By Ann Choi and Yoav Gonen
This story was originally published on April 5, 2020 by THE CITY.
Even as coronavirus deaths mount by the day in New York City, diagnosed infections are rising at a slower pace than before government stay-at-home orders.
After peaking at a jump of 118% between March 17 and March 18 — just after schools, restaurants and other gathering places closed — the increase in new cases has declined to between 9% and 13% per day since March 29, according to THE CITY’s analysis of city Health Department data.
On Sunday, Gov. Andrew Cuomo shared grim news of a total 4,159 deaths statewide as he noted a dip in new hospitalizations Friday.
“We’re looking at this seriously now, because by the data we could be either very near the apex, or the apex could be a plateau and we could be on that plateau right now,” Cuomo said.
Still, he cautioned, “We won’t know until you see the next few days.”
A shortage of tests and stay-at-home orders for all but the most seriously sick makes a full picture impossible to obtain. Still, testing is on the rise, with more than 132,000 tests performed so far in New York City. That includes a record 11,248 logged on April 3.
A new research paper by an MIT professor based on test results suggests that the slowing in the increase of new infections is a sign that people staying at home and social distancing are having their intended effect — and need to continue.
“We will have to keep at it in the coming days and weeks to see if the curve is flattened to a degree when the burden of the health care system is eased,” said Bruce Y. Lee, a professor of health policy and management at CUNY.
“It is better than the opposite, which would be seeing that things are shooting up straight, but seeing it curve down does not necessarily guarantee that the curve has been flattened,” said Lee. “It hasn’t been long enough to say for sure.”
And a grim reality remains: Because COVID-19 can take days to manifest and patients often remain in the hospital for weeks, the death toll will likely grow even after new infections have ebbed.
“Flattening the curve doesn’t mean fewer people will die,” said Joshua Zivin, a health economics professor at the University of San Diego’s School of Global Policy and Strategy. “We haven’t seen the worst of it.”
Boroughs Vary
One economist who’s also a practicing primary care physician examined the New York City infection numbers in a working paper to be officially published Monday by the National Bureau of Economic Research.
MIT professor Jeffrey Harris found that while the number of coronavirus cases reported daily initially doubled every 1.3 days, as of last week that rate had slowed to once every 12 days.
The paper cites THE CITY’s coronavirus tracker as one source of its data.
His analysis takes into account the severe limitations on testing that have left untold numbers of new infections undiagnosed, as well as several other possible alternative explanations for the dipping numbers — such as the exodus of some city residents to second homes.
“It is entirely possible that some of these alternative explanations are at least partially valid,” Harris writes. “However, it is difficult to dismiss out of hand the conclusion that the incidence of new coronavirus infections has indeed leveled off.”
He found that the pace of known infections slowed starting March 20 — four days after Mayor Bill de Blasio closed city schools and other gathering places.
The effect can also be seen in The New York Times’ visualization of the daily growth rate in new infections in cities across the U.S., which found that growth peaked at a 60% increase per day March 22, and has since declined to about 15%. It’s still growing, but at a slower pace than the earlier rapid-fire spread.
“In a sea of bad news, it is a good thing,” said Zivin of Harris’ findings.
The rate of new infections varies among the boroughs.
Queens has seen the fastest growth, with new daily reported infections on a pace of doubling every eight days between March 20 and March 30, Harris’ analysis shows. Manhattan has seen the slowest doubling rate: every 45 days.
In Brooklyn, new cases are on a trajectory to double every 10 days and in The Bronx, every 13 days. Harris didn’t offer figures for Staten Island.
Limited Testing
The alternative possible explanations for the slowing of new infections Harris considers include the rationing of testing, leaving large numbers of cases undiagnosed.
The city’s Health Department recommends reserving tests for the severely ill people or those who are hospitalized. Both city officials and hospitals have cited an extreme shortage in personal protective equipment, swabs and other materials as reasons for limiting the testing.
City Health Department officials declined to comment because they had not reviewed Harris’ study. But they said they’ve generally cautioned against reading a reduction in the rate of positive tests as a flattening of the curve.
They noted that testing was more widespread early on — including among those with mild or no symptoms who shouldn’t have been tested. More recently, the department has directed medical providers to limit testing to those who could potentially need hospitalization.
Zivin noted that in addition to the city’s limited testing capacity, some New Yorkers who continue to report to workplaces may avoid getting tested out of fear of losing work, contributing to fewer new cases being reported.
“If you are in a sector that’s still working, and have little job security, you have a very strong incentive to not get tested and convince yourself you are okay,” said Zivin.
Scramble for Equipment
City officials said early last week that they believe the apex of the crisis is still anywhere from two to four weeks away — and that the need for substantial boosts to staffing and equipment remains.
Last week, de Blasio called for a draft of medical personnel. On Sunday, he said that he believes the supplies on hand will last until Tuesday or Wednesday.
He said the city needs 20,000 intensive care beds just for patients with COVID-19 — which will require at minimum a tripling of the total number of hospital beds to 60,000.
And while the federal government has delivered 3,000 ventilators to the city over the past week to assist patients with breathing, a total of 15,000 are needed as soon as possible to weather the crisis, de Blasio said.
“The number of people being intubated each day additionally is high for sure… but it’s actually less than we feared it might be in terms of the increase each day at this point,” the mayor said Sunday. “I see a few signs that are a little hopeful for sure, and as soon as we get to a point where we think they’re consistent enough… we will say that for sure. But I think it’s early to be able to declare that.
“Let’s hope and pray, but we’re not there yet.”
This story was originally published by THE CITY, an independent, nonprofit news organization dedicated to hard-hitting reporting that serves the people of New York.
