In the course of about a month, the Hasidic village of Kiryas Joel, N.Y., managed to drop its rate of positive tests for coronavirus infection by a dramatic 30 points — from 34.2% in the last week of September, to 4.2% this week, according to state data released Wednesday.
Town leaders and New York Gov. Andrew Cuomo chalked the change up to the effect of coronavirus restrictions in Kiryas Joel, after Cuomo designated it a “red” zone on October 6, requiring schools and nonessential businesses to close, and for worship services to be capped at 10 people.
But Dr. Irina Gelman, the health commissioner for Orange County, which includes Kiryas Joel, a dense town of 26,000, has a different explanation: Village residents with coronavirus symptoms are refusing to get tested.
She said in emails to the Forward that doctors from hospitals, primary care providers and urgent cares have told her, as well as the state’s task force to stem the spread of coronavirus, that people showing coronavirus symptoms are foregoing tests altogether, including for flu and strep throat.
“This is not a typical declination in percent positive rate, which would be more gradual and over a longer period of time,” Gelman wrote in response to emailed questions. “I suspect there is some degree of correlation between the physician reported patient refusal to test and the dramatic decline in the currently reported test positive percent.”
Gelman says further investigation is needed before she can determine what exactly caused what she called the “drastic” drop in Kiryas Joel’s positive rate.
But she said that the village has seen a decline in the overall number of coronavirus tests administered to residents, even as hospitalizations have increased — two signs that the actual rate of coronavirus infection in the village has either not decreased at the rate suggested by the reported percentage of positive tests, or is in fact increasing.
Gelman’s office did not provide recent data on hospitalizations, total test volume or percent positive test rate from Kiryas Joel or its ZIP code, which includes the largely non-Hasidic town of Monroe.
Publicly available data for all of Orange County shows that overall tests have dropped somewhat over the past two weeks. The county’s rate of hospitalizations related to COVID-19, the disease caused by the novel coronavirus, has also ticked up since the middle of September.
A representative for the New York Department of Health did not respond to emailed questions about Kiryas Joel’s data or Gelman’s assertions.
Gedalye Szegedin, the town administrator for Kiryas Joel, did not comment after being contacted by the Forward.
Two major health providers serving Kiryas Joel did not respond to requests for comment.
Joel Petlin, the head of Kiryas Joel’s public school, which serves children with special needs, said that even if some residents are refusing coronavirus tests, discomfort with the tests is widespread.
“I don’t know that that problem is a uniquely KJ issue,” he said, using a common abbreviation for Kiryas Joel. “It’s probably a problem throughout the state and the country, for people who don’t want to be tested because of the intrusion, or don’t feel they’re overly sick.”
When asked why a Kiryas Joel resident might refuse a coronavirus test, Petlin said, “Because they’re human.”
Kiryas Joel is one of several designated red zones throughout the New York City region with high rates of positive coronavirus tests, all of which center around areas with large Orthdoox communities. Red zones face the harshest restrictions, with “orange” and “yellow” zones facing somewhat relaxed restrictions.
Orthodox Jews have repeatedly expressed frustration and anger at the restrictions, saying that the community felt unfairly singled out by Cuomo, and that the restrictions were unnecessary and overly burdensome.
On Wednesday, Cuomo relaxed restrictions on two once-red zones, in the borough of Queens. The red zones in Kiryas Joel, as well as the ones centered on the upstate Hasidic community of Monsey and in South Brooklyn, will remain intact, Cuomo said, because they did not fall below the state’s designated 3% threshold for positive coronavirus tests. Orange zones around those red zones have been downgraded to yellow, allowing schools and nonessential businesses to open.
“We have it managed,” Cuomo said. “We know how to do this.”
Despite Kiryas Joel’s reported drop in positive coronavirus cases, its positive test rate suggests that the village is still in a precarious place, and requires continued restrictions, said David Abramson, a professor of public health at New York University.
“The 34 number is an extremely high number. In fact it’s a set-your-hair-on-fire number,” Abramson. “The four is still much higher than we’d be comfortable with.”
Abramson said that in this second wave of the virus in the New York City region, younger people are expected to be infected at a higher rate than older people. In an overwhelmingly young, densely populated village like Kiryas Joel — about 61% of the village is under 18, according to Census data from 2019 — that could mean wide infections with few hospitalizations.
But, Abramson said, “If the number of hospitalizations is not going down, but the test rate is dropping, they’re probably trying to limit the number of tests that they take.”
Orthodox neighborhoods in New York City have seen less testing than others, despite having high rates of positive coronavirus tests, which health experts worry could mean that these hotspots are hotter than the data suggest.
Orthodox residents have received robocalls and text messages urging them to avoid testing so as to game the health data, according to audio and text messages obtained by the Forward.
In Brooklyn’s Borough Park, home to a diverse Orthodox Jewish community, one Yiddish robocall told residents that “even if they force you, even if they beat you like the Jews in Israel, and especially not voluntarily, and one must also not go get tested because this raises the statistics in our neighborhoods.”
Gelman said that doctors have told her that their patients are refusing tests for many reasons. Some believe their community either has or should achieve herd immunity, the point at which enough people in Kiryas Joel have contracted the coronavirus and developed antibodies to prevent its spread.
Others may have heard misinformation that one cannot be infected twice with the disease, or are simply experiencing “pandemic-related fatigue” over medical intrusions, Gelman said.
Health experts have said that herd immunity from the coronavirus is likely impossible, since antibodies developed by those who have it often wear off after several months. Abramson said that trying to achieve herd immunity is akin to playing “Russian roulette.”
Petlin suggested that Gelman’s statements might stoke antisemitism, pointing to early spikes in the virus in upstate Hasidic communities in the spring that led to instances of antisemitism in the area and an anti-Orthodox backlash on social media, even though he said he did not believe that was her intention.
In an emailed response to the question of whether she is concerned that her statements could stoke antisemitism in the county, Gelman said that the county’s health department “takes the health and safety of all of our residents very seriously, even more so during the worst public health crisis in a century.”
“These are not anecdotal accounts, and there is an inherent, serious population-wide health risk that impacts all residents of our county,” Gelman added.
Ari Feldman is a staff writer at the Forward. Contact him at feldman@forward.com or follow him on Twitter @aefeldman