The Upper East Side Legionnaires' Outbreak and Cooling Tower Inspections

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Thank you. Good morning and welcome to today's New York City Council hearing for the Committee on Health. At this time, ladies and gentlemen, we ask that you please silence all electronic devices. Approaching the front is strictly prohibited. Please do not block the front doors. You may begin. Good morning.

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I am CM Lynn Schulman of the New York City Council's Committee on Health. Thank you all for joining us at today's hearing on New York City's response to the 2026 Legionnaires' Disease cluster. At this hearing, we will examine the Department of Health and Mental Hygiene's response to this year's cluster in the Upper East Side of Manhattan, which sickened 94 people, of whom 79 were hospitalized. We lost 11 New Yorkers to this year's outbreak, making this the deadliest Legionnaires' outbreak in our City since 2015. We grieve for the lives lost and we send strength to their families and loved ones. I want to thank Speaker Julie Menin for being here today and for her steadfast leadership on this issue, as she advocated for her district and for all New Yorkers, demanding action and accountability. I turn to her for her remarks.

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Thank you so much. First of all, I want to thank Chair Schulman for convening this very important hearing and all of our colleagues who are here today and members of the public, and thank you to the Department of Health for being here. We look forward to hearing your testimony.

This summer, as we all know, the Legionnaires' Disease outbreak has hit incredibly close to home for many of us. It occurred in the district that I represent and took the lives of 11 New Yorkers. Our hearts break for their family members and we send them our deepest, deepest condolences. These are our neighbors. They are our friends and our loved ones. I have certainly experienced this public health crisis not only as an elected official but as a New Yorker representing constituents directly affected by the City's response. I want to be very clear from the outset. We first of all want to commend the Health Department staff who worked tirelessly to investigate this outbreak, inspect and test cooling towers, conduct outreach and protect New Yorkers. These hardworking public servants deserve our respect. But today's hearing must also ask a fundamental question: was New York City adequately prepared before this outbreak occurred?

Legionnaires' Disease is not a new threat. We know it occurs in New York City every year. We know cooling towers require rigorous inspection and oversight, and we knew before this outbreak that the Health Department needed additional staff to do this work. Yet during the outbreak, only 35 of 56 authorized water ecologist positions were staffed. That means 21 authorized positions were not yet staffed with active inspectors when the City needed this specialized work most. Water ecologists perform critical work inspecting cooling towers and other water systems, identifying potential hazards, enforcing regulations and helping prevent outbreaks.

There are also serious questions about vacancies within the Health Department's broader inspection workforce, and that is one of the many questions that we will get to today. Today we need a clear accounting of how many water ecologist and public health inspector positions were budgeted, filled, vacant and occupied by employees who were still onboarding or training when this outbreak occurred. If Legionnaires' Disease is a recurring public health threat, which we know it is, we should not be scrambling to build the workforce needed to address it after an outbreak has started. We should have been prepared.

Preparedness also means ensuring that our cooling tower laws are actually being enforced. This past summer, New York City experienced temperatures approaching 100 degrees, unusually early in the season. New cooling tower testing requirements had also just taken effect. We need to understand whether inspection and enforcement increased accordingly, whether building owners who failed to comply were quickly identified and whether the Department had enough staff to proactively enforce these requirements.

There is another area where we must do better, and that is making sure New Yorkers understand exactly what they should do when Legionnaires' Disease is detected in their community. I do not want to suggest that the Health Department did not communicate. The Department conducted outreach and distributed information, but communication is only successful if people understand the risk and know what actions they need to take. Throughout this outbreak, I heard repeatedly from constituents who did not know the symptoms of the disease, who was most vulnerable, when they should seek medical attention or what they could do to proactively protect themselves. Residents also had basic questions about whether it was safe to shower, drink tap water or use their air conditioners.

We saw just how confusing public guidance can become at Haven Plaza, in a separate Legionella situation involving a building water system. Video and reports from that situation showed residents receiving differing messages about whether they could even shower. When we are dealing with a potentially deadly disease, residents should not be left trying to reconcile conflicting information themselves. The City must provide clear, consistent and repeated guidance. New Yorkers should know the symptoms of Legionnaires' Disease before the next outbreak. They should know who is at risk. They should know when to contact a doctor, and when an outbreak occurs, they should quickly receive clear information about what precautions they should take.

Ultimately, I want to ensure that we keep our focus today on the people who really matter: the New Yorkers who became ill and the New Yorkers whose lives were tragically cut short. 11 New Yorkers have died in connection with this outbreak. We will soon hear from family members who lost their loved ones to this horrible disease. But before then, I want to read a statement on behalf of a family who lost their loved one. They wanted this statement read. They felt very strongly about this. This hearing should be about her and it should be about all 11 New Yorkers who are no longer with us today. They deserve answers. Their families deserve answers and they deserve for us as policymakers to determine what should have been done differently and make the changes necessary to prevent another family from experiencing this kind of loss.

I will now read the statement. My sister, a 32-year-old medical doctor with many decades of her life still ahead of her, was the fourth victim of the 2026 Upper East Side Legionnaires' Disease outbreak. Her career as a pediatrician, dedicating her life to helping children and young people, was only just beginning. My sister was enormously kind, funny, ambitious and exceptionally intelligent. My whole life, I looked up to her and wanted to be like her. She cared deeply for those around her: her wife, her two younger sisters, her parents, her friends and loved ones, as well as the patients she treated, who described her as incredibly compassionate. My sister had so much life left to live. Instead, she became critically ill and was admitted to the hospital with Legionnaires' Disease. Because of her autoimmune condition, my sister was particularly vigilant about protecting her health. She took all necessary precautions and followed all health guidance. However, she was not prepared for an invisible threat in her own home, the one place where she was meant to be safe.

My sister developed symptoms two to three days before she was admitted to the hospital. By this time, a cluster of Legionnaires' cases had already been identified but not yet

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widely communicated to the local residents. Had she been informed and known about the risk and early symptoms, she could have been seen sooner and started on life-saving treatment earlier. We will never know whether the outcome would have been different. My sister was admitted to the hospital, experienced an emergency intubation and fought for her life for over two weeks. She endured an unimaginable amount of invasive medical treatments and attempts to save her life. Despite all these efforts, my sister died on the nineteenth of July 2026, surrounded by her family, her wife and loved ones. We remain devastated. There are no adequate words to describe our loss. To lose her so young and in a completely preventable manner leaves us grappling with many difficult questions about the multiple failures that allowed our dearest sister, daughter, wife, friend and doctor to die so unexpectedly and so tragically.

My sister always believed in helping others and preventing suffering wherever she could. She would not want any other person to die in vain. We cannot bring my sister back, despite this being our deepest wish. We can hope to prevent her death from becoming just another number or being treated as an unavoidable tragedy. Her life mattered and her death matters. We hope it leads to honest accountability and policy and practice changes so that no other family has to experience what we are enduring. I will end with what I told my sister in the hospital while she was dying. Thank you for being my sister. We will love you forever.

Thank you. I will now turn to Chair Schulman for her opening statement.

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Thank you, Speaker Menin. Almost one year ago today, this Committee held a hearing to discuss the City's response to the 2025 Legionnaires' Disease cluster in Harlem, which hospitalized 90 people and claimed seven lives. Legionnaires' Disease is a serious type of pneumonia caused by Legionella bacteria, which can spread through water droplets dispersed by cooling towers — rooftop structures that contain water and a fan as part of a centralized air cooling system for a building. Most healthy individuals exposed to Legionella bacteria do not get sick, but individuals who are 50 years of age or older or have chronic health conditions or weakened immune systems are at an increased risk for illness and hospitalization.

When large Legionnaires' outbreaks occur, it is almost always due to the presence of live Legionella bacteria in cooling tower systems. However, I want to acknowledge that Legionella can also grow and spread within the plumbing system of a particular building. These systems are subject to different protocols. We will hear about that today as well, with the main focus on cooling towers.

Over the past decade, amid multiple outbreaks, New York City has adopted some of the strictest standards for Legionella testing, cleaning and remediation in the world. Last year, the Council collaborated on my Bill, Local Law 159, which requires building owners to conduct monthly, every-30-days Legionella testing and disinfect cooling towers when they are in operation, usually during the warm summer months when Legionella bacteria is most likely to grow and spread. We implemented this law with the promise that these requirements would help prevent the next outbreak. And yet we are here again in the wake of another deeply traumatic and preventable tragedy.

What happened? First, climate change has increased New York City's temperatures over the summer months, especially in the past two years, which gave rise to outbreaks in each of these years, creating a ripe atmosphere for Legionella bacteria to grow and thrive. And just as important, the data shows that the laws we have on the books are only as strong as the administration's commitment to enforce them.

According to open data records, the number of cooling tower systems inspected by DOHMH each year has declined by over 50% since 2017, from about 5,000 annually in 2017 to 2,300 in 2025. There is a chart with a graph on the screen and you can see the precipitous fall in the number of inspections. The slide displayed on the screen shows a recent Gotham report. It shows that over the past decade, the overall number of cooling towers inspected in the first six months of each year has declined from over 300 in 2017 to just over 150 in 2026. This too is a 50% decline.

Data recently pulled from the Office of Administrative Trials and Hearings indicates that building owners owed the City approximately $5.1 million in outstanding balances related to cooling tower violations citywide, including approximately $1.5 million associated with violations classified as public health hazards. According to a 2025 report, DOHMH received 94 test reports showing potentially hazardous Legionella levels in cooling tower systems, and yet no cleanings or disinfection were performed by or on behalf of those buildings. The same report found at least 800 critical cooling tower violations and over 250 public health hazard violations citywide last year. Tragically, none of this reporting led to aggressive enforcement prior to the cluster in 2026.

According to DOHMH cooling tower inspection data and OATH enforcement records for the three zip codes included in the 2026 Upper East Side cluster, enforcement was limited during the first six months of 2026. After excluding dismissed cases, DOHMH issued summonses to six buildings in some months and five summonses to one building in others, while issuing none in January, March, May or other months of this year. However, once the cluster occurred, enforcement increased substantially. DOHMH issued 180 summonses to 78 buildings with a combined face value of $177,000 in fines during the 2026 cluster. Of the 58 buildings with cooling towers that tested positive through culture testing for Legionella, only two received violations between January 1 and June 17. Between June 18 and July 31, however, 35 of the 58 buildings received a total of 71 summonses with a combined face value of $65,500.

While the City's outreach efforts and transparency during the cluster improved from last year, much more needs to be done to make our cooling tower infrastructure safe for New Yorkers during the summer months. The data shows that the City enforces these laws and protects New Yorkers when Legionnaires' Disease is in the headlines and people are sick. Now the agency needs to show the same level of commitment to preventive enforcement 365 days a year. I want to be very clear: this cannot be the new norm. Nobody should die from Legionnaires' Disease in our City. We cannot accept that we will lose more New Yorkers to this disease every year. It is unacceptable to enforce the City's cooling tower laws only once an outbreak occurs. The agency must renew its focus on preventive measures. Building owners need to understand that there will be strict consequences for cutting corners and violating the law.

I said this last year and I will say it again: it should not take a major outbreak to trigger enforcement of our laws. People should not have to die for building owners to face consequences. We know this from over a decade of data. When the City continuously enforces the law, we save lives. As climate change makes our summers hotter and as our City ages and becomes more vulnerable to Legionnaires' Disease, we must use every available avenue and resource to create a safer and healthier City. We must also work to identify where laws can be tightened and where we can do more to keep New Yorkers safe and informed.

This Council remains deeply committed to strengthening our laws and protecting New Yorkers from the threat of Legionnaires' Disease. Today, the Committee is considering eight pieces of legislation which all aim to stop the spread of Legionnaires' Disease and keep New Yorkers as informed and as healthy as possible when an outbreak occurs. I want to thank each sponsor for putting forward these proposals and

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for their commitment to this issue. Before I talk about the Bills, I want to mention that we have been joined today by CM Salaam, CM Epstein, CM Wong, CM Felder, CM Farías, CM Maloney, CM Wilson, CM Aldebol, CM Narcisse, CM Morano and others joining on Zoom.

These Bills include Int 1016-2026, sponsored by myself, which would establish a dedicated Legionnaires' Disease hotline for the public to request information about Legionnaires' Disease outbreaks in New York City as well as to provide hotline users with referrals to resources and medical services. Int 0999-2026, by a Council member, in relation to establishing temporary Legionnaires' Disease testing sites and a digital map of testing sites. Int 1005-2026 and Int 1006-2026, by CM Maloney, in relation to education and outreach on Legionnaires' Disease and cleaning requirements for cooling towers. Introductions by CM Thomas-Henry in relation to post-cluster analyses of cooling towers associated with Legionnaires' Disease and establishing a public database of locations affected by Legionella. An introduction by CM Hanks in relation to an annual cooling tower compliance review and increased enforcement. And Int 0181-2026, by a Council member, in relation to requiring building owners to provide shower hoses and information materials on Legionnaires' Disease to tenants.

I look forward to hearing from the administration, receiving thorough responses to the Committee's questions and discussing the proposed legislation. I want to thank Commissioner Martin and Deputy Commissioners Howard and Shift for being here. Thank you again to Speaker Menin for being here today and for your leadership. We will now move to CM Amanda Farías for a brief statement on her Bill.

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Good morning and thank you, Speaker Menin and Chair Schulman and the members of the Committee on Health. Thank you for hearing Int 0181 today. I have been working for years to push this legislation forward, along with many others that are on the docket, after an outbreak in my district and many other communities of color made clear the need for defined protocol to get information and practical protections to tenants when a confirmed case of Legionnaires' Disease is identified in their building.

In 2022, residents at Clason Point Gardens were advised not to use their showers while the Department of Health and Mental Hygiene evaluated the development following two confirmed cases. When my office pressed for an alternative that residents could actually use during what could be a very lengthy testing process — as many were people with disabilities, older adults who needed mobility assistance — we worked with management to get shower hoses installed for the affected residents, following the principle that no water vapor or steam, just water, would allow people to use their showers and not inconvenience their day-to-day lives, as many were told they could not use them.

That experience largely informed the legislation before us today. Since then, we have continued to see this issue arise in residential water systems, including in a park in my district where DOHMH initiated a building evaluation after multiple residents sharing a hot water system were diagnosed with Legionnaires' Disease, and after the Legionnaires' cluster we saw this summer.

The need to strengthen every stage of the City's response remains just as relevant. Even while DOHMH is investigating a source, directing testing and overseeing any necessary remediation, residents are still living in their homes and making decisions on how to use their water safely, or even having to purchase water to use safely. When a case is confirmed in a residential building, the response has to reach the tenants in that building quickly. Guidance should get to residents, and they deserve to know what practical precautions are available to reduce their risk of exposure while the building response is underway.

The 24-hour requirement in my bill ensures that once notified, residents can take the immediate mitigation steps available to them. The shower hose provision is another practical tool alongside the health guidance that they are given. What we were able to coordinate at Clason Point Gardens should be built into the response when these circumstances arise. Residents should not have to wait for an elected official, a building manager and a health agency to work out an alternative after the fact, when we now know that there is one available that can also help reduce risk, as we saw no other people in Clason Point Houses be diagnosed with Legionnaires' Disease.

Int 0181 is not intended to replace our existing requirements around the building's water system. It is just meant to ensure that while those processes are underway, there is also a defined responsibility for getting appropriate information and practical precautions to people living there. I am interested in hearing from the administration today about how Int 0181 can be incorporated into its existing notification and investigation process and how the department would operationalize the 24-hour requirement. Truthfully, I am looking forward to the feedback we receive on all the bills before the committee today.

After carrying this legislation for several years, I hope this hearing positions us to move toward enactment and effective implementation. Thank you again to Chair Schulman for bringing Int 0181 before the committee, and thank you to my colleagues who have joined me as sponsors of this legislation. I look forward to hearing back from the administration after today's hearing. Thank you again.

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Thank you, Councilmember. Now we will go to CM Epstein for a brief statement on his legislation.

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Thank you, Chair Schulman and thank you, Speaker Menin, for hosting this hearing today. This is a really important conversation. As the Speaker mentioned earlier, a bacteria outbreak in their water supply left tenants confused for months. Misinformation was spread, oral information was contradictory. It is really a core function of City government to protect New Yorkers from public health threats, and Legionnaires' Disease here today is a real opportunity for us to learn about what we can do better as a City when it faces challenges like this one. We know this is not the first time and unfortunately this is not the last time. The loss of life — as the Speaker mentioned earlier, the loss of 11 people in her and CM Maloney's district — is such a tragedy that New Yorkers should not have to face again.

My bill, Int 0999, addresses a challenge that my constituents faced around having access to testing. When learning about the outbreak, many wanted to get tested. However, they were given fragmented, confusing and contradictory information about whether they qualified for testing or where they could get tested. The bill really establishes a procedure and process to ensure that the Department of Health can make sure that hoses can be provided, testing provided and information can be shared. This is particularly important for older adults and people with compromised immune systems, people with disabilities and people who had to struggle to get information. Getting information about testing sites and Legionnaires' Disease is critical.

It is important for the Council to hear directly from the administration about how we can improve on what happened this year, so that when New Yorkers are exposed to Legionnaires' Disease in the future, they will have the resources they need to be able to fight back. I look forward to hearing from the administration about what we can do better to impact the lives of affected New Yorkers, to make sure there are hoses and testing and information, and to make sure those cooling

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towers get tested on a regular basis to improve the lives of all New Yorkers. Thank you, Chair and Speaker Menin. I look forward to hearing about all the bills in the package and to the passage of these important bills.

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We are going to go to CM Maloney. Thank you, Chair and thank you, Speaker Menin. As one of the Council Members representing the Upper East Side where this outbreak occurred, this is a personal issue to me and to my district. It is imperative that we get into the details of how this happened and how we can be better prepared as a City to get ahead of a recurring public health emergency that will happen in the future.

I am introducing two bills before the committee today that focus on an improved response. Int 1006 strengthens prevention at the source by requiring cooling towers to be cleaned and disinfected at least three times a year, including during the summer cooling season when we know we are at highest risk of Legionella bacteria growing. Int 1005 focuses on public education and awareness by requiring the Department of Health to conduct outreach on Legionnaires' Disease, particularly for New Yorkers who are at higher risk, so that people understand the symptoms, their risks, actions to take and when to seek medical care.

Preventing future outbreaks is going to require a multifaceted approach: stronger prevention, enforcement, better public information and increased transparency. Thank you.

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Thank you, CM Maloney. We are going to... there are a lot of statements from members on their legislation. So what we are going to do is go to the pre-panel first, because these are people who are members of the community and victims of Legionella and have family members who are victims, so we do not want to keep them here too long.

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The first one we have is virtual — Ida Goldstein. You can begin. Good morning. My name is Ida. I will tell you, Robert was an Air Force veteran and a successful businessman. He graduated with a Juris Doctor from New York Law School. I was by his side every day in the hospital, walking back and forth every day. Legionnaires' came into my home. I am concerned for my safety and anyone else's. It could have been avoided easily by having the water tower cleaned. He thought he had caught pneumonia and had a high fever of 104. Robert was exposed to this poison, being in the hospital for over two weeks. He kept declining. He was on life support and oxygen. His lungs were not working and his kidneys shut down. He was on antibiotics. His white blood cells increased. He was going in and out of consciousness. I was waiting every day to see if he would improve, but he kept getting worse. He was getting thinner every day. My heart was breaking watching him suffer with all this life support attached to his body.

This water vapor that he breathed in, with no one warning us, came into our own home from the outside. It took his life away. Coming into the privacy of our own home, it murdered him and destroyed me. We were married 50 years and my loss of him is tremendous. He really fought for his life in every possible way because he said to me, "I do not want to leave you. I am lost without you." He was my everything, my soul mate, the love of my life. There will never be another one like him. I was privileged to have him in my life. A true love story, and I do not have him anymore.

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Are you done? Thank you so much. I am so sorry for your loss. Thank you very much for your testimony, much appreciated. Thank you. And we now have

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Daniel Thomas. Good morning. Thank you for the opportunity to speak. I appreciate both Speaker Menin and Chair Schulman's comments — they were reassuring to hear. My father was Bronx-raised, raised a family in Rockaway Beach, Queens, and he retired to Manhattan...

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You are muted. We wanted... we have to... oh, I do not know if I am still on or not. We can hear you. We are having a technical issue. We are trying to resolve it. Can you hear us?

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He is still on. I cannot hear myself, but I will continue. Daniel, you can proceed. Thank you.

To the extent that my father was a lifelong New Yorker — he retired in 2010 from the Queens County Supreme Court bench and he resided in Manhattan on the Upper East Side until the time he passed. My father was actually a very pragmatic person. He understood that not everything can be fixed, not everything can be resolved. But when he received notice that he had Legionella, July 2, I took him to the hospital and he fought, nearly dying. To the surprise of many of the doctors, he survived six weeks fighting this disease. He encountered numerous complications. He had two life-saving procedures to fix arterial bleeds that developed from stress ulcers. His body filled up with fluid — he looked like the Pillsbury Doughboy, based on the amount of fluid his body was holding — because it was fighting this Legionella, which is so toxic it completely alters and creates a cascade effect on any existing problems that you have.

But he was independent. He walked the neighborhood on the Upper East Side. He went to the bank, he went shopping, he went to the park. He was a member of society, still contributing, still working, still helping young lawyers, counseling them, guiding them, giving advice to other judges. The amount of pain that he went through enduring this disease... he was compos mentis the whole time. He never lost any of his faculties. He was aware. He made videos to his grandkids. When doctors approached him and said, "You need this procedure — you are not going to survive this procedure that you need," he did it, and he was strong. But he was not strong enough.

The thing that the public needs to know and this committee needs to know: the reason Legionella is so deadly to the elderly is because it creates a cascade effect and you do not have the strength to weather the storm. There is not enough runway of health to make you last. The doctors said normal pneumonia you can get over in a matter of weeks. Legionella is going to be months, and the body weakens on a daily basis. It was very, very difficult for myself and my family to watch what my father went through. To the point where he knew, and what he said to me was: this was a completely preventable, random act of violence that occurred to me. And my whole life I have been about justice, doing it right, making sure it was done properly, and this was unjust.

So enforcement absolutely has to be stepped up. I appreciate that the City has been making changes, but they are not enough. They were not effective enough to prevent this outbreak. The 2025 outbreak in Harlem should have been a wake-up call to the entire City, every building owner, everyone who is doing enforcement. We cannot cut corners on safety when it is completely preventable, completely avoidable. My father in the hospital said to me, "What kind of judge, what kind of juror would I be if I did not stand up for myself and my own rights?" He retained a very capable attorney and said, "I want Ron Carter to represent me. I will not live to see the end of this matter, but I do want to see change. I want my grandkids to know that my death was not in vain." And to the extent that enforcement is also part of what the penalty is — I do not know that the penalties are strong enough. I would ask this committee to consider what penalties there are.

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We have tremendous means and technology today, whether it is shutting down electrical systems to these cooling towers or the buildings themselves, to force compliance if necessary. It is great that there are millions of dollars in arrears for buildings that have not complied, but that does no good for the New Yorkers walking the streets. There is so much more I can say and I am happy to do it at a later date, but right now I want to share with you that enforcement is key. I am delighted to hear that no death is acceptable from Legionella in this City at this time. No death is acceptable. To put it in context, I read an article about a fighter jet that the U.S. military has — it costs $150 million — and there is an ejection seat in that fighter jet that tells you how precious life is. So the fact that my father was 92 does not change the fact that he still had life ahead of him and he was robbed and his life was taken away. Thank you for the time.

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Daniel, I just want to thank you. I know it is obviously very painful to have to come and talk about the loss of your father. We very much appreciate you doing that, and I want to extend condolences to you and to your family, and condolences to Ida, who spoke earlier. Ida and I had a conversation right after her husband died. She told me with much love about her 50-year marriage to her husband, and I know it is very painful, Ida, for you to have to talk about this. But we appreciate you doing so as well, and our deepest condolences. Thank you very much. We really appreciate it and we appreciate you testifying because it makes a difference for us. Thank you. Now we are going to have Minister Sandra Coleman — just come and take a seat — and Valerie Mason. Minister, you can go first.

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Greetings. My name is Sandra Coleman. I am a minister, the president of One Night Advocates and co-founder of the Home Sizes Coalition. I reside at Isaac Houses on the Upper East Side. Legionnaires' Disease is 100% preventable. We should not be here today. Have we not learned from the seven souls lost in Harlem last year? One death is too many. I will repeat: one death is too many.

Legionnaires' is a year-round disease. Our Health Department should have stayed on ready. If they cared and were accountable to New York City residents, they would have hired an adequate number of inspectors who would have been able to identify cooling towers that tested positive. NYCHA has a very vulnerable population. As a minister and community leader, I had seniors from Isaac Houses and Holmes Tower tell me they were hospitalized because they had Legionnaires' Disease. An elder told me their kidneys had shut down and that disease almost killed them.

This is not a disease that is new. We know it is curable, but most of all that it is preventable. My deepest condolences to the eleven families that lost their dear loved ones to this preventable disease. Their families' pain, their loved ones' blood is on the hands of those who were supposed to protect, inform and be accountable to them. Please, please, please be vigilant and protect all New Yorkers. Keep this City safe from this year-round preventable disease. Thank you for allowing me to testify today. God bless you all.

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Thank you. Mason...

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Good morning. Good morning, members, and thank you for holding this hearing. I am Valerie Mason and I am the Chair of Manhattan Community Board Eight, which encompasses the Upper East Side and, most notably for purposes of this hearing and unfortunately, the locus of this summer's Legionnaires' outbreak. I want to acknowledge and send the sympathies of Community Board Eight to the families who lost loved ones, and our gratefulness to our health professionals that facilitated the recovery of 83 more New Yorkers. I know more about Legionnaires' than I ever thought I would.

I want to thank the City Council for passing legislation last year in response to the 2025 outbreak that set up the framework that should have, if followed by this administration, reduced the number of non-compliant cooling towers. In addition to the cooling tower outbreak, we had three separate cases of in-building Legionnaires' in my district this year. We need to come to grips with the facts that Legionella bacteria is here to stay, and with temperatures rising every summer, the conditions that we saw this summer could very easily be a regular occurrence.

The City, in its press release yesterday, is lauding itself for quote its rapid and aggressive response. I just want to go on record and say that I was in the room and that initially the City's response was not going to be rapid and aggressive. It was at the urging of our local elected officials, some of whom are in this room, that the City changed its initial plan not to wait two weeks for cultures to grow but to get out there and start. If a cooling tower preliminarily tested positive for Legionnaires', we need to be more proactive, not reactive.

I saw the Mayor's announcement of so-called sweeping measures. They do not seem very concrete to me based on what I experienced this summer in my community. My recommendation for identifying unregistered cooling towers is not quote developing synergies between the Health Department and the Department of Buildings. If you want to identify unregistered cooling towers, fly drones over the top of buildings. As for public education and transparency and an online tower lookup, that sounds great, but many New Yorkers do not have access or feel comfortable on the web. They should have as much information as those who are comfortable with it.

If you live or work in a building with a cooling tower, your landlord should be required to notify you. New Yorkers are some of the most vigilant people on earth. I know if they know what the reporting requirements are, they will make sure that their landlords are following them. People were very concerned on the Upper East Side. We were overwhelmed with inquiries about whether people should go outside, where they should leave the City until the cluster was over, should they meet their 87-year-old friend for lunch in one of the affected zip codes. These were the kinds of questions we were getting.

When a cluster is identified, the City should set up mobile units for free testing. Many people cannot afford to go into an urgent care, even if they think they have the initial symptoms. The quicker people are diagnosed, the better.

Let us not forget about the other type of Legionnaires', the in-building kind, where residents cannot shower or use hot water. The City should put into infrastructure some type of on-call arrangement for mobile shower units. These situations can last a long time and New Yorkers can and should be cared for by their government.

During the previous major Legionnaires' outbreaks, Mayor de Blasio personally visited the affected Bronx communities. He was at Lincoln Hospital. Last summer, Mayor Adams was in Harlem distributing information and speaking with residents. As of today, there has been no outreach by our Mayor to this affected community, although he lives in it. He did not attend any of the town halls nor attend any of our community board meetings, either in person or via Zoom, to find out what was happening in our community. I am so disappointed and troubled by this, and I hope you will be too.

We look at basic issues of public safety and health and we have been failed here. I appreciate all your efforts to do more because as New Yorkers living in the greatest city on earth, we deserve the best and we are not getting it. Thank you.

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Thank you, Mason. Appreciate your testimony. Appreciate both of you. Thank you. Now I am going to read...

(00:43:53)

We have some statements from other elected officials, some of whom have legislation before us. I am going to read a statement now from the Public Advocate Jumaane Williams. Good morning.

(00:44:12)

My name is Jumaane D. Williams and I am the Public Advocate for the City of New York. I want to thank the chairs and the members of the Committee on Health for holding this hearing today. This is the second consecutive year of deadly Legionnaires' outbreaks, and summers in New York are only getting hotter. It is past time we implement measures that protect residents from a disease that is both preventable and predictable.

After 94 cases and 11 fatalities this year, I am concerned that current enforcement measures for cooling tower regulations are not enough. Under the 2015 law, which was implemented after an outbreak that killed 15 individuals, all building owners must register their water cooling towers with the City and submit a maintenance plan to the City every three months to prevent and control the growth of Legionella.

In the aftermath of last year's outbreak, the Council passed Local Law 159, requiring more testing for the Legionella bacteria by building owners, increasing the frequency from 90 days to every 30 days. As Commissioner Dr. Martin pointed out at the July 6 Legionnaires' Disease virtual town hall, we have not had time to see the most recent measures take full effect. Even so, some public health experts are skeptical that more testing is a solution. They say building owners can test immediately after a deep clean, which means that they draw a negative test result even if the cooling tower had been rife with bacteria in the weeks leading up to the test.

Dr. Martin also said that DOHMH had identified two building owners in the impacted zip code that are considered particularly bad actors, one of whom had not registered the cooling tower with the City as required by law. With persistent outbreaks in the face of regulatory changes, we have seen that traditional water regulations can fall short. When water enters a private building, the responsibility of public health is shared by the City and the landlord. Unfortunately, financial incentives are oftentimes needed in order to discourage bad actors and encourage landlords to prioritize the health and safety of their residents.

I believe the current level of fines is not strict enough. As it stands, landlords are fined a thousand dollars for a first offense and two thousand for each additional offense. More meaningful, effective enforcement calls for higher fines. For this reason, my office is submitting legislation that would raise the level of fines. But even before that change is considered, the City must take proactive steps to ensure that outbreaks like this one do not happen again. I call on the City Council to push forward the preventive Bills heard at today's hearing and to hold landlords accountable by increasing fines for cooling tower violations. Financial incentives, together with more frequent inspections, can help prevent future outbreaks.

(00:46:46)

I would be remiss if I did not add my voice to the frustration that, in past years, this issue has disproportionately impacted Black and Brown communities in the Bronx and Harlem. Several survivors and families are now suing the City over the outbreak last year. This year's Upper East Side cluster reinforces the understanding that Legionnaires' is a risk to all.

In honor of those we have lost and those still concerned, we must be proactive, not reactive, in preventing outbreaks. Thank you.

Okay, let us see. The other statements that we have, we are going to submit for the record. So now I am going to call up the Health Department to give their testimony. Welcome. You can proceed whenever you are ready. And the committee counsel will swear you in. I am sorry. Okay. Please raise your right hand for me.

(00:48:47)

Good morning, Speaker Menin, Chair Schulman, members of the committee. Before I begin, I want to acknowledge the New Yorkers who shared their stories with us today. I heard you, and your stories underscore the responsibility we have to learn from this and to strengthen our system.

I am Dr. Alistair Martin, Commissioner of the New York City Department of Health and Mental Hygiene. I am joined today by Deputy Commissioner of Environmental Health Corinne Schiff and Deputy Commissioner of Disease Control, Dr. Andre Howard. Thank you for the opportunity to testify today on the department's response to the Legionnaires' Disease cluster on the Upper East Side.

In connection with the cluster that was the subject of this summer's investigation, 11 people died. My deepest condolences are with the families and friends of the people we lost. We do not take any loss of life lightly, and one of the priorities for today's hearing is to honor their lives.

I am grateful for the opportunity to outline the City's response to the Legionnaires' cluster. With that in mind, as the City's doctor, let me first explain what Legionnaires' Disease is and what it is not. Legionnaires' Disease is a serious form of pneumonia caused by Legionella bacteria that are ubiquitous in our environment and grow quickly in warm water. It does not spread from person to person. It is contracted by inhaling mist that moves invisibly through the air. People who are over the age of 50, people who smoke and people who have certain chronic diseases or compromised immune systems are at greater risk. Legionnaires' Disease is very effectively treated with antibiotics when it is diagnosed early.

Especially in the summer months when we experience higher temperatures, Legionella grows easily in cooling towers, often located on top of buildings. With climate change, New York City is experiencing longer, hotter summers and more frequent and intense heat waves every year, and that increases the risk of Legionella growth in cooling towers. It is important to note that cooling towers are separate from indoor plumbing and potable water. Cooling towers are mostly used to remove heat from buildings and cool equipment. While towers operate, they release mist into the open air outside. If the cooling tower is contaminated, that mist can carry Legionella bacteria. All of the evidence indicates that that is what happened this summer as part of the Upper East Side cluster. 94 people were diagnosed with Legionnaires' Disease and tragically 11 people died.

At the Health Department, we do everything we can to prevent disease clusters from happening in the first place and to respond urgently when they do. That is exactly what we did. On the afternoon of July 2, our waterborne disease surveillance experts, who monitor our data every day, identified a potential cluster of Legionnaires' cases even before our sophisticated surveillance analytics tools showed a signal. This allowed us to quickly mobilize our team at the earliest possible moment. Our team's decision is a credit to their years of experience and expertise. Their quick thinking and ingenuity likely saved lives.

Over the historically hot Fourth of July weekend, we mobilized to start testing all 183 cooling towers in the affected zip codes for Legionella bacteria. Our team of water ecologists, recently expanded to 56 budgeted positions including 23 new hires in November 2025, and our Environmental Health Division supported the response, including the effort to collect samples from each cooling tower and take them back to the lab. There we immediately began a two-pronged testing process. The first piece was to subject them to PCR testing, which yields results quickly to determine whether Legionella bacteria are present.

(00:53:14)

Crucially, these tests cannot determine if the bacteria is dead or alive, and only living bacteria can make people sick. We also began the culture testing process, which is the gold standard in detecting live Legionella bacteria. These tests more precisely detect the presence of the type of live Legionella bacteria that can cause illness, but they take up to two weeks to produce results.

We do not wait two weeks to act. For each of the 83 preliminary PCR tests that came back positive, we ordered building owners to fully drain, clean and disinfect their cooling towers, and all of them complied. That is a more aggressive strategy than our City has ever taken. Cooling tower cleaning and disinfecting effectively eliminates bacteria. But cleaning without testing first poses its own set of risks. That is why we did not recommend blanket biocide for every cooling tower in the investigation area. The frequent and aggressive use of biocide can corrode the internal cooling tower system and strip the protective materials, ultimately making way for more bacterial growth in the future. We recommend a balance of strategic testing and remediation rather than blanket treatments. This summer, we struck that balance.

(00:54:45)

Balance.

(00:54:46)

The data indicates that any source of bacteria causing this cluster was likely eliminated within a week of launching the investigation. Over 90% of the people in the cluster developed symptoms before July 7. Remember, we called this cluster into order on July 2, just five days after the Health Department launched its investigation. 90% of those who were sickened had already developed their symptoms. Symptoms typically appear 2 to 10 days after exposure and can take up to two weeks. That means the majority of people who got sick were likely exposed in the week or two before we discovered the cluster. As soon as we learned about a possible cluster, we took action.

While our team of epidemiologists and water ecologists worked long hours to pinpoint and contain this cluster, we were also working to keep the public informed. My team and I were in close communication with our colleagues across City government, including members of this Council, our partners at City Hall and the Mayor directly.

(00:55:54)

We also worked collaboratively with community partners and health care providers who have long-standing relationships on the Upper East Side and are well suited to be trusted messengers in moments of crisis. Above all, we spoke directly to the public and to New Yorkers who live and work on the Upper East Side in particular, starting the Friday of that holiday weekend.

(00:56:13)

We canvassed neighborhoods in the investigation area. There we handed out flyers and answered questions. I joined my team of community health workers on the streets of the Upper East Side that weekend to speak directly with New Yorkers. We worked closely with members of the press to make sure New Yorkers were hearing the most up-to-date information from me across all platforms, on the news, in the headlines and on the radio. We placed ads on link boards and on radio stations. We pushed alerts to New Yorkers' devices through Notify NYC in collaboration with our partners. At every stage of the investigation, we were direct and transparent. In total, more than 260 Health Department staff members supported this response.

(00:57:00)

And that includes scientists who interviewed and reviewed records for more than 150 potential cases, collected samples from more than 180 locations and performed more than 360 different tests on those samples.

(00:57:14)

In addition, our community health workers and communications specialists distributed over 6,000 informational fliers and palm cards in three languages, hosted a webinar for health care providers, held multiple public briefings and town halls which had approximately 2,000 attendees across all events.

(00:57:31)

We issued nine public health alerts and posted information at nyc.gov/legionnaires and on social media, which received more than 2 million impressions.

(00:57:42)

The Health Department's work is to try to prevent clusters like these from happening, and that work is about oversight. Ultimately, it is up to individual building owners to comply with the legislation this Council creates. To enforce those laws, we create targeted regulations and educate, train and provide guidance to building owners with cooling towers. We conduct inspections to promote compliance and mitigate risk. When owners are not meeting their obligations, we hold them accountable.

(00:58:15)

The owners of buildings that house the more than 5,000 cooling towers in our City are responsible for monitoring, maintaining and remediating building equipment when necessary to reduce the risk that Legionella will grow. Over the past decade, New York City has stood up and enforced the most comprehensive cooling tower oversight program in the United States.

(00:58:34)

I am grateful to Chair Schulman and to the members of this Council for the collaborative effort to create Legionnaires' risk mitigation laws that serve as a model for the world. That legislative process began in earnest after the 2015 cluster in the South Bronx, which sickened 138 people and killed 16. After subsequent clusters, including the one in Central Harlem last summer, the City Council has repeatedly amended and tightened those regulations. The latest revision of our oversight program is a local law that took effect on May 8 of this year. The central change of the local law was to increase the frequency of legally mandated Legionella tests of cooling towers that owners must conduct from once every 90 days to once every 31 days.

(00:59:26)

While the law did not take effect until we began preparing for that new requirement to take effect in the winter of 2025, that included updating our online guidance materials for cooling tower compliance, contacting owners of thousands of registered cooling towers to inform and later remind them of the coming changes.

(00:59:48)

Issuing a press release when the regulations took effect, providing individualized phone consultations with owners, reviewing the upcoming requirement at inspections, and holding training sessions on testing practices. The new requirements were just under two months old when we began our Upper East Side investigation this summer.

(01:00:12)

One of our most effective enforcement tools was public pressure and transparency. This summer, for the first time, our agency published the addresses of buildings that had a cooling tower test positive. When culture test results became available, we published those addresses as well. On July 10, we released the first list of PCR positive addresses. At that point, 74% of the Upper East Side towers our inspectors visited were meeting the new monthly testing requirements.

(01:00:48)

Two weeks later, it was 97%.

(01:00:52)

That unprecedented level of transparency pushed building owners into action. Citywide compliance rose from 77% before the cluster to 81% by late August. To contextualize those numbers, I want to clarify that the percentage of non-compliant cooling tower operators can be artificially high, and that is because that number includes all cooling tower operators not submitting documentation of taking the sample. That is even if the cooling tower is not currently running, or if building owners are testing but failed to document it.

(01:01:28)

We recognize there is always something to learn from each cluster. This summer is no exception and we are advancing five new measures, which I will address shortly. That said, our staff have conducted more inspections than this time last year and we are grateful for the additional funding to expand our team of water ecologists. Our water ecologist team has grown to 56 budget positions, including 23 new positions funded in November 2025. The majority of these

(01:01:57)

positions are filled today and we are actively recruiting for the remaining six positions. This process takes time. These are highly specialized roles and candidates must have specific credentials to comply with civil service requirements. If the Council can help us reach qualified candidates to fill the handful of remaining water ecologist positions through your district networks, we welcome it.

They are the foot soldiers of this process and I have spoken with many of them directly this summer. Some of those conversations happened at rooftop inspections across the City, which I myself personally attended. They are doing incredible work to ensure that building owners stay vigilant. I am very grateful for their work and that of the entire Health Department team this summer.

While my testimony thus far has outlined our response in the past tense, there is still one outstanding step in our accountability process. On July 31, we were confident any bacterial source had been eliminated. Two weeks — the incubation period for Legionnaires' Disease — had passed since anyone who lives, works or visited in the area reported feeling symptoms, but our work is not yet finished.

We continue with the genetic analysis aimed at pinpointing the source of bacteria that actually made people sick in this cluster. We know that not every cooling tower that harbors Legionella bacteria ultimately causes an infection. To trace the bacteria that caused this illness, our public health laboratory experts are comparing the Legionella cultured from patient samples collected by doctors to the Legionella cultured from cooling tower water samples that were collected in the investigation. We expect that analysis to be complete this fall. If there are genetic matches, we will have more information on what exactly happened on the Upper East Side to cause this summer's cluster.

Coming out of this cluster, we worked with City Hall to shape a series of five new measures to strengthen the City's education and enforcement in response to Legionella bacteria in cooling towers. These new measures include: first, identifying potentially unregistered cooling towers by developing synergy between the Health Department and the New York City Department of Buildings in the City's registration and tracking systems; second, enhancing public visibility and transparency regarding cooling tower regulations by adding a new mapping feature to the Health Department's address-based cooling tower lookup tool; third, exploring faster culture testing and novel testing approaches to decrease the amount of time it takes to get test results; fourth, accelerating enforcement of cooling tower violations by assigning the earliest Office of Administrative Trials and Hearings hearing date that rules permit; and fifth, convening a scientific advisory panel to evaluate new cooling tower technology and explore alternative cooling systems to cooling towers in the first place.

We are committed to delivering all five and look forward to working together across City government to realize them. We did not wait to act on the Upper East Side this summer and we are not waiting now.

Turning to the legislation under consideration today, we are supportive of some of the Council's proposals and we have some current concerns about other Bills. We support Preconsidered Int T2026-2364, which would require the Health and Buildings Departments to collaborate to identify unregistered cooling towers. In the last two cluster investigations, unregistered cooling towers have been discovered at buildings that were under construction or newly constructed. The Health Department and DOB have the capacity to work together to create an efficient way to cross-reference our data between DOB and the cooling tower registration portal. That would allow us to identify gaps in registration and reveal when a cooling tower exists but is not registered. This will enhance our City's ability to check compliance with cooling tower regulations, ultimately reducing risks of Legionella exposure.

We have concerns with Int 0181-2026, Int 0999-2026 and Int 1006-2026. Int 0181-2026 would require owners of buildings where one resident has Legionnaires' Disease to provide shower hoses and information to tenants within 24 hours of that person being diagnosed. There are hundreds of cases of Legionnaires' Disease in New York City each year. In our investigations, case investigators review every single one. A pattern of cases grouped in space and time suggests that Legionella bacteria may be growing in the built environment and we can act to cut it off. Most of the time our investigators do not observe a pattern and the cases are sporadic. We would not have evidence that there is any heightened Legionnaires' Disease risk for tenants and that a shower hose would serve to reduce their risk. We are also concerned the Bill does not consider the types of plumbing within the building, which could create challenges, potentially including additional expense to utilizing a hose. We want to be sure that the expense associated with the Bill would not be passed on to tenants. We have suggestions for ways the Bill can better target these concerns and look forward to discussing them with the Council.

Int 0999-2026 would establish pop-up testing sites. Legionnaires' Disease is not COVID. There is no clinical or public health benefit to pop-up testing sites and in fact it could lead to inappropriate care. Pop-up clinics are not appropriate for screening and testing for Legionnaires' Disease, which requires symptoms screening, triage, a physical exam, diagnostic testing as necessary, and that could include other things like chest X-rays and blood tests. Furthermore, there is no public health benefit to testing people with no symptoms.

As Legionnaires' Disease is not transmitted person to person, for those with signs and symptoms they should be tested and cared for by a doctor in health care settings. They should not be waiting for test results to get care and possible treatment.

Int 1006-2026 sets cleaning requirements for cooling towers at least three times per year. There are already two required cleanings — a summertime clean and disinfection — and owners are required to continuously clean and disinfect when their monthly Legionella sampling results are positive. As outlined, unnecessary cleaning and disinfection using biocide can damage cooling tower systems by causing corrosion that can make the systems more conducive to harboring bacteria and harder to clean. The new requirements for monthly Legionella sampling are available to validate water treatment in the cooling towers and drive the corrective action requirements to clean and disinfect.

Of the remaining Bills — Int 1005-2026, Int 1016-2026, Int 1017-2026 and Preconsidered Int T2026-2422 — we are supportive of their intent and have some recommendations to the Council for how to improve the legislative proposals. Int 1005-2026 would require education and outreach about Legionnaires' Disease and outbreaks. This Bill largely codifies routine, crucial work of the agency. We support the proposal and would want to clarify the language of the Bill. Int 1016-2026 establishes a Legionnaires' Disease hotline. Our call center agents can answer inquiries about Legionnaires' Disease after 311 routes them to us. We are happy to provide general guidance to New Yorkers, but if individuals have clinical concerns they should always consult their health care provider. Int 1017-2026 requires analyses of cooling towers associated with Legionnaires' Disease clusters. We are open to reporting information that could be helpful to the public regarding community clusters of the disease. We look forward to working with the Council regarding the details of the analysis and the report. Lastly, Preconsidered Int T2026-2422 would require us to maintain a public database of locations impacted by Legionnaires' Disease.

(01:10:02)

As outlined in the five new measures put forward by the administration, the Health Department will provide a map to supplement our existing address-based online lookup tool for cooling tower inspections. That tool allows any New Yorker to enter an address and see the registered towers at or near it, with each tower's registration status, inspection history and Legionella sampling compliance. The map will show the cooling tower locations and the lookup tool provides recent inspection results. However, mapping diagnosed cases in building investigations or community clusters of Legionnaires' Disease could jeopardize patient confidentiality. We look forward to discussing all of this legislation further with the City Council.

(01:10:46)

In conclusion, thank you, Speaker Menin. Thank you, Chair Schulman. Thank you to the members of the Committee for your attention and commitment to this issue. We look forward to working together to further strengthen our City's Legionnaires' Disease prevention and response infrastructure.

Before I conclude my testimony, I would like to direct your attention to the appendix in the printed copies you all have in front of you. I have walked through the major points in our response to the Upper East Side Legionnaires' cluster this summer, but this testimony is not a comprehensive report. To that end, we have included a timeline detailing every single step of our response, day by day. I hope you will find it a useful record. Each step we took to cut off any bacterial source was in service of keeping as many New Yorkers out of harm's way as possible.

I want to end today where I began, in connection with this summer's cluster. As we continue to discuss the technical details of our interventions, I want to keep their memory at the heart of this work. Thank you and I look forward to your questions.

(01:11:52)

Thank you, Commissioner. I am now going to hand it over to Speaker Menin for her round of questioning. Thank you.

(01:11:57)

Chair Schulman: Thank you so much, Commissioner, and to your team for being here today and for your testimony. I know I have a lot of questions and I am sure my colleagues do as well, so I will begin with some of them and will probably come back for a second round as well.

So I really wanted to start off by asking if you have determined the source of the 2025 cluster. I obviously saw what you said in your testimony, but have you been able to narrow it down to a source — for example, a residential building, a commercial building or a City-owned building?

Yeah, first of all, thank you again, Speaker Menin, and thank you, Chair Schulman, for bringing us here today. Before I talk about where we are with the source, let me just say a few words about the 11 New Yorkers who have passed. Each one of those deaths is a tragedy and our hearts are with the loved ones, with the friends, with the families, and each New Yorker who lost their life. This process requires us to examine every single thing that we can about this response and to identify ways to push our nation-leading Legionella laws even further.

Now, to answer your question directly: the process of identifying the exact match, pinpointing the cooling tower or towers that are responsible, is still ongoing. We are doing something called whole genome sequencing right now. My hope is that we are going to be able to provide a match — that there will be one or two, as there were last year — matches, but we do not have that data back yet. We should be able to report on that later this summer or later this fall.

(01:13:25)

I guess my response to that is, why is it taking so long? Because in the Harlem outbreak, the Department released the results of the source within 35 days or so. In the Bronx outbreak they released their results, and I believe it was 26 days. So it has now been two months.

(01:13:45)

Yeah, thank you for that question. This is a very complicated process where we are looking to make the match between the sample we take from the bacteria in the patient samples, then to match them to the bacteria in the associated cooling towers. So this process is complicated, it is complex and it takes time. Let me pass it to Dr. Howard to share a little bit more about the process and where we are.

(01:14:10)

Sure. Thank you for the question. As you heard earlier, there were 180 cooling towers and we had 59 cooling tower samples that were culture positive. For each of these cultures, we have multiple isolates that undergo whole genome sequencing. We actually do two different culture methods and for each culture there can be more than one isolate. One of those cultures is a solid culture on a petri dish. Depending upon the sample, we can have five colonies of bacteria that grow or we could have 20, and there can be more than one species of Legionella that grow on the petri dish from that one cooling tower sample. So the technicians will sample isolates from multiple colonies on the petri dish. They are doing whole genome sequencing on over 300 isolates, that includes isolates both from the cooling tower samples as well as from a handful of patients, and that takes time. After we have the whole genome sequencing comes the analysis to look for that potential genetic match — an identical fingerprint between patient samples and environmental samples. So when precisely do we expect to have these results? We expect that later this fall.

(01:15:44)

I want to move on to inspections. According to reports, and I know Chair Schulman referenced this, inspectors inspected more than 5,000 towers in 2017. By mid-2025, the number had fallen to just over 1,100. Why are we inspecting so few towers compared to nine years ago?

(01:16:07)

Yeah, thank you for the question. So our inspection work is really the third layer of defense that we have when we think about the system that exists to protect the City from Legionnaires' Disease. The first layer is really what the owners need to be doing on a daily, weekly and monthly basis. The second layer, from our standpoint, is to ask — and because of the law that was implemented from last year's 2025 law, they also now need to submit this monthly sampling to allow us to investigate how they are doing, how owners are doing, what daily, weekly and consistent actions they need to be taking. The third layer of defense in this system is what you have described — us doing these inspections, going actually physically to these cooling towers. The fourth layer is if we find things that are wrong, if there are things that need to be immediately addressed or adjusted, we enforce and issue summonses which turn into fines and we order corrective action to be taken. All of these layers together are coming together to help reduce the risk of Legionnaires' Disease clusters. One of the layers that we have, as I mentioned, is inspectors. Let me talk about the rates of inspections. Our inspections this time compared to last year are up over 30% and that work is critical, but it is also not...

(01:17:49)

I am sorry, I am going to interrupt you because it is not about what is happening right now after the outbreak. It is what did not happen before the outbreak, because obviously we know now the Department is doing far more inspections after the outbreak has already occurred. What I am concerned about is, according to reports, the Department issued no violations in the zip codes covering the Upper East Side in January, March or May of this year. The Department issued 20 summonses to six buildings in February and five summonses to one building in April. Is that correct?

(01:18:24)

Let me answer that question, but let me come back to clarify the previous point. The 30% increased number of inspections, Madam Speaker, is not after the cluster. So the new water ecologist positions, the funding that we got, has made a difference and more inspections have happened even

(01:18:49)

before this cluster. Let me pass it to Deputy Commissioner Krantz to talk about the monthly summonses and inspections you just asked about.

(01:18:59)

Thank you, Commissioner. Speaker, we are still looking at the data that was in the Council report to see if our data matches that, but I would say a couple of things. First, as we have noted, last year we were short staffed, and that is why we were not meeting our goals to inspect every cooling tower annually. The Commissioner testified we were authorized to hire additional staff in November 2025 and we have been actively recruiting, and that is why our inspections are up about 35% citywide since the start of this year. As we continue to bring staff on and train them, those inspection rates will go up.

As the Commissioner said, inspections are an important part of our overall program to promote compliance among cooling tower operators with the Council's nation-leading, incredibly protective laws and the regulations that we have issued to detail for owners how to comply with those local law mandates. So in addition to inspections, which are an important part of promoting compliance, we also offer guidance that we publish on our website and we make available to owners. We have individual consultations, we send out reminders at key points of the year, we have newsletters that we publish on key topics, we hold training sessions. All of these are designed to support owners who have very specific requirements that they have to implement all the time — there is a great deal for them to do many times a week and month.

(01:20:37)

It does not... I guess I have a very specific question, which is: it appears from the data that the department did not issue any violations in the affected cluster area in January, March or May of this year. As I mentioned, 20 summons to six buildings in February, 5 summons to one building in April, and then suddenly in July, 180 summons to 78 buildings. So look, we obviously want to see the increased enforcement, but what we are trying to get at here is why there was not enforcement when we knew the summer months were coming. And then why is there no data about the number of inspections from 2026? Normally that data is made public, and our team is telling us we cannot access any data. So if that has changed, we would want to know that. But as of when the committee report was written, our team was telling us there was no data made public about the number of inspections from 2026.

(01:21:31)

Let me share just a few words and then we will see if the Deputy Commissioner has anything else to add. Madam Speaker, we have been consistently issuing summonses and violations this last year in 2025 — to the amount of over 1,300 violations in total, totaling hundreds of thousands of dollars, $680,000 in fines. Within the cluster region that you described, we also issued summonses and violations — over 110 as part of this cluster. 15 of those were public health hazards, 50 were critical violations, 40 were general violations. So the enforcement apparatus — we have two jobs as part of what we do in our regulatory system. First is to reduce the risk of Legionnaires' Disease clusters. The second is, when they happen, to respond aggressively, transparently and quickly. The violations that you see here are us doing that part of helping to reduce the risk.

(01:22:37)

Right, but those violations occurred after the outbreak had occurred. That is really our point. Our point that we are trying to make is we want to understand why — Legionella bacteria is no surprise when it happens in the summer months, which is why the Council originally passed Chair Schulman's law a year ago that went into effect on May 8 — why there were not more violations. In addition, during the outbreak, only 35 of 56 authorized water ecologist positions were staffed heading into the summer months. So there were 21 authorized positions at the department never staffed with active inspectors.

(01:23:16)

Let me clarify the record on that account, Speaker. There are 56 total budgeted positions for the water ecologists. 50 of those positions either have people who are on the ground, on the roof — I was with some of them just a couple of weeks ago doing our water inspections — or going through the onboarding process. You are right, there are folks who we have not recruited, we have not hired. We have six open positions and we are trying to make sure we get the right people for each of those roles. Those are highly specialized roles, but the vast majority of these, even the new positions that we got more recently filled, had folks either on the ground before the outbreak occurred.

(01:23:56)

The point is, why between the start of the year and heading into the summer months did the department leave 21 authorized positions of active inspectors open? That is the point. It is very good that now it is being filled, but our point is that had the department filled these vacant positions, we would probably not be in this situation that we are in right now. So that is what I am trying to get at. If we could move on — how many buildings were noncompliant with Chair Schulman's 2025 law when it went into effect? Our understanding of the data — please correct us if we are incorrect — is that 25% of buildings were not in compliance. So why were there so few violations issued if there were 25% non-compliant buildings?

(01:24:42)

Across the city, citywide compliance with the new law was 77%. That was right about eight weeks after the new law had gone into effect. Within the cluster region, compliance was 74%. While the cluster carried on, as you know, we decided to take the most transparent step we have ever done as part of these clusters and we released the names of the PCR-positive buildings. By the end of this cluster, through that process, 97% of those that we inspected were compliant. That is why the lesson that we learned from this process is that this transparency is a critical feature, a critical part of the work to increase compliance on this brand new law. And yesterday we took a further step to increase the transparency by allowing residents to use a new tool where they can put their address in and get a map to see what the compliance history is of the towers in their neighborhood.

(01:25:55)

And that is, I guess... and I am sure Chair Schulman will talk about that, but that is why we wanted, coming into the summer months, far more proactive enforcement. Again, this is sort of one of the themes that is coming out in this hearing. We need far more proactive enforcement. If there were 25% non-compliant buildings, there should have been far more active enforcement heading into the summer months.

I have two more questions — I have many more questions, but I am going to pass it on to Chair Schulman. Oh, and one more: it was publicly reported by Melissa Russo that the department currently has no alert system to trigger quick action when a building owner fails to comply with the new cooling tower rules, including the requirement under Chair Schulman's Bill to report Legionella testing every 31 days. Is that accurate? And if so, why does not the City's portal automatically, or through some type of manual follow-up, flag missed five-day reporting deadlines or overdue 31-day testing requirements for immediate review and enforcement?

(01:26:54)

Thank you for the question, Speaker. We do have a process for capturing whether or not someone is compliant with that 31-day sampling requirement. Let me hand it to Deputy Commissioner Crane here for more.

(01:27:07)

Thank you, Commissioner. The local law requires reporting the highest level we have of Legionella bacteria to the department, which is the point at which we really want to be providing ongoing assistance to that cooling tower operator. So it is in the local law and also in our regulation that when Legionella bacteria — when the...

(01:27:33)

...results from that sample — and the Council's innovation to increase the frequency of sampling to monthly is giving owners much more information. When they get that result back that shows that they have a level of bacteria where we are starting to see that they are no longer adequately controlling the bacteria growth in that cooling tower, they report that information to us and we have a follow-up program to make sure that they are conducting the appropriate corrective action, that they are taking their compliance samples, that those compliance samples are showing that the remediation was effective, and if not, that they are continuing to remediate.

(01:28:17)

Okay, one more question I am going to ask before passing it on.

(01:28:20)

So on July 31, the department issued a press release: "New York City Health Department declares Upper East Side Legionnaires' Disease cluster exposure has ended." However, after that time, four more deaths were reported. Why did the department feel it was necessary to put that press release out? I mean, obviously we agree and we do not contest that the exposure ended on that date, but to take sort of a "mission accomplished" stance when many people were still in the hospital, and then four deaths are reported subsequent to that...

(01:28:53)

Thank you for the question. Let me sort of divide this into two separate segments. The first is: the exposure had ended, and we typically use a clock of two weeks after the last person who developed symptoms was found to have developed those symptoms. So it was two weeks into that period, which was July 31. From the perspective of the risk to New Yorkers, we wanted to make sure that we updated New Yorkers to know that the risk had been eliminated. Now, the second question that you are asking is around the continuing case counts, so I am going to turn it over to Dr. Howard to talk a little bit more about how that process works.

(01:29:39)

Yeah, sure. Thank you. And I just first want to acknowledge that every death is a tragedy and I offer my condolences to the family members of those who passed. Even though we knew the source was eliminated, that does not mean our work does not continue. Legionnaires' Disease is one of the diseases that is reportable to the New York City Health Department, and for every report that comes in, the epidemiologists have to do a case investigation. First they review medical records to confirm that it meets the case definition and then do an interview of the patient or a family member to determine a potential source of exposure.

(01:30:28)

Even though the source was eliminated, that process was still continuing. The reason why we identified additional deaths after the source had been eliminated — there are a few possible explanations. In some instances, individuals have been...

(01:30:45)

...exposed in the area but have traveled out of jurisdiction, and we might not have known about that death until sometime later. In other instances, it can be difficult to reach a family member at this difficult time, so there are delays in getting the information that we need in order to confirm that that individual was exposed to the area. And third, some people who are diagnosed weeks ago succumb to that illness after a prolonged hospitalization. So that is why we can have additional deaths even though the source of exposure has ended.

(01:31:31)

The agency's Legionnaires' dashboard literally says you cannot report any additional data. So once the department issued that press release, if you go to that dashboard, you cannot update it — even though four additional people passed away since that press release, none of that information could be uploaded onto the dashboard. It just has a notice that the dashboard is sort of closed for business, like you cannot add to it. And that is what we have done in previous clusters, Madam Speaker. We have a period of time that we do our investigation of a cluster, and when the exposure is over, we do not continue to update the public dashboard. This was not something that was new in this cluster.

(01:32:18)

But for those family members whose loved one passed away — I mean, there are four people who lost their lives, and that...

(01:32:23)

...just seems to me that it would make common sense that the dashboard, as additional people tragically lose their lives or additional people are perhaps hospitalized, the Health Department would acknowledge that and update the dashboard accordingly so that the public at large can get accurate information.

(01:32:42)

It is a tragedy for us and we have acknowledged those lives. There were many, many public communications in which we did so, including in this testimony. The dashboard itself is one specific measure that we use, but according to our typical approach, we did what we have done in the past with regard to the publication of the dashboard.

(01:33:06)

Okay, I am going to pass it over to Chair Schulman. Thank you. I have a lot of questions, so I am going to ask a number of them, and then I am going to do as the Speaker did — let my colleagues ask, and then we will go to a second round. How...

(01:33:23)

...does Legionella first enter a cooling tower or water system, and what are the ways to prevent the initial growth? Yeah, thank you for the question, Chair. Legionella bacteria is found ubiquitously — it is common in the environment and it can basically contaminate warm, stagnant water, which is found in cooling towers. What water temperatures are most conducive to Legionella growth? I presume there is a...

(01:33:50)

...certain turning point there. When is the water in a cooling tower most likely to reach those temperatures? So those are two different, two separate...

(01:33:57)

...questions. You are right. It is warm, stagnant water that is the most suitable type of environment. Is it at like 85 degrees? Is that more likely, or does it just...

(01:34:13)

...not matter? I mean, I am just trying to understand.

(01:34:14)

Yeah, we can get back to you on the exact temperatures for sure. That would be helpful. And when is the water in the cooling tower most likely to reach that temperature as it is sitting there? Because it takes a while, right? So it would not be the first day of when it is hot. Pass it over...

(01:34:31)

...okay. Deputy Commissioner, we can get you the temperature ranges, but I think what is important is that the Council has recognized that the cooling tower is an ideal environment for the growth of the Legionella bacteria, and that is why you have set out such detailed requirements for the owners to constantly monitor and maintain those. In our regulations, we set out further details, and this is so important because the owners have to maintain these cooling towers literally every single day. They cannot let their guard down, for the very reasons that you say, Chair. The cooling tower holds a tub of warm water and that is why they are constantly treating it. Really the system has — you could say belts and suspenders — they are doing visual inspections, they are adding a biocide all the time, they have a protocol that they have to develop for their specific tower, their specific cooling tower system and how it operates at their specific building, because we know that there is so much risk. That is why there is such oversight required by the owners.

(01:35:43)

No, and I appreciate that, Commissioner. I just, you know, for educational purposes, I think it would just be good for us to kind of know this. I understand what you are saying exactly, but I think it helps with the process — just in layperson's terms — to just get a sense, like it is not when it is 30 degrees out that you are going to have Legionella, right?

(01:36:07)

So what we know is that typically when we have these clusters, they are happening during the summer, like late spring. I am just saying...

(01:36:15)

And so, yes, absolutely. The warmer the water is, the more likely it is to harbor...

(01:36:20)

...it. Now let me ask a question. My understanding — I could be wrong — is that the cooling towers do not function unless... because they function to cool the building off, right? So they would not function necessarily in the winter. Is that sort of right? So it is when they actually are...

(01:36:39)

Let me hand it over. About half of the cooling tower systems in the city operate year-round. And I can give you the temperature ranges: 68 to 113 degrees Fahrenheit is the range. You are right also to say that as our climate is warming, we see additional risk, and so that is why we were so supportive of your Bill last year to increase the sampling to monthly. Because it gives owners, in that whole monitoring and maintenance program, more information — every month they are getting more information as a check on how their constant ongoing monitoring and maintenance program is going. They are getting more information about that and are able to make adjustments to their program.

(01:37:28)

To your point about some of them operating year-round and some not — you have, I assume, a list of which ones operate year-round and which do not. The ones that operate year-round: do you, are you more involved in making sure that they are complying than the ones that do not operate year-round when they are not operating? So are you more vigilant about the ones that operate year-round?

(01:37:54)

So we are vigilant about all of them, right. And I did not mean to suggest otherwise. But so this is how we plan our inspections: we want to inspect when they are operating. That is how we plan our year. So the ones that are operating all year, we can do those inspections in the cooler months, and the ones that are operating only in the warmer months, we focus the inspections in that window.

(01:38:21)

Okay, so I am going to ask — by the way, we have been joined by CM Ariola, just want to acknowledge that. Can you walk us through how exactly — because I would like to know, and I think others would too — how Legionnaires' Disease spreads from the initial proliferation of Legionella bacteria in a cooling tower or building water system, through the release of contaminated water droplets, to the development of infection?

(01:38:45)

Absolutely, and yes, absolutely. So what we see with Legionnaires' Disease clusters like the one that we are talking about here today is the Legionella bacteria contaminates that water — that warm, stagnant water we have been talking about — and then that water, the mist that is expelled from the top of the cooling tower, that mist can carry small amounts of that bacteria, and people inhale that mist, and then that is what can basically trigger the beginning of Legionnaires' Disease.

(01:39:18)

Do we know how long it takes to get to a point... when it gets to the point of becoming, you know, a deadly bacteria? I mean, how long does it have to fester in the water? As soon as it becomes...

(01:39:40)

As soon as it is detected — that is a great question, and it is one that we do not really know, and that is part of the challenge. That is why the regulation sets out tiers for response, because we want — and again, why the monthly sampling is so important. Although we are in early days, so we do not know yet how effective that is going to be, but our idea is it is going to give operators very early information when that bacteria is starting to grow, so they can take corrective action, do their confirmatory sampling, and see if it has happened and see if that remediation has been effective. If not, then there is the next step for them to do to continue to remediate. So there is not a perfect answer to your very important question, and I appreciate that.

(01:40:32)

Doctor, from what you said, if it is really windy out and you have it, it can spread further, I am guessing. Well, you are putting your finger on something very important. So when we have these clusters...

(01:40:46)

Yeah, right. It is not clear exactly where the source is, and the mist that comes from the cooling tower can absolutely migrate, and that is why we have a fairly large region that we look at. In this case it was these three zip codes that we were looking at, because of exactly what you are describing.

(01:41:03)

You expanded the zip code, if I recall correctly. We did, actually. I can pass it to my team to describe a little bit more on that. I would say that when these clusters happen, we are really doing detective work in different parts of the department. We are getting information from my team that is taking samples from the cooling towers and knows where the cooling towers are, from Dr. Howard's team who is doing case investigations, and from the laboratory scientists who are telling us what is happening from the cooling tower samples. As more information comes in, that helps us further define the area of risk, and so sometimes, as we did here, the initial area we needed to expand. The thing that we are really trying to do is get that message out to New Yorkers, because we know that once the cases have started, that exposure is underway and we want to get that message to people. They have already been exposed. We want them to listen to their bodies and get quickly into health care.

(01:42:08)

Okay. How are the first symptomatic patients identified at the beginning of an outbreak or cluster? What kinds of testing infrastructure are required to ensure that infected individuals are identified and receive care as quickly as possible, and to ensure that the outbreak response can be activated in a timely manner? Let me first start by saying that we have an incredible team of epidemiologists at the health department that are doing the work day to day to identify these cases, and they work in conjunction with data that is coming in from our many tools that can basically help to identify if there are patterns. So it is both sort of intuition from the epidemiologists as well as them reviewing the information coming in from things like syndromic surveillance, which is a tool that we have that allows us to ingest the information from all the ERs in the city.

(01:43:04)

In your testimony, you said that once you identify somebody, then you talk to all the providers in the area and so on, to make them aware. But is there a way to just make providers aware in general that if somebody comes in with flu-like symptoms, you know, they get tested right away for COVID, they get tested right away for the flu — is there a way for them to be tested right away for Legionnaires' Disease?

(01:43:30)

Yeah, thank you for that question, and that is exactly what we did this time. So before this cluster began, on June 1 we issued what is known as a health advisory out to all physicians in New York City. We jointly did that with New York State to alert providers, facilities and clinical laboratories that, you know, summer months are here — make sure to put this on your differential. I am an ER physician, and getting that kind of advisory for me would make this top of mind for me going into my ER shift. So that is why we do these health advisories.

(01:44:08)

I wanted to just bring to your attention — there is a press release on your site that says the first cases happened as of June 27 to 29. But if you go to the web page, it shows the first case was on June 20. So what is the discrepancy? Can you share more about which sites you are talking about? Which site is it?

(01:44:41)

There is a press release about the second death in the Upper East Side Legionnaires' Disease outbreak, and it lists in that press release the first cases as from June 27 to 29. But if you go to your Legionnaires' web page, it shows the first case was all the way back on June 23. So I am just asking what the discrepancy is. I do not know if it is an error or whatever, but because people are going up and looking at that stuff, I just want to point that out.

(01:45:10)

Yeah, I would have to look at the exact site to take a look, and then I would follow up with you.

(01:45:15)

Let me share — there are two different clocks that we look at when it comes to Legionnaires' Disease. There is the symptom onset date and then there is the diagnosis date. So someone might be diagnosed, for instance, on July 5, but their symptoms might start...

(01:45:35)

Because if the first case was on June 23, that is a big difference from it being a week...

(01:45:42)

Later. Yeah, we can look into it.

(01:45:43)

So yeah, take a look and see if you can get back to us. When there is Legionella growth in a building's cooling tower, who is at risk of infection? Does someone have to live in the building or physically enter the building to be potentially exposed? I am sorry, can you repeat that? When there is Legionella in a building's cooling tower, who is at risk of infection? Does someone have to live in the building or physically enter the building to be potentially...

(01:46:10)

Exposed? You are saying no, but I am...

(01:46:12)

Just asking. Yeah, we are...

(01:46:14)

Concerned when there is a cluster about the whole geography, right? Because as we talked about earlier, the microscopic water vapor can carry the bacteria in it and it can spread across the neighborhood. So that is why we issue broad guidance in those zip codes.

(01:46:34)

So here is an interesting question — can Legionella bacteria spread between cooling towers?

(01:46:38)

That is an interesting question. We do not know. Interesting.

(01:46:55)

Do all cooling towers that test positive in a specific area contribute to the cluster? Do all cooling towers that test positive contribute to the cluster in a specific area? Okay, this is...

(01:47:08)

So this is important. There are two questions that we are trying to answer when it comes to the sampling and the testing in the region. The first question we are trying to answer is whether there is a genetic match between the Legionella in the sputum that we get from the patient and a specific cooling tower — that gives us the ability to say this cluster came from this cooling tower. That is the first question, and whole genome sequencing can make that match. There is a separate question that we are asking in a cluster, and that is which cooling towers have high levels of Legionella bacteria in them. Those two questions are answering different parts of the operations.

(01:47:58)

How can people protect themselves from potential exposure? The number one most important way folks can protect themselves when we have these clusters is to understand the signs and symptoms and to get in to see a doctor. This is a highly treatable condition, but it does require individuals getting to appropriate care and getting evaluated. The department conducted over 360 tests and collected samples from more than 180 cooling towers during the Upper East Side outbreak. Where do collected samples go for analysis, and how does the department choose where to send the samples?

(01:48:37)

Those samples are coming to us, to our public health lab, where we are doing our own testing and evaluation of those samples.

(01:48:47)

In the announcement that was made yesterday about some of the proposals, one of them talked about faster testing. What was that faster testing of? It was not clear on that.

(01:48:58)

We are always looking to improve our system and identify ways to further strengthen our testing of cooling towers and our testing of individuals. It is testing of the cooling towers. Okay, so that is one of the things that we want to do — figure out if there are new, novel testing measures to speed up the testing.

(01:49:18)

How many laboratories are currently certified and available to analyze cooling tower samples for Legionella in New York City? Thirty.

(01:49:26)

I am sorry? Thirty. Yeah. Is...

(01:49:30)

That enough? At this moment we...

(01:49:30)

Do not have concerns about capacity, and we also have our...

(01:49:35)

Own testing. Are those labs standardized in their testing? In other words, is everything done the same way in each lab?

(01:49:42)

That is right. New York State does the certification for these labs. Different labs do have different turnaround times. Going back to the lab tests, unfortunately we are at the mercy of the bacterial culture process. With the bacterial culture testing that we do, that takes two weeks here and it takes two weeks up in Albany. It is the same, unfortunately.

(01:50:13)

Okay. Do these laboratories have sufficient capacity to meet the new monthly testing requirements, particularly during the summer or a community outbreak?

(01:50:22)

Yeah, at this moment we do not have concerns about the capacity. Okay.

(01:50:26)

Please explain the difference between a PCR test and a culture test. The PCR test is asking the question: is there evidence of Legionella in the sample? It cannot tell us if it is live or dead — it could be that there was bacteria at some point. Culture is asking a different question: right now, is there live bacteria in the sample? So these are two separate questions.

(01:50:58)

What is the turnaround time to receive results from each test, and are there any other testing methods which might be more efficient or effective? There are three main tests that we use. The first is PCR testing — turnaround time is between 24 to 48 hours. Culture testing is the second, and that takes up to two weeks. And then there is whole genome sequencing, which takes much longer.

(01:51:20)

The time for the testing — is that when somebody...

(01:51:24)

Shows up with symptoms? The testing that I just mentioned is the testing of the samples...

(01:51:33)

Okay, the water and the cooling towers. The testing of the individual — there are a number of different tests that we do if somebody has potential...

(01:51:41)

Legionnaires' Disease. We do a urine antigen test, we can do X-rays, we do other blood tests, and so that picture gets put together by doing these different types of testing altogether.

(01:51:56)

So if somebody had... so the initial test when somebody comes in and that is positive, then they would get treatment at that point, or does it have to wait for other...

(01:52:05)

Testing? Let me hand it over to Deputy Commissioner Andre Howard.

(01:52:10)

Yes. So when a patient goes to see a provider, the first thing that clinician would do, based upon the signs and symptoms, would be to evaluate that patient and then make a decision on a differential diagnosis for Legionnaires' Disease. First of all, you have to have pneumonia and you have to have a positive Legionella test. Our urine antigen tests can take a few days to come back. A culture of the sputum could take up to two weeks. As a practicing infectious disease physician, if I had a strong suspicion that someone had Legionnaires' Disease, you could start them presumptively on treatment right away, in addition to considering other diagnoses, including other forms of pneumonia.

(01:53:02)

Right. So the reason I am asking is because it is clear...

(01:53:06)

That if we get to it early, the patient will do a lot better. The earlier that we get to it, absolutely — and that is why our most urgent message to the public is to monitor for symptoms and to present to a clinician promptly if they have symptoms suggestive of Legionnaires' Disease. Do not wait. Do not try to think it is allergies. Do not try to self-treat. See a provider who can provide that...

(01:53:35)

Medical care. Okay. Earlier this year, the department announced its intention to award Analytical Inc., a New Jersey-based environmental testing firm, a $1.5 million contract for Legionella environmental testing through July 31, 2032. What are the terms of this contract? Does the public health laboratory conduct any testing — you said they did — if not, why not? I am going to hand it to my colleague.

(01:54:05)

The lab does do our testing, and as we just testified, during a cluster we will send the cooling tower samples to the lab. For our routine work, when we take samples, we send them to a commercial lab.

(01:54:19)

Why was an out-of-state firm chosen for this contract? Are there any New York City or New York State-based firms that could have fulfilled these responsibilities? We went through the procurement process. What role will they play in the testing process? Will they be responsible for collecting samples? Will they test the samples in their own labs, or will they outsource to other labs?

(01:54:44)

This is the lab that we will use for our routine samples. Have we used them before? Okay.

(01:54:50)

I do not know if we have used them before. We have a current agreement, a contract, with a commercial lab for our routine samples. For the cluster samples, we...

(01:55:00)

Sent them to our own lab. So on the procurement process — if you can, I know you do not have that on hand, but if we can know what the procurement process was to select the lab, that would be helpful. Are turnaround times on testing results guaranteed as part of your contract? I am sorry, would you say that...

(01:55:22)

Again? Are turnaround times guaranteed as part of your contract? We do have provisions about turnaround times, and I will also add that the firm does have a New York branch. Okay.

(01:55:36)

What is the Department of Buildings' role during an outbreak, and how does it coordinate with the department to ensure buildings are complying with orders and requirements?

(01:55:48)

As you know, from last year, Chair, we found an unregistered cooling tower that at the time was operated by a private company that was at the source of that cluster. Subsequent to that, we learned from that experience — we understood that identifying these unregistered cooling towers is a priority and put that into practice immediately. We have been working with the Department of Buildings over the course of the last five to six months to really build out this process, and we are happy to announce this new measure that we announced yesterday, which will formalize that and make it automatic. The fact that our systems talk to each other will allow us to share that information back and forth to potentially catch unregistered cooling towers.

(01:56:36)

Okay, I have a lot more questions, but I am going to let my colleagues ask and come back around. CM Maloney, thank...

(01:56:44)

You. Chair Schulman, and thank you, Commissioner, for your thoughtful testimony, your work to contain this outbreak and your commitment to doing better next time. I want to echo some of the concerns that have already been raised, including enforcement, transparency and updating the website to reflect the accuracy of what this outbreak included — every life should be counted. I want to go back to what was raised around the violations that increased after the summer months. Were the violations that were uncovered during this outbreak response things that the department believes could or should have been identified earlier through the routine inspections that are already in place? If so, what needs to change about our routine inspections so that we find these problems before there is an outbreak?

(01:57:40)

Yeah, let me speak to the violations and give some detail there, and then turn it over to the Deputy Commissioner to talk a little more. So 110 violations were identified as part of this cluster region. These are stratified into different types of violations. 15 of them were public health hazards, 50 of them were critical violations, and then another 40 were general violations found in this cluster region. So let me turn it over to the Deputy Commissioner.

(01:58:09)

Thank you, Commissioner, and the inspections that we do are part of our cluster responses, because we are also trying to understand what has happened during a cluster. But I want to just note that the inspections, which as we have talked about is one piece of our overall enforcement program which includes outreach, education and training, are designed to be an annual inspection. So it is really a point-in-time check to promote compliance along with all of the other things that we do. It is really the constant monitoring and maintenance that the owners have to do that is the prevention that we need to reduce the risk of Legionella bacteria growing in these systems, which are the ideal environment for the growth of Legionella bacteria.

(01:59:03)

So in these cases where issues were uncovered, why were they not discovered earlier through these inspections that you were talking about, and what can we do in the future to find those problems?

(01:59:14)

We aim to conduct an annual inspection, and when we conduct that inspection, if we find violations we will issue a summons. All of that is designed to provide multiple points in our overall program to encourage cooling tower operators to follow the very detailed requirements in the laws and regulations. I quickly...

(01:59:39)

...wanted to speak about the frequency of the requirements, and particularly in the summer when we know cooling systems are heavily relied upon, what are some of the best practices around scheduling, phasing in redundancy ahead of summer months so we can catch these violations before the outbreak begins. I also wanted to learn a bit more about Int 1006-2026 and your concerns there with the implementation. We want to increase the frequency but make these practical. Thank you.

(02:00:15)

Let me start with Int 1006-2026 and then hand it to the Commissioner on the first part of that. So I think the term "cleaning" can mean a number of different things, and I think we are eager to follow up with you to really get into some of the details there. But for instance, if we were to define cleaning as doing more of the hyperhalogenation, which is applying that caustic and corrosive material, that biocide, it can actually potentially create more Legionella contamination in the cooling tower. So there are ways of doing cleaning that can reduce that risk. Getting into the details is probably the next best step. Let me hand it over to the Deputy Commissioner.

(02:01:06)

Thank you, Commissioner. There are a couple of ways to think about your question. First is that the law that the Council has enacted and then the regulations that we have issued set out very, very specific timing and frequency of certain kinds of monitoring and maintenance activities. It is literally the case that some things have to happen three times a week, some things have to happen weekly, monthly, biannually and annually.

(02:01:32)

Annually, but also critically, every cooling tower operator is required to develop its own protocol and monitoring and maintenance plan that is specific to its cooling tower and its cooling tower system, and how it operates in its building, and what the requirements are for that particular system to maintain it. We want the system to remain in balance. That is why we require a visual inspection at certain points, ongoing biocide at other times, and the operators are collecting multiple indicators to see if their monitoring and maintenance plan is working to keep that system in balance and reduce the risk that the bacteria is going to grow. To do that monthly sampling so that if it is growing, they will catch it early.

(02:02:22)

We know that this bacteria can grow quickly. They can catch it early or they can catch it at a later stage, and depending on what the sample results show, if that bacteria is growing, there are specific details on the corrective action they are required to take, the confirmatory sampling timing and ongoing remediation if it does not work. I will say that the schedule that we have set out as the default schedule is based in the scientific literature and represents best practice, and what the evidence shows us are our best practices. They apply year round, but there is one additional precautionary measure that we require owners to take during the summer because we know that there is additional risk, and that is the hyperhalogenation that the Commissioner mentioned.

(02:03:14)

Let me just share one more piece of information as an update to the Council. You referenced the website not including the 11 deaths. It does include the 11 deaths. It was updated last week. The information we get comes in, as you heard from Dr. Howard, when we can get it, when we can verify it, and when we have that information we update the site. So it is updated now.

(02:03:45)

Thank you, Councilmember. We are going to ask CM Morano, who is on virtually, to ask questions, because in order for somebody to ask questions virtually we have to have quorum. We have a quorum now, so CM Morano.

(02:04:02)

Thank you very much, Chair, and I want to thank the Commissioner and his whole team, but also all the families that spoke out about a situation that I am sure was very difficult. Commissioner, in your testimony I want to touch upon a few of the areas that you brought up. Namely, your testimony says that before the Upper East Side cluster, citywide compliance with the new monthly Legionella testing requirement was only around 74%, and then there was this jump to 97% according to your testimony two weeks later. You specifically called public pressure and transparency one of your most effective enforcement tools. Why did it take a deadly outbreak and public exposure to get owners to comply at that level? If publicly identifying noncompliant buildings works, why were you not doing that before people got sick?

(02:05:15)

Thank you for the question, Councilmember. This law was eight weeks old. The ink was barely dry on it when we first started this cluster. That citywide compliance rate was 77%, and 74% was the compliance rate in that region. What we learned from this experience is that with this brand new law, having transparency be a core piece of how we promulgate the law, front and center, is how we get to the compliance rates that we want and that New Yorkers deserve. You better believe that for every single one of those cooling tower operators that were not compliant, we held them accountable. That is also reflected in the new measure that we announced yesterday, leveraging what we learned in this cluster with compliance to make it easier for New Yorkers to check their cooling tower on their building to see how compliance is going and to map that for them.

(02:06:20)

Council staff also found that in the zip codes that became the outbreak area, the Department of Health issued zero cooling tower summonses in one period and then 180 in another. What changed, and what did the City suddenly start looking for after people were already sick?

(02:06:42)

We, as I mentioned, issued over a hundred violations in this cluster region. Many of those were public health hazards and many of them were critical violations. But I also want to share that violations we issue are just one layer in a multilayered system that helps to keep New Yorkers safe and reduce the risk of Legionnaires' Disease. The first layer is what the owners must do. They must do daily, weekly and monthly actions. The second layer is they must submit their sampling to us. The third layer is we actually go and investigate. So these three layers are all happening at the same time. The fourth layer, as you have described, is the corrective actions and the fines, which are certainly one piece of the puzzle but not the full...

(02:07:33)

...picture. Finally, your testimony says the administration will now cross-reference health department records to identify unregistered cooling towers. You also acknowledged the City already has the capacity to do that. Why did it take multiple Legionnaires' clusters involving unregistered towers for the administration to implement it?

(02:08:02)

Because strong systems can improve when they identify ways to do things better. We identified in 2025 that an unregistered cooling tower was at the source of that cluster. We immediately put that knowledge into practice in 2026 and picked up an unregistered cooling tower at the start of the cluster. But we want to now formalize that. We want to make it automatic. We want to have the systems talk to each other. New Yorkers should not have to depend on staff members across two different agencies working together to figure this out. We should have systems that are automatically doing this work on the back end.

(02:08:40)

Councilmember, Councilmember... we went over already. I have to go to other members. Okay, I would love to be in the second round, just for one brief comment. So, CM Wilson.

(02:08:53)

Thank you, Chair. Thank you, Commissioner, for your testimony. Last month, near-critical rates of Legionella were found at a hotel in my district. What measures does DOHMH have in place for notifying guests ahead of, during and after their stays when there are critical or near-critical rates of Legionella that are detected at the hotel?

(02:09:18)

Yeah, thank you. The thing to make clear right up front is that the towers are consistently tested and sampled, and owners have a very clear understanding of what needs to happen at what rate of Legionella bacteria found in the water. So for instance, at a rate of 10 colony-forming units, they need to remediate. If it goes higher, there are next actions they need to take. Let me hand it to the Deputy Commissioner to talk a little bit more about the High Line situation.

(02:09:57)

Yes, I think we know the hotel you are referring to, and it is actually a great example of how the system is working. We had done a routine inspection there and taken a sample at the beginning. It was non-detect — no evidence of Legionella bacteria. Soon thereafter, the operators of that cooling tower took their own sample and did find levels of Legionella bacteria. They remediated. That initial level was low, but that initial remediation was not effective. Their compliance sampling and testing showed that there was more work for them to do. They did that additional corrective action and then found that they had eliminated that bacteria and were back to that non-detect level. So that was actually, to me, a great example of the new regime that the Council had put in place for that monthly sampling doing exactly what we wanted it to do.

(02:10:54)

So in a scenario where an employer does not do what they are supposed to do, what measures are there to hold employers accountable when workers, particularly those with pre-existing health conditions which make them especially vulnerable...

(02:11:11)

...are put in direct contact with critical Legionella concentrations? I should also add that this goes to some of the questions that the Chair was asking. The levels of bacteria in the cooling towers when we require remediation do not mean...

(02:11:28)

...that those are an immediate risk for a cluster. We know that the bacteria is going to grow in these systems, and when those sample results come back showing some growth, what that means is that the owner needs to adjust its maintenance and monitoring plan, take corrective action and see what is out of balance. If those bacteria levels are growing, they need to take a harder look and make those adjustments. The Council's law does say that owners are required, when asked, to provide that information, and I think that was one of the things we clarified for the owners here.

(02:12:05)

Sure. Can I ask one quick question? Thank you.

(02:12:09)

How can workers report conditions related to Legionnaires' Disease while being assured that they will not face any type of retaliation? Is there a tip line, an anonymous tip line, or anything like that in operation?

(02:12:25)

They can call 311. I will say that owners are always welcome to call us and to request technical assistance, as we did in this case with the High Line, and we are here to provide guidance and support.

(02:12:45)

Thank you. Okay, thank you, CM Wong. Thank you.

(02:12:51)

This is not my first encounter with Legionnaires' outbreaks. This is, in my memory, the third one. During the previous Legionnaires' outbreaks I have seen Mayor de Blasio and Mayor Adams personally go into the affected communities, hold multiple in-person press conferences and speak directly to residents. That is one thing I have not seen during this outbreak. I remember Mayor Adams even drank the tap water on camera in Harlem to reassure people that the water is safe. Is there anything being done to assure the public that the water is safe, from you or from the Mayor's Office?

(02:13:34)

Can you talk about that? So first, thank you for the question, CM Wong. When it comes to building investigations where there is a potential Legionella contamination in the potable water supply, it is safe to drink the water, so I want to set that record straight. Absolutely. If there are other areas that you have specifically in mind, we are happy to talk about this.

(02:13:59)

Yeah, okay. I think public outreach is important because if a tower is contaminated, I think it is the Department of Health's job to inform the people working there or the people visiting there that they may be exposed to Legionnaires' Disease, and if you are in the risk group you should be tested or you should go see a doctor. Because they might treat this as a regular cold or whatever it is and just stay home and rest, rather than thinking, "This is serious, I need to get myself tested." I have been hearing since 10 a.m. that you are testing the water towers, you are testing your protocol, this and that. But where is the outreach to those office workers in the tower that tested positive? I have been searching and I have not seen any social media postings. I have not seen any videos. I found videos of the Mayor talking about the World Cup, talking about golf carts, talking about Netanyahu, but nothing about Legionnaires' Disease. Has anything been done? Are there any videos or social media postings on that? Because we cannot just keep testing water towers and not telling the public they need to get...

(02:15:26)

...tested. I disagree with your assertion, Councilmember. We have been putting communications at the core of our response. To talk about social media, we had millions of impressions for this cluster from the social media content that we put out. We did 15 in total community town halls in the affected zip codes. I myself was in the community doing outreach.

(02:15:51)

Let me tell you my experience. Okay, please. As a visitor to the Met Museum, I have been there twice, once for the Raphael exhibit and once for the Revolution exhibit. I went there with my wife. She came back sick, and I have not received a single notice from the Met Museum that we should get tested for Legionnaires' Disease. Those are the concerns that I have, because we could potentially have a lot of people who got sick if they visited the Met Museum and the cooling towers were...

(02:16:24)

...infected. I am sorry to hear about your wife and I hope she is feeling better.

(02:16:27)

She was sick for like two weeks. How is she doing now? She is doing okay now. She is young, but these are the concerns I have. You have got to tell the public that if you are in this group of people and you have these symptoms...

(02:16:44)

CM Wong, if you have a question that is fine, but this is not a...

(02:16:48)

Let me just respond to that. We have been doing that messaging. We did that messaging throughout the cluster, throughout the region, with over 182 tabling events and 10 canvassing events. Our job was to get the message out and we delivered on that job, Councilmember.

(02:17:11)

Okay. CM Epstein, thank you. I really thank you for your information and the work you are doing. Does early testing help someone who has contracted Legionnaires' Disease?

(02:17:28)

Testing is incredibly important when it comes to Legionnaires' Disease, and it is also multifaceted. There is testing that needs to happen with urine, there is testing that needs to happen with X-rays and imaging, and there is blood testing. Which testing are you referring to? Early testing, so you are saying people getting tested earlier if they might be exposed — it is good for them because then we can have a medical response after getting tested, right? It is important to do early testing and also to connect people to a referring provider to then take the results of that test and act on them.

(02:18:02)

And you are aware that not every New Yorker, especially low-income New Yorkers, has providers, right?

(02:18:09)

I am aware of that, and so in a situation, especially in a lower-income area, if the people who are potentially exposed do not have a medical provider, they are at a disservice unless the government steps in and provides support. Let me hand it over to share a little more on this.

(02:18:30)

Thank you very much, Commissioner, and thank you for that question. I just want to commend you for your interest in ensuring that New Yorkers have access to health care. This is a very important issue. I also want to clarify that in terms of testing for Legionnaires' Disease, that is indicated when a person has symptoms suggestive of Legionnaires' Disease. It is not a disease that we just screen for in people that do not have...

(02:18:59)

Symptoms, so people who are elderly, or if people have disabilities, or are immunocompromised, earlier testing for them, especially if we know that they have been exposed, can prevent what we have heard from the tragedies that have happened this year in New York.

(02:19:16)

Although the groups that you just stated — those who are elderly, those who are immunocompromised, those who have underlying medical conditions such as chronic lung disease — are at increased risk of developing Legionnaires' Disease. Legionnaires' testing is only recommended if they have symptoms suggestive of Legionnaires' Disease. Legionnaires' Disease is not...

(02:19:41)

Right. There is no benefit to doing a screening test.

(02:19:43)

Okay. And as an infectious disease doctor, I do not support blanket screening for Legionnaires' Disease. There is no clinical benefit. There is no public health...

(02:19:54)

...benefit. So you are saying for people who are exposed, who are compromised, who might have some symptoms but may be concerned or not concerned, testing could assist those people. That is different than blanket screening. But you are saying there is a population that early testing could assist, especially to get them to the help that they need earlier.

(02:20:17)

Anyone who has symptoms suggestive of Legionnaires' Disease needs prompt...

(02:20:22)

...evaluation by a clinician. Right. So we agree with that.

(02:20:26)

Right. And...

(02:20:27)

That would include a clinical evaluation and the ordering of diagnostic tests for Legionnaires' Disease as well as other illnesses that can present similarly to Legionnaires' Disease. Now those are best done in a health care setting.

(02:20:42)

Right. For those who do not have access, having remote services like we do at H+H all the time — we take a show van and we get people on the street to access services. We do remote services because we meet people where they are at, because especially people with compromised immune systems, or people who are fearful, having remote access or local access is helpful for them because they may not have a health care provider that they are connected to.

(02:21:10)

Yeah. So you mentioned H+H, and as you know, H+H provides clinical services to all New Yorkers without regard to their insurance status or their immigration status, and that was part of our messaging, as well as the fact that they could call 311 and be connected with a health care provider.

(02:21:29)

Thank you, Chair. Thank you, CM Narcisse.

(02:21:41)

Oh, yeah. Good afternoon. Thank you, Commissioner, and your team for being here, and thank you, Chair and Madam Speaker. What we have seen in Harlem — I did not learn as a medical professional, as your doctor... I do not want anyone to die on my shift. That is what I was saying all the time in the ER. No one should die, right? So I know you are not taking it lightly, because as a physician your team is superior at prevention. But what I do not understand is why we were short of staff, and I heard it from my colleagues as well. Why did we never address that? Because we did not learn, and our whole life is to prevent...

(02:22:33)

...we did not learn from what took place in Harlem to make a preventative approach to prevent people from...

(02:22:39)

...dying. That is what bothers me, and I think we need to do much more than that. I heard it from the Speaker and of course from my colleagues. But I have some suggestions and some Bills, because Local Law 159 requires building owners to test their cooling towers for Legionella not less than 31 days and disinfect them during the summer months. But that information should go up. Now we put elevator inspection certificates where everyone can see them. We post restaurant letter grades and everything. Why are we not doing that in the building to let folks know when the building has been tested and what the result was? Because people want to take charge of their health. Am I correct?

(02:23:35)

Yeah. So first let me respond to the piece around staffing. I disagree with your assertion, Council Member. We do have 56 total budget positions for these water ecologists. 50 of them are filled at this moment. So we do have six staff that we are hoping to bring in, and if you have recommendations we would love to have the right person in one of those slots. Now, to talk about your idea, I think there is absolutely merit to your idea and I think we should consider it. We should follow up and talk about the details of that. What we are doing with regard to transparency is moving in the direction that you are describing, with the revamping and relaunching of our public website so individuals can put their address in and get a map feature of how their tower compares to others in their building with regard to Legionella sampling and lead history. So I think there is certainly a conversation to be had around...

(02:24:35)

...this. Yeah, I would like to see it. I put in the Bill and I would like to see it happen because people need to... One more question: what is the average cost to clean a cooling tower, and what is the average cost to disinfect a cooling tower, and what factors...

(02:24:53)

...of course, yeah, that can depend on a whole range of factors, but it is in the thousands of dollars to clean a cooling tower.

(02:25:01)

Okay. Thank you. We are running out of time. I have more questions, but we need to make sure that we hire those folks. We have 51 Council Members — you can send it to us and we can promote it — so make sure that we have enough staffing. We can ask for sorry to those that lost their life and their families. Thank you.

(02:25:18)

Thank you.

(02:25:18)

I will call Council Member Aldebol. Thank you, Chair and Speaker Menin and Commissioner for being here today. So you said you had 23 new positions funded as of 2025. When were those positions filled? Were the majority of those positions filled? You said the positions are filled today, but how long did it take you to actually fill those positions?

(02:25:51)

Yep. The majority of those positions were filled before this cluster started. We can get you the exact dates of those over the course of the several months of...

(02:26:01)

...the project. And you still have six positions that remain to be filled in this particular job title, the water ecologist title. That is right. And what have been the challenges in hiring for those titles? Obviously the most...

(02:26:22)

...important challenge is the fact that these are highly specialized, highly skilled positions. The requirements are that these folks have, for instance, a master's degree, or potentially a bachelor's with 24 credits plus related experience. So these are highly skilled, highly specialized positions, so it is not just about finding any person for these slots — we have to find the right person for these roles.

(02:26:49)

Is it possible that folks could be hired in these positions and receive additional training to get some certification? I mean, can the Department of Health provide colleges and universities with the specific criteria for these jobs?

(02:27:20)

So of course we do provide training once staff start, to be able to do the cooling tower inspections. But I think you are asking something different. You are asking about sort of...

(02:27:30)

...looking to colleges to qualify people to be able to apply for these jobs. And it is such an important point that we need more people going into the sciences to be able to do these jobs. But as the Commissioner said, these are the civil service requirements — either to have a master's degree in very specific areas of the sciences, or a bachelor's in those same areas with prior work experience. So that is the...

(02:27:57)

...challenge. I will say we would welcome your help in getting the word out that we are recruiting. It is a great job. We have a mission-driven, wonderful team and we have some more positions to fill. Yeah, not so easy — I do not know too many water ecologists running around my neighborhood who are looking for this job. But I think it requires a discussion about the qualifications and whether the recruitment for these positions is effective enough, because just putting something on LinkedIn is not going to get you there. The other question that I have, if I may, Chair: what other positions are critical to the management of those jobs, and are there vacancies in those positions currently?

(02:29:06)

Yeah. I will speak to the first, which is a new addition from last year, and then I will hand it to Deputy Commissioner Dr. Howard to talk a little bit about the laboratory work. The community health workers that we were able to deploy as part of this cluster were, from my perspective, very critical. We had these community health workers out there within 48 hours on the Upper East Side, engaging with residents and individuals. I was out there with them doing some of the canvassing and talking to residents, so that was critical when it comes to managing these clusters. Let me hand it to Dr. Howard.

(02:29:45)

Now, so we have epidemiologists that do the surveillance for Legionnaires' Disease as well as other diseases, and also do the case...

(02:29:56)

...investigations. And then on the laboratory side, we have a wide range of staff that do the actual testing of the cooling tower samples, which includes the PCR testing and the culture testing and then the whole genome sequencing and analysis. Thank...

(02:30:15)

...you, Council Member. Sorry. Okay. I will call Council Member...

(02:30:23)

Thank you, Chair. Thank you, Speaker. Earlier today I was listening to the testimony of Valerie Mass from Community Board Eight, and she testified that Mayor Mamdani did not visit the area where 94 people became sick with Legionnaires' Disease and 11 died of the same disease. I sat there, I listened, and I could not believe the horror in her voice that the Mayor was so absent during a life-threatening, life-taking crisis in his city, and yet he did not show up. Why did he not show up? He certainly was available, because he was performing for the cameras to say that he was going to arrest Bibi Netanyahu when he came here to New York City, which turned out to be false. So he wasted his time and the time of the City's residents by not giving them the personal attention they deserved for this crisis. And thankfully the Speaker, this Chair, this committee and this body would not do the same.

A question: are both the new buildings at 4130 Seventh Street and 2238 Fifth Avenue, both located in Harlem, fully staffed and in compliance with the New York City Fire Code and the Building Code, with stationary engineers that are responsible for the operations and maintenance and water treatment of the cooling towers and air conditioning systems?

(02:32:02)

Let me get to your second question in a second. But first let me start with a response to the initial statement. The Mayor has been, and was from the beginning, involved in this cluster. We spoke every single day during this cluster. He was involved. I am on this. But he was not present...

(02:32:23)

...and that is where he should have been, not trying to fool the residents of New York City into thinking that he could have had Netanyahu arrested when there were people dying in this city. That is where he should have been. So please answer the question.

(02:32:37)

The question was about these two specific buildings and whether the inspection has them fully staffed and in compliance with the New York City Fire Code and Building Code, with stationary engineers that are responsible for operations and maintenance and water treatment of the cooling tower systems and air conditioning systems. We are going to get back to you on the details on those two specific buildings, Council Member. Okay.

(02:32:59)

So do you know that the stationary engineers who operate these machines are responsible for checking the water treatment logs and testing required, which is part of their job as their civil service description provides? Are you aware of that?

(02:33:17)

The buildings that you are describing — I am not sure which buildings you are describing. We are going to get back to you on the details of...

(02:33:22)

...those. They have cooling towers. If Commissioner John Beatty were here to testify, because he is in charge of those operations and is in charge of the maintenance of those buildings — why is he not here to answer questions like that? Because those are very important questions to ask moving forward to make sure that Legionnaires' Disease does not have additional outbreaks. These answers should be able to be given to us today, but again the Mayor's office has failed to have the proper people at the dais answering questions.

(02:34:03)

Counselor, we have the right people here able to answer your questions. We will get back to you on the details of those two specific buildings.

(02:34:09)

These questions should be able to be answered now, and I thank you for the extra time.

(02:34:13)

Okay. Thank you, CM Salaam. Thank you.

(02:34:23)

Yeah. You know, our constituents have been calling for a more proactive approach in identifying and addressing potential sources of Legionella. The question remains: is what has been done actually solving the problem? We have been told that this is a preventable illness, but yet decade after decade we still see people dying. My question is: what specifically is different about the department's approach and response to the Upper East Side today, and why was that level of urgency not applied to the communities that experienced recurring cases in previous summers?

Also, as you know, we passed legislation calling for water tower inspections in coordination with the Department of Buildings to be inspected more. Why has the City not moved with greater urgency in enforcing that mandate? And lastly, how many water towers and other potential high-risk water systems have been inspected in the affected communities, and how many have not? Thank you.

(02:35:37)

Thank you for the question, Council Member. We apply a systematic protocol to our cluster response, and that protocol does not depend on geography, on zip code, on neighborhood. We apply the protocol that the system demands, that the cluster demands. And yet every time we do this, Council Member, with every single cluster that we have, we learn something. We take that experience and improve and enhance our process. The enhancements you identified this time — again, we ran the most aggressive cluster response we have ever had, moving forward remediation to the PCR step, not waiting the two weeks. We had the most transparent cluster we have ever had, not waiting the two weeks for the culture results before we shared the names. We responded quickly and immediately in this case, and the bottom line is every time we do this, we enhance and improve our process. Thank you.

(02:36:47)

Okay. Thank you. I am going to ask Speaker Menin — she has a line of questions. Yeah.

(02:36:51)

Thank you so much. I just have one last question. But before asking the question, I know Council Member Aldebol raised the water ecology issue, and I just again want to make clear that her line of questioning and my line of questioning are about why, heading into the summer months, those positions were not filled. That is what we are trying to talk about — the fact that 21 positions remained open as we headed into the summer months. So it is good that now, after this outbreak, positions are filled. But we should never be in a position where, heading into a time when we know there are likely to be these types of Legionnaires' outbreaks, positions are unfilled. We want to make sure that every single one of these positions is filled moving forward.

So I do have one last question. There was a press release that the Health Department put out around the time the second death unfortunately occurred, and in that press release it listed the first cases as June 27 and June 29. But if you go to the agency's Legionella web page right now, it shows that the first case was all the way back on June 23, which would have been the date the patient sample was collected. I am not sure how long it would have taken for that person to have tested positive for Legionella, but that is more than a week before the agency mobilized that outreach. So we wanted to understand: why is there this discrepancy?

(02:38:29)

Yeah, both great questions. Let me just say a few words about the water ecologist positions again and then hand it over to Dr. Howard, Madam Speaker. The majority of those positions were filled before this cluster. I completely agree with your point that right now, 50 out of 56 positions filled and onboarded is a strong sign and signal, and the majority of the positions that we needed were filled before this cluster. We can get you the exact numbers in a follow-up.

(02:39:04)

I would appreciate that, because that is not what our data shows. Our data shows that during the outbreak, only 35 of 56 authorized water ecologist positions were staffed — 21 were not staffed with active inspectors when the City needed that work done. So that is what our data shows. There seems to be a discrepancy. So we can follow up. Yeah.

(02:39:24)

Absolutely. And then to the second question. So this question is really about how and when do we count a case. The process that we take prospectively is to do interviews with patients that are part of the affected region, and they tell us, for instance, when their symptoms started or when they began feeling sick. So that is one clock that we are looking at — the symptom onset as a clock. There is another clock, though, and that is the lab testing, so the actual diagnosis date. So these two clocks can be running at different times. I am going to hand it to Dr. Howard to talk a little bit about back-dating, which can happen with these clocks.

(02:40:13)

Thank you, Commissioner. And thank you for that question. So as one of our public health duties, the Health Department receives reports of infectious diseases in New York City and routinely analyzes our surveillance data to identify a possible cluster of cases in space and time that would indicate a shared potential source of exposure. There are approximately 2,600 cases of Legionnaires' Disease in the City on an annual basis. Each reported case is analyzed, including a review of the medical records and then a patient interview to get information about the source of exposure.

The protection we have in New York City is very robust. We run sophisticated data analyses on a daily basis to identify clusters. In this instance, the cluster was identified by astute epidemiologists even before that data analysis system detected a signal, and we acted very, very rapidly as you have heard in today's testimony. This is really public health at its best.

Now, we only had a handful of unverified cases at the time that we announced there was a cluster of disease on the Upper East Side. Over time we are doing investigations of all these reports that we receive to determine whether someone spent time in the area during their period of exposure.

(02:41:48)

Often that work can take some time, particularly if it is someone who worked in or visited the area but did not live in the area, if that person is hospitalized, or if that person visited from another jurisdiction. We get that information in a delayed fashion and then we add cases to our case count. In some instances they might have had an earlier diagnosis date than those initial cases that we first identified through our surveillance system.

(02:42:25)

Thank you. Thank you, Madam Speaker. So I have a bunch of questions, but I am just going to do a quick round for my colleagues because they can stay here. CM Epstein, thank you. Can...

(02:42:45)

I just want to have a better understanding. So with Legionnaires' Disease, obviously the towers are affected, but the plumbing systems are impacted too, right? The bacteria is not just staying in the tower — it is going through the plumbing infrastructure, right?

(02:43:00)

The bacteria is actually in the potable water system, which can include the plumbing in those buildings, right? And so when you are testing, are you testing just the tower or are you testing the system? So these are two separate types of investigations. What we have been talking about so far has been what you just referenced, which is us testing the cooling tower.

(02:43:25)

Right. What is going on in Haven Plaza, as you know, is a separate and distinct type of investigation involving the plumbing system as well. So it is actually only the plumbing system. Let me hand it to the Deputy Commissioner to explain more. I just want to make sure I am understanding your question. I want to make sure that when we are testing and sometimes we find the bacteria present in the towers, we are also then — what are we doing about making sure the plumbing system itself, when the water is coming to the faucet, is being tested as well?

(02:43:59)

So these are completely different, right? And what we are directed to — either to the cooling tower or to a building's internal plumbing system — is based on the information that is coming from our epidemiologists, right. So as...

(02:44:14)

You have heard there are a few hundred cases every year of Legionnaires' Disease. The bacteria are everywhere. People are exposed all the time, right? And there are a few hundred cases every year. Most of those cases we consider sporadic. The case investigators are following up. They do not know where the exposure is coming from. When there are patterns in space and time, that is telling us that the bacteria is growing in the built environment. The kind of space and time pattern is what tells us which built environment is at risk.

When we are seeing, as we saw on the Upper East Side, many cases in a short period of time, our astute epidemiologists identified it very early. They could see what was coming even before, as you heard Dr. Howard say, our automated systems picked up on it. The typical community cluster pattern is many cases in a short period of time in a neighborhood. That tells us that there is a cooling tower, or could be multiple cooling towers, where the bacteria is growing. It enters the environment as mist and spreads all over that neighborhood. We are not testing the potable water system because we know that that is coming from...

(02:45:30)

If it is in the tower and spreading, you are saying it is not spreading through the water system, and that is why there is no recommendation about showering. It is never about drinking water — it is completely different. But when you are testing the tower and you find the bacteria in a building like Haven Plaza, then you are testing the water system to find out whether the water is coming out of the faucet.

(02:45:56)

Let me return to the pattern, because we are seeing a very different kind of pattern when the clues are telling us to look at the potable water system. The pattern that Dr. Howard's team is observing there is two cases, as opposed to many, over a 12-month period, as opposed to very quickly. The shared hot water system, as opposed to a neighborhood. And so that is telling us that what we suspect is the built environment that is at risk is that internal plumbing system. That is where the sampling happens. That is the community at risk, and that is when we start talking about reducing risk — if you are in a risk group — by not taking a shower. It is never about drinking water because this is about inhalation.

(02:46:44)

Right. So I am just saying, when you are testing the water that is coming out of the faucet...

(02:46:47)

But I think the distinction you are making is a really important one. To the public, it is really hard to understand and hard to communicate this information. So you are testing a tower, testing water coming out of the faucet for the bacteria — people have to have information and need to know when they need to get help and what the signs of illness are. I think what we are trying to say is that while you are experts in this and you have been trained in this, the public at large is not, and English may not even be their first language. So they need help and support. That is what we are trying to get at. I am not saying you are not all working hard, but we are saying we are not getting that information out to people in a way that is...

(02:47:34)

Helpful to provide them support. They are scared and not knowing what to do. Thank you, Councilmember.

(02:47:41)

CM Wong.

(02:47:41)

Thank you. Okay, I will be quick, really quick.

(02:47:46)

I have been here since 10 a.m. and I still did not hear from anybody on this panel what the symptoms of Legionnaires' Disease are. I believe I covered those in my earlier testimony and I will reiterate them here today. Flu-like symptoms — things like cough, fever, shortness of breath. These are the signs and symptoms. And how would an older individual distinguish that? Is that Legionnaires'? Do I have to go see a doctor, or should I stay home in my bed and just rest a few days? Where is the distinction?

So the distinction is embedded in the communications that we are giving — the targeted radio ads, the tabling events, the community presentations, the town halls, the press releases. All of these are efforts and interventions to educate the public to not look past these symptoms, because this is not potentially just a normal flu or normal cold...

(02:48:46)

Or a COVID. This can be deadly, as we have seen. And so that is why it is critically important to do the communications as we have. Well, like, back to my visit to the museum — as someone who has been there, I should have been informed that the building tested positive. Please look for these symptoms, and if you have these symptoms, go see a doctor. I have not received these notices. I do not know whether you send them out to buildings that have tested positive with Legionnaires' in the tower. So that is a question I want to know — have you done this outreach? Was it the Office of Mass Engagement doing that, or the knocking on doors, or the tenant resident meetings? Is there something that you do, or was it the Office of Mass Engagement? Thank you.

(02:49:36)

For that question — we knocked on doors as part of our community health worker team. I knocked on dozens of them myself. But to your broader question around the communications to the building owners, that is why our work with you all and the relationships that we have with you at the City Council are so important. We did elected briefings to have you help us get the message out. We did three town halls, two press conferences, and briefed building owners to share this message as well. And that is done by the Department of Health and not the Office of Mass Engagement — is that right?

(02:50:14)

We did that outreach at the Department of Health. Okay. Thank you.

(02:50:25)

So I have some questions. The Speaker talked about, and other members talked about, the unfilled water ecology positions, right? The data is showing that as of July 21, one third of the positions remained unfilled. So that was the issue that we have been trying to get to during the course of the hearing — as to why they were still unfilled at that particular point in time when the outbreak was far along. That was what we were asking: why were they unfilled at that point? And then the question is, were they unfilled because you were still recruiting people, or were they unfilled because of funding not being released?

I see. We will have to get back to you on that data to make sure that we align there. I can tell you that at this moment, of the 56 positions, 50 of them are filled. There are six that are unfilled. Understood. Yeah, but we are just going back to the heart of the cluster. I can add that we have been working very closely with... and those issues are not in play. It is a challenging... those are good questions. Yeah. Okay.

(02:51:49)

Out of curiosity, do you know what the pay level is in New York City versus other cities? Is it lower or higher? Because there are other agencies where we have that issue. Yeah, we...

(02:51:59)

Can look into it and circle back. Yeah, a comparison between cities. Yeah, we can look at that and circle back to you.

(02:52:08)

Local Law 159 of 2025 went into effect earlier this year, requiring more frequent cooling tower testing and additional biocide treatment during warm weather conducive to Legionella growth. How was the department prepared to implement and enforce the Bill leading up to its effective date?

(02:52:28)

In many ways. In fact, the preparations happened long before the May 8 rule was promulgated. Let me hand it to Deputy Commissioner... to share more.

(02:52:40)

Yes, we began preparing for that effective date late in 2025. We knew that there would be no grace period and we wanted the regulated community to be prepared to implement. So in late 2025, we began updating the guidance on our website. We would be letting the operators know that there was new information for them. We issued the new detailed regulation to implement your local law, Chair. We sent out notices when that regulation was open for comment. That is an opportunity not only to gather comments from the regulated community but also a time to notify them that this was coming. We notified them again when it became final. We held training sessions and sent out reminders. So there was a lot happening. We started talking about it and conducting inspections well before May 8. It is a new requirement and we know that not everyone is going to be in compliance immediately upon an effective date, but we wanted as many people to be ready to go right on May 8.

(02:53:46)

What additional outreach needs to be done ahead of the next cooling season to ensure greater compliance with Local Law 159? We will be continuing — it is part of our... we think of the inspection as a teachable moment, and we will be continuing to conduct education at the inspection and to do other ongoing outreach. Owners will receive violations if they are not in compliance. That is another way of providing them feedback and an incentive to comply.

(02:54:16)

What support do you need from other agencies or from the Council to conduct outreach for building owners? You should think about that and come back to us, because we can obviously help with folks in our...

(02:54:29)

Particular districts. Yeah, that is a very good point. We will think about that and circle back. Okay.

(02:54:33)

Great. Based on current rules, full remediation — including cleaning and hyperhalogenation — is required when Legionella culture results from a cooling tower indicate levels of the bacteria above a certain threshold per milliliter. In Toronto, they do it at 10, which is obviously really low. We do it at a really high level. Do you think that if we lowered that threshold it would be helpful?

(02:55:04)

Yeah, let me say a few words and then hand it to the Deputy Commissioner. First of all, we are in communication with the team in Vancouver. We are working closely to learn from them and they are learning from us. There is this question of what to do at the 10-unit line when it comes to the bacterial levels. We both agree — our system and the Vancouver system — that that needs to be treated, and that is what happens here. We do demand and require that building owners treat at that 10-unit...

(02:55:40)

Level. So things are not going untreated here. But there is a difference beyond the treatment, and I will hand it to the Deputy Commissioner.

(02:55:49)

I agree, Commissioner. The level that you just referenced, Chair, is the same level that we have here. Their regulation has very detailed requirements for levels and the corrective action that is required, and ours starts at that very same level that you have cited for Toronto.

(02:56:07)

Thank you. During previous Legionnaires' Disease outbreaks, DOHMH has had a public health engineer on staff to help with the agency's response. However, on July 22 a vacancy was posted for a public health engineering consultant in the Bureau of Environmental Sciences and Engineering. When did DOHMH last have a public health engineer consultant on staff, and how long has the position been vacant?

(02:56:35)

We have public health engineers on staff. That posting — you do? Yes.

(02:56:41)

So what was the posting for? I will have...

(02:56:43)

We have other positions that we are hiring for. And how many staff within the Bureau of Environmental Sciences and Engineering are currently dedicated to Legionnaires' Disease prevention, including tower inspection, plan review and related enforcement? I can get you specific numbers in a more detailed way, but that is the full scope of what that team is aiming to do.

(02:57:23)

Okay. There are other questions, but let us do this — we will send them to you and you will send us back answers. So we are done with this portion. Thank you. I want to thank the team here for your time. We really appreciate it. Thank you, Chair. Good morning. So, Assemblymember, right? Senator, I am sorry about the wait.

(02:58:21)

You are not okay?