What to Know
- Gov. Andrew Cuomo extended New York State's "PAUSE" directive requiring all non-essential employees to work from home until April 15; he warned NYC playgrounds could be shut down soon
- President Donald Trump extended the voluntary national shutdown for a month as sickness and death from the coronavirus pandemic rise; his top experts say the U.S. could ultimately see 100-200k COVID-19 fatalities
- More than 95,000 in the tri-state have now tested positive for COVID-19; at least 1,700 people have died, including the first child in NYC
"This virus communicates like nothing else that we have seen."
That's how Gov. Andrew Cuomo described the awesome threat of the novel coronavirus on MSNBC late Monday, saying the only reason his state is the most impacted now is because of its density. It's America's first epicenter but won't be the last, he said, warning the trend would follow in other parts of the nation.
"This is like a fire through dry grass with a strong wind behind it," Cuomo said. "New York is just the test case for this. We're the canary in the coal mine. There's nothing unique about New Yorkers' immune system. There is no American who is immune from the virus."
New York is just showing the mass vulnerability first. Statewide, there are more than 75,790 cases and 1,550 deaths as of Tuesday morning. The governor's own brother, CNN anchor Chris Cuomo, says he's among the positives. Most of the toll is in New York City, which saw its totals rise to 43,139 cases and 932 dead, including a child with underlying conditions, as of Tuesday morning.
Gov. Cuomo has asked people across the country to step up and support his state, through supplies, through personnel, through funding, and pledged to do the same in time. But first, he has to manage the crisis at home -- and prepare for what he says are worse days ahead. Mayor Bill de Blasio is similarly focused.
"For the weeks ahead, let's not kid ourselves - it gets a lot worse before it gets better," de Blasio said on "TODAY" Tuesday.
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
How many more could we lose? One projection from the University of Washington suggests another 14,000 could die in New York in just the next six weeks. Nationally, top experts say up to 200,000 lives could be lost by the time the pandemic ends. For Cuomo, it's about more than grim projections.
"To me, we're beyond 'staggering' already. We've reached 'staggering,'" Cuomo said Monday. "The point is to save every life that you can, that's what this is all about."
New Jersey and Connecticut are both losing more to the virus each day as well, tallying 198 and 37 deaths, respectively, as of Monday. Casewise, their totals stand at 16,636 and 2,571. If not for social distancing, New Jersey Phil Gov. Murphy said Monday models show his state would have hit its ICU capacity by Wednesday and exhausted its entire hospital bed capacity in 10 days.
Fines and summonses are being issued across all three states, which have to date seen more than 95,000 positive cases and 1,700 deaths. Some target businesses, others target individuals. Cuomo has warned the next hammer could fall on New York City playgrounds, which he says "have been unsuccessful" in curbing density. All of the unprecedented joint measures he, Murphy and Connecticut Gov. Ned Lamont have implemented mean nothing if people do not adhere to the most critical advice: Stay home. And when you go out, stay apart.
Yes, It's Real. War on the Front Lines
Even as President Trump insists New York has enough ventilators, implies medical supplies are disappearing out the back doors of hospitals and claims the crisis peak is days away, doctors on the frontlines in the city are painting a very different - and much more grim - picture. Cuomo listens to them and the data. He's shoring up a stockpile so New York has it when the apex hits.
It's difficult to tell exactly when that will happen, and when it does come, it will likely come in waves, the governor has said. New research from Columbia as of March 29 projects a “medium” surge to start overwhelming hospital capacity in Westchester in 12 days and Manhattan in 20 days, for example.
As of Tuesday, about 14 percent of New York's total cases required hospitalization; nearly a quarter of those were in the ICU. The city is seeing slightly higher overall hospitalization percentages (around 20 percent).
The coronavirus toll on New York City hospitals is "getting that serious" that medical professionals could soon have to decide who will get treatment, and who won't, the chair of the department of surgery at Columbia University said in his latest update. It could literally come down to a lottery for ventilators.
If we wait for the storm to hit it will be too late, Cuomo has said. He and de Blasio say New York hospitals and staff have enough for "right now." But that literally means "right now" -- and "right now" gets more taxing with each day. That's why personal protective equipment (PPE) usage is soaring, Cuomo says.
"In a hospital today, you can't tell who has the coronavirus and who doesn't," Cuomo said on MSNBC. To protect themselves and New Yorkers, medical staff put on new PPE for each new patient. The volume of patients is surging.
"So there has been an explosion in the use of this PPE equipment, the gowns, the masks. It's that increase that has forced states across the nation, as well as other countries, to go out and furiously try to find the supplies to buy, which you can't even do," Cuomo said on MSNBC. "I don't think the president got that point as the reason for the exponential use."
Reinforcements are here -- a new field hospital at the Javits Center and smaller one in Central Park, a U.S. Navy ship with 1,000 beds to treat non-COVID-19 patients. More are coming: Further defenses are in the works in all five boroughs and elsewhere across the state. De Blasio said Tuesday FEMA was sending the city 250 ambulances and 500 more EMTs and paramedics to help deal with record spikes in 911 calls. New Jersey is building a series of field hospitals as well. The federal government continues to funnel in critical supplies like ventilators and PPE and private companies and citizens are also stepping up.
Congress' $2.2 trillion relief package will provide some help, but it won't be able to buy hospitals out of shortages. And the race to acquire equipment underscores that. But as much as states are targeting critical supplies, they are acutely focusing on buttressing the battle-weary medical staff on the front lines who say their fight gets more physically and emotionally challenging daily.
In New York City, hospital staffs have been moved around in an effort to address shortages at different locations. More than 60 clinicians (including RNs, nurse practitioners, physicians and physician assistants) have been sent to help with the influx of patients at Elmhurst Hospital, along with 40 ventilators. On Saturday, more than 100 additional nurses were reassigned to the fatigued hospital.
Cuomo, Murphy and Lamont have all called on legions of retirees to help on the front lines. Tens of thousands have answered the call. In New York, at least 76,000 medical professionals, from physicians to RNS and respiratory therapists, have signed up to come back to work. Colleges like NYU and Rutgers are graduating their medical students early. More than 10,000 mental health professionals have volunteered to answer calls on the state's new hotline. And Staten Island Rep. Max Rose is being deployed with the National Guard as the military steps up its coronavirus aid to New York.
Extended Restrictions, Hard Times
The governor extended his statewide "PAUSE" directive Sunday another two weeks to help control density, while Trump extended the White House guidelines on social distancing through the end of April, which is notably after Easter -- the date Trump had said he wanted to have the country "raring to go."
Fauci has said he doesn't believe another extension will be necessary federally but says it's a possibility of course. As he told CNN last week, "You don't make the timeline. The virus makes the timeline."
Murphy has said he doesn't envision a scenario where the current restrictions would be lifted prior to May; de Blasio thinks May could be a more challenging month than April, which is expected to be deadlier than March. It's highly in doubt schools in the tri-state area will reopen in time to salvage the academic year (find an NYC school offering free meals and learn about childcare help for essential workers here).
The economic impact at all levels has been dizzying; unemployment claims have obliterated records. To help ease the burden on those who have lost their jobs or can't go to work, Murphy announced a 90-day grace period for mortgages. He also suspended commercial and residential evictions. Cuomo has announced similar policies. In the city, de Blasio has called for a rent freeze for 2.3 million tenants in nearly one million rent-stabilized units amid the COVID-19 pandemic.
Cuomo says the state, and America, can restart the economy in a "smart way" while still prioritizing public health. In his view, he says it all comes down to the scale of testing. If you can develop a new, faster and easier home-based program that can test millions of people every day -- and rapidly, you will identify hundreds of thousands of people who "can go back to work tomorrow."
Fauci says scientists are working on more scaleable, less invasive testing.
That could come too late to help New York City, de Blasio said Tuesday, but it may not be too late to make a big difference for other parts of the country.
"If we could get rapid testing on a truly universal level, that could help us a lot. That could help us immediately tell people what they have to do," the mayor said on "TODAY." "But the best kind of testing is the testing early before you get an outbreak. Some states could still benefit from that."
Where Do We Go From Here?
Numbers will continue to rise as more people are tested, officials say. New York has accounted for about 25 percent of all COVID-19 testing in America to date, Cuomo has said. That is an accomplishment, he noted: Find the cases, isolate the positives and treat them. That, in conjunction with the social distancing and business restrictions in place, will curb the spread of infection.
Governors are working to accelerate action on the drug front as well. New York launched a clinical trial for an experimental treatment and 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. Right now, everything is on the table.
How will we know when we've turned a corner? Recent research from Columbia University offers some curve-based projections. 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.
Trump signed three stimulus bills in three weeks, the latest worth $2.2 trillion - and de Blasio said Sunday it's already not enough. A fourth bill is in the works, House Speaker Nancy Pelosi said -- one that would focus on recovery from the crisis.
Responding to the Crisis
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 nearly 165,000 people have been infected and more than 3,000 have died. Globally, the numbers are far more stark.