Council Member on early testing access for low-income New Yorkers

Councilmember.

Stein?

Thank you, and I really thank you for your information and the work you're doing.

Does early testing help if someone's contracted Legionella, Legionnaires?

Testing is incredibly important when it comes to Legionnaires disease, and it also is multifaceted.

There's testing that needs to happen with urine.

There's testing that needs to happen with x-rays and imaging, with blood testing.

Which testing are you referring to?

So early testing.

So you're saying people getting tested earlier that they might be exposed is good for them because then we can have a medical response after getting tested, right?

It's important to do early testing and also to connect people to the referring provider to then take the results of that test and make it action.

And you are aware that not every New Yorker, especially low-income New Yorkers, have providers, right?

I'm aware of that.

And so in a situation, especially in a lower-income area, if a provider, if the people who are potentially exposed to Legionella don't have a medical provider, they're at a disservice unless the government steps in and provides that support, right?

Yeah, let me hand it over to Dr.

Howard to share a little bit more from this.

Thank you very much, Commissioner, and thank you for that question.

I just want to commend you for your interest in ensuring that New Yorkers have access to health care.

This is a very important issue.

I also want to clarify that in terms of testing for Legionnaire's disease, that is indicated when a person has symptoms suggested of Legionnaire's disease.

It is not a disease that we just screen for in people that do not have symptoms.

So people who are elderly or people with disabilities or immune compromised,

earlier testing for them, especially if we know that they've been exposed, can prevent from what we've heard from the tragedies that have happened this year in New York.

Although the groups that you just stated, those who are elderly, those who are immunocompromised, those who have underlying medical conditions such as chronic lung disease, are at increased risk of developing Legionnaire's disease,

Legionnaire's testing is only recommended if they have symptoms suggested of Legionnaire's disease.

Legionnaire's disease is not COVID.

There is no benefit to doing a screening test, okay?

And as an infectious disease doctor, I do not support blanket screening for Legionnaire's disease.

There's no clinical benefit.

There's no public health benefit.

So you're saying for people who are exposed, who are compromised, who might have some symptoms, but they may be concerned or non-concerned, testing could assist those people.

That's different than blanket screening, but you're saying there is a population that early testing could have.

assist, especially to get them the help that they needed earlier.

Anyone who has symptoms suggestive of Legionnaire's disease needs prompt evaluation by a clinician.

Right.

So we agree with that, right?

And that would include a clinical evaluation.

And the ordering of diagnostic tests for Legionnaire's disease, as well as other illnesses that can present similar to Legionnaire's disease.

Now, those are best done in a health care setting.

Right.

For folks who don't have access, though, having remote services like we do in H&H all the time, we take a show van and we get people on the street to get access to services.

We do remote services because we meet people where they're at, because especially people with compromised immune systems or people who are fearful, having remote accesses or local accesses is helpful for them

because they may not have a health care provider that they have connected to.

Yeah, so you mentioned H&H.

And as you know, H&H provides clinical services to all New Yorkers without regard to their insurance status or their immigration status.

And that was part of our messaging, as well as the fact that they could call 311 and be connected with a health care provider.

Thank you, Chair.