Speaker Menin on water ecologist vacancy data discrepancy and case date confusion

I'm going to ask Speaker Menon.

She has a line of questions to ask.

Yeah, thank you so much.

I just have one last question, but before asking the question, I know Councilmember Narcisse had to leave, but just one response, again, on this water ecology issue that Councilmember Narcisse raised.

I just, again, want to make clear.

That her line of questioning and my line of questioning are about, again, why heading into the summer months those positions weren't filled.

That's what we're trying to talk about, the fact that 21 positions remained open as we head into the summer months.

So good that now, after this outbreak,

position that we can fill, but we never should be in a position where heading into a time when we know that there's going to be these types of Legionnaires outbreaks.

Unfortunately, we want to make sure that every single one of these positions is filled moving forward.

So I do have one last question.

I wanted to ask

There was a press release that the health department put out around the second, when the second death unfortunately occurred.

And in that press release, it listed the first cases as June 27th and June 29th.

But if you go to the agency's Legionnaires webpage right now, it shows that the first case was all the way back on June 23rd.

which would have been the date the patient's sample was collected.

So I'm not sure how long it would have taken for that person to have tested positive for Legionella, but that's more than a week before the agency mobilized that outreach.

So we wanted to understand why is there this discrepancy.

Yeah, both great questions.

Let me just say a few words about the Watery College's position.

Again, and then hand it over to Dr.

Howard.

Madam Speaker, the majority of those positions were filled before this cluster.

I completely agree with your point that right now, 50 out of 56 positions filled and onboarded as a strong sign and signal.

And the majority of the positions that we needed were filled before this cluster.

We can get you the exact numbers in a follow-up.

Secondly...

Yeah, I would appreciate that because that's not what our data shows.

Our data shows that during the outbreak, only 35 of 56 authorized water ecologist positions were staffed.

21 were not staffed with active inspectors when the city needed that workforce the most.

So that's what our data shows.

So there seems to be a discrepancy.

So we would...

We can follow up.

Yeah, absolutely.

And then to the second question, yeah, so this question is really about sort of...

How do we and when do we count a case?

So the process that we take prospectively, right, is to do interviews.

with patients that are part of the affected region.

And they tell us, for instance, when their symptoms started or when they began feeling sick.

So that's one clock that we're looking at, symptom onset as a clock.

There's another clock, though, and that is the lab testing, so the actual diagnosis date.

So these two clocks can be going at different times.

I'm going to hand it to Dr.

Howard to talk a little bit about backfilling, which can happen with these clocks.

So thank you, Commissioner, and thank you for that question.

So as one of our public health duties, the health department receives reports of infectious diseases

in New York City and routinely analyzes our surveillance data to identify a possible cluster of cases in space and time that would indicate a shared potential source of exposure.

So there's approximately 200 to 600 cases of Legionnaire's disease in the city on an annual basis.

Each reported case is analyzed, including a review of the medical records and then a patient interview to get information about the source of exposure.

And the protection we have in New York City is very robust.

We run sophisticated data analyses on a daily basis to identify clusters.

In this instance, the cluster was identified by astute epidemiologists even before that data analysis system detected a signal.

And we acted very, very rapidly, as you've heard in today's testimony.

And this is really public health at its best.

Now, as time, so we only had a handful of unverified cases at the time that we announced there was a cluster of disease on the Upper East Side.

Now, over time, we're doing the investigations of all these reports that we get in to determine whether someone is

spent time in the area during their period of exposure.

Often that can take some time, particularly if it's someone who worked or visited the area, worked in or visited the area, didn't live in the area,

if that person is hospitalized, if that person visited from another jurisdiction, we get that information

in a delayed fashion.

And then we add cases to our case count.

And in some instances, they might have had an earlier diagnosis date than those initial cases that we first identified through our surveillance system.

Okay, thank you.

Thank you, Madam Speaker.