At the Epicenter

New York City is the epicenter of coronavirus death. 

I don’t want your pity.  The reality is that the vast majority of us haven’t even gotten sick.  We’re carrying on, as best as anyone can.

I also wish you wouldn’t gloat.  Not because it hurts my feelings, but because we don’t fully understand what’s happening, and while you’re not suffering now, your turn may come next week, next month, or next winter.  For my part, I believe the explosion of Covid in the city means that we are taking our pain now, and any future outbreaks will be less severe.

New York City has been a big, densely packed, dirty city for over 150 years.  Its character as such is independent of the politics of whoever may be Mayor or Governor.  While we can fault our leadership for what they might or might not do, the essential character of New York City, and consequent risk of disease, is a fact of life and not the politicians’ fault.

Much has been written about the subway as a vector for the coronavirus.  Uncle Andy, last week, ordered the subways closed late at night for cleaning.  While that may make some people feel good, it won’t change much.  The trains and stations were cleaned periodically even before Covid, and an enhanced cleaning regime, in itself, doesn’t require the system to be shut down.  The only difference the nighttime shutdown makes is that the homeless will be chased off the trains for a few hours every night.  But while the subway almost certainly had a role in spreading the virus through the city, blaming the spread of the virus, and the death toll, on the subway seems a bit simplistic.

Over the last week, I’ve pulled together data from various places:

PopulationCasesper 1000Deathsper 1000
NYC and vicinity:
NYC8,399,000174,70920.8019,5402.33
Westchester/NY968,81530,70831.701,3051.35
Nassau/NY1,356,56437,59327.712,3401.72
Suffolk/NY1,487,90135,89224.121,5471.04
Hudson/NJ672,39115,76923.458451.26
Essex/NJ (Newark)798,97514,52118.171,2821.60
Other US cities:
Detroit672,6629,38613.951,0851.61
DC702,4555,0167.142510.36
Orleans/LA (New Orleans)391,0066,54816.754411.13
Philadelphia1,584,06415,1379.566380.40
Allegheny/PA (Pittsburgh)1,216,0451,3451.111020.08
Cook/IL (Chicago)5,150,23343,7158.491,6730.32
Los Angeles/CA10,040,00026,2172.611,2560.13
King/WA (Seattle)2,252,7826,5452.914630.21
NY/NJ vs other states
New York State19,453,561330,40716.9826,2431.35
New Jersey State8,882,190135,84015.298,9601.01
Other 48 + DC299,903,772817,4012.7341,9630.14
Europe
London UK8,982,00018,0002.005,2310.58
Ile de France (Paris) FR12,210,00023,7571.956,1160.50
Madrid ES6,642,00062,9899.488,4201.27
Stockholm SE974,0738,5368.761,288 (1)1.32
Coronavirus in Various Places

Note 1: Estimated.  I don’t have a death toll for Stockholm by itself, but Stockholm has less than 10% of the population of Sweden, and about a third of the reported coronavirus cases.  I’ll overestimate a bit and presume that it has 40% of Sweden’s reported 3,220 coronavirus deaths.

These figures were captured at various times last week, and not all on the same day. 

For the moment, let’s focus on the death tolls: the number of reported cases depends on the availability of testing, which is more a function of politics than biology.  But dead is dead, even though politics figures here, too: about 1/4 of New York City’s dead are ‘probable’ as opposed to ‘confirmed’ Covid cases.  Nevertheless, we have to start somewhere.

The next highest city after NYC, in terms of Covid death rate, is Detroit.  But Detroit has no subway, and having suffered a great loss of population, is nowhere near as dense.  The places with comparable death rates are all in the suburbs of NYC.  Is the virus somehow wafting out of the city itself?  Do commuter trains have a role to play?

Looking at other American cities, there doesn’t seem to be much correlation.  Philadelphia, DC, Chicago, and Los Angeles all have subway systems, but have lower death rates.  In fairness, their subways are not as extensive as New York’s.  Meanwhile, New Orleans has no subway, but a higher death rate.

And all the European cities have extensive subway systems, but lower death rates, even Stockholm, which has refrained from the lockdowns in effect pretty much everywhere else.

Meanwhile, I’m also compelled to wonder about the wisdom of locking everything down.  It was OK as emergency measure before we knew quite what would happen.  But as a policy, I suspect that it only nibbles around the edges in terms of limiting the spread of the virus.

When this emergency passes, we need to calmly analyze and identify the factors that led to the rapid spread of Covid in NYC and other hot spots around the country and around the world.  And while it’s easy to blame the politicians or the subway, I suspect the reality will be a bit different.

Uncle Andy’s Four-Phase Plan

Earlier this week, Governor Andrew Cuomo released a four-phase plan by which businesses in New York State would reopen as the coronavirus threat passed:

  • Phase 1: Manufacturing, construction, curbside pickup for retail;
  • Phase 2: Retail, professional services, real estate;
  • Phase 3: Hotels and restaurants;
  • Phase 4: Schools, arts, recreation, and entertainment.

The state has been divided into ten regions for the purpose, with reopening in each region, and advancement through the phases, consistent on meeting a set of metrics.  Most of the metrics relate to hospital usage, which makes sense, although some of the thresholds seem arbitrary.  The threshold is a minimum 30% available hospital beds and intensive care beds, which most of the state passes, but if the threshold were 20%, the entire state would pass.

The one metric that worries me is the need for contact tracers.  The virus was spreading for a month and a half before it was determined to be an emergency: contact tracing now seems pointless and silly. 

Nevertheless, under the plan, there need to be a minimum of 30 contact tracers for every 100,000 residents: New York City will need over 2500.  Organizing and training a force of that size will be at least a three-month project.  Are we to remain on lockdown until then?

More worrisome is the authority to be vested in these contact tracers.  Will they have the authority to compel people to be tested?  To separate people from their families for isolation (as is happening in California)?  To compel answers to, ‘Are you now or have you ever been…’ or ‘Tell us about your friends and associates…’?

The only thing that such an effort would appear to accomplish is practice for a new Stasi whose authority, in the name of public health, would extend beyond biological viruses to embrace improper thoughts and improper speech.  That may be unconstitutional, but what the hey: it’s an emergency.

When I first read about the plan, I expected that we might be reopening in a few weeks.  I thought my work life would get back to normal in 4-6 weeks, and my wife and I would be able to enjoy dinner out in maybe 6-8 weeks.  Live baseball this summer, alas, would be a lost cause.  But if New York City will not come off ‘pause’ until we have 2500 contract tracers on staff, fully trained and ready to go, it will be a much longer wait.

I sure hope Uncle Andy reconsiders. And it’s disgusting, but right now, that’s all I can do.

*          *          *

Since the 1960s, when young men ran off to escape the military draft, the notion of running off to Canada to elude whatever turmoil the US was suffering has been with us.  It’s crossed my mind a couple of times, never very seriously, the last time in 2004 when President Bush was re-elected.

Now, in the name of public health, our liberties are basically gone.  Yes, there’s still freedom of speech, but only over the Internet, open to government monitoring.  Yes, there’s still freedom of religion–you can believe whatever you want—but all the churches are closed.

Alas, escaping to Canada won’t help.  They’re just as bad as we are.

Asbestos and Corona

Asbestos is a fibrous mineral, found in nature, which was for many years used for fireproofing and other thermal insulation.  It’s still one of the best thermal insulators known.  But asbestos fibers, when inhaled, lead to cancer and other lung diseases.  Asbestos has been the subject of vast litigation, and there is an industry built around the removal or abatement of asbestos.

The incidence of disease and death from asbestos has a random character.  In the time before the danger of asbestos was widely recognized, some people worked around asbestos their entire lives with no ill effect; others fell deathly ill over the course of a summer internship at the asbestos plant.  Most cases, though, involved repeated exposure over time.

Today, the discipline and procedures of asbestos abatement are built around the premise that the danger of asbestos is not random.  The probability of disease on exposure to asbestos above the ‘safe level’ is presumed to be unity, i.e. the stuff is presumed to be lethal.  Workers tasked with asbestos abatement must wear protective clothing and masks, and special arrangements are made to ventilate the work area and prevent asbestos fibers from escaping outside.

In an industrial environment, these rules make sense.  Employers are required to provide a safe work environment, providing training and protection against hazards in the workplace.  It would not be OK for an employer to pass the risk of illness of an incomplete protective regime to his employees, even with their informed consent.

But this character of randomness associated with asbestos applies to other agents in the environment, including tobacco and (this season’s favorite!) viral exposure.

Last week, 60 Minutes ran a segment on the military’s response to coronavirus.  The military had to develop policies and procedures on the spot as the threat emerged, without data on how deadly the virus might be or its propagation.  The result was a regime similar to asbestos abatement: the virus is presumed to be deadly wherever it might appear, and anyone not known to be safe is presumed to carry it.  Social distancing (‘tactical dispersion’) and hygiene procedures are ruthless.

And for the military, these rules make sense.  The first mission of the military is to be ready to carry out whatever other missions may be necessary, and being inconvenienced is part of military life.

But is this approach the right one for the rest of us?

What we are starting to know now from data is what many of us suspected in February: Covid-19 is similar to the seasonal flu.  It spreads almost as broadly as the seasonal flu, and while it is more serious than the seasonal flu, it’s not so deadly as to merit panic.

*          *          *

Prospect Park on a Saturday Afternoon

Yesterday, my wife and I bought lunch in a local pizzeria and enjoyed it al fresco in Prospect Park.  We took off our masks to eat and watched the people go by.  It was a glorious day: the first real spring day this season.  The park seemed busier than a normal Saturday: with everything else closed, what else was there?  We took a long walk, and when I got home, I realized I had a little sunburn.  It felt good.

Families hung out together in the park, but otherwise people were reasonably distancing themselves.  But I’m compelled to wonder: if you pass within eight feet of, say, 1,000 people, are you really safer than sitting six feet from four or five people in a subway car?

Were we taking our lives in our hands enjoying a sunny day in the park?  Even knowing about the virus, I find that really hard to believe.