Nearly one in four New Yorkers lost at least one person close to them, according to a newly released survey. The toll was even higher among people of color.Josefa Santana, 96, did not leave her Washington Heights apartment when New York City shut down to slow the spread of the coronavirus in March 2020. But her son, a butcher, had to work. He was the only one to leave the apartment in those weeks, so he probably was the one who brought the virus in.Despite her family’s efforts to protect her, Ms. Santana got sick, and then died. She was one of three relatives whom her granddaughter, Lymarie Francisco, lost to Covid-19 in the first year of the pandemic, Ms. Francisco said last week.The toll was devastating for her. It was also emblematic of the scale of loss and trauma in New York in the early stages of the pandemic, which new city data, released to The New York Times, shows in stark detail.An estimated two million New Yorkers — nearly one in four — lost at least one person close to them to Covid within the first 16 months of the virus’s arrival, according to the data, which was collected in mid-2021 by federal census workers on behalf of the city. Nearly 900,000 New Yorkers lost at least three people they said they were close to, an open-ended category that included relatives and friends, the survey found.Ms. Francisco, 36, lost an uncle about two months after her grandmother, and later, she also lost an aunt. But it was the loss of her grandmother, who raised her, that most affects her to this day.“I’m constantly thinking about my grandma,” she said. “I go every other Sunday to the cemetery and just sit there. And I just speak to her.”The finding about the scale of loss was among several from the survey, known as the New York City Housing and Vacancy Survey, that shed new light on the impact of the pandemic in the city. The survey consisted of in-person interviews with a statistically representative sample of more than 7,000 New York City households. While the primary role of the survey, conducted every three years, is to assess New Yorkers’ housing conditions, questions about Covid were added to the 2021 version.Its findings echoed earlier studies that documented how Black and Hispanic New Yorkers died from Covid at higher rates than white New Yorkers in 2020. In part, this was because of higher poverty levels and less access to high-quality medical care. But another likely reason was that people of color made up the bulk of the essential workers who reported to work during the city’s initial 11-week shutdown, when all schools and nonessential businesses were ordered to close and people urged to stay home, the survey found.Josefa Santana did not leave her apartment when New York City shut down during the early days of the pandemic. But she still contracted the virus and died.Christopher Lee for The New York TimesAbout 1.1 million of the city’s 8.4 million residents kept going to work between March and June 2020, the survey reported. Of those, about 800,000, or 72 percent, were people of color, a broad category that included all New Yorkers who did not identify as non-Hispanic and white. The areas that were hit hardest by Covid, including southeast Brooklyn, the Bronx, Upper Manhattan and the southeast corner of Queens, had high numbers of essential workers. The people who went to work delivered food, staffed restaurants, provided child care and cleaning, or worked in health care and transit.Losing loved ones to the virus was more common among those workers, especially those who were low-income and people of color, the survey found. While about a quarter of all New Yorkers lost at least one person they were close to, about a third of low-income essential workers who were people of color did. Eleven percent of all New Yorkers lost at least three people to Covid, compared with 16 percent of low-income essential workers, the survey found.Janeth Solis, 52, of the Bronx, lost four loved ones during the first year and a half of the pandemic. Her mother, step-grandmother and grandmother, who lived together in a house in Ridgewood, Queens, died one by one in the pandemic’s first weeks. Her mother-in-law died in April 2021.It wasn’t until this year that Ms. Solis was able to visit her grandmother’s ashes, which had been shipped to her native Colombia in June 2020. The visit and therapy have helped her heal.“We didn’t really have closure,” she said.Rates of depression and anxiety in New York rose during the pandemic, particularly among those who had lost loved ones and those under financial strain. Based on research from past disasters, these effects are likely to continue for months or years to come, researchers at the Department of Health have said.“Mental health needs are on the rise everywhere,” said Dr. Ashwin Vasan, the city’s health commissioner. “And it’s very difficult to separate that from the impact of trauma and grief.”By May 2021, about 33,000 New Yorkers had died from Covid-19, according to a New York Times tracker. At least 6,000 New Yorkers have died since then.Many New Yorkers are also connected to people who died elsewhere.“So many of us are close to people outside of the five boroughs, and outside of the country,” said Elyzabeth Gaumer, the chief research officer at the Department of Housing and Development.

The city has struggled to respond to a growing monkeypox outbreak, the first major public health crisis since the Covid pandemic began.Thousands of New Yorkers spent hours refreshing a city government webpage on Wednesday, desperately seeking a monkeypox vaccine that, for now, is mostly going to the most web-savvy and connected.The rollout echoed the early days of New York City’s Covid-19 vaccine, when finding an appointment could feel like winning a radio contest. The city decided to assign appointments for the first 3,500 or so doses of the highly sought-after monkeypox vaccine via an online system, using Twitter as the main way to notify people. The appointments went within minutes.On top of that, because of a glitch, about 600 appointments went only to those who happened to store an older appointment website on their browsers, because the slots appeared there before a link on the main Department of Health website went live.“By following the Department of Health’s instructions, we had zero chance of getting the vaccine,” said Nicholas Diamond, who spent hours refreshing the city’s website. “I am really concerned that the city, state and federal government have learned nothing from the Covid response, and essentially the burden again has been left on us to figure out how to care for ourselves.”New York City is the epicenter of the nation’s monkeypox outbreak, its health commissioner said, with 141 cases recorded so far, more than any other city. The disease is mostly spreading among men who have sex with men, and experts believe there may be many more cases than have so far been detected.The spreading outbreak has not yet caused any deaths in the United States, but it can cause very painful lesions that take weeks to resolve.The health commissioner, Dr. Ashwin Vasan, apologized for the appointment glitch at a news conference Thursday and explained that the city would work harder to insure a more equitable approach as more appointments become available.“Our vendor experienced technical glitches, and New Yorkers have had to wait much longer than they should have to get this vaccine,” Dr. Vasan said. “Ultimately, they work for us and the buck stops with us. And so we apologize to New Yorkers, and we pledge to do better going forward on this issue in the days ahead.”He added: “Equity is an incredibly hard thing to preserve in an environment of scarce supply.”Cases of monkeypox have been steadily increasing in the city, despite limited testing. New York City’s public health lab, which was the only place running the test for the disease in the city until Wednesday, has only been able to test 10 people per day, city officials said. But testing will now be able to ramp up: Labcorp, the commercial testing company, also began offering the test on Wednesday.Public health officials have decided not to put up billboards warning the wider public about the disease, which spreads primarily by prolonged close contact, because they see it for now as an outbreak almost completely among the community of men who have sex with men. Instead, they say they have been mostly relying on getting the word out through smaller efforts with community partners within the L.G.B.T.Q. community.That began to change on Thursday, when officials held a news conference to announce the opening of a second clinic in New York City that will offer the vaccine by appointment only, in Harlem. The first clinic was in Chelsea, which advocates argued primarily reached a well-off patient population.Dr. Vasan said that he picked Chelsea for the first site because 75 percent of the cases so far have been in Manhattan, and one-third of known cases are in the Chelsea and Hell’s Kitchen neighborhoods.Officials acknowledged that there were high levels of anxiety among men who have sex with men and that there were still many unknowns about the disease’s spread.New York City has so far received about 7,000 doses of the Jynneos vaccine, the preferred vaccine for the monkeypox. Of those about 4,000 have already been given out or assigned to appointments. An additional several thousand are being held in reserve for distribution through community partners, Dr. Vasan said.More doses are coming, said Dr. Raj Panjabi, the coordinator of the White House Pandemic Office, who also spoke at the news conference. Another 144,000 doses will be released by the federal government within the next weeks, with some of those coming to New York. In total, four million doses have been ordered for use nationwide, with 1.5 million of those expected to go out to health departments later this summer and fall.The Jynneos vaccine requires two doses to be fully protective, according to the Food and Drug Administration, but so far, all of the doses coming to the city are being considered as first doses. As more doses arrive, there will be more available for second doses, said Dr. Mary Bassett, the state health commissioner.Paul Chaplin, the chief executive officer of Bavarian Nordic, which makes the vaccine, said Thursday that research shows that one dose offers “robust protection.” Dr. Bassett, however, said that full protection from the vaccine would only come two weeks after the second dose.What to Know About the Monkeypox VirusCard 1 of 4What is monkeypox?

Be aware but don’t panic, say health officials and advocates as cases of the disease tick upward in New York and around the country.Grindr, the social networking app, sent a pop-up message about the risk of monkeypox to millions of European and American users. A sex party organizer in New York asked invitees to check themselves for lesions before showing up. And the organizers of the city’s main Pride celebrations posted a monkeypox notice Sunday on their Instagram account.As hundreds of thousands of people gather in New York City and elsewhere to celebrate Pride this month, city and federal officials, health advocates and party organizers are rushing to disseminate an increasingly urgent health warning about the risk of monkeypox.“Be aware, but don’t panic,” said Jason Cianciotto, the vice president of communications and policy at the Gay Men’s Health Crisis, summing up the message the group is trying to convey.The virus, long endemic in parts of Africa, is now transmitting globally, and, while it can infect anyone, at the moment it is spreading primarily through networks of men who have sex with men, officials say.André Thomas, the co-chair of NYC Pride, says people who don’t feel well should not attend events: “Take care of yourself and take care of each other.”Dieu-Nalio Chéry for The New York TimesSince May 13, when the first case in the outbreak was reported in Europe, more than 2,000 people in 35 countries outside Africa have been diagnosed with the virus. As of Wednesday, there were 16 cases identified in New York City, among 84 around the country. The most recent New York cases are not linked to travel, suggesting person-to-person transmission is taking place in New York City, the city health department said.While the raw numbers are still low, epidemiologists are concerned because of the level of global transmission and because cases are cropping up without clear links to one another, suggesting broader spread. The World Health Organization will be meeting next week to determine if monkeypox now qualifies as a global health emergency.Monkeypox, so named because it was first discovered by European researchers in captive monkeys in 1958, can infect anyone, regardless of gender, age or sexual orientation. While it mostly spreads through direct contact with lesions, it can also be spread via shared objects such as towels, as well as by droplets emitted when speaking, coughing or sneezing.Scientists believe it may also be transmitted through tiny aerosol particles, though that would probably require a long period of close contact. The virus in general is much less contagious than Covid-19.Monkeypox has caused at least 72 deaths this year within African nations where the virus is endemic, the W.H.O. director general, Dr. Tedros Adhanom Ghebreyesus, said Tuesday, but no other deaths have been linked definitively to the global outbreak outside Africa.The first 10 cases in New York were all detected in men between ages 27 and 50, and most have identified as men who have sex with men, following the global pattern, according to the city health department. Most of the New York cases have resulted in mild symptoms, officials said, but even mild cases can involve an itchy and painful rash, lasting for two to four weeks.Two types of vaccination are effective against monkeypox.Christinne Muschi/ReutersPublic awareness about the outbreak, which would lead to more demand for tests, is still at an early stage, and the virus sometimes causes only a few lesions in the genital area, which can make it difficult to differentiate from other sexually transmitted diseases. Two vaccines, as well as antivirals, are available, though for now vaccines are primarily being offered in America to close contacts of identified or suspected cases.Pride celebrations are the perfect time to increase awareness among people in the L.G.B.T.Q. community who are most at risk, health officials said in interviews, but also create a challenge for those seeking to get out a message about protecting the community without creating alarm or stigma. More broadly, organizers and health officials do not want to put a damper on Pride celebrations and their positive messages about sexual identity.Working with advocates and partners in the L.G.B.T.Q. community, federal and local health officials have in recent weeks begun to craft social media posts, write fact sheets and post images of what the pox look like to help people know what to look for.Pride gatherings also are coming at a crucial time, when there is still a chance that aggressive public health actions could keep monkeypox under control, but increased contact during the celebrations might create additional disease spread, particularly if people are not educated about the virus.“We need everybody to step up their game, because if we’re going to contain it, we need a real ramping-up of efforts across the board,” said Gregg Gonsalves, a longtime AIDS activist and epidemiologist at the Yale School of Public Health, in an interview. “We’re walking the line between containment and persistent spread, and containment would be better.”Health officials’ focus for now is to provide information about how the disease transmits — primarily through skin-to-skin contact — and to urge people to seek care if they have a rash or feel unwell. While the messages are targeted particularly to the gay and bisexual community, public health officials also stress that anyone can get infected.Although the current risk for the general public remains low, it could rise if the virus establishes itself in the United States and other countries outside Africa, infecting a wider swath of people, the W.H.O. warned in a recent update. The organization is also working on changing the name of the virus, which they acknowledge may be increasing the stigma surrounding it.Still, many health experts are warning that the public health messaging, which for now is mostly online, has to move quicker, and that education alone will not be enough to stem the outbreak.All aspects of the monkeypox response — from education to identification of cases to isolating those infected — should be ramped up, said Dr. Carlos Del Rio, chair of the Department of Global Health at the Rollins School of Public Health at Emory University and the incoming president of the Infectious Disease Society of America.What to Know About the Monkeypox VirusCard 1 of 5What is monkeypox?

What to Know About Covid Boosters in N.Y.C.Sharon Otterman��Reporting from New York City“No one who feels they are at risk should be turned away,” Gov. Kathy Hochul said Monday. New York is not alone. Several states, like California, Colorado and Arkansas, have taken similarly liberal stances toward the C.D.C. guidelines. The idea, said Dr. Dave Chokshi, the city’s health commissioner, is to get as many people vaccinated and boosted as possible before the holiday season.