Because New York was hit with the coronavirus early, before testing was widely available, its official count of infections – at just over 400,000 – vastly understates the scale of its outbreak.

The state’s death toll, which is relatively well-documented, can be used to sketch a fuller picture of the pandemic’s course in New York – and provide better perspective on the current outbreaks in the South and West.

Research indicates that the mortality rate among people who contract COVID-19 is approximately 1 percent or less. This suggests that the total number of infected New Yorkers would be about 100 times the number of deaths, or 3.2 million, or about eight times higher than the Health Department’s tally of known cases.


This is an installment in a special series of #NYCoronavirus chronicles by Empire Center analysts, focused on New York’s state and local policy response to the coronavirus pandemic.


Among patients who die from the disease, the median time from infection to death ranges from 18 to 21 days. With this in mind, death counts suggest that the coronavirus started spreading in New York by late February and peaked in late March.

To be clear, these are debatable assumptions – and the results obtained are at best rough estimates that are useful for illustration purposes only.

The first chart below shows estimated total infection curves, extrapolated backward from death counts, for New York and Florida.

This illustration makes several things clear:

  1. By March 1, when the state recorded its first case of coronavirus, thousands of other New Yorkers were likely already infected.
  2. By mid-March, when the state recorded its first known coronavirus deaths, the outbreak was spreading rapidly, infecting people at a rate of perhaps 60,000 people per day and climbing fast.
  3. The outbreak appears to have peaked in late March, right around the time that social distancing measures, both state-mandated and voluntary, were taking effect – an indication that these precautions helped stem the pandemic.
  4. Because New York’s death count peaked at almost 1,000 per day, the state’s infection rate likely peaked at almost 100,000 per day.
  5. In Florida, the number of confirmed cases has risen above the number of inferred cases from three weeks earlier – a clear sign that the surge is real, and not just a byproduct of increased testing.
  6. Comparing states’ confirmed infection rates currently to what New York reported back in early April is misleading, because New York was testing a much smaller fraction of its infected residents.

The second chart of national data tells a similar story: The current surge in the South and West has not yet come close to the scale of what happened to the Northeast in March and April. However, it appears to be the beginning of a second wave which, in the absence of effective containment measures, could become just as deadly as the first.

Source: New York Times data, author calculations
Source: New York Times data, author calculations

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

While pleading for money in Albany, hospitals and nursing homes spend at the bargaining table

Friday's announcement of an amended labor contract for New York City-area hospitals and nursing homes sends a contradictory message about the financial condition of the state's health-care industry. Read More

The Essential Plan’s accumulated surplus will soon break $10 billion

The accumulated surplus of the state-run Essential Plan had ballooned to $9.9 billion as of the end of December, putting it on track to break $10 billion by the close of the fiscal year on March 31, according to newly obtained records from the comptroller's office. Read More

The Hochul administration seeks more federal money for its overfunded Essential Plan

In a move that ought to raise eyebrows in Washington, the Hochul administration is requesting additional federal money for New York's Essential Plan, which is already sitting on more than $9 billion after years of running a multi-billion-dollar surplus. Read More

Hochul puts Medicaid spending on a steeper slope

Governor Hochul is releasing the brakes on Medicaid, allowing state spending on the safety-net health plan to increase more than twice as fast as it typically did during the Cuomo administration. Read More

Emails show Cuomo’s staff working on his memoir at the peak of New York’s pandemic

Newly available records shed further light on the origins of former Gov. Andrew Cuomo's pandemic memoir, which won him a $5.1 million publishing contract before contributing to his political downfall. The records reveal that his government staff were a Read More

At end of ’22, NY still near bottom in pandemic recovery

The more time passes since the spring 2020 Covid-19 outbreak, the more New York stands out among all states for the weakness of its post-pandemic employment recovery. As of December, seasonally adjusted private employment in New York was still nearly 2 Read More

The AG’s nursing home lawsuits are a wake-up call for the Health Department

Attorney General Letitia James' recent lawsuits against nursing homes have not only exposed dangerous conditions for the residents – but also dangerous blind spots at the Health Department. Read More

Hochul’s agenda mostly sidesteps health care

Governor Hochul gave health care surprisingly little attention in her State of the State speech on Tuesday – a sign that taking on dysfunction in one-sixth of the state's economy ranks low on her list of priorities. Read More

Empire Center Logo Enjoying our work? Sign up for email alerts on our latest news and research.
Together, we can make New York a better place to live and work!