Coronavirus

1 in 4 in NYC May Have Been Infected, New Study Finds; Some Parts of State to ‘UNPause’ May 15

New Jersey's shutdown order will remain in effect indefinitely statewide, while New York expects to "UNpause" certain parts of New York before others

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What to Know

  • Gov. Andrew Cuomo said Monday some parts of NY would be poised to reopen when his "PAUSE" directive expires May 15; NJ Gov. Phil Murphy said his shutdown order would remain in effect statewide indefinitely
  • A new Siena College poll brings home the grim reality of the pandemic -- nearly a third of New Yorkers know someone who has died of COVID-19
  • More than 25,000 tri-state lives have been lost to date, though NY and NJ both reported their lowest single-day tolls (337 in NY, 61 in NJ) in a month on Monday; governors do note a potential lag in weekend reporting

New York will start to reopen parts of the state after May 15, while New Jersey will indefinitely extend its stay-at-home orders — signs of a nuanced start to a process that could take months and fundamentally reshape the way people live and work.

Nearly two months into the region's coronavirus pandemic, New York released new data Monday showing that nearly 15 percent of those tested had antibodies to the virus — suggesting as many as 2.9 million New Yorkers may have been infected at some point, fully 10 times what the state has reported officially.

The numbers are even higher in New York City — antibody testing found a positivity rate of 24.7 percent in city samples, suggesting almost 2.1 million city residents could have been infected at some point.

It is that uncertainty, and concern for what happens next, that prompted New York Gov. Andrew Cuomo and New Jersey Gov. Phil Murphy to lay out visions Monday for what comes next, and how.

"Each region is facing its own set of facts. Protecting public health comes first and all decisions will be data-driven," Cuomo said. "As long as we keep being smart the worst should be over."

A Phased Approach to Reopening New York

Cuomo has unveiled a broad, gradually phased reopening plan, one that could see parts of New York, like upstate, open as early as mid-May. In that vein, the governor said Monday he could allow his "PAUSE" directive to expire May 15 in some parts of the state while extending it in "many" others.

While parts of upstate New York may be able to reopen in phases after May 15, reopening the downstate area -- New York City, Westchester, Long Island and surrounding suburbs -- is a highly complicated endeavor, given the prevalence of COVID-19 in those areas, Cuomo said. Downstate reopening requires multistate coordination, he added. Anything that involves bringing people into the city -- like a concert or parade -- will be among the last pieces to fit into the puzzle.

In the hardest-hit places, containment is still the highest priority. Cuomo noted Sunday the infection rate continues to slow. Last week, 10 New Yorkers were infecting about every nine New Yorkers. It has improved slightly -- to about eight infections for every 10 New Yorkers -- but it has to decline more to reopen safely, he says.

Should Your State Reopen?

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. Critics call the measures vague and ultimately because they aren’t binding, some states are choosing to reopen whether they meet the criteria or not.

Source: The COVID Tracking Project
Credit: Amy O’Kruk/NBC

No major reopening will happen in New York until state and regional hospitalization rates see a decline for 14 straight days, in accordance with CDC guidelines, Cuomo said. Once that metric is met, reopening will be phased.

Phase I will allow for construction and low-risk manufacturing businesses to resume. Then, there will be a waiting period of two weeks, the incubation period of the virus, so officials can monitor the effects of that reopening. If there are no glaring setbacks, Phase II rolls out. Cuomo says that involves the reopening of lower-risk, more essential businesses. He didn't give concrete examples, challenging individual companies to prove that they fit into that category.

Murphy Unveils Roadmap for New Jersey

"A plan that is needlessly rushed will needlessly fail."

That's how Murphy described a broad-based plan to reopen New Jersey. On Monday, the governor unveiled a data-based reopening strategy driven by six key principles, all of which reinforce what he describes as a critical fact: "Public health drives economic health."

The first four principles of his six-principle approach are dedicated to securing public health. Principle 1 requires a sustained drop in the curve, meaning new positive results and hospitalization numbers will need to trend down. Murphy also wants to see hospitals to step down from functioning in crisis mode. No. 2 involves expanding testing capacity and dramatically expediting results. The third step entails robust contact tracing, while the fourth involves securing safe places to isolate for future COVID-19 patients.

Once those objectives have been accomplished, Murphy says the state can move to principle 5 -- a responsible economic reboot. After that, the goal is to ensure resiliency. He plans to have a similar reopening plan to New York in terms of balancing an industry's risk with its essentiality.

"If we follow this road we give ourselves the best possible chance to succeed in the months ahead," Murphy said.

The first steps to New Jersey's reopening are likely still a few weeks away, he said -- but he wants his state's residents to feel confident the time will come.

"I don’t know when we’ll be able to formally and finally start this journey," Murphy said. "We will be ready to put the car in gear as soon as we see a green light. This is a plan for HOW we move forward – not IF we move forward."

There were some signs that the state is inching toward normalcy. Five parks in Jersey City reopened Monday, although Mayor Ravinder Bhalla kept parks in neighboring Hoboken remained closed — something most residents seemed to agree with.

Gov. Murphy is also not on board with reopening county and state parks yet, but did issue an executive order allowing some more businesses to operate as essential. Pet grooming, pet daycare and boarding, and stores that sell religious items necessary for certain observations are now considered essential, while car dealerships can conduct limited business.

Reopening decisions will be made in coordination with Connecticut Gov. Ned Lamont, who is part of the seven-state reopening coalition led by Cuomo. Connecticut has lost more than 2,000 people to date. Not all seven states in the coalition will reopen exactly the same way.

For example, Lamont has said he's not sure Connecticut is fully on board with Michael Bloomberg's contact tracing program, which is still in development. The governor said he will make an announcement regarding contact tracing on Tuesday.

His state is also a bit later on the curve, with the widely watched Gates Foundation-backed IHME model projecting it can begin to relax restrictions after June 9, presuming strong containment measures stay in place. That timeline is more than a week earlier, after May 27, for New York and New Jersey, the latest model run says.

Cuomo acknowledges there will be variations across states and within them as far as reopening, but he insists that for reopening to be effective, it must be a coordinated effort. By and large, the other governors appear to agree.

Inside the Epicenter: War Against the Virus

In New York City, the epicenter of the national crisis, Mayor Bill de Blasio said reopening would be determined by his key three daily health indicators: number of hospitalizations, number of ICU admissions and percentage of people testing positive. He wants to see all three indicators trend down for at least 10 to 14 days.

Since he's been publicly charting New York City's progress in his daily media briefings, the city has only seen two days where all three metrics declined. Those two days came more than a week apart.

The mayor, like Cuomo, has pounded the importance of testing and worked to expand capacity. Eight new community centers are now open in the five boroughs and will eventually be able to conduct 12,000 tests a week or more, de Blasio said Monday.

The Centers for Disease Control and Prevention has added six new symptoms -- including chills, muscle pain, headache,and a loss of taste or smell -- to the symptoms of the novel coronavirus. NBC10's Lucy Bustamante reports on why the new symptoms could get more people tested for COVID-19.

Testing has been cumbersome from a personnel standpoint. Healthcare workers risk exposure every time they conduct one; they have to take precautions accordingly with each new patient. The process is changing. De Blasio says the city will move to a safer, easier test method this week: Self-swab.

Going forward, people who go to one of the city's testing sites will be able to swab themselves; they'll use guidance from a healthcare worker but it'll require no direct contact with that healthcare worker. The self-swab test was approved by U.S. regulators last week. Private labs will have to step up to process results quickly; de Blasio says the city is looking into new partnerships.

"Testing achieves progress. It's as simple as that," de Blasio said.

Comprehensive contact tracing is another key component of the path forward. Bloomberg will help with that, part of an initiative Cuomo announced last week. De Blasio is working on additional tracing plans as well; he said the city plans to hire 1,000 contact tracers immediately who will work with personnel already in place and people who will be retrained to complement tracing efforts. (Visit fphnyc.org to learn more.)

Mayor Bill de Blasio announced a new "safer and faster" self-swab test for the coronavirus that will come to city hospitals this week. Katerine Creag reports.

More good news: De Blasio announced alternate side parking would remain suspended in the city for another two weeks, at least until May 12. To help give New Yorkers more open space, he said he had reached a deal with the city council to open up 40 miles of city streets to pedestrian traffic over the next month, starting with the hardest-hit communities. Up to 100 miles of streets could be made available through sidewalk expansions and conversions into pedestrian plazas. These areas do require NYPD monitoring.

"We're telling people, still you need to shelter in place and yes, of course keep your social distancing. But we knew in the warm weather there would be some impulse to get out more," the mayor said of his administration decision to change course. "The notion of opening up more space around the parks, opening up those streets made a lot of sense logistically and in terms of safety ... It's not open up a space and ignore it. It is open up a space and have enforcement to make sure that people handle it properly, but there is more space for everyone."

Ultimately, the mayor says he wants a roadmap by June 1 on how to rebuild New York City; he has said that won't include the reopening of public schools.

"It's a series of careful smart moves and then you test each one along the way to make sure there's not that backfire," de Blasio said. "When you see things working, you take that next step."

While the mayor had warned New Yorkers to have "low expectations" for summer with respect to beaches, public gatherings and other major events, Cuomo said Sunday there must be summer activities in New York City. He says people can't be locked up in their homes in a densely populated urban area like this one through August.

"There's a sanity piece to the equation here also," the governor said.

Cuomo said he can envision baseball games played without fans at Yankee Stadium and the Mets' Citi Field. He says he's spoken with teams but didn't name which ones; they'd have to make the economics work so they can rely on broadcast revenue in the absence of gate revenue.

He didn't elaborate on other possible ways New York City could engage people this summer while still protecting public health. The open streets plan de Blasio announced Monday is one step forward; his administration is working on other concepts as well. Social distancing will be a continued part of the solution.

Despite the newfound flexibility when it comes to closing streets, de Blasio said during a later interview on NY1 that there is no plan to open up pools any time soon, for social distancing and budgetary reasons. He did say there may be a small opening for beaches, however.

"Beaches are a little more flexible in the sense that right now of course they're open public spaces. There's no swimming. There won't be swimming anytime soon," the mayor said. "But if we make a lot of progress, there is a possibility of doing more with the beaches later on in the summer. Nowhere that I can identify. No time I can identify now, for sure. It’s too early to say. And nowhere near when we would normally open around Memorial Day. But I'm not ruling that out because we've made some really good progress in the last few weeks.

Just How Many Are Sick?

The question of social distancing becomes more important once you realize just how many people may have been infected. New York's second round of antibody testing found 14.9 percent of samples to be positive, a full percentage point higher than the first round, Cuomo said Monday.

That indicates even more than the 2.7 million New Yorkers identified in the first testing round may have been infected at some point. Many likely never even knew they had the virus -- and were spreading it.

New York state has reported nearly 300,000 confirmed cases to date. That number seems staggering -- until you realize the actual total could be 10 times higher at minimum.

Again, there were glaring variations by region, with samples in New York City, the nation's epicenter, showing much higher positivity rates (24.7 percent) than anywhere else in the state. The city's positive rate jumped up by about three percentage points since last week's study. Westchester/Rockland counties had a higher percentage of positives (15.1 percent) than Long Island (14.4 percent) in this round of testing, while the rest of the state averaged 3.2 percent.

Given the limitations of diagnostic testing, antibody testing paints a fuller picture of the scope of the pandemic in a given place. Cuomo has said it helps inform his opening strategy for New York: "Know what you are doing before you do it."

Antibodies don't guarantee immunity from reinfection, but the nation's top experts, including Dr. Anthony Fauci, say it's reasonable to assume someone who has had the virus won't get it again. At least not in the immediate future.

To date, New York City has seen more than 160,000 COVID-19 cases of the state's 291,000-plus total. It has also seen the most death -- 12,287 of the state's toll, which eclipsed 17,000 Monday as Cuomo added another 337 names (the lowest single-day toll in a month).

If NYC's 5,228 probable COVID-19 fatalities were included in the state count, the actual death toll in the five boroughs alone could be closer to 17,500.

A new Siena College poll released Monday brings home the grim reality of the pandemic - about one in three New Yorkers say they know someone who has died from the coronavirus.

Given the scope of the tragedy, that's not surprising. New York, New Jersey and Connecticut have lost more than 25,000 people to date. The tri-state area has seen nearly 430,000 cases (New York, 291,996; New Jersey, 111,108; Connecticut, 25,997).

Like New York, New Jersey has seen progress amid the tragedy. It saw its lowest daily death toll (61) in recent weeks on Monday; New Jersey's total stands at 6,044, more than the lives the state lost in World War I, the Korean War and the Vietnam War combined.

Connecticut saw it's fifth straight day of less COVID-19 hospitalizations Monday, and now has more than 2,000 deaths.

NBCLX storyteller Bianca Graulau spoke to Dr. Idania Rodríguez Ayuso, an epidemiologist, who explained why no one should assume they’re not contagious or at risk of catching coronavirus.

Socially Distant Nation Revs Up for Reboot

Dr. Deborah Birx, the White House Coronavirus Task Force response coordinator, says social distancing will be needed through summer to ensure public safety. Harvard researchers say such the practice could be necessary into 2022 barring a vaccine for the coronavirus, which could be 18 months out, or an effective treatment for it.

Thus far, clinical trials for experimental drugs have not spurred optimism. Hydroxychloroquine had been touted by the president; after further study, the FDA now advises against using that drug outside of medical settings. A draft document showing inconclusive results for another drug, Gilead's remdesivir, showed disappointing results. Gilead says the findings were inconclusive.

Nationally, some states, like Georgia, have already kickstarted their reopenings -- some more aggressively than America's top experts would like. Governors and health officials across the country are watching those states closely. To date, the nation has seen more than 56,000 COVID-19 deaths and nearly 1 million cases.

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