Correcting: NYC released its its tally of 13,119 cumulative cases NOT New Cases. However, the State released a figure of 12,305. For consistency we are going to rely on New York State data which brings the NYC Metro area, including parts of New Jersey, Connecticut, Pennsylvania and New York State to about 22,000 cases. A pretty awful trend regardless. With respect to testing data: we have already noted its limitations and today the CDC notified labs that it would like inpatient admissions to get priority over ambulatory patients. Test data going forward will likely reflect caseload that requires advanced care rather than mildly and severely symptomatic confirmed cases, although that trend will vary across regions.
The COVID-19 spread continues to be mostly about New York’s – and especially the New York City Metro area’s – struggle to contain the spread of the virus. Things did not get better tonight when New York released its tally of 12,305 cumulative cases. The New York Metro area now has 22,000 cases, the majority of all US cases. More worrisome, the caseload, even at these elevated numbers are doubling every other day or less.
Mercifully, Governor Cuomo, who has emerged as a solid crisis manager, set out a clear agenda on two occasions today. At a press conference this morning, the Governor indicated that he anticipated a need for 110,000 hospital beds to accommodate the patient surge. Given a hospitalization rate of 10%, the governor’s forecast suggests a total caseload of 1.1 million at peak.
To accommodate the demand, the Governor has asked all hospitals in New York State to increase their capacity by 50%. Later in the day, Governor Cuomo held a press conference at the Javits Center to announce a retro-fit of the convention space with 1,000 hospital beds that would accommodate non-COVID-19 patients.
Supply shortages related to Personal Protective Equipment have largely abated with massive influx of supplies from the federal government and accelerated procurement by the state. However, the governor estimates the state will need 30,000 ventilators and demanded federal assistance which later in the day was forthcoming.
Issues remain with managing spread in NYC. CDC officials at their daily task force conference noted an attack rate of 1 in 1,000 in NYC and are looking for answers. Governor Cuomo, continued his agitation over New York City’s response and demanded a plan to further extend social distancing, “especially in parks.”
Interestingly, Governor Cuomo began to broach the subject of re-opening the state. While noting he was not prepared to make any decisions, he did offer these clues:
- He was working with academics on developing a risk-stratified approach to restarting commerce. In doing so, the Governor noted that the young are less affected and may be permitted to return to work earlier
- Vulnerable populations are a priority and he is looking for ways the elderly and those with underlying conditions can be protected without being isolated.
- Geographical considerations will play a role as not all areas of the state are as hard hit as New York City
While the Governor ponders economic revival, the next week or so will continue to be difficult with caseload numbers skyrocketing, especially in major Metro areas.
New Orleans probably represents the next area of concern and we have added its Metro area to the regions we are tracking.
In the (relatively) good news department the Seattle Metro area’s day over day growth decelerated ever so slightly to 16% from 17% the previous day and down from the consistent 20% rates two weeks earlier
It is important to note that the Seattle area is considered by the CDC and other epidemiologists to be the place where the virus first entered the US and is a “couple weeks” ahead of New York. Undeniably, Seattle has done a better job of managing the spread of the disease. That fact did not stop Governor Inslee from issuing a “stay home” home order today, reversing his position from just a few days ago.
Like Seattle, Northern California Metros, especially Santa Clara County are having a little more luck managing the curve:
The situation is, as we say in politics, quite fluid.
Call with questions.
Emily Evans
Managing Director – Health Policy
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