What to Know
- New York has reported more COVID-19 cases than China's Hubei province, where the pandemic started; its death toll has climbed above 2,900
- New Jersey is the nation's second most-impacted state; Gov. Phil Murphy says he has ordered all flags lowered to half-staff "immediately and indefinitely" to acknowledge the lives lost and those that will be lost
- More than 136,000 in the tri-state area have now tested positive for COVID-19; nearly 4,000 have died, including first responders and children
Gov. Andrew Cuomo says he has authorized the National Guard to take ventilators from institutions that don't need them immediately and redistribute them to hospitals that do, as he reported Friday New York had seen its biggest single-day increase in deaths from the virus.
The state has now lost 3,218 people to COVID-19, more than the number who died at the World Trade Center in the 9/11 terror attacks. Nearly 103,000 have been infected, a jump of more than 10,000 cases in 24 hours. The weekly comparison is more jarring: New York's death toll has spiked 400 percent, its cases by almost 130 percent, in the last seven days.
Cuomo's new executive order, which applies to personal protective equipment (PPE) as well as ventilators, comes a day after he said he only had enough of the latter in his stockpile to last six days at the "current burn rate." The trajectory only went up — daily hospitalizations hit a new record Thursday after declining the previous two days. About a quarter of hospitalized patients are in ICUs. Those people need ventilators, and they stay on them 20 to 30 days, much longer than the typical two-to-three-day use for a non-COVID-19 patient.
There's increasing need — and less turnover. Cuomo has procured thousands of ventilators in recent weeks but says the market has "collapsed" as states vie for the coveted life-saving machines and the federal stockpile dwindles. He is leveraging creative techniques to stretch supply like co-venting and retrofitting anesthesia machines. It's still not enough.
NYC Mayor Bill de Blasio repeated the numbers he believes the city needs in order to adequately treat COVID-19 patients: 2,500-3,000 ventilators (part of 15,000 needed by the end of April), 45,000 new medical personnel (37,500 for the new field hospitals, the other 7,500 at regular hospitals), and 85,000 hospital beds (an increase from 20,000 the city had before the crisis).
Tracking Coronavirus in Tri-State
Cuomo and de Blasio maintain that facilities which have their ventilators redistributed will get them back; if that doesn't happen for one reason or another, they'll be reimbursed. And if their need eclipses others' at some point in the near future, he'll reallocate again.
"The practical solution at this point is focus on the emergency that is in front of you," the governor said Friday. "I'm not going to be in a position where people are dying and we have ventilators in our state somewhere else."
De Blasio said the best source to get the ventilators is through the federal government, which he said has 10,000 units still in the national stockpile. Despite that claim, President Trump on Friday said that he could not guarantee New York would get the ventilators it would need, saying the state "should have ordered more."
The mayor also said the state has 2,000 in stockpile, which need to be distributed to the other hard-hit areas of New York as well. De Blasio said the city had so far gotten 1,780 ventilators from private companies, and supported the governor's order to get more by taking them from companies not using them.
Thousands of lives have already been lost --teachers, first responders, health care workers; the virus has ripped whole chunks from families and taken many friends. New York City, impaired by the density that makes it one of the world's most vibrant places, had 1,867 dead and more than 57,000 cases as of Friday.
Cuomo says the surge of COVID-19 patients has overwhelmed hospitals, so much so that he announced the Javits Center field hospital, intended to be a 2,500-bed facility for non-virus patients, will now exclusively treat coronavirus patients. The U.S. Army will run it.
The next battlefront, the apex, could be catastrophic. All of the current plans and efforts currently in place are designed with that in mind, Cuomo says. State consultants say New York will need 75,000-110,000 COVID-only beds when the apex hits. Estimates vary as to when that will happen. On Thursday, Cuomo said his team pegs it hitting at the shorter end of a seven-to-30-day range.
De Blasio said on MSNBC Friday he expects an initial surge of coronavirus patients in New York City next week -- a flood of easily 5,000 or more people who need to be on ventilators. Right now, he says, "We have enough ventilators just to get to Sunday/Monday."
"I'm guaranteeing you that next week is going to be a lot tougher. Next week in New York City is going to be very tough," de Blasio said. "We have days to set up a structure to truly mobilize the medical community of this nation ... If that is not done in the coming days, you're going to see people die who did not need to die."
The mayor continued to press President Trump to get the military involved, saying it would make sense to get them involved because the country is "dealing with an enemy that is killing thousands of our fellow Americans."
New York City is the national epicenter of the crisis, but the alarming curve it is seeing will trend to other parts of the state -- and other parts of the country, Cuomo has said. New Jersey Gov. Phil Murphy said Friday he thinks his state, which is America's second-most impacted and has nearly 30,000 cases, is running about a week behind New York in terms of the curve of the virus spread.
Cuomo, meanwhile, says he is worried about hospitalizations rising on Long Island and in Westchester. He has a Central Coordinating Team that is constantly working to best allocate resources, from staff to equipment and supplies, and shift them to where they are most needed.
Ultimately, New York needs three things -- beds, staff and equipment, Cuomo says. Beds are the easiest to acquire. On the staff front, nearly 100,000 retirees and volunteers, including former White House physician Jennifer Peña, have answered the call. Some colleges are graduating medical students early to provide reinforcements. De Blasio called for a national medical personnel enlistment program Friday, saying the country needs a wartime footing to battle the virus.
"No state is equipped to handle this situation. States don't do public health emergencies," Cuomo said on MSNBC. "There is no capacity in my state health system that runs 50,000 beds to create and maintain an additional 50,000 beds, just in case once every 20 years there's a pandemic. It doesn't work that way."
The mayor said they would get more medical workers into the city by contracting; 3,600 had already been added, and he hoped to double that number quickly. He also hoped for 1,000 paid volunteers, and for FEMA to send 1,000 nurses, 150 doctors and 75 respiratory therapists.
About 21 percent of NYC's cases have required hospitalization, slightly higher than the rolling statewide average (14 percent). Half of those patients are 75 and older, but 10 percent are children, according to the city's latest data. The vast majority of fatalities, though, are people older than 65; nearly 99 percent of all victims had prior conditions or conditions under investigation.
One projection from the Gates Foundation-funded IHME suggests New York could lose a total 16,000 people through the second week of May.
New Jersey has lost more people to COVID-19 than any other state next to New York -- as of Friday, it had 646 dead, Murphy said, as he added 113 names to the growing toll. In terms of overall cases, New Jersey is up to 29,895.
Amid the mounting tragedy, Murphy said he was ordering all flags in New Jersey lowered to half-staff "effective immediately and indefinitely to honor those we have lost and those we will lose. And we will lose more sadly as a result of this pandemic. This is one of the greatest tragedies to ever hit our state and our country. We must have a constant and visible memorial."
Dr. Deborah Birx, the White House Coronavirus Task Force response coordinator, says Connecticut could be one of the nation's next hotspots. As of Friday, Gov. Ned Lamont had reported 131 deaths and 4,914 cases.
To date, the tri-state area has seen a combined 137,672 cases and 3,995 deaths. All of the unprecedented joint measures Cuomo, Murphy and Lamont have implemented mean nothing if people do not adhere to the most critical advice: Stay home. And when you go out, stay apart.
"Too much is at stake," Cuomo said. "We have to get this right."
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
New NYC Guidance - Cover Your Face (Just Don't Use a Surgical Mask)
Cover up before heading out: That's the new message de Blasio has for all city residents, whether you feel sick or not. And, still, stay 6 feet apart from others.
De Blasio announced Thursday that all city residents are advised to wear face masks anytime when going out in public. The mayor discouraged purchasing surgical or professional masks, encouraging people to use items already available or make them at home from different materials. If you go the homemade route, make sure the mask covers your nose and mouth; you can clean it daily by hand with soap and warm water, then let it dry.
Anything such as scarves or bandannas would work, de Blasio said, strictly specifying that "it does not need to be a professional surgical mask. In fact, we don't want you to use the masks our first responders use."
Nationally, the Trump administration said the CDC recommends all Americans wear non-medical face coverings in an effort to slow the spread of the new coronavirus. However, in the same press conference, Trump said that he would not be wearing any protective masks.
"I'm choosing not to do it. It's only a recommendation," Trump said.
Why now? You simply don't know: Did that person who crossed the street just ahead of you have the virus and recover? Could they still be contagious? Do they have COVID-19 now and show no symptoms? Are they sick and just pre-symptomatic?
"Studies are showing asymptomatic individuals are transmitting this disease," de Blasio said. He, along with the city's top doctor, Oxiris Barbot, stress the masks aren't to protect the people wearing them but to protect everyone else. And they're meant to reinforce the social distancing guidelines, not replace them.
De Blasio says up to half of New Yorkers could contract the virus at some point -- and many won't even know it. New CDC research suggests anyone can be a carrier of the virus, healthy-looking or not. It offered one particularly striking example. Two tourists who had no symptoms sat in a Singapore church. Two days later, a 52-year-old woman sat in one of the seats they had used. She got sick -- and researchers, using closed-circuit camera recordings of the church services, linked her infection to those tourists. Both of them later fell ill.
Mask use should not give people a "false sense of security," the White House's Dr. Birx warned; she says social distancing remains the best way to slow the spread of infection.
In New Jersey, Murphy said residents are welcome to use masks as long as they're not the ones needed on the front lines. But he reiterated the same message he and others have stressed for weeks: Social distancing is the best offense and defense against the spread of the novel coronavirus.
"In the absence of a vaccine, it's our best surrogate vaccine. There is no silver bullet to make it go away overnight," the governor said Friday. "It will take all of us over the coming weeks to stay disciplined in our social distancing, disciplined in our hygiene and disciplined in our basic common sense."
Test More, Reboot Economy
Numbers will rise by default as more people are tested, officials say. New York is testing more per capita than anywhere in the globe, Cuomo says. As of Friday, nearly 40 percent of the total tested had been positive, well above the national average. The testing in and of itself is an accomplishment, Cuomo has noted: Find the cases, isolate the positives and treat them.
That, in conjunction with the social distancing and business restrictions in place, will slow the spread of infection, the governor says.
The economic impact has been dizzying at all levels. The number of people filing first-time claims for unemployment doubled last week to 6.6 million, nearly 10 times the pre-pandemic record. Before this crisis, weekly unemployment claims had never topped 700,000 in U.S. history. On Friday, the national unemployment rate saw its biggest month-over-month increase in 45 years as a decade-long cycle of job growth came to an end.
Trump signed three stimulus bills in three weeks, the latest worth $2.2 trillion with a promise to send millions of Americans virus relief checks. But those checks may not come for months, a new government memo to Congress reveals. A fourth bill is in the works, House Speaker Nancy Pelosi said -- one that would focus on recovery from the crisis. By the time it comes to fruition, though, it may be too late to save many small businesses. A new survey says a third of them can't last another three months under the current pressure.
Public health and the economy aren't mutually exclusive priorities, Cuomo has said. Bring testing up to scale quickly -- make it faster, easier, home-based and able to test millions -- he says, and you will identify hundreds of thousands of people who "can go back to work tomorrow."
Fauci says more scaleable testing is in the works nationally. In the meantime, rapid testing is becoming available locally.
Last week, the FDA granted Abbott Laboratories emergency use for its rapid COVID-19 test for doctor's offices and urgent care centers. The test delivers positive results in as little as 5 minutes and negative results in 13 minutes. Three Long Island locations of American Family Care started to use the test Wednesday, becoming the nation's first health care providers to do so.
New Jersey's testing capacity also got a boon Wednesday. Rutgers says its RUCDR Infinite Biologics launched a genetic test for the novel coronavirus. It has requested emergency authorization for a saliva collection method to broaden population screening. The project will help curb the spread by identifying more positives and allow infected front-line personnel to get back to work faster after recovering and testing negative, Rutgers says.
Governors are working to accelerate action on the drug front as well. New York launched a clinical trial for an experimental treatment, though no results have been made available. It also 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.
Where Do We Go From Here?
How will we know when we've turned a corner? Recent research from Columbia University offers some curve-based projections that suggest new cases will need to decline for at least 10 straight days. But it's still too early to tell.
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.
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 more than 275,000 people have been infected and more than 7,000 have died. New projections from the White House suggest up to 240,000 lives could be lost to the pandemic, even with mitigation efforts like social distancing. See how COVID-19 has spread across the United States since March 1 using this interactive map.