Second wave: Are NY's testing and tracing programs ready for the school year?

Sarah Taddeo
New York State Team
  • New York went from testing several hundred people a day for COVID-19, to over 50,000 a day.
  • Contact tracing helped with controlling outbreaks, such as those in New Rochelle, Chappaqua and Oswego.
  • But there are still concerns about testing capacity and accuracy, especially going into the fall school term.

Editor's Note: COVID-19 killed tens of thousands in the Northeast, caused massive unemployment and wrecked the economy. In an ongoing series of stories, the USA TODAY Network Atlantic Group examines what the government got wrong in its response to the virus, what policies eventually worked — and why we remain vulnerable if the coronavirus strikes harder in the fall.

Westchester County’s brush with COVID-19 started with a mushrooming cluster of cases in early March that outpaced nearly every early effort to control it. 

Just before the disease took hold of multiple U.S. states in mid-March, COVID-19 spread rapidly through New Rochelle, a suburb north of New York City, following several events at a local synagogue that were attended by hundreds of people.

At that point, the county public health department was still trying to understand the disease and get its hands on test kits — let alone manage its own major cluster of cases. 

“We really didn’t know anything about the virus,” Westchester Public Health Commissioner Sherlita Amler said of the early days of the county's COVID-19 response. The county was one of the first hot spots in the nation.

“We didn’t know what kind of tests to do, and we weren’t totally sure what symptoms to even look for," she said.

Five months and more than 415,000 tests later, the county now has the equipment, resources and expertise to shut down potential outbreaks before they happen. It's one way, officials say, the state is more prepared for a potential second wave of the virus to strike, and perhaps equipped to discourage it from happening.

The COVID-19 pandemic and its early hit on New York necessitated the hasty creation of a widespread testing and tracing initiative, meant to keep the virus at bay as reopening started this spring.

In June, for example, a graduation ceremony in Chappaqua became cause for alarm when attendees were exposed to COVID-19.

Out of hundreds at the ceremony, only 27 people tested positive. The county health department quickly identified the outbreak thanks to an attendee who contacted the department. A student who attended the gathering started showing COVID-19 symptoms soon after. 

South Greeley Ave. in downtown Chappaqua was quiet July 1, 2020. Many shops were closed after a Horace Greeley High School graduation celebration led to a new cluster of COVID-19 cases.

"Therefore we knew we had an outbreak and it didn't languish another two or three days," County Executive George Latimer said last month. "If there's a word, I'm appreciative. I'm appreciative that the system worked in this particular way.”

Initially the state could only administer several hundred COVID-19 tests a day, and only those who met specific criteria were permitted to receive one.

All of them had to be sent to the Centers for Disease Control and Prevention in Atlanta.

It took several days to a week before test results would emerge, and by then, a contagious person could have spread the infection to dozens of family members, friends or people in the emergency department waiting room. 

Now, more than 50,000 people are being tested daily at drive-thru sites, health centers or pharmacies across the state, and results are typically back within a few days — though the pace of results has been strained amid the crush of tests being administered in states with high COVID-19 infection rates. Gov. Andrew Cuomo on Wednesday announced a state-record 87,776 were reported to the state on Tuesday alone.

Some emergency drive-thru sites have been able to close, due to the ease of obtaining tests elsewhere. More than one fifth of the state’s population has been tested, and anyone who would like a test can get one, free of charge, at a state-run site. 

Cars line up at the entrance to a drive through COVID-19 testing site manned by state police at Glen Island Parkin New Rochelle March 25, 2020.

A partnership with Bloomberg Philanthropies and Johns Hopkins University was able to jumpstart the state’s contact tracing program in April, paving the way for a statewide training course for tracers.

County health departments partnered with the state to interview those who've tested positive, and then contact their friends, family and coworkers to alert them to possible COVID-19 exposure and the state’s quarantine and isolation orders. 

The state rolled out a unified surveillance system that provides uniform metrics for tracking those who tested positive and their contacts, and maintaining vital records, a state spokesperson said. 

With the equipment, workforce and protocol in place, the state has the weaponry to quell a regional ‘hot spot’ outbreak and fight a potential second wave of COVID-19 cases in the fall.

Still, health officials warn if the amount of testing required as reopening continues overwhelms lab capacity, the state would be back in a situation in which it cannot diagnose and respond to positives quickly.

More:Contact tracing in New York: How to become one, how it works and why it's important

What didn’t work

Sherlita Amler, M.D., the Commissioner of Health for Westchester County, delivers remarks concerning the first case of the Coronavirus Covid-19 in Westchester, during a press conference at the Westchester County Office Building in White Plains, March 3, 2020.

As COVID-19 swept the nation in early 2020, even the basic pieces of the testing and tracing initiatives we see today were difficult to set up.

Test kits were hard to come by. Only those who had symptoms or who'd traveled abroad recently were able to get tested at first, and when they did, results took weeks to arrive. Health professionals working directly with COVID-19 patients couldn't get tested easily. 

"It seems simple now, but it wasn’t then," Amler said of constructing an organized public health response to COVID-19. 

Before the New Rochelle cluster appeared, Westchester had been monitoring travelers who’d recently returned from China, so the health department had some experience with personal protective equipment, testing and quarantine/isolation. 

But once the caseload in the county ramped up, so did the backlog of people wanting to be tested. Initially, they were turned away if they didn't meet certain criteria, said Amler.

The results are not always accurate, even today, with tens of thousands of tests being administered daily, said Michael Mendoza, Medical Director in Monroe County, in the Finger Lakes region.  

Monroe County Commissioner of Public Health and Human Services, Dr. Michael Mendoza.

Nearly 38% percent of people who take a test on the first day of their COVID-19 infection get a negative test result, which is called a “false negative,” according to a recently released Johns Hopkins study. That means that person could be contagious or became symptomatic in the days following a negative test. 

“Do not be falsely reassured when you have a negative test result," Mendoza said. 

Back in Westchester, the health department initially had trouble contacting those who tested positive, because they didn’t collect addresses or contact information for everyone.  

“We were getting literally hundreds to a thousand positives a day,” Amler said. “It was very difficult to reach people.” 

The department also didn’t have the contact tracing workforce to make those calls, or monitor those people in quarantine or isolation in the county. Once the Bloomberg partnership emerged, the state helped Westchester hire six contact tracers to help handle the caseload. 

More:Local parents and superintendents react as schools get OK to reopen this fall

More:Reopening schools and colleges in New York: Why unions are voicing serious concerns

What's working

Contact tracing was a vital piece of the state’s coronavirus counterattack.

When the state rolled out its benchmarks for regions to show, statistically, they were ready to reopen businesses, it required regions to have hundreds of trained tracers ready to nip the momentum of possible clusters. Thus, it had to rapidly increase in scale and function.

Contact tracers are deployed in a community depending on that community’s rolling, 7-day average infection rate, the state said. If a spike occurs in a specific area, additional trained tracers will assist with the workload. 

More than 50,000 people applied to be a part of the state’s contact tracing program as of mid-June, according to state officials. About 6,000 had been activated at the time and were working on the effort somewhere in New York, and another 4,000 people had completed the course.

In Dutchess County, for example, there were about 20 contact tracers trained as of early March. Primarily they were Department of Behavioral & Community Health staff, with some volunteers from the local Medical Reserve Corps. chapter. 

By July, the number of tracers in Dutchess topped 370. The Dutchess Medical Reserve Corps. likewise gained more than 500 volunteer members between March and July, doubling its membership.

Catherine Tegtmeier, assistant commissioner for community health for Dutchess, said volunteer contact tracers are mostly on standby due to the drop in local COVID-19 cases. But, she said the size of this team is crucial for examining a potential second wave.

“With a more robust infrastructure, we have the ability to mobilize if we see that second wave of the coronavirus,” she said.

Given the new hires, new protocol and the evolving nature of the virus, it took until June for Westchester's Amler to feel the county’s tracing program was truly running smoothly. It was that well-oiled machine that allowed the county to tamp down the Chappaqua graduation outbreak before it got out of hand. 

More:COVID what’s next: Colleges prepare, students wait for what happens this fall

The Champlain Valley Specialty food packaging facility in Oswego County was the site of a COVID-19 outbreak in July. Eighty-two people tested positive.

What's next? 

With several successfully mitigated potential outbreaks under their belts, county health departments are looking ahead to the school year, and the new challenges it could bring. 

One of the biggest hurdles to overcome when students return to college and K-12 schools will be lab testing capacity, said Jiancheng Huang, Public Health Director in Oswego County, a rural area north of Syracuse that's home to just over 117,000 people. The State University of New York at Oswego brings about 8,000 students to campus each year.  

Huang's team managed an outbreak at a local food processing plant in July that ultimately sickened 82 people but didn't spread beyond the workers and their families. 

“The concern is that testing capacity will be jammed, even before you talk about a ‘second wave,’” said Huang, who expects the need for testing will increase rapidly as  students interact in crowded school environments. 

He noted the Oswego County health department’s experience with facilitating testing for employees at skilled nursing facilities earlier this year. Initially, test results were coming back in three to five days — then it slowed down to a week or 10 days for some labs, he said. 

Hatzolah paramedic David Rosenberg tests congregant Sandra Weinstein to confirm she is negative for COVID-19 outside Young Israel of New Rochelle March 31, 2020. Young Israel members, who are now symptom free after testing positive for the coronavirus, began donating blood at the synagogue to see if they have enough antibodies to fight off COVID-19.

There are also questions around contact tracing and FERPA, and how much health department officials can learn and disclose about specific students who become infected with COVID-19, said Huang. 

The success of New York's COVID-19 response hinges on a number of basic elements, said Westchester's Amler. 

Residents must continue following public health regulations like masking, social distancing and hand washing.

People should know the difference between the various COVID-19 tests — a rapid test yields almost instant results but is less accurate than a molecular test, which involves the familiar nose swab and looks for genetic markers of the virus. An antibody test uses a blood sample to test whether a person has antibodies related to a past COVID-19 infection, but isn't reliable to diagnose a current COVID-19 infection. 

A negative test can lull a person into "a false sense of security," said Monroe County's Mendoza, but residents should resist that urge. 

"The moment we start letting our guard down, that’s when we put ourselves at risk to sliding back," said Monroe County's Mendoza. 

If a person suspects they may have COVID-19, they should contact their local health department immediately to discuss their symptoms, how to get tested and when and where they've interacted with other people. 

More:Now hiring: New York looking for thousands of contact tracers to slow COVID-19 spread

More:Is day care in NY safe during the coronavirus pandemic? Here are some guidelines

Sarah Taddeo is the consumer watchdog reporter for USA Today Network's New York State Team. She investigates stories about your consumer rights, including scams, negligent landlords, safety issues and wayward businesses.

Got a story tip or comment? Contact Sarah at or (585) 258-2774. Follow her on Twitter @Sjtaddeo. This coverage is only possible with support from our readers. Sign up today for a digital subscription.