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As Second Wave Looms Over NYC, So Does The Prospect Of A Return To More Restrictions
By
Elizabeth Kim
Published Sep 25, 2020
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CHINE NOUVELLE/SIPA/Shutterstock
By
Elizabeth Kim
Published Sep 25, 2020
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As constrained as life under coronavirus has become, New Yorkers had an enviable summer compared to most of the country, basking in a low level of infection that at times seemed too good to be true. Across the city, most residents stayed put, wore masks, and did their best living outdoors—by way of dining and drinking, protesting, exercising, watching street performances, flocking to parks and playgrounds, and forming communities.
But as evidenced this week after a warning from the Department of Health about an alarming increase in coronavirus cases across South Brooklyn and two neighborhoods in Queens, the landscape is changing.
Schools are set to reopen their doors next week to hundreds of thousands of children, restaurants are planning to resume indoor dining at the end of the month, and more and more companies are summoning their workers back to work, leading to more crowded buses and subways. Out-of-state travelers also continue to flood the city, many of them from places where infection levels are high. Meanwhile, the weather is getting colder and drier, conditions believed to make the virus more transmissible and which will simultaneously force people to spend more time indoors, where very tiny respiratory particles floating in the air may serve as major drivers for infections.
"New York has been livable because we’ve been doing everything outside," said Manhattan Councilmember Mark Levine, who chairs the council's health committee. "We are now entering a challenging new phase where the weather is going to make that more difficult."
Asked about a second wave, Dr. Jay Varma, Mayor Bill de Blasio's senior adviser for public health, said, "I don't think it’s inevitable but it is a credible worst case scenario."
Earlier this week the city reported on an Ocean Parkway cluster with a 4.7% positivity rate, more than quadruple that of the citywide rate. Late Thursday, the Department of Health announced they would begin regular inspections of all non-public schools within the affected areas. In the harshest threat made to specific communities since reopenings began, the city also said that it would consider shutdowns of non-essential businesses and other crackdowns if cases do not stop rising by Monday evening.
"This may be the most precarious moment we are facing since we emerged from lockdown," said Dave Chokshi, the city's health commissioner, said during a Friday press conference held in the Brooklyn neighborhood of Gravesend.
Among some experts, the prospect of a second wave has become a question of when, not if. Europe, which was thought to have largely contained the virus has now seen cases return to March levels. Several countries are now scrambling to contain outbreaks.
How New Yorkers and city officials respond to this new environment will determine how much cases rise, experts told Gothamist. A Columbia University model projects that cases in the New York metropolitan area could rise from around 500 to more than 4,000 a day at the end of October, assuming the reproductive rate of the virus stays the same.
In another worrisome factor, there are signs that quarantine fatigue is growing. On Wednesday evening, Hasidic congregants in Borough Park could be seen crowding into synagogues without masks on the very same day city officials pleaded with them to take precautions. Some Orthodox residents have asserted that the community has achieved herd immunity this past spring, after reports that an estimated 700 Orthodox residents in the New York area died from the virus. Most experts, however, say the city is far off from reaching herd immunity, and that it is not even clear how durable such an immunity would be.
The order involving the inspection of schools appeared to be directed at yeshivas. During the crisis, some Brooklyn yeshivas had continued to hold in-person classes despite the ban on gatherings. Most recently, a yeshiva in Far Rockaway continued to conduct classes after it was ordered to switch to virtual learning by the mayor's office due to more than a dozen students testing positive for coronavirus.
Orthodox men seen shopping without masks in Borough Park.
Scott Heins / Gothamist
"Will things spin out of control? Will we have a repeat outbeak on the level of Texas in July? New York City in April?" said Jeffrey Shaman, a Columbia public health professor. "It depends on how well we manage the disease and if we have the political and public will to step back from re-opening (businesses, schools, restaurants) if the virus surges."
In May, Shaman released a study showing the high human cost of lockdown delays. He said city officials need to set up a "formal decision architecture," a decision tree framework that would enable them to act swiftly in response to rising infections.
"If you have certain rules in place, that allows you to structure your thinking so you're not wondering what to do," he said.
Mayor de Blasio has already announced at least two explicit thresholds that would trigger rollbacks in reopenings. A citywide positivity rate of 3% would cause in-person learning to cease, while a 2% rate would force the city city "immediately reassess" indoor dining.
Shaman said that while the city's testing capacity has ramped up it is not clear whether it will be sufficient to contain flare-ups through test and trace methods. Unlike places like South Korea, privacy laws prevent the government from applying the most invasive tracking methods. To date, 69% of all people identified as testing positive have completed interviews with the city's contact tracers but only 45% have of all positive cases have shared their contacts.
Denis Nash, an epidemiology professor at the CUNY School of Public Health, said the South Brooklyn and Queens cluster identified on Tuesday "could be the beginnings of a second wave, or it could be increases in local transmission that we get tamped down and under control." Regardless, he said he expected to see setbacks. He said some schools will have to close due to infections, and that he would be surprised if indoor dining lasted.
But Nash added that he felt that the city had established a strong surveillance system and was well-positioned to detect increases in community transmission early. In an effort at transparency, New York City has over time built a robust public data website that tracks not only the most recent cases but also those over a four-week span, a feature that the Department of Health added five weeks ago.
Wafaa El-Sadr, an epidemiology professor at Columbia University, said that when it comes to identifying a second wave, experts are looking for sustained trends. "A consistent increase over several days or seven days that then would really trigger the alarm that there is something going on," she explained.
El-Sadr said scientists avoid focusing only on one data point, which can have large oscillations. Two critical parameters that she regularly checks on the city's website are the seven-day average of cases and the positivity rate.
Beginning in early September, both figures for the city climbed for a period of roughly two weeks. The seven-day average of reported virus cases reached 300 on September 17th, the highest it has been since late July. And for the first time in more than two months, the positivity rate topped 2% on September 13th.
The seven-day average of cases have since dropped to under 200. The city's positivity rate is now back to hovering around 1%, a number that Governor Andrew Cuomo said regions should seek to stay at or under as much as possible. (Asked about a possible second wave on Thursday, Cuomo said, "We watch the numbers, if we get into real trouble, real trouble, then you would have to start considering closing things. But we're not at that point yet.")
According to Varma, city officials track three indicators most closely: the number of people admitted to hospitals with covid symptoms, the total number of confirmed cases and the positivity rate.
In looking at geographic trends, he said the city uses a 3% positivity threshold in deciding whether to launch a hyperlocal response in the form of increased testing and expanded outreach. Officials will also take the number of tests being performed in a neighborhood into consideration.
Nash, of CUNY, urged the city to report more neighborhood-specific trend data. He said the Department of Health should add new visualizations to its data website that show how infection rates are increasing daily at the neighborhood or zipcode level, information which the city is currently mapping out over four weeks. He also said that hyperlocal maps that show where cases, hospitalizations and deaths are increasing most rapidly would also be useful for the public to see.
With nearly 2,500 new cases every week, he added that he "deeply troubled" by how little the city has said about how so many individuals are becoming infected each week.
"Are the cases linked to public transportation? Individuals who were infected elsewhere, but recently arrived in/returned to NYC? Are some essential workers not being provided sufficient PPE? Is transmission occurring at workplaces? In households? Or do we just not know where the new infections are coming from?" Nash wrote in an email, adding "If we don't understand what and where the major sources of transmission are in NYC now, I fear that we will be much worse off when a second wave arrives."
Varma said that the breakdowns of the sources of infections vary from week to week. But he said that generally around 35% of cases are among people who have had close contact with somebody with covid, 15% of cases are travel associated, and 5% to 10% are linked to congregate settings like nursing homes and homeless shelters. Another 5% of infections arise from exposure in a healthcare facility. Of the remaining roughly 40%, the cause of infection is not known.
Some experts, like Varma and Columbia's El-Sadr, expressed confidence in the city's ability to avert a second wave.
"We have the control measures within our hands," El-Sadr said, citing the wearing of masks as an example.
She also argued that the memory of the city's tragic spring would help keep residents in check. To date, more than 23,000 New York City residents have died as a result of the crisis—more than eight times the number of those who perished during the September 11th attacks. In what may be a harbinger or lesson for the city, Italy, which was also scarred by the pandemic, has not had the same rebound in infections as some of its European neighbors, which some credit to the diligence of Italians in continuing to follow public health rules as well as a relatively effective test-and-trace effort.
"I feel confident that New Yorkers will rise to the occasion and do what is needed because we fear the worst of times," El-Sadr said. All they need to do, she added, is "remember the terrible days of March and April."
Tagged
COVID-19
second wave
coronavirus
Elizabeth Kim
Elizabeth Kim is a reporter on the People and Power desk who covers mayoral power. She previously covered the pandemic, housing, redevelopment and public spaces. A native of Queens, she speaks fluent Mandarin. Got a tip? Email [email protected]
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