Coronavirus

No Room for Error: NY Over Peak But Cuomo Urges Caution Or We Face ‘Hell All Over Again'

If social distancing is continued, new projections say the tri-state may be able to loosen restrictions after June 1; NYC canceled permits for June's Pride and Puerto Rican Day parades, hopes to hold them at later time

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What to Know

  • New York reported its lowest single-day death toll (478) in weeks Monday; key metrics have declined for several days across the board and Gov. Andrew Cuomo says we have to tread carefully to maintain progress
  • NYC Mayor Bill de Blasio says city permits for June events, like the Pride March and Puerto Rican Day Parade, have been canceled; they may be held later this year. May's permits were pulled last week
  • More than 20,000 confirmed lives have been lost to coronavirus in the tri-state area to date; more than 350,000 people have been infected -- and those are just the ones we know about

You may have heard Gov. Andrew Cuomo say New York appears to have past the peak of its coronavirus outbreak. You most definitely did not hear him say, "Throw a party," like the one the NYPD had to bust in Brooklyn this weekend.

Tensions are boiling over. People want this crisis to end. But it's not over.

Monday marks 51 days since the first confirmed case of COVID-19 in New York; today the state has nearly 250,000 cases (and those are just the ones it knows of). It took 51 days to climb up the mountain, traverse the plateau and begin the trek down the other side. How long will it take to descend? No one knows, Cuomo says. But he does know we must proceed with caution.

"The worst thing that can happen is for us to go through this hell all over again," Cuomo said. "Think about what we’ve gone through. Think about how many New Yorkers we've lost and are still losing. We must tread very carefully."

No one wants to go through this twice, New York City Mayor Bill de Blasio says. He announced Monday the city canceled major event permits through June, including for the Pride March, celebrating its 50th anniversary, the Celebrate Israel parade and the Puerto Rican Day Parade. The hope is the festivities can be held later this year, and the city will work with organizers to try to make that happen.

"That celebration will be back. We will do it at the right time," de Blasio said. "We're not doing anything but what is right to protect New Yorkers and this country."

The tri-state has paid an astronomical price for the progress it has made; missteps now could threaten it all, Cuomo says. More than 20,000 confirmed lives have been lost to COVID-19 across the region, almost 75 percent of those in New York state (NYC accounts for about 3/4 of those and reports another 4,582 probable COVID-19 fatalities unincluded in official state counts).

Still, for the first time in weeks, New York's daily death toll fell below 500 (478) Monday, marking its third straight day of notable decline. Total hospitalizations are trending down; net intubations are decreasing, which may be why the daily death toll, while still staggering, is much lower than it has been. New Jersey and Connecticut have seen hospitalizations decline the last few days as well -- and Gov. Phil Murphy says infection rates have "significantly" slowed as well.

Through mitigation, the infection rate has slowed in New York to a point where every 10 people infect about nine people, Cuomo says. That means the outbreak is slowing, not growing. And that leaves very little room for error, he says.

"We need to bring the infection rate down even more in order to safely reopen the economy," Cuomo said. "The continuation of this positive trend depends on our actions. What each of us does makes all the difference."

Should full adherence to social distancing continue through May, new projections from the widely cited Gates Foundation-backed IHME suggest New York, New Jersey and Connecticut might be poised to loosen stay-at-home orders and reopen non-essential businesses after June 1. That model predicts all three states have passed their projected day of peak resource use and that New York and New Jersey have turned the corner on daily death rates. It also projects a slightly higher overall number of fatalities for all three states by early May than it did in its previous iteration.

Healthcare workers say their emergency rooms are less crushed lately, but demand remains heavy in intensive care units. Medical emergencies are trending down in New York City; it's taking EMS less time to answer serious calls. Fewer FDNY paramedics are out sick. Hospitals have enough masks and ventilators for the coming weeks, though de Blasio says gowns are an issue.

For an increasing number of nurses, the greatest concern is not the current patient volume or even immediate supply needs. It's the desperate chaos they fear could surge back through their doors if states are too quick to reopen.

“We will end up where we started, an influx of people and struggling to save them all," Mount Sinai West nurse Diana Torres told the AP. "If we reopen now, we just wasted our time."

Cuomo says frontline warriors like Torres deserve federal hazard pay in the form of a 50 percent bonus for the work they've done and will do. He also says the states need hundreds of billions more in federal funding to not only get through this phase of the crisis but to protect their citizens moving forward and ensure Torres' fear of resurgence isn't realized. That protection requires a robust testing infrastructure -- and funding to prop up states amid astounding revenue loss.

Facing severe economic shortfall, Cuomo on Monday forecast 20 percent state budget cuts for schools, hospitals and local governments unless Congress passes a $500 billion state aid bill in the coming days. De Blasio has issued similar pleas, citing a virus-related loss of $7 billion in tax revenue alone as he revealed an emaciated budget plan for the city's next fiscal year.

Congress is said to be nearing a bill worth up to $450 billion in funding for hospitals, COVID-19 testing and small businesses. Cuomo is heading down to Washington, D.C., on Tuesday to talk with President Trump at the White House. The meeting comes just days after the two traded jabs on Twitter on the handling of the crisis. It was not immediately clear what the two would discuss, but the re-opening of the state is likely to be a main focus.

The president later tweeted that via executive order, he would be temporarily halting all immigration into the U.S. as the country fights to stop the spread of COVID-19. Though no details regarding how the implementation would work or what/how many countries would be impacted, a senior administration official later told NBC News that the move "had been under consideration for a while." The official said the order could be signed as early as this week, but didn't say whether it had been drafted or where the process stood.

Moving Forward: Capturing a 'True Snapshot' of Pandemic's Scope

With a virus that has proven it can transmit even among asymptomatic people, it's difficult to ascertain the full scope of the epidemic in a given place -- and understanding that full scope is critical to getting states back on track, experts say.

To gain a "first true snapshot" of how the coronavirus has infiltrated New York, Cuomo says the state has launched the most "aggressive" antibody testing effort in the country on Monday. This is the test that can identify people who have recovered from COVID-19 even if they never knew they were infected. It identifies people who may be immune and expedites their return to work. By painting a picture of how many people may have really been infected, it helps develop a more risk-averse regional "return to work" strategy -- one that has a greater chance to stick.

Under Cuomo's antibody testing plan, about 3,000 random New Yorkers will get tested per day. Antibody testing will be used in conjunction with expansive diagnostic testing already in place. The capacity isn't sufficient at this point to test all 17 million New Yorkers but it's a start.

In a small California town, a research project is underway to test every resident for antibodies, as well as active virus, regardless of symptoms. It'll be the first community in America where that is done. Researchers hope that by grasping the scope of infection there, they can learn lessons that may apply nationally -- particularly in hotspots like New York that can't test to the same scale.

De Blasio has said that kind of scale is necessary before officials can think about relaxing restrictions. He wants citywide testing; he opened up new community testing sites in each of the five boroughs to ensure the hardest-hit places have access. To further that goal, Cuomo said Monday the state was launching a partnership to expand testing specifically to public housing residents in New York City. He's also sending those facilities 500,000 cloth masks from the state, at least one for every resident, to arm people with self-protection supplies.

“To be able to come back you need testing to be — in our city probably hundreds of thousands of tests a day,” de Blasio said on MSNBC Monday. “You need temperature checks going into workplaces. You need all sorts of things to make sure that anyone who is sick is immediately isolated and supported in quarantine.”

Then you need to get those people well. New York state is expected to get results from an FDA/CDC-run clinical trial on hydroxychloroquine, one of the experimental treatment drugs, sometime in the near future. If promising, it could further boost local governments' efforts to open their economies. The study is being conducted with about 20 hospitals in the state, and though the first batch of results has been sent to the federal agencies, it wasn't clear exactly when the results would be made available.

Dr. Deborah Birx explains the difference between the two types of testing that will happen with coronavirus as the United States begins a path toward reopening the country.

Regional planning to do that is already in the works. Cuomo and six other governors in the Northeast recently announced their appointees for the multi-disciplinary council that will devise and execute a gradually phased approach to reopening -- one that prioritizes a "do no harm" policy above all else.

"Personal health creates economic health, and it has to happen in that order," Murphy said Monday. He pledged to lay out a blueprint for New Jersey's reopening in the coming days.

Ongoing testing, surveillance, mitigation and contact tracing will be key components of any plan going forward and will to varying degrees remain in place even after a semblance of normalcy returns to the virus-ravaged region, officials say.

Dr. Anthony Fauci, the nation's top infectious disease expert, says he was on the frontlines of the HIV war since Day 1. He compared the personal responsibility one must take to avoid that virus to the personal responsibility individuals must own in what he says will be a sustained battle against COVID-19. Just because you aren't infected one day doesn't mean you won't be infected the next day, Fauci said. Certain precautions have to be maintained -- and governments and employers must facilitate a framework that encourages individuals to do so.

It's not a given that coronavirus antibodies grant future immunity, Fauci says. It's a reasonable assumption based on past experience, he notes, but even if it proves true, it's not clear how long the immunity would last. Three months? Six months? Scientists are studying it, but in the meantime, Americans have to stick with what has proven to work: Social distancing.

Barring a vaccine, which could be anywhere from a year to 18 months out if not longer, those precautions are all we've got. Harvard researchers say social distancing measures may need to be in place into 2022 to prevent resurgence.

No state is more desperate to do that than New York, which has reported 247,512 virus cases -- more than any country in the world apart from its own -- and 13,869 deaths to date. New Jersey remains the nation's second-most impacted state, with 88,806 cases and 4,377 deaths as of Monday.

Forty-percent of its virus deaths to date, nearly 1,800 people, come from long-term care facilities, and New Jersey has taken an aggressive reporting approach to tackling that particular challenge. Health officials in the state launched a web page Monday night, naming each and every facility with reported cases and deaths after loved ones claimed they were being left in the dark about residents' conditions.

Connecticut, meanwhile, had 19,815 cases and 1,331 fatalities at last report.

Nationally, the United States has seen more than 764,000 COVID-19 cases and more than 40,000 deaths, by NBC News estimates.

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