Police response to mental health crises, winter storms' health tolls, and infectious diseases
The NY Dose
If you want to know how a city really functions, watch it in a blizzard. NYC, I’m impressed. This storm came out of nowhere, and the city moved fast—increasing plows, recruiting temporary shovelers, and providing clearer info on warming centers and buses. I’m still watching the aftermath (big storms will have health tolls after), but overall this felt better than the last storm.
And even as the snow melts, I’m covering why snow and ice still matter for health, plus new data on police responding to mental health 911 calls and the latest on infectious diseases.
And if you’re in your 20s or 30s and this newsletter helps you make decisions—at work, for your family, or just for you—I really want your input. We’re running a quick reader survey, and I’m trying to avoid the problem that “only people with extra time respond.” If you’re so busy that you usually skip a survey, I ESPECIALLY want to hear from you. Your voice helps shape what I cover and how I cover it.
The blizzard’s hidden health toll
Not so fun fact: hundreds of people end up in the hospital after shoveling snow each year, and injuries like wrist and ankle fractures spike.
1. Heart attacks can spike after storms (especially from shoveling).
Heavy snow with cold air is a rough combo for your cardiovascular system. Snow shoveling is essentially short-burst, high-intensity exercise, often done by people who haven’t done that kind of exertion in months. Freezing temperatures can constrict blood vessels, increasing blood pressure. Studies have linked heavy snowfall to increased risk of heart attack, with snow shoveling as a key trigger.
What to do:
If you have heart disease, high blood pressure, chest pain with exertion, or you haven’t exerted yourself in a while: avoid shoveling if you can (ask a neighbor, hire help, or wait for plows).
If you must shovel: go slow, take frequent breaks, push snow when possible, and lift small loads.
Know the red flags: chest pressure, shortness of breath, dizziness, nausea, pain radiating to arm/jaw. If any of these show up and persist, stop and seek emergency care.
2. Slips on ice lead to a wave of fractures.
After storms, the most dangerous part is often what you can’t see: ice under snow. When people fall, they instinctively throw out a hand, which is why forearm and wrist fractures jump during icy periods (classic “FOOSH” injuries: fall on outstretched hand). The risk of more serious injuries also increases, including head, spinal, and hip injuries.
What to do:
Wear traction-focused footwear (or add ice cleats/spikes for errands).
Walk like a penguin: shorter steps, feet slightly outward, hands out of pockets for balance.
Assume shaded sidewalks, corners, and curbs are icy even if they look “just wet.”
Use salt/sand if you can, and give yourself permission to delay non-urgent trips until ice is cleared.
Storms create a second wave of harm including overexertion and falls. But slowing down, adding traction, and treating shoveling like the workout it is can reduce risk.
Mental health crises and 911: Police still respond most of the time, even in B-HEARD areas
On January 26, 2026, 22-year-old Jabez Chakraborty was in a mental health crisis in Queens. His family did what we tell people to do: they asked for help. They asked for clinicians. They asked for medical support and an ambulance. Instead, NYPD was dispatched. And during that response, Chakraborty was shot by police.
This isn’t just one story. When you call 911 for a mental health crisis in NYC, even in neighborhoods with the B-HEARD program (which aims to respond to 911 mental health calls with trained medical and mental health teams), police still show up 86% of the time instead. And that trend has been going up year over year.
I don’t read this as a failure of B-HEARD, but an example of how B-HEARD is constrained by upstream functions of 911.
Between 2022 and 2024, there were more than 96,000 mental health-related 911 calls. A city comptroller audit last year found that about 40% were eligible for B-HEARD (I covered it here). Of the calls that were ineligible, some were excluded because of safety concerns, and others because there weren’t enough EMS resources available to help screen for medical needs. Even among calls that were eligible, 35% never received a B-HEARD response for reasons that aren’t clear. Add in the fact that B-HEARD only operates in about 40% of NYC, and you can see how narrow the funnel is.
These are what I see as the system-level constraints:
1. 911 operators have to make high-stakes decisions with limited information.
These calls are often chaotic and time-pressured. Dispatchers rarely have access to someone’s mental health history, and they’re being asked to rapidly assess safety, medical need, and violence risk. These are all genuinely hard to predict over the phone.
2. EMS can’t always arrive as quickly as police.
In NYC, EMS response times have been getting slower, averaging about 11 minutes in 2025. That’s driven largely by staffing shortages, and traffic to a smaller degree. When the system is strained, “who can arrive fastest” becomes the default safety plan, even if it’s not the best medical plan.
3. B-HEARD eligibility criteria screen out a lot of calls, and the screening process itself is fragile.
911 dispatchers can route a call to B-HEARD only if it’s clearly nonviolent and there’s no imminent risk. But when that’s not clear, NYPD gets sent. On top of that, if a 911 dispatcher needs a second opinion, EMS is not always available to help screen, increasing the likelihood that the call gets the default NYPD response.
What would actually improve B-HEARD expansion and access
Expanding B-HEARD was one of the actions Mayor Mamdani campaigned on. But if 911 mental health calls continue to be triaged through NYPD protocols, then even if B-HEARD expands to more neighborhoods, it may not change the mechanism that keeps routing police to the scene instead of health professionals.
I think that greater impact will come from changing the front end in two key areas:
Better decision support for 911 dispatchers. Can we get to a point that for mental health related calls, sending the police is the exception, not the default (e.g. only if there is a weapon, active violence, or a credible threat)? Are there risk assessment tools that could be implemented, or could we have more clinical backup to help evaluate more ambiguous calls?
Faster clinical response times and greater capacity. We need to increase EMS staff to improve response times.
If NYC expands B-HEARD precinct-by-precinct without changing the routing logic, we should expect to see the same results: police will continue to respond to most calls.
What to do: know your options before a crisis
When there isn’t a threat to others, NYC’s 988 Suicide & Crisis Lifeline connects you to trained counselors and can dispatch mobile crisis teams without going through 911. Call or text 988.
If you are in crisis and need to call 911, absolutely call, and try to be as specific as possible about what you’re seeing and what you’re requesting, to increase the chance of the most appropriate routing.
If you have a family member with mental illness, work with their treatment team to create a psychiatric advance directive or crisis plan that specifies preferred interventions (what helps, what escalates, medications, de-escalation strategies).
This isn’t about what type of responder is “good” or “bad.” The most important thing is designing a system where the tools to triage and send help actually match the need. For many mental health crises, that need is medical emergency response, not law enforcement.
Infectious disease weather report
RSV: RSV is the main story right now. This is the ninth week in a row that hospitalizations have held steady at a high level.
Who should pay extra attention right now because of RSV risks:
Older adults
People with chronic conditions
Pregnant people (to protect newborns)
Families with young infants
What to do:
If you’re eligible and haven’t gotten protected yet this season, it’s still worth doing because we have weeks ahead of us of elevated activity.
Layer in protections when you can: avoid visiting newborns or older people when sick, mask in crowded indoor spaces, and keep an eye on breathing symptoms in little kids (fast breathing, retractions—when the skin sucks in around the ribs, collarbone, or stomach with each breath—or dehydration).
Flu: Across New York state, including NYC, flu cases increased slightly, but for the most part, activity has dropped down to lower levels.
Covid: Covid cases slightly increased, while ED visits and hospitalizations didn’t change. Overall, Covid remains low compared to previous winters.
Bottom line
Stay warm and I’ll see you next week :)
Love,
Your NY Epi
Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health expert. This newsletter exists to translate complex public health data into actionable insights, empowering New Yorkers to make informed and evidence-based health decisions.
Thanks for the snow shoveling advice! Don't forget about all the muscle strains and tears. Many, many years ago, my father, who was very strong, lots of weight lifting, etc, enjoyed lifting heavy loads of wet snow. On one of those occasions, he felt a "snap" in his pelvic floor that laid him up for years, with only Valium as a way to treat it when it became too painful. It took nearly 40 years to find a physical therapist who knew how to work with pelvic floor pain in men (most specialize in treating women) and was able to eliminate it with pressure on specific areas of muscle spasm. In addition, a physical therapist (or even the rare Alexander Technique teacher) can provide guidance in how to shovel without getting hurt.
Something I’m thinking about — if we want to increase EMS staff, we have to increase their salaries. At least in California, EMS staff are paid minimum wage or barely above that. It’s grueling, necessary work, and should be compensated as such.