New York hails comeback from Covid-19, but hidden dangers lie ahead

Patience and Fortitude are proud advocates of social distancing and mask-wearing. The famous marble lions which guard the steps of the New York Public Library on Fifth Avenue and 42nd St have sat 90ft apart for more than a century, and this week were adorned with giant blue facial coverings.

The masked lions today stand as symbols of the extraordinary turnaround of this recently stricken city. Just three months ago, New York was the coronavirus capital of the world, with more confirmed cases than any single country outside the US.

More than 14,000 New Yorkers were being hospitalized every day, with a daily death toll of more than 1,000.

Weeks of aggressive lockdown and ramping up of testing have finally put the city on track to contain the disease. Hospital admissions for Covid-19, which were running at 850 a day at the peak, were on Monday down to 51; the number of infected patients in ICUs was down from 887 to 297.

“The New York City story is pretty damned good when it comes to the comeback we are making,” mayor Bill de Blasio boasted.

The success story looks even more striking given what is happening to the rest of the country. According to a group of epidemiologists and public health experts, Covid Act Now, all but four states are failing to get ahead of the disease, while 30 states are at risk or already facing alarming surges of infection.

It all makes New York look rather superior. But there is a hidden danger to the dramatic and widening gulf between the city and states like Alabama, Arizona, Florida and Texas which are wrestling with major Covid-19 outbreaks.

Much as it likes to see itself as its own sovereign entity, detached from the rest of America, New York, as a major travel destination, is profoundly exposed to the rest of the US. That was evident at the start of the pandemic, when international travel imported the virus without anyone noticing for days.

It could happen again, with the virus being reimported to New York from other parts of the US. This is why a new quarantine requirement has been introduced for travelers entering the city from 16 states with high positive tests rates.

“We can’t assume we are unconnected to what we are seeing in the south and west. It would be naive of us to think we are insulated from the increases and spread of the virus,” said Mark Levine, chair of New York City council’s health committee.

As a warning sign, Covid Act Now changed its designation of New York state on Thursday from being on track to contain the virus to the more at-risk category, “controlled disease growth”. The slip in status could be a portent of further trouble to come.

The sight of large states like Texas and Florida going up in Covid-19 flames is troubling for New York for other reasons. Many of the current increases are being spearheaded by the more reckless behavior of young Americans, a substantial proportion of whom are asymptomatic which makes it more difficult to detect the spread of disease.

That’s a phenomenon familiar to the city. Many New York neighborhoods saw resistance to lockdown orders even before reopening began on 8 June.

Large crowds began congregating outside bars, parents sneaked into mothballed children’s playgrounds and thousands of official warnings were issued against those who breached stay-at-home orders.

“Citizen compliance is slipping. That’s a fact – look at the East Village, the West Side, Brooklyn, Queens.” Andrew Cuomo, the governor of New York state, said on Wednesday. “It’s a very real problem. Young people can get sick, and young people can infect older people.”

The risk that such behavior could see New York slide back into the dark days of April and May is all the greater given the gradual reopening of the economy. Phase three of the reopening is scheduled for Monday, which initially allowed for the return of indoor dining at 50% capacity.

Given the conflagration that is now tearing through states like Florida that reopened precipitously, Cuomo this week delayed indoor dining – a significant move for a city with such a huge restaurant culture and economy. The cost of going too quickly, and seeing the virus surge again, would far outweigh the economic benefits.

“The one thing we don’t want to happen is for things to get out of hand so that we have to shut down again, which would be devastating,” Levine said.

There’s another good reason for New York to avoid complacency about its current relatively happy status. The fact that it got itself into such a terrible predicament in the first place – with data compiled by the independent newsroom THE CITY putting the latest number of confirmed cases at 212,072 with 23,096 deaths – should in itself give pause.

On Wednesday, Cuomo bragged that “we’ve been smart from day one on how we handled Covid”. But that’s not how it looked to many observers.

The governor and De Blasio were both slow to grasp the scale and speed of the Covid-19 threat when it first erupted. The two leaders fell back into their default position – rowing with each other – with the result that vital days were lost in ordering the shutdown.

The experience in April of such a traumatic explosion of Covid-19 cases – the images of patients being parked on stretchers in hospital corridors and of refrigerator lorries waiting to receive corpses will forever be seared into New Yorkers’ minds – has left the city in reflective mood.

“We’ve been through unimaginable hell,” said Levine. “I don’t think any of us got through this all right.”

Cuomo in particular has come under heavy criticism for his handling of nursing homes which have seen concentrated clusters of infection and death. On 25 March he introduced an order that older patients with Covid-19 who were “medically stable” should be transferred out of hospital and back to their nursing homes.

The governor ditched the order on 10 May, but by then considerable damage had been done. Cuomo has tried to defend himself against the allegations, calling them “politics”, but questions about that decision are likely to hound him for some time.

The hope is that the mistakes of the past will have been learned from, and that the disaster now unfolding in other parts of the US will not be suffered a second time by New York.

Certainly, there are signs that New York has reached a level of seriousness in its response to the pandemic that makes other states look in complete denial – not least this week’s announcement that there is sufficient testing capacity for any New Yorker to have a coronavirus test at any time.

Wan Yang, an epidemiologist at Columbia University who has been preparing projections on the virus for the city’s health department since March, said that enormous challenges still lay ahead if the virus is to remain under control.

“We have to keep an eye on a large number of factors,” she said. “The city has a test-and-trace program in place, but a large portion of infections are asymptomatic. So we have to watch hospitalization rates, trace people with no symptoms, and test high-risk populations.”

For an expert like Wang at the heart of the storm, there is no room for complacency.

“There’s still a lot of work to be done. You can never be too careful to reduce transmission, especially after what happened to this city.”