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To fully recover from COVID-19, we must focus on preventative care
BY DR. RAMON TALLAJ
For the last two years, the COVID-19
pandemic has eff ectively pulled the curtain
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back on longstanding health inequities
across the United States. Now that we
are entering a tentative recovery phase, it
is critical that we learn from the past two
years — and, to ensure that we are ready
for any future variants and that we as a
city seize the opportunity to rebuild stronger,
that we focus on applying a preventive
care strategy.
From the beginning of the pandemic,
New York City saw immense disparities in
not just who got infected, but which of our
friends and neighbors needed to be hospitalized,
and ultimately who died. Today,
out of the 39,192 people who have died
from COVID in New York City, 841.6 per
every 100,000 are Latino, 809.0 are Black,
449.89 are Asian and 493.3 are white.
Th ese trends refl ect the long-standing
disparities caused by language and cultural
barriers, racism and discrimination,
and already disproportionate poor health.
It’s not just that a delivery worker in
Jackson Heights, the school cafeteria
worker from the South Bronx or the nurse
from East Flatbush had to go to work
while so many had the privilege of staying
home. Th ey also likely did not have health
insurance and may lack a primary care
physician, access to preventative care, or
other resources or information that support
better health outcomes.
Th ese are the factors that have worked
against government and health care
responders. And this is where a long-term
preventive strategy that’s a smart use of
public resources comes into play.
For fi ve years before the pandemic, doctors
and policymakers united to focus on
boosting care quality while driving down
costs — a formula that has consistently
eluded national politicians, but that
we’ve been able to get right here in New
York. With the state’s support, doctors
took on a challenge: how to drive down
avoidable hospital visits, which cost taxpayers
billions and distracted emergency
room providers away from focusing on
actual emergencies. Th e eff ort has been
successful.
In focusing on fi ve chronic conditions
that plague poor communities including
obesity, hypertension, asthma, heart disease
and sicknesses related to smoking, we
have used a culturally competent, community
based outreach and care delivery
strategy focusing on meeting patients
where they are to get them in front of primary
care doctors before they get sick.
At SOMOS, the network I lead, that
works primarily in some of New York’s
poorest neighborhoods, we have been
able to raise outcomes while saving the
state over $340 million.
Th is has meant reintroducing family
doctors who speak patients’ languages to
neighborhoods that are otherwise health
deserts or only have large, corporate hospitals
where care is impersonal and intimidating
— especially for immigrants —
and, frequently, where staff doesn’t speak
the same language as the highest-need
patients.
To reach patients, we have used community
organizing strategies that are normally
associated with political campaigns
to switch emphasis off crisis management
and to get them in front of doctors early.
We focused on partnering with trusted
neighborhood fi gures such as pastors
and teachers, and we even joined up with
popular entertainers to penetrate hardto
reach communities using in-language
content. And in a revolutionary formula,
doctors are now being reimbursed by the
state for the total health of a patient, not
fee-for-service.
Th ese non-traditional strategies have
worked: by focusing on total health and
on prevention, we have driven unnecessary
hospital usage down by more than
25% in fi ve years.
Back to the recovery from COVID-19.
Let’s use this moment to dramatically
accelerate vaccination in all hesitant
communities to prevent serious illness in
case of another wave, and adopt a wraparound
care strategy to do so. We must
meet these New Yorkers where they are,
not where we want them to be. We must
partner with public housing, neighborhood
media outlets and even social media
infl uencers and well-respected local politicians,
principals, pediatricians and pastors
and use them to educate and encourage.
Authenticity and access are crucial.
And while any strategy must be led by
doctors, an eff ective preventive response
cannot be limited to the healthcare sector
only. Th at’s why I am encouraged that
Mayor Adams has fi lled his new COVID-
19 task force with diverse leaders from
labor, homeless services, faith, hospitality,
teachers, media, representatives of businesses
large and small, real estate and the
disability community. Our focus will be
on rebuilding a city with a stronger social
fabric, long-term.
We will live with COVID-19 in some
variation for the foreseeable future. But
we need to prevent it from ravaging our
city or bringing it to a standstill. A totalhealth,
preventive strategy and a focus
on long-term health equity can prevent
future episodes from quickly becoming
tragic or overly disruptive.
Dr. Ramon Tallaj is the co-chair of
Mayor Adams’ COVID-19 Recovery
Roundtable and Health Equity Task Force
and the chairman of SOMOS Community
Care.
PRAYERS FOR THE
UKRAINIAN PEOPLE
As Grand Knight of St. Anastasia
Knights of Columbus in Douglaston, I
off er my heartfelt prayers for the people
of the Ukraine both there and here
in New York.
Russian President Vladimir Putin
and the Russian military have declared
war on the innocent Ukrainian people.
Th ese people did no wrong and
only stood in the way of President
Putin’s evil ambitions.
In my opinion, President Putin’s
invasion is a most egregious act and
he must be stopped. As a veteran of
the U.S. Navy and a member of the
American Legion Post #103, and having
served in the Vietnam era, this
war greatly saddens me.
Please pray for the Ukrainian people,
who can be oppressed from this
horrendous and nefarious invasion by
these evildoers.
Frederick R. Bedell Jr., Bellerose
BETTER WAYS TO
SPEND $100M
Th ere are better ways for the MTA
to spend $100 million than the installation
of platform gates at three NYC
Transit subway stations. Worse would
be spending billions more to do the
same at even more stations. Th e MTA
estimates it would cost $7 billion to
install barriers at all 472 systemwide
stations, although only 28 could physically
accommodate them. Th is would
do little to attract all 5 million plus
pre-COVID-19 NYC Transit subway
riders. Better to spend these funds for
more transit police. Th ey could assist
the MTA in dealing with the far more
frequent daily occurrence of muggings,
robbery, fare evasion, vandalism,
urination, defecation, panhandling
and the homeless taking over
whole subway cars or sleeping on platform
benches. Th is adversely impacts
both commuters and NYC Transit
employees. Investing $100 million
would go a long way toward paying
to assign a transit police offi cer to ride
each train and patrol all 472 stations.
Installation of security cameras on
trains and more stations would serve
as a better deterrent against crime,
fare evasion and vandalism. Th ere is
also the need to increase fi nes and
penalties as a deterrent for those who
don’t pay their fare, commit assaults
or vandalism. Manhattan District
Attorney Alvin Bragg and other DAs
must follow up and prosecute those
who commit these acts. End revolving
door justice when the same criminals
are released without bail. Too many
return to our transit system within
days to commit the same off enses.
Larry Penner, Great Neck
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