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Is New York's Infection Rate Artificially Low?
By
Fred Mogul
Published Sep 5, 2020
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By
Fred Mogul
Published Sep 5, 2020
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For months, Governor Andrew Cuomo and Mayor Bill de Blasio have pointed to the shrinking infection rate as evidence that measures to suppress COVID-19 are working. For almost a month, fewer than one person in 100 tested have been found infected with the coronavirus, in New York City and state-wide, and in the preceding month that rate hovered just above 1%.
That low infection rate, sometimes referred to as the positivity rate, is seen as evidence that students can attend school in person—if parental will and building ventilation permits—and that gyms can reopen (though indoor restaurant dining remains prohibited).
But experts disagree about how much the infection rate really tells us about how prevalent the disease is in our area and whether it should be used as the basis for public and private decisions.
“It’s very self-selected, so it’s not a great number,” said Dr. Irwin Redlener, a professor at the Columbia University Mailman School of Public Health and former director of the National Center for Disaster Preparedness. “To get a real picture, you’d need a much more random sample of people – people from different areas, people from different ethnic and racial backgrounds, people with different income levels, and so on.”
The city and state haven’t released information on the demographics of people being tested. What they have done is encouraged everyone to get tested, regardless of whether they feel sick or have a known exposure to someone who is. At publicly-funded testing centers and several operated by private non-profits, the tests are free.
Around 85,000 people are now getting tested daily, state-wide, and roughly 35,000 tested in New York City. Health officials are hoping to increase those numbers to 100,000 and 50,000 in the coming weeks. Proportionally, more people in New York are getting coronavirus tests than any state other than Rhode Island or Alaska, according to the Johns Hopkins University Coronavirus Resource. As of this week, 4.5 out of every 1,000 New Yorkers were tested. By comparison, in California, Texas, and Florida, the numbers were 2.7, 1.5, and 1.3, respectively.
“We're not restricting testing to just the tip of the iceberg,” said Dr. Anna Bershteyn, a professor of population health at the NYU Grossman School of Medicine. “I would hesitate to call that inflating the denominator,” or deliberately packing testing centers with healthy people, “because it's actually a wonderful thing to do. As soon as we have the technology and the bandwidth to do it, I think every place should be testing people beyond the tip of the iceberg.”
Bershteyn acknowledges the infection rate in New York isn’t representative of the population at large, but despite its imprecision, she said it’s still a helpful shorthand. It’s accurate enough, she said, to assure people who move around New York that the odds they’ll run into someone who can infect them are relatively low — even if it's impossible to be 100% certain.
“The positivity statistic has two things wrapped up in it. It's how much testing you're doing and how bad of an epidemic you have all wrapped up into one number,” she said. “Both of those things kind of move you in the same direction, mentally: if you have a really bad epidemic, that number will be high, and if you're not doing nearly enough testing, that number will be high. And if either of those two things is your problem, you want to be much more careful.”
But she said “triangulating” the infection rate with other figures, including the hospitalization and fatality rates, helps generate more accurate estimates.
“Every piece of data you have, whether it's cases or hospitalizations or deaths, comes with some uncertainty,” she said. "But if you consider all of it together carefully, it gives you something to go on in terms of the whole picture.”
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