New NYC Health Commissioner denies evidence for herd immunity in NYC, urges continued precautions

By Yehudit Garmaise:

   With a friendly, warm, and straightforward demeanor, Dave A. Chokshi, MD, MSc, New York City’s new health commissioner, reached out to members of the Jewish press, to address the recent report of a new cluster in Boro Park of 16 patients who have been infected with Covid-19 as a result of attending a wedding two weeks ago.

  “I am concerned about the reports that our public health protocols and limits on public gatherings are not being followed,” Dr. Chokshi said.

   Dr. Chokshi explained that his perspective comes from having worked on the front lines at NYC Health + Hospitals in Queens, where he was treating patients during the worst days of the virus in March and April.

   “I saw the intensive care units tested, and I saw the toll that it took on our system,” Dr. Chokshi said. “I saw firsthand the intense suffering of patients, family members, neighbors, and community members, and I will never forget that. I will pledge to you that I will do everything in my power to prevent us from ever going back to those days.”

   Dr. Chokshi explained that he has heard this week about new transmissions of Covid in Boro Park, Sunset Park, and Williamsburg that are raising some alarm.

   “We must ensure that precautions to prevent Covid-19 continue to be taken seriously by all New Yorkers,” Dr. Chokshi insisted. “We want to be as careful and cautious as possible to prevent further suffering.”

     Dr. Chokshi who attended medical school at Penn and earned a Master’s degree in global public health as a Rhodes Scholar at Oxford, first wants to educate the public that herd immunity has not yet been achieved.

      “We must keep adhering to the protocols,” insisted Dr. Chokshi, who also is an associate professor of population health and medicine at the NYU School of Medicine. “Just because we are in a better place than we were in March and April, does not mean that we can let down our guards.”

   Two weeks ago, Mayor De Blasio appointed Dr. Chokshi to replace Oxiris Barbot, MD, who resigned after several conflicts with the mayor. In his very first solo press conference as health commissioner, Dr. Chokshi told several Jewish journalists that he wanted to lay out clearly the facts as he understands them right now.

   “First, despite the attitude of many New Yorkers, there continue to be cases of Covid-19,” the new health czar reported. “During the four weeks that ended on August 8, Boro Park saw 54 cases, which is certainly lower than it was a few months ago. Just to be clear, 54 remains a significant number of cases for one neighborhood.

   “Secondly, we do not have evidence of herd immunity anywhere in New York City, including Boro Park. We all look to a day perhaps when there is a vaccine, and when we have herd immunity, but unfortunately that is not yet the case.

     “Lastly, our early warning signals indicate that a potential uptick in Boro Park is a cause for concern.”

    These three points, Dr. Chokshi said, justify the great need for New Yorkers to remain vigilant and to do everything that they can do to prevent further suffering from the novel coronavirus

   Dr. Chokshi said that he is also responding to anecdotal and other evidence that many larger events and groups are not adhering to the crucial guideline that halls and other rooms must not be filled with more than 50% of its normal occupancy. In addition, all gatherings must be capped at 50 people.

            Dr. Chokshi declined to identify the Boro Park catering hall in question because the hall is currently under investigation by what he called, “disease detectives.”

   “The fact that these large events are happening is problematic, and that is what is most concerning and worrying to me,” Dr. Chokshi said.

   Disease investigators, who aim to determine the sources of Covid clusters, have gathered the information that some of the gatherings in Boro Park have, unfortunately, exceeded the recommended safe limit, the health commissioner said,

   “When people are indoors around people other than their families,” Dr. Chokshi continues, “our guidelines also require that everyone keeps his or her mask on at all times. “In addition, people must remain socially distant at all public events.”

  To clarify the city’s restrictions on social gatherings. Dr. Chokshi explained that disease detectives will reach out, in what sounds to be a friendly way, to the Boro Park catering hall that hosted the wedding that resulted in 16 new cases of people with Covid-19. This morning, Spectrum News, NY1.com even raised the possibility that the catering hall in question might be liable to “face punishment,” however, Dr. Chokshi reassured Yehudit Garmaise of BoroPark24.com that his role was not to punish, but to educate and engage the community.

   “My most pressing goal is to prevent a resurgence of Covid-19 in New York City,” Dr. Chopski said. “But I am also convinced that a healthcare agency, or a government cannot stop this virus alone.

  “We need all New Yorkers to take precautions and to keep practicing the rules we call the ‘Core Four,’ which are: Wearing face coverings, washing and sanitizing hands, keeping six feet of distance from others, and staying home when feeling ill.”

     One journalist raised a concern that many members of the frum community have felt, which is that Mayor de Blasio has been inconsistent in his enforcement of the health protocols, such as the requirements for smaller gatherings, mask-wearing, and social distancing: depending on the events in question.

   Funerals, weddings, shuls, and parks in which Jewish children play, one journalist pointed out have been publicly criticized, while the “gatherings” that took place as a result of protests and even riots, looting, and even recently, various forms of partying over the summer, received no criticism at all. However, in the cases of the protesters  who failed to follow the guidelines, the mayor spoke of words of approbation.

  “The mayor’s message is not uniform,” one journalist pointed out. “Why are the Covid restrictions important for us, but not for the protestors out in the streets? It seems like the mayor makes rules based on his personal politics.”

  Dr. Chokshi responded to everyone’s relief when he said, “We are all in this together: the mayor, the rest of media, and the citizens of New York.”

   The new health commissioner emphasized that he wants to make sure that everyone understands the rules, why we have these rules, and that the rules are not arbitrary for different populations.

            “Social distancing is important for everyone,” Dr. Chokski said. “Wearing masks or face coverings is important for everyone, regardless of the different reasons and circumstances for why people are out of their homes. Everyone must follow our guidelines to uphold the health and safety of everyone in our city.”

  Dr. Chokshi also pointed out that Mayor de Blasio met with several community leaders, although he did not say whom, of the Orthodox community yesterday to try to reinforce the protocols and to make sure that no one becomes complacent in our fight against Covid.

   To continue to spread the word for New Yorkers to remain vigilant about adhering to the “Core Four,” Dr. Chokshi is spearheading a NYC Health Department campaign that is reaching out to practicing physicians, particularly in Boro Park and in other communities in which frum Jews live to help to get the word out and reiterate that we must continue to take precautions and avoid large gatherings, to stop the spread of Covid-19.”

   When asked to what he attributed the significant drop in cases of Covid infections over the summer, Dr. Chokshi emphasized New Yorkers’ initial adherence to the protocols of masks, hand-washing, and social distancing.

  “The honest scientific answer to the question of what caused the drop in Covid cases is attributable to a few different things happening at once,” Dr. Chokshi said, “but the largest contributor was social distancing, wearing masks, washing hands, and people taking these protocols very seriously.”

   Dr. Chokshi added that although New Yorkers have much lower rates of infection with Covid than they did a couple of months ago, he wants to keep the numbers down as much as possible.

    Dr. Chokshi also debunked the popularly held opinion that those patients who were infected with Covid feel that they therefore cannot be re-infected; Dr. Chokshi warns, “Those views are not yet supported by science.”

   Dr. Chokshi tells his patients and his family members who have positive antibody test results, that those positive test results do not mean that they are protected from Covid-19.

   Interestingly, the New York Times reported today that of the entire city, Boro Park had the second highest rate of positive antibody tests: with 46.8% of residents testing with positive antibodies. Boro Park was second only to the neighborhood Corona, in Queens, in which 51% of residents had positive antibody results.

     The Times attributed the high rates of antibody tests in Boro Park to “large households and a “tight-knit, communal way of life,” and the high rates in Corona, Queens to “an especially high rate of household crowding,” and a population that includes “construction workers and restaurant employees,” many of whom had to work throughout the pandemic, and thereby raising their risk of infection.

    “Everyone, whether they have positive or negative antibodies for Covid-19, must continue to take precautions to prevent the spread of this disease,” explained Dr. Chokshi, who added that he hopes for definitive evidence on the protection of positive antibodies. “Until we have scientific evidence that people are immune from Covid-19, our job as healthcare providers is to protect people and prevent further suffering.”

    Science has not yet determined as to what precisely what a positive antibody result means for future immunity and reinfection, Dr. Chokshi explained.

   “The duration of any immunity that exists and how protective it is remains uncertain, which is why regardless of whether you have a positive antibody test or a negative one, we all must continue to adhere to preventive and protective measures,” Dr. Chokshi said.

    While he pointed out the lack of scientific proof of herd immunity and immunity from positive antibodies, Dr. Chokshi explained the other factors that do have a strong scientific basis to protect New Yorkers from Covid-19.

  “We know that face coverings save lives, says Dr. Chokshi. “Hand washing saves lives. Keeping your distance from others saves lives, and getting tested if you have been exposed can save lives.

   Dr. Chokshi also wants to test more New Yorkers to determine whether they are infected with Covid-19.

   “I want to help New Yorkers who test positive and make sure that they have the support they need to stay isolated from others,” Dr. Chokshi said. “We also need to make sure to protect and treat not only people who are infected, but we also have to enforce our protocols to protect our community members from those who are infected.”

  Dr. Chokshi welcomed ideas and input from New Yorkers, and he encouraged readers to keep up-to-date on Covid-19 news by zipcode checking out: nyc.gov/coronavirus.