As the number of coronavirus cases began its rapid rise in New York, Gov. Andrew M. Cuomo warned that what was happening here would soon afflict many other parts of the nation.
“We are your future,” Cuomo said on March 25, five days after ordering New Yorkers to stay at home and closing non-essential businesses. “New York is the canary in the coal mine. New York is going first. …What happens to New York is going to wind up happening to California, and Washington state, and Illinois. It’s just a matter of time.”
In the weeks since, Cuomo’s prediction has not been borne out: As of late last week, California had about 550 deaths associated with the illness; Illinois had 528; Washington — the first state in the nation to deal with a widespread COVID-19 outbreak — had 446.
As of Friday, New York has lost 7,844 lives — including 5,820 in New York City.
Cuomo has received widespread praise and attention for his calm, commanding daily press briefings, which are viewed as reassuring by many across the country and are often contrasted with the statements made by President Donald J. Trump at his daily appearances.
But the praise has dampened in recent days as it’s become clear that — at least so far — the crisis has hit New York much harder than anywhere in the country.
How much responsibility lies with elected officials such as Cuomo, Trump and New York City Mayor Bill de Blasio remains a point of contention. While New York was slower than California to respond to the crisis, it acted faster than most other high-population states. And the epicenter of the outbreak, New York City, has certain unique characteristics that made it especially ripe for transmission of the disease.
At a press briefing on April 8, Cuomo noted that New York’s curve of new hospitalizations and fatalities appeared to be flattening. He brushed aside questions about whether he and de Blasio, who have a long history of feuding, waited too long before ordering schools and businesses to shut down.
“I think the actions we took were more dramatic than most and were criticized, frankly, for being premature,” the governor said. “There was a debate about closing (New York) City schools, and people thought I closed the city schools prematurely. If anything, in retrospect, it shows what we did was right.”
Cuomo also said in an MSNBC interview last week that social-distancing measures could not have been ordered earlier because the public would not have followed them.
While New York City is unlike anywhere else, it does share some similarities with San Francisco, a city that has fared far better in the crisis.
Indermit Gill, a senior fellow at the Brookings Institute who recently wrote about the very different outcomes in the cities, noted that they bear common characteristics: Both are coastal, located at roughly the same latitude, with similar March climates and similarly strong linkages with China, where the pandemic originated.
On the other hand, Gill noted, San Francisco is much more affluent, with a much lower poverty rate and more educated population than New York City, where there’s been a much higher infection rate in poor neighborhoods where residents lack the luxury of staying home and avoiding mass transit. New York has more health professionals per capita: 10 percent to San Francisco’s 6 percent, he noted.
New York City is more densely populated than the Bay Area, with 10 times San Francisco’s population. New Yorkers use public transit to a greater degree and go out to eat more. Los Angeles is also less densely populated than New York.
Their governments also reacted differently.
“San Francisco was much quicker to adopt the recommendations by medical and epidemiological experts — economic lockdowns, physical distancing, and hygienic safeguards — and has been better in implementing them,” Gill wrote. “Private enterprises, especially big employers, in the Bay Area also showed much greater flexibility than in New York City.”
On March 16, San Francisco County, home to San Francisco’s 800,000 residents, joined five neighboring counties in northern California in announcing a stay-at-home order. Three days later, California Gov. Gavin Newsom extended the order statewide.
On March 17, de Blasio began warning that a “shelter in place” order could soon be imposed in New York City. But Cuomo balked, arguing that de Blasio’s terminology could incite panic — and made it clear that any such order would have to be made by the governor.
“Look at your words: ‘Shelter in place’ — you know where that came from? That came from nuclear war,” Cuomo told reporters on March 19. “What it said is people should go into an interior room of their home with no windows, stay there until they get the all-clear sign. Now, that’s not what people really mean, but that’s what it sounds like.”
“Look, I would know, I would have to authorize those actions,” Cuomo said. “It’s not going to happen.”
He called the rhetoric “as contagious or more contagious than the virus. … Misinformation, emotion, fear, panic (are) truly more dangerous than the virus.”
But just a day later, on March 20, Cuomo announced his own “stay at home” order — which would go into effect two days later — arguing that the measure needed to be done on a statewide and even multi-state basis in order to be effective. New Jersey and Connecticut joined New York’s plan.
Lori Post, a Northwestern University professor of emergency medicine and medical social sciences, said one day makes a difference when it comes to shelter-in-place orders. And waiting a few days to issue a stay-at-home order means that the number of cases and deaths has grown exponentially, she said.
“One person infects dozens and dozens of people in cities, just because you’re so densely populated,” Post said. “(And) each of those people infect dozens and dozens.”
Post said the New York metropolitan area has a large airport system, so a lot of people were coming into the region before the Trump administration banned travel from many European countries and before the city went into lockdown.
Nicholas Jewell, chair of biostatistics and epidemiology at the London School of Hygiene and Tropical Medicine, said California’s shelter in place order went into effect at an earlier stage in the state’s growth of COVID-19 cases and that helped lead to better results in California than in New York. Several Bay Area counties in the San Francisco region imposed stay-at-home orders on March 16, six days before New York’s statewide order went into effect on March 22. California imposed a statewide stay-at-home order on March 19.
The spread of COVID-19 follows an exponential growth pattern. If the growth starts when only a low number of people have coronavirus, it will be slower than if it had started when a higher number of people had the disease, Jewell said. An early shelter-in-place order is a way to achieve that.
On March 20, when New York state announced a stay-at-home order, it had confirmed 7,102 cases of COVID-19. Jewell said that while the order was “way too late,” he does not “blame anyone.”
“I think (Cuomo) has been showing a great deal of leadership, but the bottom line was it was too late — if they’d had the good fortune to go a couple of weeks earlier, it would have been much better,” Jewell said.
George Rutherford, a professor of epidemiology and biostatistics at the University of California San Francisco, noted that Manhattan, the borough in New York with the highest density, has the lowest number of COVID-19 cases, so density isn’t the only factor contributing to the spread of the virus in New York. Where the first New Yorkers with the disease traveled to in the city also matters, he said.
Also, a man in the New York City suburb of New Rochelle spread the virus to 113 people, Rutherford said. The virus would normally spread to three people, who would each give it to three more people, he said. But when one person gives the virus to 113 people, those 113 will each transmit it to three people.
“You get overwhelmed really quickly,” Rutherford said. “I mean, that’s just bad luck.”
De Blasio’s rhetoric and actions have faced criticism from other quarters. On March 16, as New York City schools were closed and restaurants were about to be shuttered, de Blasio took one last trip to the YMCA in Park Slope, Brooklyn, his old neighborhood, where for years he has trekked the 12 miles with a mayoral motorcade to use the elliptical machines, despite now living in the mayor’s mansion on the Upper East Side of Manhattan. The trip was viewed as especially tone deaf in light of the growing concerns about use of public places, including gyms, in transmitting the virus.
Asked in a recent radio interview if he regretted also telling New Yorkers to visit their local neighborhood bars on March 16, a day before they were to shut down, de Blasio blamed the federal government for the city’s problems and said that his local government could only do so much.
“What I’ve learned throughout this is that it is about the people themselves,” de Blasio told WNYC, referring to social-distancing measures credited with flattening the disease’s curve in New York. “The government plays an absolutely crucial role, but it’s about the people. And the people of New York actually had been heroic.”
The differences in rhetoric between de Blasio and other elected leaders, including San Francisco Mayor London Breed, had begun earlier. On March 2, New York as a state had reported a total of just one coronavirus cases and no deaths, while California had reported 38 cases and no deaths.
On that day, Breed tweeted that San Francisco residents needed to prepare for possible disruptions from the outbreak, including having supplies of essential medicines, making child care plans, responding to school closures, and planning for how to care for oneself or a sick family member.
That same day, de Blasio tweeted out a recommendation that New York City residents should get out and see a film together at the Lincoln Center in Manhattan.
“Since I’m encouraging New Yorkers to go on with their lives (and) get out on the town despite coronavirus, I thought I would offer some suggestions,” the mayor tweeted.
State Sen. Gustavo Rivera, the chairman of the chamber’s health committee and an occasional Cuomo critic, said New York state’s shelter-in-place order should have been imposed earlier.
“When you are in the beginning of these types of situations, it is best to seem like you’re overreacting,” he said.
The Bay Area and other parts of California shutting down earlier than New York made “a lot of difference” on the impact on the health care system, Rivera said.
“Unfortunately, we did not act aggressively enough right at the beginning,” he said. “We have since made some measures which … seem to be having a positive impact. We cannot take our foot off the gas.”
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