What to Know
- New York has reported more COVID-19 cases than China's Hubei province, where the pandemic started more than three months ago; many on the front lines are getting infected, some have already died
- Gov. Andrew Cuomo said Wednesday all NYC playgrounds would be shut down, citing ongoing density issues; parks are still open for now
- Nearly 110,000 in the tri-state area have now tested positive for COVID-19; more than 2,600 have died, including first responders
The tri-state area has now seen well over 100,000 coronavirus cases, with New York's numbers spiking by thousands again overnight. Nearly 2,000 people have died in the Empire State alone.
To date, the state has 2,219 deaths, up more than 500 in 24 hours, with 83,712 infections. One projection from the Gates Foundation-funded IHME suggests New York could lose a total 16,000 through July, meaning the crisis would extend well into the summer, Gov. Andrew Cuomo said in his daily briefing Wednesday.
New York City, impaired by the density that makes it one of the world's most vibrant places, is the nation's epicenter. As of Wednesday, the city had 47,439 cases and 1,374 dead, an increase of nearly three hundred fatalities from the night before.
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Cuomo said Wednesday that all NYC playgrounds would be shut down by the end of the day Thursday, citing ongoing density issues. He said the state would leave open spaces available for people to move freely; the city's street closure plan is part of that. City Hall said in a statement they they agreed with the move to shutter playgrounds, with a spokeswoman for the mayor saying "As the weather warms up, we must act clearly to limit any possibility of crowding. We know this will be painful for many families, but we must put the health of New Yorkers first."
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
This is all to plan for the next battle -- the apex, Cuomo says. State consultants peg the peak of COVID-19 cases to hit New York at the end of April, with 75,000-110,000 COVID-only beds needed, the governor said Wednesday. Some models predict it could hit in seven days; others have it in six weeks. His team works to develop moderate projections to best plan for need.
"The higher models, we don't have a chance at meeting that capacity anyway," Cuomo said. "We are still climbing up the mountain and we're not sure yet when we are going to get to the other side. The anxiety is what's most oppressing here."
The city alone said it needs 65,000 beds by the end of the month. In order to help reach that number, field hospitals at locations like the Javits Center, Central Park, USTA tennis center and the Brooklyn Cruise Terminal will be able to house thousands of non-coronavirus patients. At least 20 hotels in NYC, which have seen business grind to a halt since the outbreak began, have been leased out by city hospitals to house 10,000 beds. The city hopes that in the next phase of leasing hotels and converting large venues, as many as 39,000 beds could be created, in addition to on-site and off-site hospital facilities.
The virus doesn't discriminate. Cuomo's brother, CNN anchor Chris Cuomo, is among the infected, but one of the 80 percent of mild cases, the governor said. Still, an obviously moved Andrew Cuomo admitted he's frightened: "I couldn’t protect my little brother. He couldn’t protect himself. And it's scary. I'm worried about him just as we are all worried about the people we love. I love you, little brother. Stay strong."
About 20 percent of all NYC cases to date have required hospitalization, slightly higher than the statewide average. 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; more than 98 percent of all victims had prior conditions or conditions under investigation.
The five boroughs account for nearly a quarter of all cases in America -- and a slightly higher share of the nation's surging death toll. Most NYC hospitals now have refrigerated trailers they're using as temporary morgue space, according to Lenox Hill Hospital, where one was spotted on East 76th Street Wednesday.
President Trump warned America the next two or three weeks could be the "roughest" the nation has ever seen, saying in a briefing that "we're going to lose thousands of people."
Thousands have been lost locally already. New Jersey and Connecticut have both seen their totals soar. Gov. Phil Murphy reported more than 3,600 new positives overnight, bringing New Jersey's case total to 22,255. Nearly 100 more lives were lost, including a 60-year-old woman who founded a food pantry, helping feed families for over a decade. New Jersey has 355 COVID-19 deaths to date; it is the nation's second-most impacted state. Some on the front lines have already died.
Health officials say they're already seeing a surge in northern New Jersey; seven hospitals are already on "divert" status. If not for social distancing, Murphy said models show his state would already have hit ICU capacity and max out on beds next week. As he said Wednesday, "We're in the fight of our lives."
In Connecticut, 3,557 cases have been reported and at least 85 people have died, Gov. Ned Lamont said Wednesday. The city of Danbury is using a hanger at Danbury Airport to house two refrigerated trailers to serve as an overflow for the Danbury Hospital morgue, its mayor said. There were also more field hospitals opening or set to open soon in places like large gymnasiums across the state.
Among the latest deaths in Connecticut was a 7-week-old newborn, Lamont said, adding that the child is likely one of the youngest-ever victims of COVID-19.
Experts have cited some evidence -- it's taking longer for New York hospitalizations to double, for example -- in assessing the overall effectiveness of social distancing. Only time will tell, and right now, tri-state governors say we have to use every preventive measure at our disposal to slow the spread. Fines and summonses for noncompliance are being issued across all three states, which have seen a combined 109,524 positive cases and 2,354 deaths.
"How many people have to die before the people ignoring social distancing get that they have a responsibility?" Cuomo asked. "One person sneezes — another person gets intubated. We all have to look out for each other."
All of the unprecedented joint measures Cuomo, Murphy and Lamont have implemented mean nothing if people do not adhere to the most critical advice, Cuomo says: Stay home. And when you go out, stay apart. Too much is at stake.
In the words of Winston Churchill, Cuomo said: "It is no use saying 'we are doing our best.' You have got to succeed in doing what is necessary."
The governor also said that even when the virus works its way through, he's not sure the country will go back to "normal" any time soon.
"I don't think we get back to normal. We get to a new normal," he said, adding that the pandemic may transform some behaviors for a long time.
Funnel Help Where It's Needed
To better track the spread of COVID-19 in NYC and funnel resources where they're most needed, a team of data scientists, physicians, and engineers across the Mount Sinai Health System has launched STOP COVID NYC, a web-based app. They are asking everyone to enroll. Text COVID to 64722 to get it.
Cuomo has pledged to support the rest of the nation, which he says will see a curve similar to the one in New York in time. He has asked the White House for assistance, resources -- and said "I personally guarantee" to redistribute them to other states. But first he has to fight the war at home -- and he's shoring up a stockpile so New York has reinforcements when the apex hits.
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. One NYC per diem doctor who has worked shifts in more than a dozen ERs says they are "all on fire." Hospitals have said they fear they could soon have to triage patients; ventilator use could come down to a lottery.
Critically ill COVID-19 patients need ventilators -- and they stay on them for 20 to 30 days, far more than the typical two-to-three-day usage for non-COVID-19 patients. That further taxes capacity, and Cuomo and Murphy are both looking into "co-venting," where two patients share a single ventilator, to stretch supply.
Cuomo said New York has ordered 17,000 ventilators from China (at $25,000 each), but it will be weeks before they arrive. He also voiced frustration at now having to compete with FEMA bidding on the necessary items as well — calling it "almost impossible" to buy a ventilator now — but said getting the equipment is necessary in order to provide relief for medical workers.
"They are the front line, and they need relief. They are physically exhausted, even more they are emotionally exhausted," Cuomo said of health care workers. "Seeing the pain, seeing the death, that they're dealing with every day."
A doctor in Queens who says he spent 24 of his last 36 hours in the ER describes "an absolute nightmare." He says he intubated three patients in under 60 minutes and 82 of his hospital's 400 COVID-19 patients are on ventilators. They're having to manage ventilators in hallways because the ER is so crammed, he said.
Nearly 200 non-ICU patients and dozens of ICU patients from Queens hospitals, including hard-hit Elmhurst, have been moved to other city hospitals to help the borough deal with the amount of cases they are handling.
One idea NYC Mayor Bill de Blasio came up with to help hospitals get necessary medical supplies and staffing is to put someone in charge of managing the supply chains all city hospitals — private or public — are using. And to lead that effort, he tapped an old friend and colleague: Former NYPD Commissioner James O'Neill.
"He's answered the city's call before, and he's answering it again," de Blasio said.
O'Neill was based in San Francisco for his new job with Visa when that city implemented its shelter-in-place order, and had been updating de Blasio on how those measures were working there. He said he wants to establish a "system of accountability" to ensure hospitals are getting everything they need to fight COVID-19, including N95 face masks, face shields, gowns and more.
To that end, the mayor said Wednesday that all city hospitals will have enough equipment to last them through April 5, but after that it becomes unclear. While there should be enough face shields and gloves, he said NYC still needs millions of N95 and surgical masks, as well as 400 more ventilators to make through next week.
"Next week is going to be a difficult and intense week," de Blasio said.
Congress' $2.2 trillion stimulus package will provide some relief, but it won't be able to buy hospitals out of supply and staffing shortages. To help best allocate resources across New York, Cuomo said the state is creating a Central Coordinating Team, led by the Department of Health. That team will organize upstate-to-downstate staffing needs, patient transfers between hospitals and transfers to the USNS Comfort.
"Our health care system is a chain," Cuomo said. "If one link breaks the whole chain breaks. The distinction between private and public, upstate and downstate needs to end. New York is one state. In New York we stand together."
Tens of thousands of retirees have reenlisted to help answer the call. Mayor de Blasio said 500 nurses arrived in the city last week, and another 5,000 are on the way. Health and Hospitals got an additional 1,000 as well, meaning thousands of nurses have been added to the system in a matter of days.
Murphy signed an executive order Wednesday authorizing the New Jersey Division of Consumer Affairs to temporarily reactivate the licenses of recently retired health care professionals and grant temporary licenses to foreign doctors. That should usher in a new flood of medical personnel, the governor said. He also welcomes volunteers.
More than 6,000 COVID-19 patients in New York have been discharged from hospitals over the last 30 days -- but the influx of new patients, especially critically sick ones, poses fresh challenges. The signs of strain are everywhere.
Field hospitals in Manhattan have started taking non-COVID-19 patients and new ones are being built in each of the other four boroughs as well as in Westchester County and on Long Island to boost capacity. The USNS Comfort is poised to take patients to ease the burden.
New Jersey is building field hospitals, too -- and Murphy was expected to tour the one at the Meadowlands this week. In the meantime, he's working to build up New Jersey's medical supply, saying Wednesday he had secured another 350 ventilators from the national stockpile. New Jersey now has an extra 850 on hand. Murphy says that's not enough: "Ventilators are our #1 need right now and I won't stop fighting to get us more."
Local leaders say this is a war -- and they need wartime help. De Blasio said Tuesday the city will still need military medical personnel by April 5. He said he again asked the White House about that and was awaiting a response.
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.
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."
The governor said that there were 500,000 new testing kits that were being distributed throughout the state, and another company donated 100,000 tubes for more testing to be done.
Dr. Anthony Fauci, the nation's top infectious disease expert, says more scaleable testing is in the works. In the meantime, rapid testing is becoming available.
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 say they'll start using 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 and is using its automation experience and infrastructure to test up to tens of thousands of samples daily. It has also submitted an emergency use authorization request 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 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 that suggest new cases will need to decline for at least 10 straight days. But it's still too early to tell.
Responding to the Crisis
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.
Some Wall Street banks project that more than 5 million people signed up for first-time unemployment benefits in the last week, versus 3.3 million the week prior. Before this crisis, weekly unemployment claims had never topped 700,000 in U.S. history. The federal tax filing deadline has been extended, while New York and New Jersey have pushed their state filings to mid-July to give people time.
Trump signed three stimulus bills in three weeks, the latest worth $2.2 trillion - and de Blasio has already said it's not enough. A fourth bill is in the works, House Speaker Nancy Pelosi said -- one that would focus on recovery from the crisis. By the time that 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.
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 211,000 people have been infected and at least 4,700 have died. New projections from the White House suggest up to 240,000 Americans could die by the time the pandemic ebbs even if social distancing guidelines are followed.
