Despite Staggering Death Toll, N.Y. Outbreak Could Be Slowing

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New York, the epicenter of the global coronavirus outbreak, has begun to show the first signs of controlling the crisis: Its staggering death and hospitalization rates have started to stabilize, according to figures released by Gov. Andrew M. Cuomo on Monday.

But striking a note of optimistic caution, Mr. Cuomo warned that the state’s progress could continue only if New Yorkers maintained a sense of discipline and suppressed their natural impulse to gather in the parks or on the streets, especially as the spring weather starts improving.

“We get reckless,” Mr. Cuomo said at his daily news briefing, “you will see these numbers go up again.”

The governor’s mixed assessment came as the pandemic entered its second month and neared what federal officials called a crucial moment for determining its future. The seesawing nature of the crisis was apparent on Wall Street: The stock market had one of its biggest rallies of the year on Monday, with the S&P 500 closing up 7 percent, even as the death toll in the United States surpassed 10,000.

Even with the promising signs, the virus’s overall toll in New York State was still astonishing: Nearly 5,000 people in the state have died, half of those in New York City. More than 120,000 residents have tested positive, and more than 16,000 are hospitalized.

And across the country, many states were reporting alarming increases in cases that were straining hospitals. Federal officials, who have cited projections indicating that the virus could ultimately kill more than 100,000 people nationwide, warned that the next few days could bring a ghastly uptick in the number of deaths and infections.

In Florida, Indiana and Louisiana, the number of fatalities attributed to the virus more than doubled in a week. But there were also signs that the situation was improving on the West Coast, where the virus first surged in the United States. The governors of California, Oregon and Washington said they would send ventilators to states that needed them more.

“We want every American to know that what they’re doing is making a difference,” Dr. Deborah Birx, the leader of the White House coronavirus task force, said Monday during the group’s daily briefing. “But we need to have solidarity of commitment from everyone.”

Outside the United States, Western Europe reached its own important turning point on Monday: While the total number of patients on the continent continued to climb, the rate of new infections was no longer rising.

The shift seemed clearest in Europe’s two most battered countries, Italy and Spain, where the daily number of deaths has been running into the hundreds and where the number of infections is well above 100,000.

But in Britain, developments were grimmer: Prime Minister Boris Johnson, who has contracted the virus, was moved into intensive care on Monday night, one day after being admitted to the hospital. Britain had reported more than 5,900 new infections on Sunday, its highest single-day total so far.

Mr. Cuomo’s fatherly appeal to New Yorkers to stay the course — and to stay away from one another — came at one of his regular daily briefings, which have become a kind of touchstone for many Americans in the past few weeks.

As always, his presentations were filled with an array of detailed statistics. Though New York’s daily death toll peaked at 630 on Saturday, it hovered around 600 on both Sunday and Monday, he said. That followed a long stretch in which hospitalizations in the state were growing at a rate of 20 to 30 percent a day, but are now increasing at a single-digit rate.

“While none of this is good news, the flattening — or possible flattening — is better than the increases we have seen,” Mr. Cuomo said.

The continuing flood of patients into hospital emergency rooms has presented a daunting challenge to policymakers like Mr. Cuomo who are trying to predict on the fly not only where the crisis might be headed, but also when New York might be able to return to a semblance of normalcy. The governor said on Monday that schools and nonessential stores would remain closed at least through April 29.

The governor’s staff, in attempting to divine the course of the outbreak, has been using statistical models created by the Institute for Health Metrics at the University of Washington, which has received funding from the Bill and Melinda Gates Foundation, as well as predictions generated by McKinsey & Company and Weill Cornell Medicine.

Much of the uncertainty comes from the fact that the statistics themselves are far from solid indicators.

The number of hospitalizations, for instance, depends partly on admission standards. Some overwhelmed hospitals are sending home people who are in less dire shape, but whom they would admit in normal circumstances. There are also indications that Covid-19 deaths are being undercounted — especially those who die of the illness at home, rather than a hospital. And studies have shown that many people never even know they have been infected, one reason the governor spent much of his time in front of the camera scolding those New Yorkers who found the outdoors too inviting to resist.

“Frankly, there has been a laxness on social distancing, especially over this past weekend,” he said. “Now is not the time to be playing Frisbee with your friends in the park. Now’s not the time to go to a funeral with 200 people.”

“I understand how the religious services can help with the grieving process,” he said. “But, as a society, the risk is too great.”

To ensure that downward trends continued, officials in New York City announced that they were closing all dog parks and dog runs because people using them were not practicing adequate social distancing. City officials also promised to crack down on funerals where people were ignoring separation measures.

On Sunday, after people complained about crowds, the police broke up a funeral for a prominent ultra-Orthodox Jewish rabbi who died of the virus in Borough Park, Brooklyn. And the governor said the state was doubling the maximum fine for ignoring social distancing rules, to $1,000.

Mr. Cuomo has continued to shore up the state’s battered hospital system, which, like those across the nation,is suffering from acute shortages of crucial medical supplies, according to a study released by a government watchdog.

On Monday, nursing unions in New York called for more protective equipment like N95 masks and increased staffing during the pandemic. Mr. Cuomo also announced that he was planning to move more than 800 ventilators to New York City and its suburbs from less-affected areas.

The governor said as well that President Trump had agreed to a change in policy that would allow the U.S.N.S. Comfort, a Navy hospital ship that arrived in New York City last week, to care for people infected with the virus. The ship had previously been reserved for non-Covid patients, but was being underused because hospitals had so few of them to send.

In another stark symbol of the crisis, officials of the Episcopal Diocese of New York announced on Monday that the Cathedral Church of St. John the Divine in Manhattan would be turned into a field hospital.

With the number of city residents dying of the virus outpacing the system’s capacity to handle them, officials were considering temporarily burying people in mass graves in a park, the chairman of the City Council’s health committee said on Monday.

“It will be done in a dignified, orderly — and temporary — manner,” the chairman, City Councilman Mark Levine, wrote on Twitter. “But it will be tough for NYers to take.”

A spokeswoman for Mayor Bill de Blasio disputed Mr. Levine’s remark, saying, “There are no plans to bury anyone in local parks.”

Mr. Cuomo also stepped into the debate over the use of hydroxychloroquine, an anti-malaria drug, to treat virus patients, which the president has promoted even though the administration’s health experts have noted a lack of conclusive evidence that it works.

Mr. Cuomo said that hospitals in New York were already using it, and that he planned to ask Mr. Trump to increase the federal supply of the drug to New York pharmacies.

“There has been anecdotal evidence that it is promising,” he said. “That’s why we’re going ahead.”

But the governor suggested that even though New York had reason to hope in recent days, the weeks and months ahead were likely to be grueling.

“This is an enemy that we have underestimated from Day 1, and we have paid the price dearly,” he said.

Reporting was contributed by Joseph Goldstein, Sarah Mervosh, Andy Newman, Mitch Smith, Benjamin Weiser and Karen Yourish.



Source : Nytimes