SCOTT SIMON, HOST:
New York public health leaders and elected officials say the city's in a much better position to withstand a COVID-19 surge than it was in March and April. But as Fred Mogul from member station WNYC reports, many caregivers are still getting nervous.
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UNIDENTIFIED PERSON: (Singing) Oh, when the nurses go marching in.
FRED MOGUL, BYLINE: In the Bronx, members of the New York State Nurses Association are calling on Montefiore Medical Center to hire more nurses.
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UNIDENTIFIED PERSON: (Singing) Oh, then we fight through (unintelligible).
MOGUL: Accompanied by a band and bagpiper, they march from the hospital to a nearby cemetery. Union representative Michelle Gonzalez says in the critical care unit, nurses like her typically handle one or two ICU patients. But with the number of COVID-19 patients creeping up once again, they're now being asked to handle three.
MICHELLE GONZALEZ: When we started to get tripled in the frequency that we're seeing right now, we know that it's because they're short-staffed and they're not getting ICU nurses into the building. We're scared because we're afraid that we're going to have to go through this again.
MOGUL: Montefiore officials say they're far readier than they were in March, when the hospital took in 2,000 patients in the first two weeks of the outbreak. Since then, Peter Semczuk, the head of operations, says they've invested millions of dollars in personal protective equipment, training and technology and have enough staff to handle as many patients as necessary.
PETER SEMCZUK: We have a contractual agreement with the union, and we meet the contractual obligations of that agreement.
MOGUL: Compared with last spring, health leaders say the metropolitan area has much more hospital capacity, much more knowledge of how to treat patients and, they especially emphasize, much more testing.
DAVID CHOKSHI: It's the first step to actually interrupting further spread.
MOGUL: Dr. David Chokshi is the city health commissioner. He says mass testing interrupts further spread in two ways - by identifying hot zones so health workers can target them with hyper-local messages about COVID-19 to get people to change their behavior and also by communicating with people individually.
CHOKSHI: Once someone tests positive, we very quickly help them isolate. And then we call those contacts and make sure that they're quarantining as well.
MOGUL: But the city's contact tracing program has had mixed results. The people tracers reach say they're staying put, but fewer than half of them share names of contacts they might have exposed. Dr. Denis Nash, an epidemiologist who previously worked for the city health department, says the program hasn't been as effective as it could be because contact tracers aren't asking people questions about...
DENIS NASH: For example, use of public transportation or working in office buildings that didn't have rigorous safety protocols or indoor dining.
MOGUL: Others fault the city's testing and tracing program for not reaching out enough to poorer communities of color, which suffered disproportionately during the first COVID-19 wave. The city says getting testing sites to these neighborhoods has been a priority, but a recent analysis suggests it's not working as well as intended.
WIL LIEBERMAN-CRIBBIN: There's clearly a disparity.
MOGUL: That's Wil Lieberman-Cribbin, a graduate student and environmental health researcher at Columbia University. He analyzed testing and results by neighborhood, and he found that wealthier people are getting many more tests than low-income people, who also turn out to have many more infections. More screening in those areas would pick up cases earlier, before people develop symptoms.
LIEBERMAN-CRIBBIN: Widespread testing is really, really needed not only to protect the most vulnerable, but to collectively try and get a handle on COVID and reopen New York City.
MOGUL: At New York City Health and Hospitals, the largest municipal hospital system in the country, emergency rooms are going from busier than normal to a little stretched. Dr. Laura Iavicoli, a senior executive for preparedness, says two hospitals have had to transfer ICU patients to other public hospitals.
LAURA IAVICOLI: We are doing a little bit of redistributing around the system to give them COVID capacity, but it's very manageable.
MOGUL: Iavicoli is also an ER physician at Elmhurst, the hospital in Queens that was the COVID-19 epicenter last spring. And she says medical staff there remain traumatized and are increasingly anxious about what lies ahead.
For NPR News, I'm Fred Mogul in New York.
(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.