What to Know
- More than 28,000 tri-state lives have been lost to date; daily hospitalizations also dropped below 1,000 for the first time this month
- The United States topped 1 million confirmed cases Tuesday; New York accounts for nearly a third of those. Nationally, nearly 60,000 have died
- Gov. Andrew Cuomo says some parts of NY may be poised to reopen when his "PAUSE" directive expires May 15; NJ Gov. Phil Murphy says his shutdown order will remain in effect statewide indefinitely
New COVID-19 hospitalizations in New York state averaged under 1,000 a day for the first time this month Tuesday and stayed there Wednesday, the latest sign of slowly decreasing pressure on the health care system. In the city, emergency rooms are less crushed.
A week ago, New York City hospitals were admitting more than 200 virus patients a day. That number could soon regularly be below 100 (despite a slight increase Wednesday). The death rate, which lags other indicators like hospitalizations, has finally started to descend the curve.
But it's all relative — a virus that was unknown to science six months ago is still killing someone every 2 minutes across the tri-state region. Cuomo reported another 330 deaths Wednesday, even as testing hit a new high over 30,000 per day.
But a clearly agitated Cuomo said Wednesday that more needed to be done -- and he once again called out Congress, particularly Senate Majority Leader Mitch McConnell and Sen. Rick Scott of Florida for not helping the states.
"They want to fund corporate America," Cuomo said. "I say fund working Americans."
The comments came hours before McConnell reversed course, saying that he was "open" to considering additional relief funds for state and local governments in the next coronavirus relief bill.
Right now, each day the daily toll seems to tick down. Two weeks ago, there was a stretch of days where it did the opposite -- climbing closer to 800 each day. U.S. Surgeon General Jerome Adams had warned that would be the "saddest week" of the pandemic for America. He was right. We're on the slope down now.
The casualties of this pandemic could fill arenas, concert venues, sports stadiums. New York state's official toll (which doesn't include the city's separate list of 5,302 "probable" cases) has topped 18,000. That's almost the capacity of the Barclays Center. New Jersey has lost 6,770 people, while Connecticut reports 2,168 fatalities. Nationwide, NBC News reports that more than 60,000 lives have been lost from the coronavirus.
At his daily briefing on Wednesday, Murphy noted that more Garden State residents had died from COVID-19 than were lost during World War 1, the Vietnam War, the Korean War, both Gulf wars, the Afghanistan war, the Sept. 11 attacks and Superstorm Sandy -- combined.
"To think we've added a number that is more than all of those combined takes your breath away," he said.
Despite the staggering number of deaths, Murphy announced on Twitter that he would be reopening state parks on May 2. Golf courses and county parks will also have the option to reopen that day. But restrooms and clubhouses will remain closed, and team sports will still be prohibited.
Murphy noted that the decision to reopen the parks came based not on public pressure, but on public health data. He said it was that same data that led him to close the parks in the first place.
He also referenced Tuesday's protests in Trenton, saying that while he wasn't against demonstrations, he wished they would be done virtually. State troopers said that they'd also authorized charges against the event's organizer for violating the state's social distancing orders.
Some of those protesters were vocal supporters of President Trump, with whom Murphy is set to meet on Thursday, the governor announced Wednesday night. The two will discuss testing for the virus and financial assistance for states at the White House, Murphy said.
Hospital workers battling on the front lines for months say the all-out chaos has subsided, but still report feeling overwhelmed by the sickness and death. They still find themselves serving as families' surrogates, the last to hold a loved one's hand. They still are getting sick. They still leave 12-hour shifts in tears. For many, the worst fear is possibly having to go through it all over again.
We can't let that happen, Cuomo says. "We have gone through hell and back ... and we have to respect what we accomplished here."
Cuomo Lays Out New Guidelines for Reopening
While New Jersey's governor has extended his shutdown order indefinitely statewide, Cuomo says he'll likely allow his "PAUSE" order to expire after May 15 in some parts of the state. The upstate region has seen a much slower infection rate than New York City, which is expected to see the state shutdown directive extended along with spots like Long Island and Westchester.
Cuomo outlined additional guidelines Tuesday for his New York state rollout plan, one he says each region -- from New York City to the Finger Lakes -- must follow as they look to re-open.
A robust testing regimen and tracing system are key to re-opening, Cuomo has said, and regions must build those into their reopening structure. The governor says he wants at least 30 tracers for every 100,000 people, and regions must continue to monitor their infection rates. Currently, the state is conducting about 30,000 tests a day, he added.
It's not clear how many counties hit all of Cuomo's criteria for reopening. In Nassau County, for example, hospitalizations and positive tests are both down. But a third key metric - ramped up testing - is still an ongoing process.
White House Reopening Guidelines Leave Room for Interpretation
For states considering lifting quarantine measures, the official guidelines propose either a downward trajectory of COVID-19 cases within two weeks or a downward trajectory of positive tests as a percent of total tests.
As shown below, when you compare yesterday’s new case count with that of two weeks ago, the number is often lower, simply because the counts fluctuate. The criteria has been criticized by some for being vague, creating the opportunity for any governor to argue the numbers are favorable enough to start reopening.
Source: The COVID Tracking Project
Credit: Amy O’Kruk/NBC
They must also present plans to make rooms available to people who cannot self-isolate (New York City has made 1,000-plus hotel rooms available). Then comes the re-opening of schools, transit, testing and tracing with surrounding regions, which Cuomo says regions should coordinate with surrounding regions.
Still, some areas close to the city are showing signs of slowly dipping their toes in the reopening waters even in the next few days. Rockland County will reopen county parks on May 1 for walking only, with all other amenities remaining closed. Masks or face coverings will still be recommended for those who visit.
Reimagining -- the workplace, telemedicine, tele-education -- is a big component of the process. Cuomo says New York will reopen differently but it can be rebuilt better, turning all the painful lessons from the pandemic into future strength.
Each region must appoint an oversight institution as its "control room" to monitor key metrics, including hospital capacity, infection rate, PPE burn rate and businesses, the governor said. If any indicator becomes problematic, officials can flick a sort of emergency switch to manage the issue before it metastasizes.
City, State Mull Plans to Combat Homelessness on the Subways
Regions must all continue to ensure protections are in place for essential workers, Cuomo says. He described the homeless situation on New York City subways as a "disgusting" affront to their commitment to get to work every day. On Wednesday he said the MTA would come up with a plan to clean vehicles more frequently.
Mayor Bill de Blasio said the city offered a plan to close 10 key station hours overnight, which would disrupt service but allow people to more effectively reach homeless people on the trains. He said the city will pay for it and "we could get going immediately," but his administration is awaiting an okay from the MTA.
"What we are seeing here is a real problem, but it's not because something fundamentally changed over the last decades," de Blasio added. "It's that there are very few people riding the subways, there's much less service, so the homeless individuals who have been riding the subways stand out more. It's also a call to action to help them more."
De Blasio unveiled new plans Wednesday to do that. He said the city would move 1,000 people from shelters to commercial hotels this week, with the goal of moving 1,000 more each week on top of the 6,000 already in hotels. The health department will also launch testing this week at large city shelters, expanding access across the system by mid-May. Anyone who tests positive will be safely isolated, the mayor said.
Tracking Coronavirus in Tri-State
The Uncertainty Problem: Painful Reality, Profound Fear of the Unknown
More than a million people in the United States have been diagnosed with coronavirus. Far more likely have had it and recovered without even knowing they were sick in the first place. In New York City, up to 2.1 million may have been infected, data released this week shows -- 13 times the more than 164,000 cases reported.
Uncertainty — Who is infected? How do I pay my bills? When will this be over? — has entrenched a new kind of fear in the mindsets of many Americans, one that makes them question the very routines they comfortably abided for years.
Think of it like "combat stress," a phrase typically used to describe war trauma, de Blasio said. "I never thought we'd have to use this word in the middle of New York City civilian life but in fact, it is the right word and we do need the help of our military to make sense of this situation."
The Department of Defense is stepping up to the plate, training 1,000 behavior health staff in "helping healers heal" to supplement the comprehensive hotlines and programs already in place, New York City First Lady Chirlane McCray announced Wednesday. Those 1,000 specialists will provide a "whole new level" of care for first responders, who, like soldiers of war, will no doubt face continued trauma long after the last COVID-19 patients exits their hospitals, McCray said. The program is expected to be up and running at some point in May.
If you or someone you know is in a crisis, including at risk of suicide or self-harm, help is available. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Trained counselors are available 24/7.
As New York and the nation begin to move beyond the first phase of the crisis, one question continues to haunt many leaders. Did it have to get this bad?
In an interview with Axios, Cuomo admitted that he wished "someone stood up and blew the bugle" sooner regarding how serious of a threat the virus was and didn't take China at their word back in December or January. "And if no one was going to blow the bugle, I would feel much better if I was a bugle blower last December and January," the governor said. "I would feel better sitting here today saying, 'I blew the bugle about Wuhan province in January.' I can't say that."
Cuomo also confessed that even as late as March he was confident about New York's chances to beat the virus, partly out of "arrogance" regarding the state having some of the best health care in the world, leading him to believe the situation wouldn't be "as bad as it was in other countries."
There's a lot about the virus that no one knows or fully understands, not even the globe's top health experts and scientists. They don't know how long antibodies may provide immunity or even if they do for sure. They don't know if the virus is seasonal; there's evidence it is and that it may not be. If COVID-19 does come back in the fall, the White House says it'll be ready.
New symptoms continue to emerge. The CDC recently added chills, muscle pain and sore throat to its mounting list of possible symptoms. An earlier update added sudden loss of smell. Patients have described memory loss.
This virus never existed before it emerged in China's Wuhan province last year. It's a daunting task for states to try to manage their outbreaks as scientists and health experts try to build up their research base and set guidelines in real-time.
The rapid spread of infection hasn't given them any other choice; they know the spread is far greater than the number of confirmed positives. The tri-state area alone has more than 450,000 of those: 299,691 in New York, 116,264 in New Jersey, 26,767 in Connecticut. Early antibody testing results indicate more than 2 million may have been infected in New York City alone at some point; many of those patients likely had mild to no symptoms and may not have sought testing at all.
New York City will offer free antibody tests, courtesy of the federal government, to more than 150,000 healthcare workers and first responders starting next week. Tests will be available at hospitals, police precincts, firehouses and other central locations. It's an imperfect test, but it indicates whether someone may have had the virus and recovered -- and de Blasio hopes it will help first responders who do test positive for the antibody feel more confident at work.
The state has conducted preliminary antibody testing on NYPD and FDNY/EMT members; 10.5 percent of NYPD samples turned up with the antibody, compared with 17.1 percent of the FDNY/EMT group. Overall, New York City samples had a 24.7 percent positivity rate in the latest testing round, much higher than anywhere else in the state. Cuomo said Wednesday he plans to test transit workers for antibodies in the next phase of the study."
Barring a vaccine or effective treatments for the virus, Harvard researchers say social distancing could be necessary into 2022. More than 70 vaccines are in development worldwide, but approval could be 12 to 18 months out if not longer.
Clinical trials for experimental drugs have not spurred much optimism thus far, though some have appeared more effective than others in initial study. Northwell Health in New York says it has found some promising early results in a trial that uses a common, inexpensive heartburn drug as treatment in tandem with other experimental drugs. Final results are still about a month out.
Doctors could use multiple treatments on a single virus patient-- or maybe one helps one person and something different helps another. Bill Gates wrote in a recent essay that an effective treatment has to reduce the death rate by 95 percent. We're not there yet, he said -- not even close.
