In case it wasn’t obvious from the headlines and body count, New York is currently suffering more severely from the coronavirus epidemic than almost anywhere else.

The city and its surrounding suburbs are experiencing infection and death rates as high as any on the planet — outstripping even those of Italy’s Lombardy region, formerly the chief object of the world’s horror and pity.

Already, more than 10,000 residents of the five boroughs have lost their lives, counting both confirmed and presumed fatalities — and although new hospitalizations have slowed, hundreds more still succumb every day. It’s not quite the worst-case scenario envisioned by some experts, but it’s catastrophic all the same.

Getting to the bottom of why things went so badly wrong will be crucial to the city’s future. The answers are not as obvious as they might seem.

Many fingers are being pointed at Mayor de Blasio, Gov. Cuomo and President Trump for initially pooh-poohing the threat and hesitating to take precautionary steps — such as banning mass gatherings, closing schools and businesses, issuing stay-at-home orders and requiring the use of face masks.

Certainly, with the benefit of hindsight, they could and should have acted sooner. But the shutdown itself, which is unprecedented, is causing real harms of its own. And it’s not clear that the delays alone explain why things went so badly for New York.

California Gov. Gavin Newsom, for example, has been credited for issuing his stay-at-home order relatively early, on March 19, when his state had 1,000 cases and 19 deaths. Cuomo followed suit the next day, but by that time New York had 4,000 cases and 30 deaths.

However, Florida Gov. Ron DeSantis did not issue his stay-at-home order until April 1, by which time his state had more than 7,000 cases and 100 deaths. As of April 13, Florida’s mortality rate of 23 deaths per million residents was higher than California at 18. But both were a mere fraction of New York State’s rate of 554 deaths per million.

Another much-cited factor is New York’s population density, an obvious suspect. It’s hard if not impossible to practice social distancing in large apartment buildings, crowded sidewalks and packed subway cars.

This is an especially existential argument, because it goes after the city’s identity as a jostling, teeming metropolis. A New York City without crowds and subways would not be New York City at all.

Yet only a handful of urban areas worldwide, such as Madrid and the Lombardy region of Italy, have seen outbreaks as deadly as New York’s. Seoul, a tightly packed city of skyscrapers and subways, has recorded fewer than 1,000 deaths, as have Chicago and Philadelphia. Tokyo and Singapore have reported fewer than 100 fatalities each, and Hong Kong less than 10.

Korean authorities resorted to video and telephone surveillance to control that country’s outbreak, tactics that might offend American sensibilities, not to mention infringe on constitutional rights. Yet Seoul’s relatively low death toll shows that good infection control is achievable even in a dense, urban setting.

This is not to deny that crowded subways and bumbling politicians deserve a share of blame for New York’s grim outcome. They obviously do. But those factors alone do not fully explain what happened.

This raises the question of what else went wrong. Is there something different about New York’s infrastructure, its health-care system or its public policy? Could it be related to the nature of its economy, demographics or culture?

Or is the strain of virus afflicting this part of the country — which apparently arrived via Europe — particularly infectious or lethal?

“If we don’t learn the lessons from this situation, then all of this will have been in vain,” Cuomo said at Wednesday’s daily briefing.

Once the immediate crisis is past, nothing will be more important than getting to the bottom of this mystery. New Yorkers and other armchair epidemiologists should suppress their preconceived ideas, follow the facts, and prepare to be surprised.

© 2020 New York Daily News

About the Author

Bill Hammond

As the Empire Center’s director of 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

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