Rats and sewage are overwhelming America’s biggest cities

This is the tale of two cities with garbage and sewage problems, but with perhaps a glimmer of hope for one of them: my city, New York.  

The New York where I’ve lived since the 1980s has had relatively clean streets, but since the pandemic began, I have spent many nights and early mornings walking back and forth between my apartment and my office, four long blocks away, dismayed by the growing piles of garbage stacked alongside the curb awaiting pickup. More dismaying still are the rats that dart between and among the piles.  

Like everyone else, I am startled and fearful of the size, speed and teeth of these rats but as a physician, I also view them differently — as carriers of contagion. I am quite aware that they can carry fleas ridden with bubonic plague or that their urine can transmit the equally problematic leptospirosis or lymphocytic choriomeningitis, not to mention the risk of wound infection or rat-bite fever if they were to actually bite you. According to the New York City Department of Health, there are still no cases of plague here and leptospirosis (symptoms include red eyes, yellow skin, muscle aches, fever, and vomiting), is still rare though increasing. 

In the past few months, I have begun to notice a change for the better in the semi-quiet back channel streets I use to walk to work, though no public official would point to these particular tiny streets to demonstrate a new policy is working. Instead, there would be a display somewhere like Broadway or Fifth Avenue, which would suddenly be immaculate. This hasn’t happened — at least not yet. There is clearly an improvement, but it is more gradual.

Jessica Tisch was appointed sanitation commissioner by Mayor Eric Adams back in April. She has a long history of public service for the city dealing with infrastructure management and information technology, with many accomplishments along the way. She is the right person for the job and has strategies in place that could help clean things up with a corresponding recovery in property and real estate value. Keep in mind the total number of complaints about rats has been close to 45,000 since the pandemic began.  

New York City’s response, led by Tisch, is to expand the use of rat-proof trash containers and reduce the amount of time between when trash bags are put at the curb and when pickup occurs. You may say that these are obvious fixes, but we are a city where, unfortunately, too often politicians miss the forest for the trees, or in this case, the rats. Additionally, bills are being considered to expand composting services (to go to landfill), and the Department of Sanitation is again enforcing commercial composting rules.

There is also a new allocation by the City Council to increase garbage pickups to four times a day on the upper east side of Manhattan, an area that sorely needs it, and an additional allocation for street and sidewalk cleaning by the nonprofit Association of Community Employment Programs, which employs New Yorkers who were once homeless. Rat-baits will be installed in neighborhoods around the city. There is still a long way to go and a literal mountain of garbage to climb to even get back to where we once were. 

At the same time that these positive initiatives are taking place here in New York City, on the left coast, the Los Angeles County Department of Public Health is recommending that people avoid swimming at many ocean beaches because of sewage. Ironically, these closures include RAT (Right After Torrance/Redondo) Beach, only 30 miles from LA. There is a direct correlation between the sewage problem and the homeless population in LA, which according to their Homeless Services Authority grew by 4.1 percent to 69,144 in 2022.   

By contrast, the growth of NYC shelters has certainly helped to keep people off the streets. We have five municipal shelter systems here run by four different agencies. These shelter over 52,000 people on any given night.  

Presently, LA County has 24,000 beds, an increase of 57 percent over three years which still doesn’t come close to meeting demand.  Our population in New York City is around 8 million, whereas LA County has around 10 million residents. Our beaches have been wide open while theirs are shuttering by the droves. LA has a garbage and rat problem that is compounded by its burgeoning homeless population and the lack of regular cleanups. New York’s problem is tied more directly to sanitation.  

I can’t speak as directly to the growing problem in LA, but I have real hope that New York can beat its problem under the capable leadership of Jessica Tisch. If both cities fail to act, the health of millions of Americans in two of the nation’s most populous regions will remain in jeopardy.   

Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID; the Politics of Fear and the Power of Science.”