New York’s New Covid Surge Is Deep, But Less Deadly This Time

New York, once the epicenter of the Covid-19 pandemic, sits on the brink of breaking its case record from last spring. The impact of this latest surge, though, is almost unrecognizable from those nightmarish early days.

For now, the state is staving off the repercussions of the current spike in cases, with ample hospital capacity and one of the nation’s lowest death rates. Dozens of other states are being overridden with hospitalizations, and seeing deaths climb to new highs.

The contrast is a testament to the lessons New York residents and officials have learned in the last several months. The question facing them now is how long can New York keep the virus at bay, and whether all the excitement over an impending vaccine -- and the flouting of Covid-fighting rules -- could lead to a relapse.

New York’s New Covid Surge Is Deep, But Less Deadly This Time

In a briefing earlier this week with Anthony Fauci, the U.S. government’s top infectious-disease expert, New York Governor Andrew Cuomo recalled the Javits Center field hospital during the worst days of the pandemic. “It looked like a field hospital in an army,” he said. “You just saw an ocean of cots. And I just hope we never have to get to that point.”

New York reported 10,178 new cases Thursday, approaching the state’s mid-April record, according to Cuomo. He said he would announce more details on Friday about his plans to contain the virus in what’s already turning into a harrowing season for the pandemic.

New York’s New Covid Surge Is Deep, But Less Deadly This Time

Earlier this week, Cuomo mandated a 25% increase in bed capacity statewide and said the state is watching each region’s seven-day average hospitalization growth rate. If it shows the region poised to hit critical capacity of 90% within three weeks, he’ll institute more drastic restrictions such as closing non-essential businesses.

In New York City, hospitals have been planning and preparing for months, City Health Commissioner Dave Chokshi said in a briefing Wednesday: “But our shared goal should remain to do the things that we know can work to keep people from getting to the hospital threshold in the first place.”

Daily deaths are not spiking as sharply as cases, but that doesn’t necessarily mean New York is in the clear -- especially with the Christmas and New Year holidays approaching.

“Our biggest fear is that it will continue to spread at a rapid pace because of gatherings,”said Robert Mayo, chief medical officer for Rochester Regional Health, which serves nine counties in Western New York and the Finger Lakes. The system has seen three times the number of admissions as it did in the spring. “Hospitals only have so many people and so many resources.”

More patients are coming from home settings, getting the illness through community spread, he said.

New York’s New Covid Surge Is Deep, But Less Deadly This Time

Testing is one of the clearest explanations for today’s differences. New York City Mayor Bill de Blasio said Thursday that the city tested half a million people in the week before Thanksgiving, a record. Added testing capacity allows the city to better track the spread. It now has capacity for 120,000 tests a day.

New Yorkers are now encouraged to get tested regularly, unlike during the first wave when a bulk of the tests were reserved for patients with severe cases.

Hospitals also have more space thanks to patients moving through the hospital faster. The number of patients hospitalized statewide, though rising, is about a quarter of what it was in April, according to Covid Tracking Project data. At its worst, coronavirus was sending one in every four hospitalized New Yorkers into intensive-care units, and 85% of those patients required intubation.

Those ratios both fell significantly -- to 45% in the case of intubations, according to Cuomo. Hospital visits on average are also half as long as in April, because of more sophisticated care and drugs like Regeneron Pharmaceuticals Inc.’s antibody cocktail, which received emergency-use authorization in November. That also has helped drive down Covid deaths. Daily deaths statewide are still shy of 100, far below the nearly 800 in April, even though cases are hovering around the same levels.

New Surge

New York’s daily death rate, scaled for population, is lower than many of its neighbors such as Pennsylvania and Connecticut, which are in the midst of their own spikes.

Officials and health professionals warn that although New York seems to be handling the Covid surge better this time around, things could get bad again quickly -- especially if residents think a vaccine is on the horizon and they can let their guards down.

“Nothing’s a fait accompli -- our actions now dictate what happens in the hospitals in the next few weeks,” Cuomo spokesman Rich Azzopardi said in an email. “New Yorkers need to remember they bent the curve the first time by being smart, by wearing masks, by socially distancing. They did it then, they can do it again.”

At Westchester Medical Center Health Network, the roughly 50 confirmed Covid-19 cases on Thursday were well below the spring peak of more than 225. Staff morale is good, and the hospital is well stocked with protective gear, said Michael Gewitz, senior vice president for clinical operations.

But Gewitz said he’s concerned that holiday travel, fatigue and pressure to get back to normal living could lead to further increases.

The numbers can revert quickly if people stop being cautious and flout restrictions, said Anna Bershteyn, an assistant professor at the NYU Grossman School of Medicine. “We have every reason to expect another surge,” she said. “It really is the behavior of people.”

The geography of the current case spike also has shifted. New York City, though still a major driver of cases by absolute numbers, is far from the top when controlling for population.

New hot spots have bubbled up elsewhere, like Erie County, home to Buffalo, which reported 621 new cases on Tuesday, more than double the spring peak of 277.

Before, if New York City needed reinforcements, it could ask doctors and nurses from upstate to come and treat patients. If rural cases worsen, there will be nowhere to go for help.

©2020 Bloomberg L.P.

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