What to Know
- New York has now reported more cases than China's Hubei province, where the pandemic started; NJ saw another record single-day death increase Tuesday, counting a 33-year-old firefighter among new fatalities
- Gov. Cuomo extended the nonessential business shutdown through mid-April; Mayor Bill de Blasio shut down 10 NYC playgrounds Tuesday, and said more would close if social distancing protocol isn't followed
- More than 97,000 in the tri-state area have now tested positive for COVID-19; more than 2,000 have died, including the first child in NYC
New York saw its highest daily increases in coronavirus deaths and cases overnight as the number of positives reached another milestone, eclipsing the total reported in China's Hubei province, where the pandemic started.
Nearly 10,000 new cases were added to the state's new toll of 75,795 — and the governor's brother, CNN anchor Chris Cuomo, can be counted among them.
Andrew Cuomo said his brother will be fine — he's in good shape, he's strong and he's quarantining in his basement, concerned for the well-being of his family. Chris Cuomo is among the 80 percent of COVID-19 patients who can expect mild symptoms. Eighty percent is an overwhelming percentage, but for a state as big and dense as New York, the other 20 percent may be the more critical number. As of Tuesday, New York had lost 1,714 people to the virus — a number which will continue to rise.
How Coronavirus Has Grown in Each State — in 1 Chart
New York has quickly become the epicenter of the American coronavirus outbreak. This chart shows the cumulative number of cases per state by number of days since the 10th case.
Source: Johns Hopkins University
Credit: Amy O’Kruk/NBC
"The number of cases is still going up. We're all in search of the apex, and the other side of the mountain. But we're still headed up headed up the mountain," Cuomo said Tuesday.
New York is just showing the mass vulnerability first, particularly in the city. As of Tuesday evening, New York City had 43,139 cases and 1,096 dead, according to the state, including a child with underlying conditions. The city's death toll shot up quickly due to a span of 24 hours that saw 182 people die across the five boroughs. The city's health department put the number of total slightly lower than the state's at 41,771 — but that's not exactly a world of difference.
Most of the cases are people under 50. The vast majority of fatalities, though, are people older than 65; all but a few have prior conditions. The five boroughs account for nearly a quarter of all cases in America and a slightly larger portion of the national virus death toll.
Cuomo has asked people across the country to step up and support his state, through supplies, through personnel, through funding, and pledged to do the same in time.
"Let's help one another. New York needs help now," Cuomo said. "Come help us in New York. Get the equipment, get the training, get the experience. And then let's all go help. The next place, and then the next, and then the next place, and then the next place. That would be a smart national way of doing this, and showing that unity."
But first, he has to manage the crisis at home -- and prepare for what he says are worse days ahead.
Mayor Bill de Blasio is similarly focused.
"For the weeks ahead, let's not kid ourselves - it gets a lot worse before it gets better," de Blasio said on "TODAY" Tuesday.
Tracking Coronavirus in Tri-State
How many more could we lose? One projection from the University of Washington suggests another 14,000 could die in New York in just the next six weeks. Nationally, the White House said Tuesday that between 100,000 and 240,000 lives could be lost by the time the pandemic ebbs — and that's assuming social distancing guidelines continue to be followed and enforced.
Dr. Deborah Birx said it's possible that figure could go down if enough people change their behavior, but there is "no magic bullet, there's no magic vaccine or therapy. It's just behaviors."
President Trump said at his press conference that slowing the spread of COVID-19 is “a matter of life and death,” urging the public to heed his administration’s guidelines. He said he believed the country would soon see a “light at the end of the tunnel” in the pandemic that has killed more than 3,800 Americans and infected 186,000 more.
"I want every American to be prepared for the hard days that lie ahead,” Trump said. “We're going to go through a very tough two weeks ... this is going to be a very painful, a very, very painful two weeks ... This is going to be one of the roughest two or three weeks we've ever had in our country. We're going to lose thousands of people."
For Cuomo, it's about more than projecting the cost when it's over.
"To me, we're beyond 'staggering' already. We've reached 'staggering,'" Cuomo said Monday. "The point is to save every life that you can, that's what this is all about."
New Jersey and Connecticut are both losing more to the virus each day as well. Gov. Phil Murphy added another 69 deaths overnight, its largest single-day increase to date, bringing its total to 267 by Tuesday. Murphy said a Passaic firefighter was among the new fatalities; he was only 33 years old. Thousands more cases were added as well. To date, New Jersey has 18,696 known positives.
If not for social distancing, Murphy said that models show New Jersey would have hit its ICU capacity by Wednesday and exhausted its entire hospital bed capacity by next week. "Please stay home before this hits home, like it has for 267 of our families," he pleaded Tuesday.
In Connecticut, cases rose to 3,128 while the number of deaths nearly doubled, going from 36 to 69 Tuesday. State officials said the rapid increase was due to more than a dozen deaths over the past two weeks that weren't reported to the Department of Public Health and hadn't previously been accounted for.
Fines and summonses for noncompliance are being issued across all three states, which have seen a combined 97,600 positive cases and more than 2,000 deaths. Some target businesses, others target individuals. Cuomo for days cited a problem with density in New York City playgrounds. On Tuesday, de Blasio announced 10 city playgrounds would be closed effective immediately, saying, "If people do not follow the rules we will continue to shut them down aggressively."
All of the unprecedented joint measures Cuomo, Murphy and Connecticut Gov. Ned Lamont have implemented mean nothing if people do not adhere to the most critical advice, Cuomo says: Stay home. And when you go out, stay apart.
Yes, It's Real. War on the Front Lines
Even as President Trump insists New York has enough ventilators and implies medical supplies are disappearing out the back doors of hospitals, doctors on the frontlines in the city are painting a very different - and much more grim - picture. Cuomo listens to them and the data. He's shoring up a stockpile so New York has it when the apex hits.
It's difficult to tell exactly when that will happen, and when it does come, it will likely come in waves, the governor has said. On Tuesday, Cuomo said peak infections could hit anytime in the next seven to 21 days. New research from Columbia as of March 29 projects a “medium” surge to start overwhelming hospital capacity in Westchester in 12 days and Manhattan in 20 days.
As of Tuesday, about 14 percent of New York's total cases required hospitalization; nearly a quarter of those were in the ICU. The city is seeing slightly higher overall hospitalization percentages (around 20 percent). The small amount of god news: Nearly 5,000 patients were discharged from New York hospitals from Monday into Tuesday, up more than 700 from the previous time.
The coronavirus toll on New York City hospitals is "getting that serious" that medical professionals could soon have to decide who will get treatment, and who won't, the chair of the department of surgery at Columbia University said in his latest update. It could literally come down to a lottery for ventilators.
Cuomo said the state has ordered 17,000 ventilators from China (at $25,000 each), but it will be weeks before they arrive. Cuomo also voiced frustration at now having to compete with FEMA bidding on the necessary items as well — calling it "almost impossible" is buy a ventilator now — but said getting the equipment is necessary in order to provide relief and help for medical workers.
"They are the front line, and they need relief. They are physically exhausted, even more they are emotionally exhausted," Cuomo said of healthcare workers. "Seeing the pain, seeing the death, that they're dealing with every day."
If we wait for the storm to hit it will be too late, Cuomo has said. He and de Blasio say New York hospitals and staff have enough for "right now." But that literally means "right now" — and "right now" gets more taxing with each day.
That's why personal protective equipment (PPE) usage is soaring, Cuomo says; that surge is simply coinciding with the overall surge in patient volume. People on the front lines must protect themselves and others from infection. The "front lines" extend beyond hospital staff -- they include first responders, transit personnel, people who answer the 911 calls and make sure healthcare workers have the means to get to where they need to be to treat patients in the first place.
Current CDC guidelines on PPE simply don't reflect the situation in New York, hospital chiefs and others say. MTA Chairman and CEO Pat Foye, who has tested positive, along with nearly 600 other agency employees, told MSNBC Tuesday that "the CDC's direction is still not to provide masks except to those who are ill or medical people. We have decided not to take that advice."
Reinforcements are here: a new field hospital at the Javits Center and smaller one in Central Park, a U.S. Navy ship with 1,000 beds to treat non-COVID-19 patients. More are coming: Further defenses are in the works in all five boroughs, including a center at the Brooklyn Cruise Terminal and a 350-bed hospital at the USTA tennis center in Queens that is designed to take some of the non-virus patient load off the besieged Elmhurst Hospital.
That hospital saw 13 deaths in one night last week; before sunrise the next morning, the line of people to get tested stretched around the block.
"This place will be a life-saving place," de Blasio said in a briefing from the tennis center Tuesday. "We want to give them as much relief as possible."
All of the additional places is helping NYC inch closer to the goal of having 60,000 beds, Mayor de Blasio said Tuesday. The city had 20,000 before the outbreak began.
The FDNY has also been stretched to the max. De Blasio said Tuesday that FEMA was sending the city 250 ambulances and 500 more EMTs and paramedics to help deal with record spikes in 911 calls. At least 135 of those ambulances had already arrived in the city, along with 270 EMTs and paramedics.
The mayor said 500 nurses had already arrived in the city last week, and another 5,000 are on the way. Health and Hospitals has an additional 1,000 coming as well — meaning thousands of nurses have been added to the system in a matter of days. But de Blasio said the city will still need military medical personnel by April 5, and is awaiting a response from the White House.
To help best allocate resources across New York, Cuomo said Tuesday the state is creating a Central Coordinating Team led by the Department of Health. That team will organize upstate-to-downstate staffing needs, patient transfers between hospitals and transfers to the USNS Comfort.
Also on Tuesday, de Blasio said he was redistributing millions of masks and tens of thousands of PPE items to hospitals throughout the city -- not just the city-owned ones, but the ones most in need. That falls well within the mission Cuomo described in his briefing earlier in the day.
"Our healthcare system is a chain," Cuomo said. "If one link breaks the whole chain breaks. The distinction between private and public, upstate and downstate needs to end. New York is one state. In New York we stand together."
Congress' $2.2 trillion relief package will provide some help, but it won't be able to buy hospitals out of shortages. And the race to acquire equipment underscores that. But as much as states are targeting critical supplies, they are acutely focusing on buttressing the battle-weary medical staff on the front lines who say their fight gets more physically and emotionally challenging daily.
Cuomo, Murphy and Lamont have all called on legions of retirees to help on the front lines. Nearly 100,000 have answered the call to date -- and colleges like NYU and Rutgers are graduating their medical students early to add support.
More on Coronavirus
Extended Restrictions, Hard Times
Cuomo extended his statewide "PAUSE" directive Sunday another two weeks to help control density, while Trump extended the White House guidelines on social distancing through the end of April, which is notably after Easter -- the date Trump had said he wanted to have the country "raring to go."
Dr. Anthony Fauci, the nation's top infectious disease expert, has said he doesn't believe another extension will be necessary federally but notes it's a possibility. As he said recently, "You don't make the timeline. The virus makes the timeline."
Murphy has said he doesn't envision a scenario where the current restrictions would be lifted prior to May; de Blasio thinks May could be a more challenging month than April, which is expected to be deadlier than March. It's highly in doubt schools in the tri-state area will reopen in time to salvage the academic year (find an NYC school offering free meals and learn about childcare help for essential workers here).
The economic impact at all levels has been dizzying; unemployment claims have obliterated records. Murphy urged employers to keep their workers on payroll throughout this crisis, saying Tuesday that those who do will be eligible for a dollar-for-dollar payroll tax credit against those costs. That is available to 99.8 percent of all businesses in New Jersey, he said.
Months-long grace periods for mortgages, along with suspensions of commercial and residential evictions are already in effect across the tri-state area. In the city, de Blasio has called for a rent freeze for 2.3 million tenants in nearly one million rent-stabilized units. On Tuesday, the mayor said all non-essential construction work should be halted immediately. He also said alternate side parking would remain suspended for another two weeks, through April 14.
Cuomo says the tri-state area, and America, can restart the economy in a "smart way" while still prioritizing public health. In his view, he says it all comes down to the scale of testing. If you can develop a new, faster and easier home-based program that can test millions of people every day, he says you will identify hundreds of thousands of people who "can go back to work tomorrow."
Fauci says scientists are working on more scaleable, less invasive testing.
That could come too late to help New York City, de Blasio said Tuesday, but it may not be too late to make a life-saving difference for other parts of the country.
"If we could get rapid testing on a truly universal level, that could help us a lot. That could help us immediately tell people what they have to do," the mayor said on "TODAY." "But the best kind of testing is the testing early before you get an outbreak. Some states could still benefit from that."
Where Do We Go From Here?
Numbers will continue to rise as more people are tested, officials say. New York has accounted for about 25 percent of all COVID-19 testing in America to date, Cuomo has said. That is an accomplishment, he noted: Find the cases, isolate the positives and treat them. That, in conjunction with the social distancing and business restrictions in place, will curb the spread of infection.
Governors are working to accelerate action on the drug front as well. New York launched a clinical trial for an experimental treatment and plans to be the nation's first state to try to heal critically ill patients using recovered people's plasma — a process called convalescent plasma that was used during the flu epidemic of 1918. Right now, everything is on the table.
How will we know when we've turned a corner? Recent research from Columbia University offers some curve-based projections. But it's still too early to tell.
"Everyone wants to know when this will be over. The truth is: We don't know. No one knows," Cuomo said Tuesday. "We are still climbing up the mountain and we're not sure yet when we are going to get to the other side."
The depths of the outbreak — and its impact — are incomprehensible at this point but most definitely catastrophic: Billions upon billions of dollars have been lost and more will be lost; many have died, far more have been sickened.
Trump signed three stimulus bills in three weeks, the latest worth $2.2 trillion - and de Blasio has already said it's not enough. A fourth bill is in the works, House Speaker Nancy Pelosi said -- one that would focus on recovery from the crisis.
Responding to the Crisis
The World Health Organization declared the novel coronavirus a pandemic, the first coronavirus to ever earn the dubious distinction. It's novel — that means it's new and no one has immunity to it.
Nationally, NBC News estimates that nearly 187,000 people have been infected and more than 3,800 have died. Globally, the numbers are far more stark.