Elmhurst Hospital urgent care remains closed nearly two years after pivot to vax hub

Elmhurst Hospital’s ExpressCare clinic, which offered local uninsured residents a quick and inexpensive health care option, was closed to in-person visits in January 2021 and turned into a vaccination hub. Nearly two years later, it remains closed as locals demand its return. Eagle photo by Rebecca Rand

By Rebecca Rand

A little more than a year before the start of the pandemic, the city’s hospital system launched an urgent care clinic in Elmhurst Hospital. 

The new clinic, known as the ExpressCare Clinic, quickly became one of the only affordable ways for uninsured immigrants to get urgent, in-person medical treatment without spending hours waiting in the Emergency Room or without having to travel to another borough for care. 

And then the COVID-19 pandemic began. The clinic, and the hospital it was housed in, were located in the epicenter of the public health crisis, and soon became overburdened with patients testing positive for the virus. However, the clinic remained open. 

But as the city began its efforts to get New Yorkers immunized in January 2021, the hospital transformed the ExpressCare clinic into a vaccination hub, closing one of the only in-person urgent care facilities that offers low- or no-cost health services to the uninsured. 

Nearly two years later, the clinic remains closed to in-person care, offering only virtual appointments to a population that advocates say prefer to be treated face-to-face. And even with the city’s vaccination efforts operating at a fraction of the rate they once operated at, New York City Health + Hospitals Elmhurst Medical Center says it has no plans to re-open the clinic any time soon.

‘The community was happier’

Not long after its opening in the fall of 2018, the clinic became popular with residents of Corona, Elmhurst, East Elmhurst and Jackson Heights, all of which have the highest rates of uninsured and undocumented residents in the city. 

“People were getting it,” said Adriana Huinatl, the health care services coordinator at the local immigrant health advocacy organization Voces Latinas. “If anything, we were promoting it more often, and the community was happier.”

“Within two hours, [patients] were in and out and they're like, ‘Here? At Elmhurst?’” Huinatl added. 

Elmhurst Hospital serves a large number of residents living in Queens Community Districts 3 and 4, which, combined, are home to an estimated 60,000 undocumented residents. 

Queens’ Community Districts 4 and 3 have the highest percentage of undocumented residents in the city. Chart by Rebecca Rand

Approximately 16 percent of the population in both areas is uninsured, the highest percentage in the city. In most cases, undocumented immigrants in New York State are not eligible for regular Medicaid or subsidized health plans. 

Problems with telehealth

Huinatl said that telehealth is difficult for some of her clients to access. Many don't know how to navigate the internet or don't have an internet connection at home. Voces Latinas clients often need help creating their first email account. 

“Some people don't have a phone,” she said. 

Goleen Samari, Ph.D., a population health demographer who has studied barriers to telemedicine in New York’s Latino immigrant communities, was dismayed to hear that the Elmhurst ExpressCare had closed. 

“That’s sad,” Samari said. “Maybe telemedicine is one option, but that doesn't overshadow the need to have a physical entry point to care, particularly urgent care settings.”

In her research, Samari documented concerns in the Latino immigrant community about the quality of care delivered through a screen. 

“A participant [in one study] described it in this way,” Samari said. “‘I was always in doubt because the doctor only looked at my face, he didn't look at my body, so how does he know what it was?’” 

Huinatl’s colleague, Erika Arevalo, underlined the importance of healthcare with a personal touch for her community. 

“People in our communities sometimes are very sensitive if they're struggling with other issues,” she said. “In their countries, they've faced some type of violence.” 

Arevalo said that she often feels emergency rooms lack “empathy,” but that the ExpressCare clinic was different. 

“I went to the urgent care and it seemed that they really cared about me,” Arevalo said.

Samari noted that some immigrant New Yorkers she interviewed had benefited from telemedicine visits.

“It's easier to access because they have like frontline jobs and it allows them to not miss work,” she said. “For those who have children and don't have to figure out childcare, it was very helpful to have virtual visits.”

But on its own, Samari said, “telemedicine is not sufficient.”

Tough decisions

Elmhurst Hospital staff and leadership faced a number of difficult decisions at the start of the pandemic. By March 24, 2020, Elmhurst Hospital was already at 125-percent capacity, with 13 patients dying in a 24-hour period. Hospital leadership was forced to ration protective gear, turn away sick patients and use a refrigerated truck as a morgue.  

Nine months after the first COVID-19 patient came through the hospital’s doors, a number of Elmhurst Hospital employees became the first New York City Health + Hospitals staff members to get vaccinated.  

Less than a year after the city’s vaccination efforts began, the number of Queens residents vaccinated far out-paced the number of vaccinated residents in the city’s four other boroughs. 

Queens was the first borough to vaccinate 1 million people, and was also the first borough to have 90 percent of its residents receive at least one dose of the vaccine. As of Oct. 18, Queens has the highest percentage of residents who have received at least two doses of the vaccine. 

A woman approaches the Elmhurst Hospital Emergency Room, currently the only local option for affordable walk-in care for those without insurance. Eagle photo by Rebecca Rand

But even with the updated Omicron booster shot now widely available and the threat of a winter virus surge looming, demand for vaccines is much lower than it was when the vaccine hub first opened. 

In the first three months of 2021, an average of 47,980 doses went into New Yorkers’ arms per day. That number has fallen to an average of 1,506 doses per day since the bivalent booster became available in public hospitals on September 12.

However, Elmhurst Hospital has given no indication that it plans to reopen the urgent care clinic – the only other ExpressCare clinic in Queens, located at New York City Health + Hospitals Queens in Jamaica, is also currently closed to in-person care and operating as a vaccination hub.

“We encourage Queens residents and all New Yorkers to take advantage of the [clinic’s telehealth] service, which allows them to speak with a healthcare provider in minutes from the comfort of their own home at any hour of the day,” said a hospital spokesperson. 

Huinatl remains hopeful that the urgent care clinic will eventually open its doors to in-person services at some point, adding that she believes New York City Health + Hospitals had been more open to community feedback in recent years. 

“They're working on getting better and taking more of a community approach,” Huinatl said. 

But things do need to change, she added. 

“They have to make an effort to reopen it, or at least have it in their agenda that it needs to reopen,” Huinatl said. “Because it's not the same care.”

Correction: An earlier version of this story said that Elmhurst Hospital’s ExpressCare clinic opened in the fall of 2019. That is incorrect. It opened in the fall of 2018.