations and intubations in New York City - where more than 10,000 residents have died as a result of the virus – and cautiously explained “the numbers would suggest we are seeing a descent…the question is how long and how steep the descent? Nobody knows.” That descent will play a major role into when the state reopens. 

Governors in each state will decide when to re-open, and President Donald Trump has recommended in advance of a phased-in approach to reopening there should be, among other things, a decline in COVID-19 cases for 14 days. 

Regionally, however, the percentage of the number of people testing positive for COVID-19 has been steady, or rising. A three-day sample in Saratoga County from April 15-17 indicates of 267 people tested, 17 (or about 6.4%) tested positive, while more recent tests of April 19-21 sample shows 13 of 175, or about 7.5% tested positive.  Overall, as of April 21 in Saratoga County where about 3,500 people have been tested, 7.6% percent of those tested positive. Albany County shows a 9.8% overall rate, Warren and Washington counties each are over 11%, and Schenectady County is over 12%. And indications are that those percentage numbers have not fallen in any of the counties. 

On April 17 Rensselaer Polytechnic Institute researcher Malik Magdon-Ismail discussed a new model showcasing the pandemic impact in smaller cities. The model indicated that with 75% of the population in the Capital Region in New York remaining at home, the COVID-19 pandemic will peak locally in about four weeks, in late May. 

“How do you educate yourself on reopening? Testing,” said Cuomo, who explained he had a “productive” meeting with Trump at the White House April 21, and one of the results of that meeting is the expectation that the number of tests in New York State will as much as double in the near future - from approximately 20,000 to 40,000 per day. 

“Make the decisions on the facts, not on political pressure. We make a bad move, it’s going to set us back,” said Cuomo, adding that it is vital to also understand the consequences of opening one region at a time, so as to not flood that region with unanticipated problems, presumably meaning an influx of people coming from areas still on “pause.”    

“We can’t make a bad decision and we can’t be stupid about it. This is a marathon, not a sprint. More people will die if we’re not smart,” he said.   

As Cuomo spoke inside the State Capitol, a rally organized by the group “ReOpen New York State” was staged outside on Wednesday to protest the New York on Pause coronavirus plan. While protest organizers told people planning to attend the rally to respect social distancing, most were crowded on the sidewalk and in the road, and many were not wearing masks, according to WRGB. 

At the same time and of a different view, a letter signed by Saratoga Unites, Saratoga DSA, Saratoga Progressive Action and more than a dozen other area organizations and individuals was issued in support for efforts taken by New York state leadership with the current stay at home orders. The letter states, in part: “It is natural to feel like we need to ‘do something,’ and we encourage people to focus on support for healthcare and essential workers, the unemployed, and the small businesses which are all so vital to the Capital District.”

Cuomo said he anticipates “a rolling curve” of infections. That is, that different test-positive hotspots will flare up at different times. “New York City had the first curve and then they project higher curves in other states and in other parts of our state,” the governor said. “Buffalo will have a later curve, Albany will have a later curve, and we’re watching the curves in different parts of the state. Our strategy is: we deploy to wherever the curve is highest.” 

ANTIBODY TESTING UNDERWAY

A weeklong statewide antibody testing survey that will randomly sample 3,000 people began April 19 in a handful of upstate communities, Saratoga and Schenectady among them. 

The antibody test – which is different than the tests which currently identify the virus -  will tell whether a person had previously had COVID-19. The state is hopeful this large-scale antibody testing will help determine the percentage of the population that is now immune to the virus, allowing more individuals to safely return to work. The finger-stick blood samples will be tested at the Wadsworth Center, which is located in Albany. 

The “random” designation is particularly important. The other tests conducted – the ones which tell whether a person currently has the virus -  are mostly conducted with people showing symptoms of illness, or those potentially exposed to it. 

Preliminary data of the antibody tests  -  randomly conducted in grocery stores and box stores in 19 counties, 40 localities overall - showed 13.9% overall tested positive for antibodies – that is 13.9% of people randomly tested across the state have, at some point, had the virus.

In Schenectady, where the information regarding the random testing was not made public, those showing up to be tested included “several county legislators” according to the Gazette. In Saratoga County, where the information was made public by Saratoga County on its Facebook page, many more people turned out than were anticipated. 

 “It should not have been posted on Facebook – both for randomizing purposes, but also a (Price Chopper) manager told me at one point there were nearly 300 people in there just to get tested,” said Saratoga Springs Supervisor Tara Gaston, who visited the Price Chopper store in Malta where the testing took place. “That 300 is in addition to the people who were just shopping. My understanding is those (tests) are going to take place, but not in the same spot and they’re not going to be announced. My hope is no one puts it on the county website or Facebook page. That shouldn’t happen (again). I’m not going to say that it won’t – but, that’s our goal.”

While different parts of the state may open at different times, Cuomo said regardless of where reopenings occur, schools and businesses will be open at the same time in that particular region. 

There is no specific committee charged with specifying reopenings. A region-by-region determination will be addressed via discussions in a collaborative effort between state and local governments. Cuomo did not specify whether a “local” government make-up would consist of county, city, town, and/or village officials.

SARATOGA SPRINGS — Dead & Company have canceled their previously scheduled Aug. 3 appearance at Saratoga Performing Arts Center. 

The statement, released Tuesday afternoon reads: "Because of the global coronavirus outbreak and to help prevent the spread of COVID-19, we have no choice but to cancel Dead & Company's Summer Tour 2020.  The well-being and safety of our Deadhead community, venue staff and the band’s touring family is of the utmost importance.  We also want to get refunds back to our fans while so many are hurting economically.  All tickets will be fully refunded at point of purchase. We are thankful for your understanding and we look forward to the day when we can all be reunited.  In the meantime, keep the faith and believe in the power of music.  We will return.  We will get by.  We will survive."

The show marks the third cancellation of the summer pop season at SPAC. 

Cancelations were earlier announced for shows featuring Celtic Woman (June 7), and Zac Brown Band (June 13).