In Brooklyn virus ‘red zone,’ why do some posters only tell healthy people to get tested?
When Borough Park, the hub of Orthodox Jewish life in South Brooklyn, was included in a designated coronavirus “red zone” in South Brooklyn earlier this month, its rate of positive tests for coronavirus was 10.6% — more than five times New York City’s overall rate.
For the past three weeks, Borough Park’s leaders — rabbis, nonprofit directors and politicians — have worked to encourage the community to get tested. Their efforts contributed to a total of 41,981 tests administered in the Brooklyn red zone from Oct. 7 to Oct. 27.
Now, Borough Park’s positivity rate rate has dropped to 6.35%, according to the most recent data from the city.
Yet some physicians and Borough Park residents are asking whether the testing campaign is part of a broader effort to get a more accurate picture of the community’s health, or whether community leaders are trying to manipulate the positivity rate in order to get Gov. Andrew Cuomo to relax the restrictions.
Both city and state health officials are urging everyone, both with and without symptoms, to get tested.
Yet Jewish organizations and political figures in Borough Park have mostly emphasized the need for healthy people to get tested. They have cast the testing campaign as a way to lower the share of positive tests, and in turn enable the community to reopen its businesses, schools and synagogues.
Indeed, Yiddish posters reviewed and translated by the Forward not only focus attention on healthy people, but sometimes urge people with symptoms not to be tested.
“Do you feel like you’re healthy and strong and don’t have the virus? Very good! Make sure the government knows that as well!” reads one Yiddish-language poster created by the Boro Park Jewish Community Council, a social services provider that receives government funding. “Your community and your synagogue are asking you to get tested. It’s in your own interest not to refuse!”
At the same time, many residents within the community do not understand the need for testing when healthy, both out of leeriness of what they feel is unnecessary medical intervention and concern about government intrusion. If the numbers of people who test negative aren’t fully represented in public health data, that would lead to misreported data, which a testing campaign could address.
The Boro Park Jewish Community Council did not respond to an emailed list of questions.
Dr. Marc Sicklick, an Orthodox physician on Long Island who says he sees patients from Borough Park and the other Orthodox areas that were designated as red zones, said he frequently gets calls from patients asking them why they should get tested at all.
“If someone feels it’s not gonna change anything, why do a test?” Sicklick said, summing up those patients’ attitudes. He added that some doctors in Orthodox areas do not urge even their symptomatic patients to get tested, privileging the patient’s comfort over the potential benefit to epidemiological data.
While three areas designated as red zones by New York Gov. Andrew Cuomo in the first week of October have been downgraded to “orange” and “yellow” levels, Borough Park’s Jews continue to live under stringent restrictions on daily life: Nonessential businesses are closed, schools are remote only, and religious services must be 10 people or fewer.
Cuomo said that urban areas can be downgraded after getting below a positivity rate of 3% — and staying there for at least 10 days.
At the same time, New York City’s overall positivity rate has been steadily rising, nearing 2%, according to data released Thursday.
‘Help lift the lockdown’
Since the restrictions were announced, they have been a subject of scorn and anger within the Borough Park’s Orthodox community.
Cuomo touted the fact that the zones were not done by ZIP code but rather by address, in “micro-clusters,” which he said would help the state more effectively address localized jumps in the virus, and thus allow areas to exit the restrictions sooner.
Yet Orthodox politicians representing the Brooklyn red zone called the restrictions a “duplicitous bait-and-switch,” after Cuomo initially told a group of Orthodox politicians and religious figures that synagogues could operate at 50 percent capacity, before announcing the 10-person limit.
Some in the Brooklyn red zone have shirked the restrictions entirely. Lax enforcement by local police has allowed them to continue to attend synagogue. One man reported running in-person yeshiva classes illegally from his basement.
Leading community institutions have already tried manipulating the health data. At first, residents were urged to avoid testing at all.
In September, a Borough Park yeshiva asked teachers to do it a “favor”: to not test “even if you have fever.” In early October, just before the holiday Sukkot, a Yiddish robocall to neighborhood residents urged them not to test “because this raises the statistics in our neighborhoods.”
Then, after the restrictions took effect, community leaders and organizations called for widespread testing, in English and Yiddish, in order to lift the restrictions.
“Please take a few minutes to help lift the lockdown,” Kalman Yeger, a city councilman representing Borough Park, wrote on Twitter over information about testing sites.
Some Yiddish language posters specifically called for people with symptoms not to test. A Yiddish poster released by the United Talmudical Academy of Borough Park, a yeshiva, urged residents to get tested, before adding, “Those who are experiencing any symptoms of the virus or are unsure about the symptoms should stay home and not circulate among people.”
Some Borough Park residents and physicians who treat patients from the neighborhood worry that the emphasis on positivity rates is coming at the expense of measures to curb the real spread of the virus.
“There is definitely a feeling of trying to manipulate the numbers, and I am personally not a fan of this concept of percentage positive, because it’s so easy to manipulate,” said Sicklick.
“They actively encourage people with symptoms not to test themselves,” said one Borough Park resident of synagogue and yeshiva leaders. The resident spoke on the condition of anonymity for fear that being known for criticizing the community would lead to their children being unable to enroll in local yeshivas.
The resident said that prominent community members are urging healthy people to test themselves frequently, as much as once a week, to lower positivity rates.
A spokesperson for the New York City Department of Health and Mental Hygiene said the department is not concerned that posters from community organizations are artificially driving down testing, since “the positivity rate is still elevated and this area is still considered a NYS red zone.”
A spokesperson from the state Department of Health did not respond to an emailed question from the Forward about whether the state’s Department of Health is concerned about an artificially depressed positivity rate. The spokesperson said that the state is “actively engaging with community partners across the state” to insure treatment and testing.
‘Not enough testing’
Despite the community leaders’ efforts at testing, Borough Park’s testing rate remains much lower than most parts of the city.
According to city data updated Thursday, there were 7,410 tests per 100,000 people in the preceding four weeks. In neighborhoods in Manhattan and North Brooklyn, where testing rates are highest, most neighborhoods are well over 10,000 tests per every 100,000 people.
And then there’s Borough Park, which has its high positivity rate, as well as a high, if declining, case rate (the proportion of the population diagnosed with COVID-19): 83 cases for every 100,000 people, down a third in the past two weeks.
“The fact that you have a high positivity rate, a high case rate, and a low testing rate suggests that there’s a high level of community transmission and not enough testing,” said Dr. Dennis Nash, an epidemiologist at the City University of New York.
Nash said that whether or not there is an effort to manipulate the positivity rate, at this point in Borough Park, even widespread testing of healthy people will likely still show an elevated rate of coronavirus infection.
“Even if you increase testing among people who are healthy, there are a lot more cases out there to be found,” he said.
Hana Cohen, a Borough Park resident, told the Forward earlier this month that many residents feel uncomfortable getting tested when they’re healthy, in part because they already feel targeted by the government for the restrictions.
“The random testing, to the community, feels like, are they just looking for Jews in Borough Park to test positive?” Cohen said.
Borough Park is not the only community to come under scrutiny for a declining positivity rate amid decreased testing.
The Orange County Health Commissioner, Dr. Irina Gelman, said last week that she has received reports from doctors of residents of the county’s red zone, centered on the Hasidic village of Kiryas Joel, who are refusing coronavirus tests despite showing COVID-19 symptoms. Gelman told the Forward that she suspected that Kiryas Joel’s positivity rate, which dropped by a massive 30 points in four weeks, has “some degree of correlation” with the test refusals.
On Wednesday, Cuomo downgraded Kiryas Joel to an “orange” zone, citing its lowered positivity rate.
One official at a Jewish community group representing a neighborhood in the Brooklyn red zone said that the leadership organizations’ emphasis on positivity rate is tied to the state’s focus on positivity rate for determining which areas can exit the red zone. The official spoke on condition of anonymity, saying that he feared reprisal from the governor’s office.
He said that the state does not share detailed data with community leaders, hampering their efforts to target hotspot areas or institutions in their neighborhood. (The city releases its data by ZIP code, but only lists hospitalizations at the borough level. The state releases data by county.)
Cuomo “always thumps his chest: ‘Look at how good we can get these numbers, we can do block by block,’” the official said. “So why don’t you tell us what those numbers are? Why are you hiding them from us?”
Molly Boigon contributed reporting.
Jordan Kutzik contributed Yiddish translations.