June 30, 2022
Dr. Ted Long, Senior Vice President of Ambulatory Care, New York City Health+Hospitals: All right. Thank you everybody for joining us today. My name is Ted Long. I'm the Executive Director of the NYC Test & Trace Corps program and Senior Vice President, NYC Health + Hospitals. I'm excited to be here today because today we're announcing the new, first of its kind, mobile Test to Treat program. Our mantra in New York City throughout COVID has always been to meet every New Yorker where you are. Two years ago, we started to do this by creating a mobile testing fleet. We grew it, it soon became the largest in the country, and it was so successful we created a mobile vaccine fleet. Then after that, we created mobile units that enabled us to take special care of New Yorkers that were living with homelessness.
Dr. Long: Now, as I've told our mayor, COVID is like the weather system. A new variant can be a drizzle or it can be a thunderstorm, but we're here today because expanding treatment today will allow us to have a stronger roof over us, whatever COVID has in store for us in the future to keep our city safe and healthy throughout. Now, the last two years have been tough, but today in New York City, getting treated is easy. Under Mayor Adams, we've already distributed more than 33 million home tests. We set up our (212) COVID-19 hotline so that if you take a home test, it comes back positive, you can then call that number, a matter of minutes later be on the phone with a clinician, and then through Ashwin, Dr. Vasan, and our amazing Health Department, we can deliver you the lifesaving medication, Paxlovid, to your home that same day.
Dr. Long: Now, for me, this is important because I'm a primary care doctor in the South Bronx. I practice just a few miles from here, and I know that for every 18 of my patients that I treat with Paxlovid, I potentially prevent one of my patients from getting so sick that they'd have to be admitted to the hospital. With our new model, we're making today treatment faster and easier than ever before. Here's how it works. You come up to our mobile unit here. We're going to swab you with a rapid test. If that comes back positive, you're immediately going to speak with one of our clinicians. If you're eligible, we'll prescribe for you Paxlovid. You'll walk inside the pharmacy right here, and a matter of minutes later, you'll walk out with a lifesaving medication. This summer, we're going to be unveiling 30 of these units. Some are going to be in collaboration with local pharmacies, just like this one. Some will be able to hand you the Paxlovid pills themselves directly from the mobile units.
Dr. Long: I want to take a moment to say thank you to Dr. Ashish Jha and to Dr. Tom [inaudible] and his team for their constant encouragement of us to build out this new one-stop-shop mobile model. This new first of its kind mobile Test to Treat model is the future and is how we're going to help our city to continue to recover together. So thank you for joining us here today. Now I'm going to walk us through the agenda. Now for the reason you're really here, I'm going to first introduce our mayor of New York City, Eric Adams.
Mayor Eric Adams: Thank you. Thank you. Thank you. Thank you. Thank you so much. It's good to be up here in the Heights, and it's even better when you have just an amazing healthcare team. Dr. Long, Dr. Vasan, and Dr. Jha that's here, COVID Coordinator from the White House. We spoke and met earlier and the great interaction between the two entities as we move forward and deal with COVID.
Mayor Adams: I said this over and over again. COVID is a formidable opponent. It pivots and shifts, and we are clear that we are going to pivot and shift with it. And we're leading the way in the country on how we utilize all of our assets to address this serious crisis that we have faced and that we cycle out of. No, let the baby talk. We like babies here. Let them speak.
Mayor Adams: So, I'm proud to be here with this public health team. We meet every morning in our communications, as we stay abreast of what's happening with COVID, and this team has really led the way as we cycle out and as we deal with variants as they continue to just be unpredictable as the future moves forward. As we focus on these issues, we were the epicenter of COVID pandemic at the start, but we are leading the way in prevention and mitigation. What we're doing here, other cities can look at and make the determination how they want to address COVID.
Mayor Adams: This mobile testing unit is the first of its kind. How many times did I say that, Michael? First of its kind, once again. This is going to deal with equity because we talked about the equity issue. Dr. Vasan has leaned into the equity issue so much, and when you are mobile, you can pinpoint the areas that need the support immediately and we can get this unit out to those areas, and that's why we're really impressed by that.
Mayor Adams: We are now leading the way again, by having this mobile unit. This new public health service will help all New Yorkers get access to life saving treatments. When I had COVID, being able to get my medicine right away, same day, delivered to me to Gracie Mansion, ghosts and all, we were still able to survive and get our medicine there. And help protect our city against any new variants of future waves of transmission.
Mayor Adams: As COVID may still be a fact of life, but it doesn't have to be the cause of death, and that is what we will continue to say. It is preventable, it's treatable, and caught early, that treatment is really part of what's keeping us moving forward in the right direction. And so I'm proud of this response to COVID-19. We didn't allow COVID to define us and we darn won't allow it to defeat us. We looked out for each others as New Yorkers. We continue to do so as New Yorkers, continue to evolve out of this crisis.
Mayor Adams: When you look at the numbers, the numbers are clear. 90% of New Yorkers are vaccinated and that includes even our younger people. Dr. Vasan has been waiting for this moment for a long time. He talks about it often. When it comes down to zero to five year olds, we are making it eligible for them as well, and they're going to get the resources that they need. This is an exciting moment for us. New York is back to work, back to school, most importantly back to life, but we're not going to let down our guards. We're going to continue to remain focused and committed to this important endeavor and continue our mission of being as safe, sane, and prepared. Not panicked, but preparation. That's what we have accomplished and that's what we will continue to do. And so I'm going to turn it back over to Dr. Long, who's going to introduce our next speakers.
Dr. Long: All right. Thank you, sir.
Mayor Adams: Hold on one moment. Let them finish and we're going to rock with you, okay?
Dr. Long: Yeah, we'll do questions at the end. So for our next speaker, I'm excited to introduce the White House COVID Response Coordinator, Dr. Ashish Jha.
Dr. Ashish Jha, COVID Coordinator, White House: Thank you, Ted. Hard to follow the mayor. Really is. So let me take a couple minutes to talk about why this is a very special day, and I want to start off by reminding us how much progress we've made as a country. Think back to where we were two years ago. We've had more than 200 million Americans have gotten vaccinated, more than 100 million Americans have gotten boosted. We have treatments available. We have made incredible progress.
Dr. Jha: And so despite the fact that 100,000 people are getting infected every day, which is not great, we got to work on that, deaths are way down. And so as a nation, we have made incredible amount of progress. But today we're here to talk about New York City. We are here to talk about New York because New York of course was the epicenter of this pandemic, suffered more than any other city, but also recovered faster, was more resilient, and the way New York has done that is by being innovative, by staying focused on the stuff that matters, and has been leading the nation on so many important issues.
Dr. Jha: New York is more vaccinated than the rest of the country, not just for adults, but as you heard from the mayor and you'll hear from Dr. Vasan, New York's track record on vaccinating children outpaces so many other parts of the country. We're seeing great uptake of kids under five and vaccinations. That stuff doesn't happen randomly. It happens because of leadership and it happens because of focus and leadership of the mayor, leadership of the health commissioner, and leadership of public health workers and healthcare workers across the city.
Dr. Jha: Beyond vaccines, which are incredibly important and really the bedrock of our response, is also treatments, and that is what we're talking about today. I want to take a minute to talk about Paxlovid. This is a pill that the US government has put a lot of effort into making sure is widely available. We have seen over the last two months a huge increase in the use of Paxlovid and actually think that's making a major difference in keeping our hospitalizations low, keeping deaths low.
Dr. Jha: But we've also discovered something else. As we have ramped up use of Paxlovid, we have seen that the penetration of Paxlovid, the use of Paxlovid in communities of color, in neighborhoods with high social vulnerability is not as good as it needs to be, and we have, as a nation, a real equity challenge in front of us. And again, because we are facing a national problem, we are not surprised to see New York City take the lead to begin to address it.
Dr. Jha: The mobile Test to Treat program that we are launching today, as the mayor said, is the first in the country, and the reason I am so excited about this, not just because I love New York and I love seeing great things happen in New York, but because this will become a national model. Once New York begins to do this on a regular basis, it makes it easier for folks like me to talk to mayors and governors across the country and say, "What, you're going to let New York show off and you're not going to play the game here?" Little friendly rivalry moves everybody, and that rivalry is going to make the country better off. So this is about equity. This is about making sure that everybody who needs and can benefit from treatments gets it. This is about meeting people where they are, literally. Going into neighborhoods, going into communities and making sure that we're not asking people to come to us, that we are going to them, and that is the ultimate public health.
Dr. Jha: So I am thrilled to be a part of this event today to celebrate this moment. I know New York is going to continue to lead the nation on so many great things, and again, it happens because of great leadership. And so Dr. Long, thank you for your leadership, and do I just turn it over to Dr. Vasan, our health commissioner, who's doing a great job for the City of New York and really leading the country. Ashwin, to you.
Dr. Ashwin Vasan, Commissioner, Department of Health and Mental Hygiene: Hi everybody on this chilly afternoon. [Laughter]. Good to be with you. I'm not at all hot. Our city's approach to fighting this pandemic has from the beginning been about meeting people where they are, ensuring equity, and setting a clear north star that is about saving lives, protecting people and delivering results. The nation's first Test to Treat program right here in New York City, and thanks to Dr. Jha and the entire Biden-Harris administration for their support, is once again setting a standard as we enter into the next phase of COVID-19.
Commissioner Vasan: The mobile Test to Treat program brings the best of public health and healthcare together to deliver life saving treatment in an end-to-end fashion for the people in the communities who need it the most. This work will help us chip away at some of the barriers that in part explain why people of color and people in less economically advantaged communities have had higher rates and worse outcomes from COVID.
Commissioner Vasan: We're solving for access, speed, service and equity With this approach. We're reducing wait times to find a testing site by bringing care to where people are. We're slowing delays IN seeing a provider by bringing care to where people are, and we're reducing slow downs in access to a pharmacy and picking up prescriptions by bringing care directly to where people are, and we're overcoming cost barriers by making this free to the public.
Commissioner Vasan: This model of convenient, fast, and no cost to the patient community care should be the new normal in healthcare, not only during pandemics. Like all human rights, healthcare shouldn't be hard to come by, especially for the most vulnerable. Strategies like Test to Treat represent the next pillars of our COVID response as we prepare for whatever this virus throws at us and as we ready for the fall. We are over the last several months and for the first time in two and a half years seeing a clear break between cases, hospitalizations, and deaths, and the widespread distribution of Paxlovid is one part of that. Test to Treat makes getting Paxlovid even easier and reaches into communities and connects with vulnerable people.
Commissioner Vasan: The past weeks and months have taught us a lot about how this virus and these variants are behaving in addition to studying the effects of new tools in our armament, and while we continue to see a lot of transmission here in New York, we're also at a different phase of the pandemic that demands new analytical tools to match our assessments and communications about risk with reality, accounting for the multiple inequitable realities faced by New Yorkers and Americans of different stripes and different situations, which is why today we're reevaluating our color coded risk alert system, as we said we were going to do, every three months, taking into account what we've learned over these recent weeks and where we are as a city and as a society in terms of our perception and the reality of risk from COVID-19.
Commissioner Vasan: So in addition to our thanks, again, to the federal administration and thanks to the mayor, of course, I finally want to recognize Dr. Long, the fantastic work of T2, Health + Hospitals, and of course my colleagues at the health department. This kind of partnership and strategic alignment to meet unified public health goals is the best of what we are as a city. And it's certainly new and even stronger day in our interagency collaboration between the best public health department and the best public hospital system in the world.
Commissioner Vasan: Mayor Adams, again, has been consistent in his mantra, pivoting and shifting. I've taken it on as my mantra as well, to face whatever the virus throws at us. And this launches, once again, an embodiment of that ethos. We'll do whatever it takes to meet the needs of New Yorkers, especially those most at risk. Thanks, and we're really looking forward to the work.
We're going to do the press, and then we're going to come to you, okay?
Mayor Adams: Okay, mommy.
Question: I got an off topic too, but on topic…
Question: So on topic, now the beginning of this is you've got three mobile test units and three pharmacies partnering. Can you talk about the expansion aspect of this? How quickly do you expect to expand into other locations? How many other locations? What's the overall scope of this end game?
Dr. Long: Thank you for the question, Michael. So in seven days, we're going to be expanding to 10 units. That's seven more than the three that we currently have. Right now, we're working through being able to, again, have some units be able to dispense the Paxlovid directly from the units, but at the same time, we also want to work with our local trusted pharmacies that are pillars of our communities. So we're looking forward to having our model be able to be flexible and to, based on whatever community we're in, meet the needs of that community with the resources that they have here.
Dr. Long: At peak, when we have ... I shouldn't say at peak. When we have the 30 units up and running, we'll be able to do 6,000 tests a day, and we'll be able to dispense 600 treatments a day. That's our capacity when we have 30 units up and running.
Question: Does that mean 30 pharmacies, too?
Dr. Long: Well, so the model will be mixed. Some will be pharmacies, some will be dispensing the medication directly from the mobile units, but that's the overall capacity.
Question: Got it, thanks.
Dr. Long: You're welcome.
Question: So my question, I just wanted to clarify on eligibility. Can anyone get this vaccine? And then also for Dr. Jha, I know there's 8,000 vaccines for monkeypox coming to the state. There's growing concern obviously there. Could you just share your message on people who are worried that that might not be enough?
Dr. Long: I'll start, and I think I'll turn to Dr. Jha if he wants to share more on the monkeypox question. So we do have eligibility criteria for the Paxlovid medication. The way it works, again, is you go here, you have a positive test. Our clinicians are at the table right there, and they'll go through both your eligibility and they'll go through ... There's some drug interactions with Paxlovid, so go through all of that with you. So if you go inside the pharmacy and walk out with Paxlovid, you are eligible and we've taken care to make sure that you're safe to take the medication.
Dr. Jha: Yeah, and just to build on what Dr. Long said, eligibility is determined by the FDA on this, and basically anybody who's at elevated risk of having a bad outcome is eligible, and then I've got to make sure that you can take it from a drug point of view.
Dr. Jha: In terms of monkeypox, yes, indeed. So, the Department of Health and Human Services, the administration rolled out yesterday its plan. We have about 56,000 doses across for the whole nation right now. 8,000 of those can go to New York as New York is eligible to get 8,000, but that's as of today. We are getting a lot more vaccines for monkeypox in the days and weeks ahead, so my expectation is we're going to see many more thousands of vaccines coming next week and the week after that.
Dr. Jha: We're working really hard to expand the vaccine capacity of how much vaccine we have, and so I think you're going to see a good number of vaccines. So for people who are concerned, they want to get the monkeypox vaccine, we are going to make sure that New York gets what it needs to meet all those needs so that…
Question: Where can they...
Question: Mayor, I had a question about vaccinating more children ahead of the school year in September. Have you made a decision about that, and how do you increase these rates among people like my son and young children?
Mayor Adams: When you say vaccination, you're talking about is it going to be mandatory or not?
Question: For schools, yes.
Mayor Adams: Yes, we are still meeting, we're discussing to come up with the best way to do it. We want to do it in a way that is thoughtful and that is not going to decrease our number of students who are in schools, but Dr. Vasan and the team is really flushing through. And we want to notify parents as early as possible so that they can be prepared. Within the next few weeks, we'll know exactly how we're going to move.
Question: And short of a requirement, how do you increase rates among children?
Mayor Adams: Well, we are hoping... And Dr. Vasan can talk about that more. This is his expertise. We are hoping that parents are going to see the full benefits of the vaccine the way we see it in others, smallpox, measles, mumps, and we are a society where vaccines have played a major role in preventing the spread of these viruses and diseases. But our goal is to really educate parents as much as possible, put money in a public relation campaign, and try to get parents to really be a part of this team of getting our children vaccinated. You want to touch on anything else, Dr. Vasan?
Commissioner Vasan: No, that was great. Pretty much whatever the mayor said. I mean, we're here to build confidence amongst parents, which is why particularly for our under five vaccine rollout, we've really leaned on pediatricians. We want this to be incorporated into your normal conversations around making medical decisions for your child.
Commissioner Vasan: I have three kids of my own. One of them is under five, and I'm getting them vaccinated, but it's a conversation with pediatricians and trusted people around whom and with whom you make medical decisions for your child. But look, I think we're also waiting for products to become fully licensed by the FDA. That builds a lot of confidence in our student required vaccines. Most of our student required vaccines are fully licensed products by the FDA and mandated by the state. And so we're working with the state, we're working with our federal partners to really decide what's the right timing and when and if we bring in a student vaccine requirement, and so we're under consideration now. It's definitely something we're talking about.
Question: Don't forget me.
Mayor Adams: We won't mommy, we won't.
Question: Thank you. I'm wondering if you could give us a little bit of a sense of the supply here. How much Paxlovid does the city currently have? How much are you expecting in the coming weeks and months? Just a sense of the supply would be great. Thank you.
Commissioner Vasan: Yeah, that's a great question. The funny thing is we actually have ample Paxlovid, and so to be perfectly honest, I don't have the number off the top of my head because we haven't had any supply issues in recent weeks and months.
Commissioner Vasan: In the beginning, of course, of our rollout, we decided to partner with an online pharmacy to do same day deliveries in an environment where there was very little Paxlovid around the country and relatively little in our city, but now we're kind of awash in Paxlovid. Is that fair to say?
Dr. Jha: Yeah.
Commissioner Vasan: Maybe you want to talk about the federal supply?
Dr. Jha: Yeah, I'll very quickly say we've been working really hard on the federal level to make sure that there's plenty of supply, and what we want is for jurisdictions like New York City to figure out how to get it to its people. And our job is to make sure we get plenty of Paxlovid to New York. And so it's been a great partnership, and I don't want you to know the number. I never want you to think about it.
Commissioner Vasan: There you go.
Dr. Jha: I just want you to know that when New Yorkers need Paxlovid, there will be Paxlovid for New Yorkers.
Mayor Adams: Love it, love it.
Dr. Jha: Thank you. Perfect.
Question: Dr. Jha, New York triages antivirals like Paxlovid using race as one of several factors. Is that a best practice? If so, why? If not, why not?
Dr. Jha: Yeah. So first of all, I think Paxlovid should be widely available to all Americans, again, within the eligibility criteria that FDA has laid out. I think different jurisdictions in terms of targeting where they're going to make sure that Paxlovid is even more easily accessible, what tools you're going to use, different jurisdictions are going to take different approaches on this.
Dr. Jha: But the bottom line is that when I look at the clinical data on Paxlovid, which is the clinical trials were good, the real world experience is even better, and so my view is we still have a virus out there that's killing a lot of Americans. We should be doing everything we can to make sure every American who's even remotely eligible gets it, and we should absolutely be making sure that people who have been disproportionately harmed by this virus have easy access to Paxlovid.
Question: Is recent acceptable factor [inaudible].
Question: Mayor Adams, may I ask you to comment on the DOJ investigation?
Mayor Adams: I will, but let me just have this... Yes, go ahead. Go ahead, ma'am.
Mayor Adams: Okay. Well thank you.
Dr. Long: We will try.
Question: [Inaudible] is what is the percent of effectivity? [Inaudible] right? What is effective? 100%? 80%? 90%? And it's only in New York City. What about the other cities?
Dr. Long: So it was found to be in the clinical trials 89% effective. The way I talk to my patients about it... and I do this, I see patients every week in the South Bronx. I tell my patients that have COVID, for every 18 patients that I care about, that I treat with Paxlovid, I'll prevent one of the patients that I care about from getting so sick, which I don't want to see, that they have to go to the hospital.
Question: Okay. [Inaudible] for New York?
Mayor Adams: You're like Michael.
Mayor Adams: Everywhere, everywhere, everywhere. So, I think it's very important to respond to the Department of Justice investigation on the Sex Crime Unit in the New York City Police Department. There's no higher level of priority for us to ensure that victims of sexual assault receive the right treatment, investigation and resolution, and we're looking forward to partnering with the Department of Investigation, to fully cooperate with it. We were not sitting on our hands. The police commissioner immediately started taking actions towards what we perceived as how to make sure that unit is a professional unit.
Mayor Adams: And so we think that the Department of Investigation is going to conduct their review, and we are going to be supporting whatever information they need from our agency, but we're also going to continue to move forward. The police commissioner has already taken steps, and we're going continue to do that now. And that is our concern, but since it's an active review, we don't want to in any way give the appearance we're trying to persuade the review, and so let's let the Department of Justice do their job.