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July 1, 2020

Maintaining Control of the Coronavirus in New York City

I wanted to review and document our life in NYC in a collage - since the pandemic spread to the US. 

New York City had its first documented China travel Covid-19 case on March 1st.  On March 2nd a patient was reported in the county next to NYC, and he had no travel or known exposures.  But he worked in Manhattan.  This was the first sign that we had community spread in our area.   This 2nd patient infected many people - most who attended two big social events with him as he was becoming symptomatic.  This cluster in Westchester County was contained quickly by limiting travel in or out of the community.  They set up testing, isolated positive cases, and traced and tested their contacts.  Meanwhile testing kits were so limited that only people who traveled to China, or had contact with someone who did, could be tested here.  It was many weeks later that the genome of our coronavirus proved that our early infections came from Europe - not China - so the City was already infected in the beginning of March.

The surge of new cases began full force on March  14th and by the apex of new cases on April 15 there were over 8000 new cases per day.  On March 20th the Gov. instituted a strict "stay at home" mandate, and a daily morning briefing with lots of cheerleading by Governor Cuomo was able to slow the virus spread.  Only when NYC met preset criteria for the number of new cases, and hospitalizations, did NYC begin a 4 phase reopening schedule on June 8th.  The graph in my collage shows how long that took! 

We are now in Phase 2, behind all of the other regions in our state.  Yesterday we only had 189 new cases and for several days there were only 30 or less deaths.  thousands of virus tests are done daily and only  1-1.2% of the tests are positive.  The graph in the collage below is an actual copy of the statistics for NYC.  When I walk in my neighborhood in the morning there are no groups of people congregating,80-90% of people are wearing masks, and we go out of out way to stay 6' away from others even with our masks on. 

I don't think New Yorkers want to go back to our surge and consequent "stay at home" restrictions that lasted from March 20th to June 8th.  There is an early warning "dashboard" on our state website for people to follow, and at the first sign that more cases or hospitalizations are occurring, Gov. Cuomo will dial back the "faucet and pipes" as he says continually.   We currently have 1-1.2% positive tests per day (~30,000 tests per day) and less than 30 deaths per day. 

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This is the graph for the daily death counts in NYC over the same time period.  There was surge and very slow gradual decline as New Yorkers worked hard to contain the virus. 

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 If you want to hear an example of good leadership, here is the 30 min briefing on the day he told the 3million people in this City that we were closing down.

Governor Cuomo had a televised briefing every morning and I understand my friends from around the country listened like the New Yorkers did.  If you want to listen to "good leadership"   

June 26, 2020

Can We Contain the Coronavirus?

Make America Great Again (MAGA) Red Hats were seen all over Trump Rallies in Tulsa and Phoenix.  He is a president who doesn't believe in science, and he has been a horrific President as a leader during the worst pandemic since 1918.  If you listen to dozens and dozens of epidemiologists and public health scientists, we need to control the coronavirus and "Stay at Home" until you can limit the  number of new cases and hospitalizations.  Then, and only then, should there be a carefully planned reopening - occurring in phases and monitored by "testing - isolating - tracing contacts". 

Our population should wear masks, wash their hands frequently, and socially distance, perhaps even until a vaccine is available. 

The above two rallies were held in cities with increasing Covid-19 case numbers, and there was no social distancing or masks required.  Because our anti-science President, who never understood the basis of containment and refused to wear a mask, these cities might have a significant increase in new cases and deaths in the next 2-3 weeks.  He is directly responsible for the increased number of deaths.  This will not "Make America Great Again."

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New York State was the epicenter for Covid-19 in the US, and there were more than 11,000 new cases per day at the peak.  Now, under the guidance of Gov. Cuomo and a population that was willing to work together to "flatten the curve" daily testing of more than 50,000 people/day shows that only slightly more than 1% of the population has Covid-19. And a phased reopening will depend on keeping that percentage and the number of hospitalizations steady. 

June 24, 2020

My Pandemic Wardrobe

A "Stay at Home" order in New York State was made on March 20th. From then until June 8th, when we started a Phase 1 reopening in New York City, my husband and I left our apartment only 6 times - mainly for quick grocery shopping 2 blocks away.  During these 3 months I've been very comfortable in a pandemic wardrobe, which consists of a cotton T-shirt and a pair of leggings.  I am barefoot and alternate among different colors based on what is next in the pile. These choices even work well with ZOOM and FaceTime and I can order additional clothes online with no delays.

 

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June 17, 2020

Bar Scene Crowds and NO MASKS

Bar Scene:  New York City residents worked very hard and stayed at home for 100 days before we could begin to reopen in Phase 1.  Our 5 boroughs were the epicenter of Covid-19 in the US and in mid-April we had over 118,000 cases with over 7800 new cases in one day and almost 11,000 total deaths.  During those days more than 500 people were dying each day.  Yesterday NYC had only 332 new cases and 21 deaths (Gothamist Stats). 

At the peak of the infections, there were few cars on the streets and even fewer people on the streets.  That is why many of us are very upset about the behavior of those who chose to celebrate every evening in large groups in front of bars and in the street.  There were no masks to be seen, and no one was more than 1-2 feet apart.  PARTY TIME. 

Phase 1 reopening was June 8th - and it didn't include bar parties.   Residents are supposed to wear masks outdoors.  Only 1.2% of NYC residents had positive tests yesterday in a random sample of the virus in as many as 28,000 residents.  The testing will be done daily, and as soon as positive tests start to increase, the reopening "will be dialed back" per Governor Cuomo.  The party groups across the City appear to not understand the concept of "deferred gratification."

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June 13, 2020

Fighting the Coronavirus

New York City (NYC) is ending the first week in our Phase 1 reopening.  My husband and I both walked with social distancing and masks, which felt really good.  Each day the Government goal was to test 35,000 people in NYC and there were only 1.2% positive virus cases in Manhattan from Thursday.  Governor Cuomo, right from March, planned to reduce the number of cases based on CDC guidelines and consultation with other epidemiologists, and only then to begin Phase 1 reopening, by regions, across the state. If the numbers increase, we will be held in this phase until the number of cases drops again - or go back to partial shutdown. 

The Rt (rate of transmission) was 0.77, which means that each infected person is infecting <1 other person.  An Rt above 1.2 will mean one person is infecting more than one other person and it could be the beginning of another surge.  We've been there and don't want to do that again.  Last Sunday NY State had 2% positive cases (~50,000 tests), and yesterday it was 1.5%.  Each region has an army of trackers and a tracker contacts each positive patient, for quarantine.  Their contacts are then traced, tested, and asked to begin quarantine. I look at the increasing number of cases in other states and don't want to be there again. 

I think we can now be sure that the coronavirus will be with us for months or until we have a vaccine and robust vaccination program.  Test-Track-Quarantine is a new concept for me, but every epidemiologist says that is the only way to control a pandemic.  New Knowledge for this old MD!

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