NYC health commissioner confronts coronavirus future

As health commissioner of New York City, the epicenter of the coronavirus outbreak in the U.S., Dr. Oxiris Barbot has played a vital role in slowing the virus’s spread. Though her guidance has sometimes been impeded by politics – with her agency most recently being passed over to manage the city’s contact tracing initiative – Barbot has served as a key health expert throughout the crisis. A pediatrician, Barbot’s latest focus has been exploring recent cases of heart and kidney failure in children who have the coronavirus.

The health commissioner joined City & State’s webinar on Tuesday to discuss how the city can support its most vulnerable communities during the pandemic. This interview has been edited for length and clarity.

There’s been recent news that contact tracing in New York City is going to be done by New York City Health + Hospitals. I’d assume there’ll be some kind of partnership with the health department? How is that going to play out?

We at the health department have a long history of being involved and bringing to an end epidemics that have affected the city, from (tuberculosis), HIV and most recently measles. And I’m really proud of the staff that we have and the years of experience that they have in doing contact tracing. We will continue to partner with our sister agencies because, from the beginning, we have said that this is an all hands on deck approach.

You spearheaded Take Care New York 2020, which focused on addressing social determinants of health and engaging communities on the issues of health equity. Did the city make clear measurable progress on that front? And now, given the coronavirus pandemic, how far are we set back?

I think that it is abundantly clear that the underlying drivers that have contributed to health inequities that we were trying to address through Take Care New York have absolutely wreaked havoc during this public health emergency. Black and brown New Yorkers are dying at twice the rate as white New Yorkers, and I have no doubt that that in part is due to the underlying drivers – things like insecure housing, things like lack of economic opportunities.

Going forward, as we develop treatments and vaccines, how can we ensure that this kind of care reaches the most vulnerable and not just the richest?

I think one of the things that the city is really leveraging and lucky to have is a robust system of public hospitals. And I think that where we are seeing high levels of transmission, we are also seeing (New York City Health + Hospitals) provide that ongoing care. That being said, we do have issues around ongoing access to care. For example, now that we’ve got many, many people out of work, one of the things that I asked myself is, how long will we still have employer-based health insurance? I think there are lots of policy questions that are being raised by this public health emergency.

We’re getting a lot of questions on what is the “new normal” going to look like. You read about things like widespread temperature checks, a huge level of testing, maybe even certificates for people who have antibodies and people wearing masks everywhere. What other things might become normal going forward?

I still think we are in the development phases, but one thing I anticipate is that the use of face coverings will be something that remains for the foreseeable future. The emphasis on hand hygiene will remain for the foreseeable future. One of the cultural changes that I hope will happen as a result of this is that we won’t continue adopting the “tough it out” mentality of when somebody gets sick, they feel they will get judged if they don’t go to work.