- New York City is reporting less than 20 COVID-19 deaths per day now, a stark comparison to the more than 700 daily deaths in April.
- Experts say New York was able to eventually get control of the outbreak by locking down the city and providing daily information to citizens in a clear manner.
- They warn, however, that the city could see a resurgence of the disease if people become less vigilant about wearing masks, maintaining physical distance, and not gathering in large groups.
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It was a rare Saturday to celebrate in the Big Apple.
On July 11, officials in New York City reported zero deaths linked to COVID-19 in the previous 24 hours, marking the first time there had been no such fatalities since March.
That statistic was later updated to 5 deaths for that day, but since then the city has reported less than 20 COVID-19 deaths per day, a far cry from the days in April when more than 700 were being recorded every day.
Despite the milestone, however, New York is by no means in the clear when it comes to the pandemic that has killed more than 32,000 people in the metropolis.
“It is wonderful that it happened, but it’s only a battle in this really, really long war,” said Maureen Miller, PhD, an infectious disease epidemiologist and adjunct associate professor at Columbia’s Mailman School of Public Health in New York.
“I don’t want to take away the celebrations and the joy from that, but I do want to raise a reminder that this is round one, and we have to be vigilant,” Miller said. “This is a really scary disease and it’s not going away. Certainly not willingly.”
Miller and other experts told Healthline how New York City was able to get COVID-19 under control.
They also discussed what the city must continue to do to keep the virus at bay and what surging states can learn from New York City’s experience.
New York City got a handle on the virus by a complete and total shutdown, according to Miller.
“They stopped all businesses. They insisted that there be no social gatherings. They had shelter-in-place laws in place and enforced by fear. People were terrified. We had watched what had happened in Europe and then suddenly it’s happening in New York City, our home,” she said.
When the healthcare system first reached a breaking point in March, measures such as physical distancing, mask wearing, and limiting the number of people allowed in essential businesses were “rigorously adhered to,” Miller said.
That helped bring numbers down.
“New Yorkers know what’s up, so they actively, voluntarily participated in these efforts,” Miller said.
Dr. William Schaffner, a professor of preventive medicine in the department of health policy and a professor of medicine in the division of infectious diseases at the Vanderbilt University School of Medicine in Tennessee, said something else helped New York on its course.
“Leadership, leadership, leadership,” he told Healthline. “Clear, sustained communication so that you have a plan and everybody knows what the plan is and you update everyone as the plan has to change, as you learn things (are) changing — and New York state had that leadership from the governor.”
Daily press conferences addressing the issues at hand and instructing New Yorkers what to do — physical distancing, wearing a mask, avoiding large groups, and lockdown — were integral in stopping the spread of the virus, Schaffner said.
“So there were two things: they had a plan and the communication was sustained. Clear, crisp, and the average person could understand readily. What does this mean to me? What does the governor want me to do?” Schaffner explained. “I think that having the plan and then having the communication were the two critical elements.”
“We know that, when you do it properly, you bring down those cases. We have done it. We have done it in New York,” Fauci said in an interview with PBS NewsHour.
Experts emphasize that New York isn’t out of the woods yet and the city shouldn’t act like it is.
“Do more of what you were doing,” Miller advised. “The fatigue is really setting in (here) so people are congregating, especially outside of bars.”
Miller said it’s worrisome that people in the city have become more lackadaisical about maintaining the COVID-19 safety measures.
“I’ve also noticed that there’s less mask wearing,” said Miller. “Or the mask is worn under the chin or on an arm. It’s like, that doesn’t do anything for you. And it’s particularly evident among young people and among men who are at higher risk.”
On Monday, the city will enter Phase 4 — the last region in the state to do so. Included in this reopening are schools, professional sports without fans, TV and film production, and, at reduced capacity, outdoor activities such zoos and botanical gardens.
Entering the final phase does not mean going back to pre-pandemic lifestyles, however.
Miller predicts another spike eventually in New York City, citing an uptick in cases among people in their 20s.
“That’s really scary because many of them will have little to no [symptoms]. They’ll have a little summer cold, they’ll think nothing of it,” she said. “So it takes a while for these chains of transmission to work their way to people who are more vulnerable.”
Another factor that could impact New York between the next 6 to 10 weeks, Miller said, could be people coming to the city from areas across the United States with high case numbers.
“Moving back to New York or visiting New York, or visiting friends in New York. Or escaping their own high prevalence situation,” she noted. “The governor has put in a mandatory quarantine for visitors from high prevalence states, but it’s not being implemented very well. People are doing whatever they want to do.”
Schaffner said there’s always the potential for things to get bad again in New York.
“But I would hope that New York, and generally that group of northeastern states, can maintain this discipline because the discipline of social distancing will need to extend for months,” he said. “If you back off now, if you become carefree rather than careful, then the virus will have a resurgence.”
Following the guidelines is crucial to preventing another spike in cases.
“The only way we know to stop this virus — we don’t have a vaccine yet, we don’t have a drug that can prevent infection — is the public health measures,” Dr. Thomas A. Russo, chief of the division of infectious diseases in the Department of Medicine at the University at Buffalo in upstate New York, told Healthline.
The fall and winter are of particular concern, a sentiment expressed last week by Robert Redfield, the director of the Centers for Disease Control and Prevention.
In particular, he noted that flu season is approaching.
“In New York, we’ve kind of got the wildfire sort of under control, but the embers are still smoldering out there,” Russo said. “If we regress, if people start to get lax and fatigued about following these public health measures, the concern will increase when our ability to do things outdoors no longer becomes as feasible. Then we start to shift some of our activities indoors and we know that will increase the risk.”
Russo said New York City will definitely be susceptible to “a flare” and an increase in the number of cases.
“There’s no question about it,” he added. “And of course the huge wildcard is going to be schools.”
At this moment, many cities and states across the country are looking more like New York in March and April.
The advice to these regions? Shut it down.
“It’s completely out of control. They have to lock down,” Miller said. “I think it’s never too late to do something to flatten and then bend the curve. But they have to do it, and they have to do it aggressively. And even with that done a lot of people are going to die who didn’t have to.”
Without a lockdown, health systems in many areas will face collapse.
“They’re already teetering. They’re all full,” Miller said. “They’re in the same situation that New York was facing, only by the time New York was facing it they’d started to really aggressively shut down. The states that are seeing the highest number of cases aren’t doing that yet.”
As hard as it is to do in warm weather states such as Florida or Arizona, Miller recommends closing activities indoors.
It’s something California’s governor did last week when he ordered a shutdown of bars and other establishments as cases rise there.
“Outside it’s better, so we’re probably having lower rates of transmission than we will when people are inside. So close down everything inside,” Miller said.
Essential services are necessary to keep open but “you can’t have Disney (World) opening,” she added. “You cannot do that.”
Schaffner said it would take a “huge effort” to turn things around in states such as Florida.
“I don’t think it’s too late,” he said. “It would take the leadership of the state, the governor, to say we’re now going to do this differently.”
“The governors need to take a page out of [New York] Governor Cuomo’s book. You’ve got to be very clear about what your goals are and update the state’s citizenry on a regular basis and you would be well to do that yourself and to do it in concert with the public health officials,” Schaffner added.
Russo hopes these surging states saw how New York took care of their most vulnerable citizens and follow suit.
“Our nursing homes, for example, I’m hoping that these states have at least paid attention to that lesson — we are protecting our vulnerable population in a better fashion,” he said. “So that’s one hope that certainly the number of deaths won’t be as great as we experienced in the early phases of this pandemic.”
Russo also noted that there are now drugs such as remdesivir that can help the most severely ill.
The bottom line is if you’re in a state that’s surging, do what you can to protect yourself by following safety measures.
And if you’re in a state like New York that’s experienced some success stopping the virus? Don’t let your guard down.
“We know that the states that got in trouble, the public health measures were not mandatory. And even in some states where they were mandatory, there was significant push back and people weren’t following the public health officials’ recommendations for mask usage and distancing,” Russo said.
“No one is out of the woods with this until we get a vaccine. You’re only as good as your last good behavior with public health measures,” he said.
Miller also emphasized the importance of wearing a mask, keeping physical distance, and taking activities outside while you still can.
Because once it gets colder, taking activities outdoors will be more difficult.
“I think that we have learned, and we’ve learned the hard way, how this virus works,” Miller said. “I would not be surprised if suddenly, as we’re starting to see, we’re no longer a state where the cases are declining.”