What to Know
- Gov. Andrew Cuomo says some parts of NY may be poised to reopen when his "PAUSE" directive expires May 15; NJ Gov. Phil Murphy says his shutdown order will remain in effect statewide indefinitely
- NYC Mayor Bill de Blasio says the city will change its grading policy to reflect unprecedented hardships students are facing; struggling students will be targeted for summer-fall programs to get back on track
- More than 26,000 tri-state lives have been lost to date, though NY reported its lowest single-day toll in a month (335) on Tuesday; daily hospitalizations also dropped below 1,000 for the first time since late March
Three months after the coronavirus pandemic hit America, the United States on Tuesday topped a stunning 1 million cases — and that's a conservative estimate. New York state will pass 300,000 confirmed cases on its own this week — again, possibly orders of magnitude less than reality.
Yet in this unprecedented battle, there has been undeniable progress -- and governors across the country, including New York and New Jersey, are outlining their visions to reopen states in the coming months.
The economic toll of this crisis is catastrophic by any measure. The psychological cost is incalculable. It's one thing to reopen a restaurant. It's another thing to convince people it's safe to eat dinner out. Or go out at all.
Uncertainty — Who is infected? How do I pay my bills? When will this be over? — has entrenched a new kind of fear in the mindsets of many Americans, one that makes them question the very routines they comfortably abided for years.
Heartache and sheer exhaustion have fueled an almost communal depression. Countless loved ones have had to say goodbye to the patriarchs and matriarchs of their families through the comparatively impersonal means of Facebook Live, FaceTime or other video messaging services. Many fear they'll have to do the same. The crisis has crushed jobs; it's crushed souls. It has worsened mental illness for many already struggling, left many to fight their demons alone, isolated at home. Domestic violence is spiking, along with anti-Asian attacks in New York.
Hospital workers battling on the front lines for months say the all-out chaos has subsided a bit, but still report feeling overwhelmed by the sickness and death. They still find themselves serving as families' surrogates, the last to hold a loved one's hand. They still are getting sick. They still leave 12-hour shifts in tears. For many, the worst fear is possibly having to go through it all over again.
At least one nurse from Mount Sinai West in Manhattan says if society reopens too quickly, everything she and her colleagues have sacrificed will have been a "waste" of time.
We can't let that happen, Gov. Andrew Cuomo says. The price has been too high already.
"We have gone through hell and back over the past 60 days. What the American people have done, what New Yorkers have done, has been to save lives, literally," Cuomo said Tuesday. "But we have to remain vigilant. As much as we want this to be over, it's not over. And we have to respect what we accomplished here."
To honor the achievements, and the frontline heroes who save lives daily, Thunderbirds and Blue Angels flew in formation over New York City and Newark Tuesday. By all accounts, the powerful salute drew millions of New Yorkers together in a way they haven't been since the pandemic hit.
If you or someone you know is in a crisis, including at risk of suicide or self-harm, help is available. Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Trained counselors are available 24/7.
Many states, including New York and New Jersey, have established new mental health hotlines amid the crisis. They urge anyone who is struggling to call without hesitation. Learn more about the hotlines and find more ways to get help here.
In a recent New York City press briefing, Mayor Bill de Blasio says he believes the psychological crisis born out of the pandemic will be more challenging to cope with than the economic one. As Cuomo says, coronavirus will transform this generation -- and shape the next one.
Picture Madison Square Garden, jam-packed. There wouldn't be nearly enough seats to hold the tri-state's dead. If you add New York City's 5,395 "probable" COVID-19 fatalities to the state's official toll, there wouldn't even be enough seats for New York's casualties alone. Cuomo added 335 more names to the mounting list Tuesday, bringing New York state's confirmed virus deaths to 17,638. For the third time in as many days, it was the lowest single-day death toll in weeks.
The widely cited Gates Foundation-backed Institute for Health Metrics and Evaluation (IHME) does incorporate the NYC data, along with data compiled by The New York Times, in its virus modeling. In its latest run Monday night, IHME projected New York's ultimate death toll to be nearly 24,000 by early June, slightly higher than its previous iteration.
New Jersey could see 7,250 lives lost by June 1, IHME says. The state's toll currently stands at 6,442. After announcing a new single-day low Monday, Gov. Phil Murphy added 398 fatalities to the state's toll Tuesday, marking a new single-day high. He says Tuesday numbers often reflect a weekend reporting lag, but "the math doesn't really matter."
"What matters are the precious lives lost," Murphy said — and New Jersey has lost more people to the virus than to World War I, the Korean War and the Vietnam War combined.
Connecticut has lost more than 2,000 so far and could lose up to 3,340, IHME says, but over a longer period of time. IHME revised its national death projections upward as well. It now says more than 74,000 people could die by July 1; that number is 23 percent higher than it was 10 days ago, and the last death comes more than three weeks later. To date, the country has lost at least 57,000.
White House Reopening Guidelines Leave Room for Interpretation
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. The criteria has been criticized by some for being vague, creating the opportunity for any governor to argue the numbers are favorable enough to start reopening.
Source: The COVID Tracking Project
Credit: Amy O’Kruk/NBC
IHME also evaluates reopening timelines, presuming strong containment measures stay in place. Current modeling says New York, New Jersey and Connecticut have all past their peak death and resource use points. Connecticut was a bit later on the curve, and IHME says that state shouldn't look to relax restrictions until after June 17, more than a week later than its previous model run predicted a few days ago.
The timelines for New York and New Jersey were pushed back a day; IHME now says the two states can begin to relax restrictions after May 28, again presuming continued adherence to social distancing and strong containment measures.
While IHME offers the same date for New York and New Jersey, it's just one data point within one model. Key variations in the reopening blueprints the two states' governors' unveiled this week reflect the start of a nuanced process that could take months and fundamentally reshape the way people live and work.
Murphy has extended New Jersey's shutdown order indefinitely statewide. In New York, Cuomo says he'll likely allow his "PAUSE" order to expire after May 15 in some parts of the state, particularly upstate, which has seen much slower infection spread, while extending it in others like New York City.
Tracking Coronavirus in Tri-State
"We want to reopen but we want to do it without infecting more people or overwhelming the hospital system," Cuomo said Tuesday.
The governor has outlined a gradual, phased approach to what he says will help the state reopen safely. On Tuesday, he announced the creation of the NY Forward Reopening Advisory Board, comprised of 100 business, community and civic leaders to help guide strategy.
As the state moves through Cuomo's plan, reopening construction first and then other industries on a business-to-business case, officials will monitor the healthcare system capacity. Alarm bells sound if that capacity exceeds 70 percent, Cuomo says. Once elective surgeries resume, he wants to see a 30 percent buffer on both hospital and ICU beds.
Each region must appoint an oversight institution as its "control room" to monitor key metrics, including hospital capacity, infection rate, PPE burn rate and businesses, the governor said. If any indicator becomes problematic, officials can flick a sort of emergency switch to manage the issue before it metastasizes.
Earlier projections for much higher death and hospitalization rates in New York and the nation weren't wrong, Cuomo said: "We changed the reality."
Murphy announced a strategic council similar to Cuomo's in his state Tuesday. The two governors are also leaders of the seven-state coalition coordinating a Northeast reopening.
While Murphy was briefing the media, a group of protesters gathered outside (many ignoring social distancing measures, saying it wasn't necessary if they weren't sick) to demand the state reopen the economy. The group said it's their Constitutional right to congregate at the State House in Trenton, with many of the protesters angry with the governor for the stay-at-home order they say deprives people of paychecks, and could slow the development of herd immunity.
“I understand there are people dying. I think they’re dying with it, not from it. And I think there’s got to be an immunity built up with the community, because if you’re keeping everybody inside it’s not going to happen," said protester Gerry Molion.
Governor Murphy said he respects the right to these protesters, but suggested crowds like this are foolhardy, and said he wished they would do it at home instead.
New Grading Policy for NYC Schools
The fate of New York schools, the city's in particular, has been a controversial topic. Mayor de Blasio has said New York City public schools, the nation's largest public school system serving 1.1 million students, will stay closed until September. Cuomo has yet to rule out an earlier return.
When students do return to class, de Blasio says educators will face an unprecedented challenge in motivating them to make up for lost ground and helping them overcome the pain they've been through. Many students are consumed with self-doubt about their futures, crippled by anxiety over whether they will even know how to succeed going forward, de Blasio said.
The mayor announced Tuesday the city will restructure its grading policy. The goal is to keep all students engaged and reach those who are most struggling while equipping teachers with tools to help kids process the very real trauma. For example, all students in kindergarten through fifth grade will get two possible grades: Meets standards or needs improvement.
In lieu of traditional grades, middle school students will receive one of three ratings to cover the crisis-induced gap: The same two as elementary school students (meets standards and needs improvement), as well as course in progress. That is designated for students who have struggled with a particular topic or have not completed work, and may be targeted for summer program enrollment.
High schools will use existing grading scales and expand them. Students who require more time to master a particular subject will get a "course in progress" rating and be enrolled in summer-fall support programs. Once those students receive a passing letter grade, they'll have the option to convert the "course in progress" rating to a "pass" rating. A course in progress rating will not impact their GPA.
"The difference is that if a student chooses to keep the letter grade that gets factored into the grade point average, the GPA. But if the student opts to take the pass then it doesn’t impact the GPA," NYC Public Schools Chancellor Richard Carranza said.
The virus has cheated graduating high school students and their families of one of life's most pristine moments -- walking to a podium to get one's diploma, surrounded by relatives and friends as you take that next critical life step. Not wanting to lose that entirely, de Blasio said plans are in the works for a citywide virtual graduation to honor their achievements. No date has yet been set for that event.
The mayor ended Tuesday's briefing with a direct message to all New York City students:
"To every kid out there, every student, every young person, if you feel like you're going through a lot right now, we understand that. You're going through a hell of a lot. You're being asked to shoulder a burden that young people haven't been asked to shoulder in a long, long time. We'll be there with you every step of the way. There's a bright future ahead and it's because of you."
The Density Problem: Just How Many Are Sick?
Density complicates matters, given the proven ability of asymptomatic patients to transmit the virus. New York City has more than 160,000 of the state's confirmed 295,106 virus cases. But new data released Monday suggests nearly 2.1 million city residents could have been infected at some point.
A second round of antibody testing found a positivity rate of 24.7 percent in city samples. That means 1 in 4 New York City residents could have been infected. Nearly a third of New Yorkers say they know someone who has died of the virus, according to a Siena College Poll. These statistics are startling for many -- and they crystallize the potential scope of a pandemic that even the nation's top researchers and health experts readily admit they don't fully understand.
In an interview with Axios, Cuomo admitted that he wished "someone stood up and blew the bugle" sooner regarding how serious of a threat the virus was and didn't take China at their word back in December or January. "And if no one was going to blow the bugle, I would feel much better if I was a bugle blower last December and January," the governor said. "I would feel better sitting here today saying, 'I blew the bugle about Wuhan province in January.' I can't say that."
Cuomo also confessed that even as late as March he was confident about New York's chances to beat the virus, partly out of "arrogance" regarding the state having some of the best health care in the world, leading him to believe the situation wouldn't be "as bad as it was in other countries."
New Jersey is the nation's second-most impacted state, reporting 113,856 cases to date. Connecticut has more than 26,000 cases. Almost every state has traveled the same road to get to this point. Their roadmaps back will be a bit different, and the roadmaps within individual states like New York will vary by region, Cuomo says, to protect public health.
That's what the tri-state governors believe is most important -- and not just because it's the right thing to say. As Murphy said Monday, "Public health drives economic health. It's as simple as that."
Dr. Deborah Birx, the White House Coronavirus Task Force response coordinator, says social distancing will be needed through summer to ensure public safety. States from New York to Florida are looking at how they might be able to incorporate that into potential plans for summer beach and restaurant reopenings and beyond. The Centers for Disease Control and Prevention is working on a uniform set of guidelines for reopening various businesses.
Among the recommendations, which have been sent to Washington, D.C., to be finalized: Businesses should close break rooms. Restaurants should consider disposable menus and plates. Schools should have students eat lunch in their classrooms.
Even as they fight the battle at hand, health officials are preparing for a potential return of the virus this fall. Birx told Fox Tuesday that the White House Task Force's top job right now is to ensure readiness in the event that happens. Key to planning will be a robust surveillance system “that understands that we have to track for asymptomatics as well as symptomatic individuals.”
Barring a vaccine or effective treatment for the virus, Harvard researchers say social distancing could be necessary into 2022. More than 70 vaccines are in development worldwide, but approval could be 12 to 18 months out if not longer. Japan's top doctor said Tuesday the already postponed Olympics may be impossible to hold next year unless an effective vaccine is available.
Clinical trials for experimental drugs have not spurred much optimism thus far, though some have appeared more effective than others in initial study. Northwell Health in New York says it has found some promising early results in a trial that uses a common, inexpensive heartburn drug as treatment in tandem with other experimental drugs. Final results are still about a month out.
Doctors could use multiple treatments on a single virus patient-- or maybe one helps one person and something different helps another. Bill Gates wrote in a recent essay that an effective treatment has to reduce the death rate by 95 percent. We're not there yet, he said -- not even close.