[music]

Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning, everyone. Here at a minute before ten o'clock, it's already 87 degrees in New York City according to my friendly neighborhood weather app. Going up to 95 by this afternoon in Manhattan, even hotter inland. 97 is the projected high for Newark. According to The Weather Channel app, the real-feel heat index for New York City is expected to hit around 102 today. It's supposed to be like this even worse, in fact, through the weekend.

Luckily, we are not London, where their triple-digit hottest temperatures ever have led to multiple major fires around the city and stretches of tarmac at the airport literally melting, according to news reports, in addition to more than 1,000 people dying around Western Europe. It is still hot enough here to be dangerous, especially for seniors who do not have air conditioning. Subway platforms are also expected to become scorching places to be at many stations.

New York City has opened cooling centers in all five boroughs and extended hours at city pools. It's good to stay hydrated and take breaks from the sun in the shade if you're outside and you're able. Keep your pets cool and hydrated too. With us first today for a few minutes is Christina Farrell, first deputy commissioner of the New York City Office of Emergency Management. Commissioner Farrell, thanks for coming on to talk to everyone. Welcome to WNYC.

Commissioner Christina Farrell: Thank you. Good morning. Thank you for having me.

Brian Lehrer: For many people, okay, it's 90-plus degrees in July. That's just summer, but for others in certain age and health and income demographics, this could be dangerous or deadly. Who's at the highest risk today?

Commissioner Farrell: Definitely. As you mentioned, vulnerable New Yorkers, the very young, older New Yorkers, those with preexisting conditions, the heat can hit them differently. Heat is something that can sneak up on you. By the time that you start to feel effects, it may be kind of late. It's definitely better if people know that they're at risk or they know that family members or their neighbors are at additional risk that they're older. It would be great for people to check in on them. As you mentioned, the city has opened cooling centers. We have over 550 open today across the city. People can call 311 or go to nyc.gov/beattheheat and they can find a cooling center close to them in the hours and other details.

Brian Lehrer: I see the cooling centers aren't necessarily special spaces for this in many cases. They're common places in people's neighborhoods that they know. Many public libraries, for example, and senior centers that already exist at senior centers. We have tweeted out. Listeners, if you want to go to this, obviously, you can, we have tweeted out the city's cooling centers map and public pools map. Commissioner, for those listeners not online, including some of our seniors who maybe don't use the web that much, where's the first place to look in your neighborhood if you're looking for a cooling center?

Commissioner Farrell: For sure. Before anyone goes anywhere, even if they are used to going to their library or going to their senior center, if you don't have access to social media or to the web, I would call 311. If you give your address, they can double-check. Just because with 550 different locations, there can be changes in hours. Sometimes if the air conditioning is not functioning properly temporarily in a building or maybe they're doing a little construction or something, the last thing we want is for people to venture out in the heat and then go to someplace that they think is open.

For whatever reason, it might not be open. Like you said, we have terrific partners around the city. The three public library systems, they make all of their spaces available. Senior centers for people over 60. There are Salvation Army centers, park centers, public housing, so many different spots. It's also just important to note that, like you said, this is not like a hurricane shelter or something.

It's just most important that people stay cool. Malls are great spaces if someone has one of those or other shops, a place where people get coffee if they can be there for a little extra. The cooling centers are designated spaces that the city puts on this map, but really any space that is cool where people can escape the hottest part of the day is the best place to be.

Brian Lehrer: In fact, I saw a Petco pet store in Little Neck listed as a pet-friendly cooling center on the city's map. Are there many of those around the city designated as pet-friendly or other places that are stores, not just public sector buildings?

Commissioner Farrell: Yes. Right now, thank you for bringing that up. Last year, through a partnership with Petco, because that's a question we've gotten, we know that pets are part of people's family. People may make the decision not to leave their house or apartment even if it's really hot if they can't take their pet with them and we understand that. We were able to work with Petco. We really thank them.

They have 16 locations in the city that, like you said, they're designated on the map that are recognized as cooling centers where people can bring their pets. We've actually gotten feedback that a fair amount of people have been using them. We are talking to other similar stores that would also be willing to be put on the map. People should avail themselves and it's a great resource for pet owners.

Brian Lehrer: Seniors are also at the highest risk if they get COVID-19. Are there any kinds of COVID precautions that you're taking at the city-run cooling centers this year?

Commissioner Farrell: Yes, we are. We know that COVID is still active. We see with the variants, the numbers going up and down over time. Senior centers, they are only available for people that are seeking a cool space for those 60 and older. In the past before COVID when we activated the cooling centers, if younger New Yorkers that felt at risk wanted to enter a senior center, they could because of the COVID considerations that you have laid out.

Right now if you're under 60 and you want to hit a cooling center, I would focus on libraries or other locations. Also, we work with all our partners. In addition to multilingual signage, all the centers have masks. They have hand sanitizer, other things available. It's important to note that when people go to these centers, every location may have different policies. If there are mask mandates or other things at place in certain locations, people need to follow whatever those mandates are for each individual center.

Brian Lehrer: If you're a younger companion of a senior, you can go into the senior center, right?

Commissioner Farrell: Yes, most of the senior centers, the people that go there are well-known. They work with their population. I think they have those kind of things worked out. It is great when younger New Yorkers if they're helping the seniors to stay cool.

Brian Lehrer: I guess it's the opposite of the sign that I've seen in some New York City playgrounds that say, "No adult admitted unless accompanied by a child," huh. What about--

Commissioner Farrell: I will say we've also put a lot of cooling implements in the parks. There are sprinklers. There are misting stations. That's also a good option for people if they are outdoors. If they want to cool down, there's a New York City Cool It! map, which lists the different outdoor implements that are in place.

Brian Lehrer: What are you allowed to say officially and what would you say off the record if you were allowed about fire hydrants? I certainly see some of them opened in my Upper Manhattan neighborhood on days like this.

Commissioner Farrell: There is a program where people can go-- I believe it's anyone over 18. If they go to their local firehouse, there are spray caps that could be put on the fire hydrants so they can't be made into sprinklers. It does it properly and without losing water pressure, which is obviously the most important because it's great for people to stay cool. If people take it into their own hands and it affects the water pressure in a neighborhood, there could obviously be very bad impacts if there were a fire. If people go to their local firehouse or, again, call 311 or go on Beat the Heat, it'll tell people how they can get spray caps to safely use fire hydrants to stay cool.

Brian Lehrer: What about the city pools? The story earlier in the summer was curtailing some pool hours or some locations because of the lifeguard shortage. Now, I see pool hours are being extended into the evening. I think it's eight o'clock tonight, is that right? What's the latest?

Commissioner Farrell: It is. The parks department, city hall, other city agencies I know, they have been working to recruit and other incentives for lifeguards. We're really thankful to the parks department because today and tomorrow, which, right now, our forecast to be the hottest days, they were able to get proper staffing and extend pool hours till eight o'clock so people can go to their pools and enjoy the-- That's obvious. That's one of my favorite ways to stay cool. They can enjoy that for some extra time in the evenings, which is great.

Brian Lehrer: Is that weather forecast you just gave us, the latest information you have that today and tomorrow are expected to be the worst days? That would actually be relatively good news, I think, because I had earlier seen forecasts saying this was only going to get gradually worse through the weekend with Saturday and Sunday being the hottest days.

Commissioner Farrell: Right now, hot is hot, right? When you're over 95, you feel the effects. Right now, I believe that what I saw earlier from the weather service was a potential heat index, which is what it feels like outside, of 98 today and up to 100 or 101 tomorrow. I think Friday right now-- Again, the forecast as we know constantly evolves. I think Friday may be a little cooler, but still within a very hot forecast, and then the weekend is shaping up to still be over 95. I would say for the next several days, it's going to continue to be very steamy and uncomfortable.

Brian Lehrer: Now, the New York State DEC, Department of Environmental Conservation, at the state level has a webpage about the effects of global warming in the state, including average temperatures. Folks, listen to some of these stats. Average temperatures are already 2.5 degrees warmer in recent years than they were in 1970 according to the state. That's a big increase in a relatively short amount of time. Sea levels are a full foot higher than 1,900. It says sea level rise is already locked in by existing greenhouse gases to be another 18 to 75 inches by the end of this century on New York's shorelines.

It says heat waves can cause heat-related illnesses, heat stroke, and other serious health problems. Heat waves can also make it more likely that people who already have heart, lung, or other chronic conditions might get sick. Commissioner, this is a global warming question in relation to the heat. In your 20 or so years in emergency management in the city, have you been seeing more heat-related deaths or illnesses over these last few decades as global warming has increased?

Commissioner Farrell: That is probably best asked to the health department as they keep those numbers and things. We know obviously that the planet everywhere is getting hotter. Like you said, there's an island effect and an urban heat effect in the city. We have learned more over time about the effects. Sometimes when people end up having these effects and everything, it's not clear until after the fact that that was, in effect, the cause of death. The city is taking global warming very seriously as is the state and looking at different things.

One thing that was implemented while we were in the midst of COVID was looking at the heat vulnerability index, which was put in place, which was neighborhoods that may be hotter may have less resources to cooling centers and to other things in more vulnerable populations that may hit different New Yorkers of color or other populations disparately. That is in large part why we have increased the number of cooling centers focusing on neighborhoods that have a high heat vulnerability index, that may have limited transportation or other options to try to really do what we can to get people the resources we need and keep them safe.

Brian Lehrer: That was the last question I was going to ask you. I think you might have just answered it, but I'm going to ask it anyway just to make the point, which is about how you're set up to deal with heat inequality, which is a very real thing. For example, The New York Times had an article about this in May. One of the contrasts it gave was that in Crotona Park East in the Bronx, 41% of residents fall below the federal poverty line, 24% of households there lack air conditioning, and few have cars to reach beaches or forests.

By contrast, in Carnegie Hill on the Upper East Side, one of the city's wealthiest, whitest sections, it says 96% of households are air-conditioned. So many residents have money and flexibility to flee the city that during the hottest weeks last summer, some streets felt empty, that from The New York Times on May 28th. Just give us one more thought on the city's role in fighting heat wave inequities like that and if there's anything new from the Adams administration on that front for this year.

Commissioner Farrell: No, for sure. Like I said, that is something that has covered from the last mayoral administration to this one. The last couple of years, the number of cooling centers was greatly reduced due to places being closed and the strong COVID considerations. The fact that we're up over 550 cooling centers is really terrific. Again, we're focusing on neighborhoods like you mentioned in the Bronx that need access to additional resources.

We work with elected officials. We thank our partners in the media for highlighting this, talking to nonprofit organizations and our volunteer groups really to get the message out that even a couple of hours outside of the heat, especially if you are in a really hot building, can make the difference for people. We know that there's always more work to be done. As we noted, this is a long-duration event.

We haven't even touched on potential power outages and what we can do to stay safe there. This is something very important. As you may know, two years ago at the height of COVID, emergency management and others were able to install 74,000 air conditioners to vulnerable seniors around the city, and also it's the HEAP program. I don't remember what the acronym is. It's like heat energy assistance program or something.

Through HRA and other city agencies, they work to install air conditioners and to also give vulnerable New Yorkers some assistance on their heat bills because sometimes people have air conditioners. As we know, the cost of energy has been increasing, and so people may not run their air conditioners. There are programs available through the city and the state to help people cover those bills and to access air conditioners if they don't have one.

Brian Lehrer: Just to follow up before you go on something that you said that I didn't even think of before you said it but I should have is, are you at the Office of Emergency Management in contact with ConEd or any other power supplier? Especially ConEd because we know there have been some blackouts at this time of year in the city's history on really hot days.

Commissioner Farrell: Yes, for sure. ConEd is one of our really strong non-city partners. We talk to them constantly. They have opened up their engineering room and other things to deal with the heat and we send staff there. They are 24/7 in the mix. We are definitely talking to them all the time, looking at any conservation method that can be put in place. The same with National Grid and the other suppliers. If we do, it's still early days in this heat wave. As we said, the effects on the grid can be cumulative. So far, things have been holding up well.

If we start to see some challenges, we will work. Part of the message is to ask New Yorkers to do their part to not run heavy appliances, dishwashers, washers, dryers in the hottest part of the day. I know people like to have their apartments really frosty sometimes, but trying to increase it just a couple of degrees so you're still comfortable, but it's not. You don't have to wear a sweatshirt maybe inside your house to take a little heat off the grid. For sure, we're in touch with ConEd and the other suppliers.

Brian Lehrer: That's a great point about personal responsibility with respect to the air conditioning and, as you say, I guess the threat increases of power outages as this goes on. One of the unusual things about this heat wave is the number of days over 90 degrees that are being forecast. Has ConEd expressed any confidence level one way or the other that they'll still be okay on Friday, on Saturday, on Sunday?

Commissioner Farrell: Yes, like I said, heat waves, fortunately, you can see them coming. They can bring in extra crews. They can extend hours. There are a lot of demand reduction programs. You may have seen the mayor and the Citywide Administrative Services commissioner this morning. They're in the city. We're obviously a large landlord. We have a lot of buildings in the city.

Right now, our building for emergency management, we're part of the demand response program. We are increasing the thermostat and taking out air conditioning from stairwells or conference rooms, areas where we may not need it. I think upwards of 90 city buildings, some libraries, the fire academy, some other locations have been added to that to try to help do our part on the grid.

I know our private sector partners. They are also part of demand response programs. Personal, individual ConEd customers can also be part of that where you agree to let them decrease the power coming into your house a little bit and you see the difference on your bill. That is another area where the city, the private sector, and individual New Yorkers can participate.

Brian Lehrer: Christina Farrell, first deputy commissioner of the New York City Office of Emergency Management. Thanks for giving us some time today on what I know is a very busy day for you because of the heat. Thanks very much.

Commissioner Farrell: No problem. Thank you for having me.

Brian Lehrer: Brian Lehrer on WNYC. More in a minute.

[music]

Brian Lehrer: Brian Lehrer on WNYC. With us now, Manhattan Borough President Mark Levine, formerly chairman of the city council's health committee before his election as borough president last November. He's got more for us on protecting yourself and your loved ones in an extended heat wave like this. He's also got suggestions for getting more monkeypox vaccines to more people and more equitably while New York City remains the epicenter of that. We'll touch on other issues too. Mark Levine is also the only New York Democrat other than Bill de Blasio not running in the 10th congressional district primary. Just kidding. Hi, borough president, welcome back to WNYC.

Mark Levine: Good morning, Brian. Also, you can't redistrict the island of Manhattan, so I had that going for me as well.

Brian Lehrer: [chuckles] Yes, Manhattan is Manhattan, so the borough president district is what it is. Let's pick up right where we left off with the emergency management deputy commissioner. Is heat risk inequity something you're dealing with as borough president?

Mark Levine: Absolutely, Brian, and, boy, this has been a tough stretch. We're in another COVID wave. We have monkeypox. We had terrible flooding on Monday in Uptown Manhattan in the Bronx, so this is a lot. Now, we have a heat wave. It is a public health matter. We have over 100 heat-exacerbated deaths in New York City every year. That number is increasing. There's enormous inequality. The health department has run the data and African-American New Yorkers are more than twice as likely to die from heat-related causes as white New Yorkers.

There's enormous inequality. If you map the neighborhoods where there's high heat vulnerability, it is Uptown Manhattan. In particular, East Harlem. It's the South Bronx, it's Central Brooklyn, and it's Southeast Queens. There again, inequality. By the way, Brian, almost every single case of someone dying at home from a heat-related cause is in a home without an air conditioner. This just reminds the public of how important it is for people who are medically vulnerable to find a way to stay cool.

Brian Lehrer: Boy, it's such a long-term challenge too. I don't want to get too far away from the immediate challenge of the heat and helping people get through it, but, "Yes, get everybody air conditioners." Then at the same time, we say, "Hey, we have to fight global warming and reduce our dependence on things like air conditioners."

Mark Levine: We have a two-front war here. We have to accelerate our move to carbon neutrality to slow climate change, but we have to deal with the climate change and extreme weather that is already here. We focused probably more on flooding events, especially on the coastline, but rising heat waves is also a factor here and we have to prepare for it.

We're not doing enough by the way to get people air conditioners who need it, low-income families who need it. There is a program funded by the state, the Home Energy Assistance Program, that will pay up to $800 for you to get an air conditioner, but it's limited. It's first-come, first-served and then they run out of money. The program closed on July 8th. We need to fund that better to get people who needed access to air conditioners.

Brian Lehrer: Listeners, we can take phone calls for Manhattan Borough President Mark Levine on the heat, on monkeypox, on other things that might be relevant to his job as borough president, 212-433-WNYC, 212-433-9692, or tweet @BrianLehrer. That, of course, can include citywide issues. You don't have to be in Manhattan to call in and talk to Mark Levine, citywide issues, regionwide issues. If they're relevant to his work, 212-433-9692 or tweet @BrianLehrer.

Borough President, we'll talk later in the show about trees in New York City specifically as a source of protection from heat and other threats. A separate segment on trees in that context coming up. What can you do as borough president about these longer-term weather and climate inequities like so many untreed streets in the poorest neighborhoods as if it was designed that way? What do you have to rely on the higher levels of government for, the city, the state, the federal government, that you can't change as borough president?

Mark Levine: Well, I'm really glad you're focusing on trees, Brian, because trees cool neighborhoods by some estimates as much as 20 degrees in the midst of a heat wave. There's enormous inequality in where trees are planted. East Harlem as an example has far fewer trees than, say, the Upper West Side. It makes the neighborhood hotter on a day like today.

I have joined, as you have covered with my four colleagues, all five of the borough presidents in New York City to call for the planning of a million more trees on streets focusing on neighborhoods, which have too little tree canopy, but also looking at adding trees in parks and natural areas and places like NYCHA campuses, rooftops, et cetera, to add cooling benefits, resiliency benefits, cleaning the air. This is, I think, got to be one of the most important resiliency projects of the city.

Are you asking about the broader fight for climate change? Because in this era where the federal government is really paralyzed because of Republican intransigence in Congress and the refusal of Senator Joe Manchin to support good climate change legislation, it's going to fall on local government to tackle this. There's a lot we can do to make our buildings greener, to make our transportation network greener, to make our food system, our waste system greener. We can talk about those things. While we're working on resiliency to protect the city from heat waves and flooding, we also, every single day, need to do more to slow climate change.

Brian Lehrer: As you try to get more trees planted in lower-income areas on lower-income blocks, are there particular impediments to that? I think Mayor Bloomberg had a big tree planting program. I can't remember whether it was Bloomberg or de Blasio who had that one million trees from the parks department, but they both were into planting a lot of trees. Here, we still are. I don't know how much has actually changed. Is it tough to actually get a lot of trees and change the feel of some of the blocks in East Harlem you were referring to or anywhere else?

Mark Levine: The Bloomberg administration launched the first million trees initiative, but they didn't hit the million mark until the de Blasio administration. It was enormously successful, but it's a big city and there are still many neighborhoods that are underserved. We've calculated that. Citywide, there's probably a capacity to add as much as 200,000 more street trees. It is more expensive to plant a tree on a city block than it would be to say in a park. It can be as much as $5,000 if you've got to dig a new tree pit. By the way, there are empty tree pits in most neighborhoods.

Brian Lehrer: Wow, for one tree, huh? $5,000?

Mark Levine: Yes, often because of what's underground and sometimes you need to move utilities. It's complicated in an urban environment. I would argue that that's a bargain. Health benefits, the mental health benefits, the resiliency benefits are significant. Tree pits now are often being built with what's called a bioswale underneath. They are essentially cisterns, which can collect hundreds or even thousands of gallons of water.

If you look at the flooding that we saw in Upper Manhattan in the Bronx yesterday, if we had more of that kind of green infrastructure to help absorb storm runoff, it would make us more resilient in the face of heavy rain events. This can be done. It needs to be done. Our estimate for an eight-year plan to plant a million trees, Brian, is $500 million. That's capital-eligible. Compared to the scale of the city budget, the scale of our capital budget over a period of eight years, that is eminently doable and, in my opinion, absolutely a smart investment.

Brian Lehrer: When you plant a tree on a city block, and I promise not to spend the whole two hours this morning talking about trees, although I could, but when you plant a tree, what do you plant on a city block? You can't just install a 50-foot shade tree, right? Is it a little sprout that's going to grow into a tree that makes a difference in 20 years or what do you actually put on a block in New York City?

Mark Levine: You're planting a sapling. The city has a nursery and we sometimes contract with providers to bring it from other nurseries outside of the city. We've learned a lot from the first million tree initiative about what species of trees do better and in what kind of conditions in the city. You want to vary the species on a block so that in the case of contagious disease among trees, it's less likely to spread. You get benefits from day one and more each year. It doesn't take 20 years to start enjoying the shade and the cleaner air and the cooler climate from trees, but we got to start now. This is eminently doable. It's an equity issue. It's a health issue. To me, it's an investment that we have to start making now.

Brian Lehrer: With Manhattan Borough President Mark Levine, you will take a caller from Brooklyn, won't you? You'll gain to do that. Paul in Brooklyn, you're on WNYC with the Manhattan borough president. Hi, Paul.

Paul: Yes, hi. I noticed no one has mentioned fans as a way to stay cool. I find it very effective, particularly ceiling fans. In terms of getting stuff out to people who don't have money, it's cheaper than giving away air conditioners. I have an air conditioner. I haven't turned it on for 10 years.

Brian Lehrer: Right, I personally have a ceiling fan in my bedroom and no AC. Borough president, I don't know if this is above our--

Mark Levine: Paul is right. In fact, the program I mentioned called HEAP, the Home Energy Assistance Project, gives you up to $800 to buy an air conditioner or a fan. Unfortunately, that program has closed for the year because, as I mentioned, it's got a limited budget. That is an option for New Yorkers who want it.

Brian Lehrer: Again, this might be over the scientific pay grade of either of us, but I did see on a TV weather forecast talking about this heat wave. Their meteorologists say fans won't cut it. You need to be in air conditioning for at least part of the day in these days where the heat index is going to be 100 degrees-ish and that surprised me. I hadn't heard anybody say that before. I'm not saying he's right or I'm not saying he's wrong, but that was a credible meteorologist, whose information I've taken many, many times, saying fans won't cut it in this heat, not by themselves without being in air conditioning some of the time. That was interesting to me. Do you have any information to the contrary?

Mark Levine: I can't say I can confirm or not, but it sounds pretty credible to me. There's no doubt that air conditioning is the best solution for protecting people against adverse health effects. That's why we open cooling centers and why we subsidize the purchase of home air conditioning.

Brian Lehrer: Lisa in South River, New Jersey has something to say about this. Lisa, you're on WNYC with the Manhattan borough president, Mark Levine. Hi, Lisa.

Lisa: Hi, Brian. All right, I have some tips as regards to what the previous caller said using fans. I love fans because they feel like you're in the Caribbean or something. You can spritzer yourself and keep the spray bottle in the refrigerator. I'm talking about things get really gritty.

Brian Lehrer: Yes, water.

Lisa: You can sprinkle yourself, stand in front of the--

Brian Lehrer: Cool showers, that's another good thing.

Lisa: Yes, you can put cold packs in the freezer, but what I mentioned to your screener was that I use window tinting that you can get at Lowe's or Home Depot wherever that cuts the UV rays. They do come in different shades like the black, the smoke, the whatever. Then I used polarized screening, which cuts UV rays. Then when I open part of the window, I use one of those fold-out screens that has polarized screening.

Brian Lehrer: Thank you, Lisa. I appreciate that. I don't know if that's for-- I'm familiar with some of the window tinting to block the UV rays as a hedge against skin cancer. If your window gets a lot of direct sunlight and you like the light, but you don't want to sit in the window as if you are outside and you don't want to wear sunscreen in your living room, that's what that's for. Does it also help with the heat?

Lisa: Totally. I rarely put on the air conditioner because my house is so cool due to the polarized screening, the polarized window tinting. Then if I open a window, I put in the fold-out polarized screens.

Brian Lehrer: Right, thank you very much. I guess there are different kinds not to go down this rabbit hole too much that are tinted as Lisa was saying, I guess, for light and other ones that are just for UV that can actually be clear, but just block out the potentially cancer-causing rays.

Mark Levine: Brian, can I say one thing on the spritzing front?

Brian Lehrer: Yes.

Mark Levine: There's over 700 sprinklers in city parks and they turn on any day. It's over 80 degrees. There's a really excellent map that you can find if you just google "Cool It! NYC" and you can find all the sprinklers in your neighborhood. There's lots of other things you can look up on the map, including pools. For little kids, it's a great option.

Brian Lehrer: That's great. Again, listeners on our Twitter feed just a few minutes ago retweeted out the New York City map to the cooling centers. So many of them in the five boroughs. There's going to be one in your neighborhood. If you want a cooling center, go to that map. Just go to our Twitter feed. You'll see that map. Also, we tweeted out the map to all the New York City public swimming pools. If that helps anybody, it's out there. Changing topics. Let's talk about monkeypox. The Feds are giving New York tens of thousands of doses now, but you've said the city's real need is closer to 100,000 doses. Where does that number come from?

Mark Levine: Well, Brian, I have to say how frustrated I am that almost two years after dealing with this exact same challenge on COVID vaccination, we are, once again, in a shortage situation, also shortage of test capacity and treatment capacity, which maybe we can talk about. I'm also really upset that New York City has not been getting its fair share of monkeypox vaccine doses. We are now registering 30% or more of the monkeypox cases daily in the United States, yet we've been getting about 10% of the supply.

That's why there's just been this crush of demand for vaccine appointments, which we're unable to meet. Last week on Friday evening, 9,200 appointments went live and they were gone within a matter of minutes as an indication of demand. The hundred-thousand estimate is based on the fact that, right now, this is overwhelmingly impacting gay, bisexual, and men who have sex with men, and that if you look at the number of people who might qualify for PEP or PrEP, that's where the hundred-thousand estimate comes from. We're still very far off from meeting that need and there is--

Brian Lehrer: That's an HIV-related reference, the PrEP, right?

Mark Levine: Yes, exactly. People who are at risk based on sexual activity. We are getting a large shipment, I believe, later this week. I think it's over 20,000 doses were expected later this week. We don't have confirmed yet when the appointments will go live, so that's a big step in the right direction. In the meantime, we still face a severe shortage and it's really unacceptable.

Brian Lehrer: You have an idea, I see, for a monkeypox vaccine waiting list partly as an equity measure. Explain your waiting list idea.

Mark Levine: Well, the current system requires you to know when appointments will open. Then go to the appointment website and hit refresh and you're essentially competing with thousands of other people in hopes that you can grab an appointment. Someone who doesn't have computer access or reliable internet or maybe is working long hours or just didn't know they needed to go to the website at that time is going to be blocked out.

We have seen certainly anecdotal evidence of inequality and who's getting vaccinated, what appears to be underrepresentation of gay men of color and who's getting vaccinated. That's also really unacceptable and yet, again, a repeat of some of the mistakes we made in dealing with COVID. A better system is to allow people anytime their night to add their name to a pre-registration list.

Then the city can use that list, first of all, to ensure there's allocations evenly saved by zip code so that people from Black and brown communities are not underrepresented. Then as appointments open up, use a lottery system to inform people that it's their turn and they can sign up. This is being done in some other parts of the country. Washington, DC, health department started it over a week ago. It's a more efficient, I think fair, and probably less frustrating, but also more equitable system.

Brian Lehrer: There's also a need versus stigma issue emerging with monkeypox and I'd like you to comment on it. The spread, as you said, is largely in the gay male community, so we want resources to be targeted there where they're needed. This is also not some disease of being gay, right? Advocates keep having to remind everyone, there was nothing about the biology of any LGBTQ people that makes a monkeypox carrier. How do you see the reason for the current concentrations of the virus and how do you see the risk of discrimination and stigmatization and how the anti-LGBTQ wave in American politics might use this like they once used AIDS and HIV?

Mark Levine: Well, it is both true that this is a disease which anybody can catch and anybody can spread, and that it can be spread outside of sexual contact through usually skin-to-skin contact sometimes between the medical provider and a patient, for example, or between people who live together. It is also true that in this current outbreak, virtually, every case that we know of is occurring amongst men who have sex with men. We do have to be honest about who's facing the greatest risk and, yes, doing without stigma and doing without obscuring the fact that this disease can spread in other communities.

To a minimal degree, there have been some women diagnosed, I don't believe in New York City yet, but nationally and in Europe. In theory, children could get it as well, though, I don't believe there's any diagnosis yet in the US among children. I think it's about the right balance of being clear about what the science says that this can spread broadly, but also alerting the LGBTQ community that the risk right now is elevated in that segment.

Brian Lehrer: We certainly know that HIV became much broader than that, even though that's the community it was first discovered in. There's that risk to keep in mind and that context to keep in mind. We leave it there with Manhattan Borough President Mark Levine. We always appreciate when you come on. Thanks a lot.

Mark Levine: Thank you so much, Brian.

 

Copyright © 2022 New York Public Radio. All rights reserved. Visit our website terms of use at www.wnyc.org for further information.

New York Public Radio transcripts are created on a rush deadline, often by contractors. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of New York Public Radio’s programming is the audio record.