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Brian Lehrer: Brian Lehrer on WNYC. Did your neighborhood get sprayed with pesticides last night? Now, I'll discuss how New York is grappling with West Nile virus, a COVID spike, and the possible return of Mpox, all at the same time. The spraying to kill mosquitoes that might carry West Nile was in upper Manhattan. Tonight, it will be in parts of Brooklyn.

Did you hear, by the way, that Anthony Fauci was recently hospitalized with West Nile virus? We'll update you on the newest generation of viruses in our area. Also, the newest generation of the COVID vaccine, and who's being advised to get it, and when? We may also touch on questions about HIV and polio in the news, well, with Eliza Fawcett, New York City Reporter for Healthbeat.org, comma, a new public health news site. Eliza, thanks for coming on. Welcome to WNYC.

Eliza Fawcett: Thanks so much for having me.

Brian Lehrer: Would you like to introduce people to Healthbeat first? What is this new news organization?

Eliza Fawcett: Absolutely. We are a new public health-focused, nonprofit newsroom. We're from Civic News Company, which your listeners might know from Chalkbeat and Votebeat, and we're partnered with KFF Health News. We're starting out in New York and Atlanta, and really excited to dig into hyperlocal public health issues.

Brian Lehrer: Great. Can we start with hyperlocal West Nile virus? Why is that in the news again in New York?

Eliza Fawcett: Absolutely. Well, West Nile virus is a mosquito-borne disease that's found across the United States. New York City reported its first human cases of West Nile virus last week, so humans can get West Nile when mosquitoes feed on infected birds, and then bite people. In the vast majority of cases, it leads to asymptomatic or mild disease, but in rare cases, it can be severe, or even fatal.

Obviously, with Dr. Fauci, he was hospitalized, so he had a more severe form of the disease. There's no vaccine for West Nile, and there's no specific treatment for it either, so the best way to protect against it is, is to avoid getting bitten by mosquitoes.

Brian Lehrer: Yes, I read that Fauci said he had fever and chills, and extreme fatigue. Where was this spraying overnight? I mentioned Upper Manhattan. I'm not sure that, that's inclusive of every place that was sprayed. You tell me, where was the spraying overnight, and what's the substance that they use, if you know?

Eliza Fawcett: Well, the spraying happens throughout the summer. We're right now in the peak of mosquito activity in New York City. It's August and September. Neighborhoods across New York will be sprayed, and have been sprayed. I believe, last night it was in Manhattan, Upper Manhattan, primarily. Tomorrow night, it will be in parts of Brooklyn, including Bensonhurst and Coney Island.

It's, basically, these trucks go through these neighborhoods, and spray pesticides to kill adult mosquitoes, and folks are advised to keep their windows closed when that happens, so do keep an eye out for these alerts when they come out.

Brian Lehrer: Right. Somebody told me that they heard a loudspeaker on a truck that was coming around with the spray at about 20 after five this morning. Is that what people should expect wherever they're doing it?

Eliza Fawcett: I believe so. It's good to know that there are also other things that you can do just around your house to reduce the risk of mosquitoes carrying west Nile virus. For instance, the big one is eliminating standing water, which is often a key breeding ground for mosquitoes. If you have a backyard and a bucket left out, you want to make sure that that doesn't have any water sitting around in it.

Brian Lehrer: Listeners, your questions or comments or stories, welcome on West Nile, Mpox, and COVID, 212-433-WNYC. How the spraying seemed to go on your block? If you got sprayed on your block, or if your block got sprayed, hopefully, you didn't get sprayed. Questions about the new COVID vaccines, Mpox, anything related, 212-433-WNYC, 212-433-9692, call or text for Eliza Fawcett, New York City Reporter for Healthbeat.org, the new public health news site. What is the recent history of the battle against West Nile suggest the effectiveness of spraying is? Do you have anything on that?

Eliza Fawcett: That's a good question. I'm not entirely sure. I mean, I think the mosquito control that the health department does is pretty standard practice. I know that they also, in marshy areas that aren't really inhabited in New York, will spray those from helicopters. Every year, there's a pretty significant fight against West Nile virus. I think the thing that a lot of public health people are thinking about now is just that, with climate change, we might start to see West Nile virus, and other mosquito-borne diseases become more common, as our climate becomes warmer, and potentially, the conditions for mosquito breeding become more favorable.

It is a concern. While, again, in the vast majority of cases, even if you are infected, you probably won't get severe disease, it could be serious, and is particularly a risk for people who are older, or have weakened immune systems. If you're outside this summer, you want to make sure to wear bug spray, wear long-sleeved shirts, use screens in your windows and doors. Again, try to eliminate standing water.

Brian Lehrer: Let's take a phone call. Pat in Brooklyn Heights, you're on WNYC. Hi, Pat.

Pat: Hi. Thanks so much for taking my call. I have a situation where my backyard becomes uninhabitable, because there's a neighboring property that has some standing water, and I have nothing-- There's nothing I can do about that, but, of course, it's such an attractant to mosquitoes, and I don't know what I can do about that. I feel like I'm helplessly subject to--[crosstalk]

Brian Lehrer: Have you spoken to your neighbor?

Pat: No, it's a difficult situation.

Brian Lehrer: Pat, thank you very much. Sounds frustrating. I don't know if you have any advice [chuckles] as a health reporter for Pat. We may need a neighbor relations counselor instead, but what were you thinking, as you listen to that call? Anything?

Eliza Fawcett: Yes. Well, actually, one thing you can do, especially, if you feel like you can't talk to your neighbor, is call 311, and report standing water. Property owners in New York City are actually required to eliminate it, and so, that might be a good thing for you to do, if that's a concern for you.

Brian Lehrer: I think you cover New York City, specifically, but I'm curious if you know, if they're spraying elsewhere in the Metro region. I did read that there was at least one case, I believe, maybe a couple of cases in Westchester county, but I haven't been able to find anything on spraying happening in Westchester or Rockland or Long island, do you happen to know, or Jersey, for that matter?

Eliza Fawcett: Yes, that's interesting. I mean, my focus has really been on New York City, but the State Health Department certainly has similar recommendations for individuals to use bug spray, and get rid of standing water, use window screens. I think you can also use larvicide yourself on your property. I'm not sure about broader efforts to spray areas. I think it particularly works in New York City with an urban setting, where they can bring these trucks through, and quickly spread this pesticide around.

Brian Lehrer: Let's take a call on the pesticide from Diesel in Ridgewood, Queens. You're on WNYC. Hello, Diesel.

Cecil: Hi, it's Cecil. Yes, I was just wondering, it sounds like the consequences of West Nile virus are relatively low for humans. How do you balance that against the consequences of the biodiversity loss with mass pesticide spraying?

Brian Lehrer: Thank you very much. Are they having that conversation at City Hall? Do you know? Have they balanced-- Have they done a risk-benefit analysis, and talked about it?

Eliza Fawcett: That's a good question. I know that the City Health Department says that no reported diseases in people, or pets have been linked with the use of pesticides in their West Nile control efforts since 1999. I don't know that that, as far as we know, is a significant concern. Of course, it is something to balance. Again, you do want to close your windows when these trucks come by, so, obviously, you don't really want that in your home.

I mean, with any of these infectious diseases, it is important to take these proactive measures to make sure that they don't spread significantly. I mean, the first outbreak in the United States was in New York in 1999, with a number of very, very severe cases, particularly in older residents. It is important to make sure that mosquitoes aren't breeding as much as they can, and biting as many people as possible, because left unchecked, it could become a much more serious outbreak, which we, fortunately, haven't seen in a long time.

Brian Lehrer: George in Washington Heights heard the spraying truck go by in the middle of the night. George, you're on WNYC. Hello.

George: Yes, hi. About 1:30 AM today, they were spraying and they had the loudspeaker you spoke about. I have all my windows closed because the AC has been on. Also, I have a property upstate New York, but what I'm about to say applies anyway. You buy mosquito dunks, D-U-N-K-S. They're little tablets, and you put them in standing water, and it prevents the larvae from maturing into mosquitoes.

Brian Lehrer: Oh, interesting tip. Maybe Pat in Brooklyn Heights can surreptitiously sneak some of those into her neighbor's standing water pond. I don't know if that's ethical, but [laughs] it occurred to me. CJ in Midtown West has a good question about post spraying. CJ, you're on WNYC. Hello.

CJ: Hi. How are you? I walk my little dog, my new rescue, around the baseball field and the ramble. However, at the baseball field, there are giant flags to indicate that they're spraying along with written documentation, so I am a little concerned about my little baby, who's a rescue, who I love dearly, who's walking around, and we're flopping around the grass, and in the sand. I'd like to know when, if she has any remote clue when this stuff might dissipate, because I like to keep him away after they spray.

Brian Lehrer: Good question. Everybody has to walk their dogs, whether or not the advice is to stay indoors for a period of time during and after the spraying, even if the humans have the option of that in their own lives. Do you know, does the city say? Because they do say, as you mentioned before, "Close your windows when the spring is taking place." What about for how long after?

Eliza Fawcett: Yes, I haven't seen a specific timeline there. I mean, I think it's probably a good idea if you know that there has been spraying to maybe avoid those areas for, at least, a couple days, I would think. I mean, again, the Health Department says that it's not a serious health risk to be around in those areas, so I think it's your judgment, and particularly, with your dog, you might want to change your walking route.

Brian Lehrer: All right. We have now spoken about one of the three viruses that this segment is about, West Nile. We're going to go on to the COVID spike, and the new COVID vaccine, and also Mpox when we come back from a break, and continue with Eliza Fawcett, New York City Reporter for Healthbeat.org, a new public health news site.

We're going to start leaning on the phones, too, on the topics of COVID, COVID vaccines, and Mpox. Call with those questions or comments, 212-433-WNYC, 212-433-9692, and don't be insulted if we're clearing the board of some additional West Nile calls that we didn't get to. Brian Lehrer on WNYC. Stay with us.

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Brian Lehrer on WNYC, as we continue to talk about three viruses in the news in New York City, and vicinity. West Nile, COVID, and Mpox, with Eliza Fawcett, New York City Reporter for Healthbeat.org, a new public health news site. Let's go on to COVID. One of your articles, Eliza, I see, seems to juxtapose the rise in local cases of COVID, as with the waning of public health efforts. What are you seeing on each side of that?

Eliza Fawcett: Yes, I mean, we're at a strange moment in the pandemic, in that, we saw pretty big summer surge in infections in New York City in recent months. Now, we have these new vaccines coming out that the FDA just approved, but they're missing the surge that we just saw, where many New Yorkers were infected. It's also an interesting moment, because, as your listeners will remember, earlier in the pandemic, the federal government was buying huge numbers of vaccines, and distributing them for free.

It was easy to get free COVID tests. Everything was being tracked pretty carefully. Now, we don't have great vaccination data that's publicly accessible. The federal government is no longer buying and distributing vaccines. They've hit the commercial market last year, and even tests are harder to come by for free, and most people are just having to go to CVS, and buy them themselves, so it's a strange moment.

I think the bottom line is that, it's really important still to get vaccinated. These vaccines should be accessible at pharmacies, and at your local health provider in the next couple weeks. COVID remains a real concern. I wouldn't at all downplay the importance of going and getting vaccinated.

Brian Lehrer: Before we get too far from the West Nile section of this segment, we did look up what the official recommendations are for how long to do what around spraying in your neighborhood. This is from the New York State Health Department. It says, "If possible, remain inside, or avoid the area whenever spraying takes place, and for about 30 minutes after spraying." They're just saying 30 minutes after spraying.

It says, "That time period will greatly reduce the likelihood of your breathing pesticides in the air." It goes on to say this, which might be important for me to say, because it might be counterintuitive from what some of you think. It says, "Close windows and doors, and turn off window air conditioning units." I imagine some people might be keeping their air conditioning units on, thinking that helps insulate from the outdoor air, but this says, "Turn off window air conditioning units, or close their vents to circulate indoor air before spraying begins."

I guess depending on your unit, you might have that option to close the vents to circulate indoor air, instead of taking in outside air before the spraying begins. Then, it continues, "Windows and air conditioner vents can be reopened again about 30 minutes after spraying." That, from the New York State Health Department, good information for those of you to whom the spraying has yet to come.

Again, with Eliza Fawcett, New York City Reporter for Healthbeat.org, a new public health news site. Just to put a pin in that Health Department advice. When they say just 30 minutes before your risk of breathing pesticides in the air is greatly reduced, I guess that assumes that the risk is primarily from airborne particles, right? The risk would be from breathing in pesticide right after they sprayed, as opposed to anything that may be left on the ground that you could, or in water that you could come into contact with in other ways. Right, Eliza? That seems to be their emphasis?

Eliza Fawcett: Yes, I think that's true.

Brian Lehrer: All right, back to COVID. How bad is it this summer? We keep hearing about a spike. I've read that, nationally, it's the worst summer so far of COVID. What do you know?

Eliza Fawcett: We have had a surge this summer, particularly, in New York City. Based on the most recent data, it looks like the total cases have started to decline a bit. I mean, yes, we've seen a lot of infections. Certainly, if you've been following the DNC, there were a lot of infections that came out of that, so COVID continues to be highly transmissible. In addition to vaccination, mask-wearing is still important, if you want to reduce your risk of getting COVID, and spreading COVID.

Brian Lehrer: Let's take a phone call from Arnold in Brooklyn. Arnold, you're on WNYC. Hello.

Arnold: Good morning. When should a senior citizen or anyone, I guess, get a COVID booster this season, right?

Brian Lehrer: Right. The new vaccine is out. I saw online that pharmacies are beginning to schedule dates for it. I think you could probably get one in the next 24 hours at a lot of pharmacies, if you wanted to, but you tell me about the availability, Eliza, based on your reporting, and then, we'll go into the question of timing that Arnold's asking about.

Eliza Fawcett: Yes, so the updated vaccines from Pfizer and Moderna were just approved last week, so it may take a little time for them to be fully stocked in pharmacies, but I would certainly check in with your healthcare provider, or try to book an appointment with a local pharmacy soon. New York City has an online vaccine finder appointment database, that's really helpful. I haven't seen those appointments start to be filled in there, but I would keep an eye on that.

Yes, certainly if you're older, or have otherwise higher risk of severe illness for COVID, I would get a vaccine as soon as you can. One thing to keep in mind also is that, we will likely see another COVID wave this winter, as we've seen in previous years, so even if cases are maybe starting to decline a bit from the summer surge we've seen in the city, it's important to look ahead as well. The only caveat maybe is that, if you did get COVID this summer, you will want to wait maybe a couple months before getting the vaccine.

Brian Lehrer: Yes, I was on the CVS site, frankly, looking to schedule my own COVID vaccine for about a month from now, which is the timing that I want, and I'll explain why, and how that might relate to other people, or why you might choose a different time. It looked like I could go into CVS today. A CVS near where I live, and get that vaccine. They're not yet making appointments for very early October, which is when I want to get mine, or, yes, very early October.

They seem to be there now, at least in the CVS chain, and a number of individual ones near where I live. On the timing, I think what they've been advising, Eliza, throughout the pandemic is to get your-- Oh, to the point, I was going to back up the point you were making about, if you got one very recently, so they won't let you get a COVID vaccine, if you had one within the last two months, and two months might be-- Even that would be maybe too soon, you wouldn't probably need a COVID vaccine.

From everything I've read over the years, we've just had one two months ago. I guess, if people got another booster in the spring after getting one last fall, or earlier in the summer by a number of months, that would influence when your own personal judgment about yourself would be, in terms of timing for you. For me, there are some exposures to groups that I know I'm going to have in the weeks after the time I want to get the shot, and less so before then.

I think this is what they've been saying for years. If your exposure to groups of people is going to be consistent, then just go and get it any time. If you think you're going to have your most exposure around the holidays, Thanksgiving, the December holidays, New Year's, then wait until closer to then, and base it on that kind of thing, so they're still giving that advice, right?

Eliza Fawcett: Yes, absolutely. I mean, and another thing to keep in mind here is that, the reason why it's important to keep getting COVID vaccines, even if you've gotten them a couple times before, is because COVID keeps changing. The updated vaccines that will soon be hitting pharmacies are targeted to the KP.2 strain of COVID, which is one of these so-called FLiRT variants that have been circulating since the spring, and have been driving infections this summer. They are the ones that are most targeted for the transmission that we are currently seeing.

Brian Lehrer: You reported on a new vaccine access issue as some programs from the Pandemic Emergency Legislation era end in Washington. What's the issue there?

Eliza Fawcett: Last year, the COVID vaccines hit the commercial market. The federal government was no longer buying them in bulk, and distributing them for free. For most people who are on private insurance plans, who have Medicare, they will continue to be able to get COVID vaccinations for free. The issue is really for folks who are uninsured, or underinsured.

Last year, the CDC had a Bridge Access Program which provided 1.5 million free vaccines to uninsured, and underinsured Americans. That program was supposed to run through December, but is now ending early this month, so it's a little tricky if you are uninsured. The CDC has said there might be some additional funding available to help fill some gaps there.

The New York State Health Department told me that they have some funding for about 12,500 COVID vaccines for uninsured and underinsured New Yorkers, which is obviously not that many. One silver lining here, I guess, is that New York City Health and Hospitals, the Municipal Health System, told me they'd continue to offer the vaccine at no cost to patients, so if you're part of that system, that's really good.

It seems likely that it's the smaller clinics and health centers that work with uninsured, or underinsured folks who are in a tougher spot right now, given just the fact that COVID is not getting the kind of federal funding that we saw a couple years ago.

Brian Lehrer: What's the best route for somebody who's uninsured to try to get COVID shot access if they think they can't afford to pay for it easily?

Eliza Fawcett: I mean, yes, it's complicated. I think I would reach out to local health clinics, federally-qualified health centers, and try to see if you can book an appointment. Again, if you are a New York City resident, the Health and Hospital system is a good place to look. Yes, unfortunately, these vaccines are expensive now. CVS told us that the out-of-pocket cost would be about $200 per vaccine. Might be different in different places, but they're not cheap, and they're not widely available for free anymore.

Brian Lehrer: Here's a good question. In a text message from Scott in Azusa, California, who writes, "You say this has been the worst COVID summer ever. Please clarify. Has this been the worst COVID summer, in terms of death and hospitalization from COVID?" Certainly in terms of death, the answer is, "No", right? It may be just in terms of cases.

Eliza Fawcett: Yes, we've seen a lot of transmission, but thankfully, the number of hospitalizations, the number of deaths is nowhere near what it was earlier in the pandemic. That's really important, because we haven't seen the burden on hospitals and healthcare systems that we saw in 2020 and 2021.

Brian Lehrer: Largely, it's presumed, because of the immunity people have developed over time from being infected, or from the vaccines, right?

Eliza Fawcett: Yes, absolutely. I mean, again COVID is still a threat. It can put you in bed for a week, make you unable to go to work, and conduct your daily life. Importantly, the risk of long COVID is still real. Long COVID can be debilitating, and even disabling for folks. Data show that vaccination is your best bet of reducing your risk of getting long COVID. Even though we haven't seen the kind of hospitalizations and deaths as we saw previously, you really just want to reduce your risk of getting COVID, overall.

Brian Lehrer: Mpox. The World Health Organization has declared a global health emergency, but there have been no cases recently in New York. Is that correct?

Eliza Fawcett: It's partly correct. There are two types of Mpox, clade I and clade II. In 2022, if you remember, New York City had a significant outbreak of Mpox, which was due to clade II cases, and that has receded, although there have still been some cases circulating in the city. The concern right now that the World Health Organization has spotlit is that, this other type of Mpox, clade I, has had a pretty big outbreak in the Democratic Republic of Congo, that has now spread to more than a dozen other African countries.

Clade I Mpox is considered to cause more severe infection, and has a higher mortality rate. We haven't seen clade I Mpox cases in the US, or in New York, but the way these infectious diseases work is, you only need one person to get on a plane, and start a local outbreak, and then, it's a real concern.

Brian Lehrer: Would you remind people of what Mpox is, and the effects on people who contract that?

Eliza Fawcett: Sure. Mpox, we previously called it monkeypox. Now, Mpox, it's related to smallpox. It's not as severe as smallpox, causes symptoms like fever and chills, and can also lead to painful blisters. It's mostly spread through direct contact, especially, sexual contact. There's a vaccine for Mpox, and part of the reason New York City was able to really fight that outbreak in 2022, is because of really high vaccination rates.

More than 100,000 New Yorkers have been vaccinated against Mpox by 2023, so the Health Department is saying that, "Now, it's still really important to get vaccinated, if you haven't, and if you are at risk for Mpox," and those at risk for Mpox include those who have sex with men, and identify as male, or transgender, non-binary, genderqueer, or folks who otherwise consider themselves at risk.

Brian Lehrer: Why a global health emergency declaration from the WHO on this right now?

Eliza Fawcett: My understanding is, it becomes a global health emergency when it really starts to spread to other countries, and isn't just a local outbreak. Again, this is how it works with infectious diseases. They can start to spread pretty quickly. I think part of the World Health Organization declaring Mpox a global health emergency, is to draw attention to it, try to get prevention measures in place, so that we don't see it spreading significantly across the world.

Brian Lehrer: What would bring it to New York, or help prevent that as compared to trying to prevent spread locally through behavior?

Eliza Fawcett: I mean, again, it could be one or a couple people getting on a plane, and coming through New York City, which obviously, is a place in the US that has a lot of travel, a lot of people arriving, and departing from different places. This is often how these kinds of infections start, just one person, one community where it's circulating, and then spreading further and further.

Again, while it's not an emergency in New York City right now, and folks shouldn't be panicked, the Health Department is emphasizing that vaccination is important, and it's just something that we'll need to keep an eye on.

Brian Lehrer: By the way, contrary to what the CVS website seemed to show me as options, a listener writes, "CVS and the other drug stores did not have the new COVID vaccine. I got a shot at NYU Hospital. CVS said it was the only place to go, so it could be that CVS is listening times without actually having times available, without actually having vaccines in the pharmacies yet."

I guess we can't confirm that. I can only confirm what I saw online and passed along what that listener wrote the reality might be. Obviously, you'll have to check with your own local pharmacy, or other provider. As we run out of time, Eliza, I just want to acknowledge that a number of people are calling, or writing in to say, "Okay, we've talked about these particular three viruses, West Nile, COVID and Mpox, but there's also news on HIV that should be discussed."

"There's also news on polio," somebody says should be discussed. Another person says, "What about RSV?" Another one says, "Please comment on avian flu, as there have been a number of serious cases in other countries, and might it not spread here?" Is there anything else you're reporting on that goes in this bucket that you would want to say anything about before we go?

Eliza Fawcett: Sure. I mean, I think vaccinations, for example, RSV remain important. I have done some reporting on HIV, which has been interesting in that, overall, New York has seen years of steady declines, but new HIV diagnoses have ticked upward in recent years. There was a dip during COVID, likely, because folks weren't going in to see their doctors as much, and then an uptick, particularly, among Latino New Yorkers.

That is something that public health experts are looking at, are concerned about. It's not a huge surge in diagnoses. There is an element of playing catch-up here from the pandemic, but that is something that I'm looking into.

Brian Lehrer: Eliza Fawcett, New York City Reporter for Healthbeat.org, a new public health news site. Thank you so much for joining us today, and explaining so much.

Eliza Fawcett: Thanks so much for having me.

 

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