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Density Is New York City’s Big ‘Enemy’ in the Coronavirus Fight Density Is New York City’s Big ‘Enemy’ in the Coronavirus Fight
(about 8 hours later)
New York has tried to slow the spread of the coronavirus by closing its schools, shutting down its nonessential businesses and urging its residents to stay home almost around the clock. But it faces a distinct obstacle in trying to stem new cases: its cheek-by-jowl density.New York has tried to slow the spread of the coronavirus by closing its schools, shutting down its nonessential businesses and urging its residents to stay home almost around the clock. But it faces a distinct obstacle in trying to stem new cases: its cheek-by-jowl density.
New York is far more crowded than any other major city in the United States. It has 28,000 residents per square mile, while San Francisco, the next most jammed city, has 17,000, according to data from the U.S. Census Bureau.New York is far more crowded than any other major city in the United States. It has 28,000 residents per square mile, while San Francisco, the next most jammed city, has 17,000, according to data from the U.S. Census Bureau.
All of those people, in such a small space, appear to have helped the virus spread rapidly through packed subway trains, busy playgrounds and hivelike apartment buildings, forming ever-widening circles of infections and making New York the nation’s epicenter of the outbreak.All of those people, in such a small space, appear to have helped the virus spread rapidly through packed subway trains, busy playgrounds and hivelike apartment buildings, forming ever-widening circles of infections and making New York the nation’s epicenter of the outbreak.
“Density is really an enemy in a situation like this,” said Dr. Steven Goodman, an epidemiologist at Stanford University. “With large population centers, where people are interacting with more people all the time, that’s where it’s going to spread the fastest.”“Density is really an enemy in a situation like this,” said Dr. Steven Goodman, an epidemiologist at Stanford University. “With large population centers, where people are interacting with more people all the time, that’s where it’s going to spread the fastest.”
The challenge facing New York and other tightly cramped cities around the United States can be seen by comparing the country’s largest city to its second biggest, Los Angeles.The challenge facing New York and other tightly cramped cities around the United States can be seen by comparing the country’s largest city to its second biggest, Los Angeles.
As of Monday, there were more than 13,000 confirmed cases of coronavirus in New York and about 500 in Los Angeles. New York reported 125 deaths; Los Angeles reported seven.As of Monday, there were more than 13,000 confirmed cases of coronavirus in New York and about 500 in Los Angeles. New York reported 125 deaths; Los Angeles reported seven.
The population of Los Angeles is about half of New York’s, and it has conducted significantly fewer tests for the coronavirus. But researchers said one of the biggest reasons for the difference may be that in general, California residents live further apart from each other.The population of Los Angeles is about half of New York’s, and it has conducted significantly fewer tests for the coronavirus. But researchers said one of the biggest reasons for the difference may be that in general, California residents live further apart from each other.
“Out here, we’re spread out,” said Dr. Lee Riley, professor of infectious diseases at the University of California Berkeley School of Public Health. “People use cars, the public transportation system is terrible. Whereas in New York City, you have the subways, the buses, Times Square, people living in your small apartment buildings.”“Out here, we’re spread out,” said Dr. Lee Riley, professor of infectious diseases at the University of California Berkeley School of Public Health. “People use cars, the public transportation system is terrible. Whereas in New York City, you have the subways, the buses, Times Square, people living in your small apartment buildings.”
By almost any measure, New York has more bustling humanity living, working and playing side-by-side than anywhere in the country.By almost any measure, New York has more bustling humanity living, working and playing side-by-side than anywhere in the country.
On an average workday, more than 5 million people jostle onto the city’s subway trains — as many trips as Los Angeles sees in half a month. Far more people live in cramped public housing units in New York — 400,000 — than in any other city. And nearly 40 million people visit Times Square every year, making it one of the busiest tourist attractions in the world.On an average workday, more than 5 million people jostle onto the city’s subway trains — as many trips as Los Angeles sees in half a month. Far more people live in cramped public housing units in New York — 400,000 — than in any other city. And nearly 40 million people visit Times Square every year, making it one of the busiest tourist attractions in the world.
In the past weeks, as the coronavirus crept into the country, that crush of people was a vulnerable target.In the past weeks, as the coronavirus crept into the country, that crush of people was a vulnerable target.
Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, said on Monday that the “attack rate” — the percentage of the population infected with the virus — was nearly one in 1,000 in the New York area, five times higher than in other parts of the country.Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, said on Monday that the “attack rate” — the percentage of the population infected with the virus — was nearly one in 1,000 in the New York area, five times higher than in other parts of the country.
“So, to all of my friends and colleagues in New York, this is the group that needs to absolutely social distance and self-isolate at this time,” she said. “Clearly, the virus had been circulating there for a number of weeks to have this level of penetrance into the general community.”“So, to all of my friends and colleagues in New York, this is the group that needs to absolutely social distance and self-isolate at this time,” she said. “Clearly, the virus had been circulating there for a number of weeks to have this level of penetrance into the general community.”
Concerns about density were also at the forefront as New York officials discussed the spread of the virus in increasingly alarmed tones. New York City is now among the worst hot spots in the world: The city now has more coronavirus cases per capita than Italy, the world’s epicenter of the virus outside of China, where it originated.Concerns about density were also at the forefront as New York officials discussed the spread of the virus in increasingly alarmed tones. New York City is now among the worst hot spots in the world: The city now has more coronavirus cases per capita than Italy, the world’s epicenter of the virus outside of China, where it originated.
Gov. Andrew M. Cuomo said more than 20,000 people throughout New York state had tested positive for the virus so far, and 157 had died. More than 2,600 remained hospitalized.Gov. Andrew M. Cuomo said more than 20,000 people throughout New York state had tested positive for the virus so far, and 157 had died. More than 2,600 remained hospitalized.
Hospitals across New York City and surrounding areas reported increasing numbers of cases as administrators announced new restrictions on visitors, and workers warned about shortages in protective equipment. Mr. Cuomo announced plans to send hundreds of thousands of masks, gloves and gowns to health care facilities, and said the Jacob K. Javits Convention Center in Manhattan would be repurposed into four “emergency hospitals.”Hospitals across New York City and surrounding areas reported increasing numbers of cases as administrators announced new restrictions on visitors, and workers warned about shortages in protective equipment. Mr. Cuomo announced plans to send hundreds of thousands of masks, gloves and gowns to health care facilities, and said the Jacob K. Javits Convention Center in Manhattan would be repurposed into four “emergency hospitals.”
But he said that initial measures to control the spread of the virus were not working, especially in New York City, where people had been gathering in parks over the weekend and not staying far enough away from each other.But he said that initial measures to control the spread of the virus were not working, especially in New York City, where people had been gathering in parks over the weekend and not staying far enough away from each other.
He said he was still awaiting a plan from the city to prevent residents — especially young people — from getting too close, perhaps by imposing more controls on public spaces and opening some streets to pedestrians.He said he was still awaiting a plan from the city to prevent residents — especially young people — from getting too close, perhaps by imposing more controls on public spaces and opening some streets to pedestrians.
“I touch this table — the virus could live here for two days. You come tomorrow, I’m gone, you touch that spot,” Mr. Cuomo said. “In New York City, all that density, a lot of people are touching a lot of spots, right? Park bench, grocery counters. Just picture the city in daily life.”“I touch this table — the virus could live here for two days. You come tomorrow, I’m gone, you touch that spot,” Mr. Cuomo said. “In New York City, all that density, a lot of people are touching a lot of spots, right? Park bench, grocery counters. Just picture the city in daily life.”
Gov. Ron DeSantis of Florida said on Monday that he would sign an executive order directing the state’s surgeon general to require anyone flying to the state from New York or New Jersey to observe a mandatory 14-day quarantine.Gov. Ron DeSantis of Florida said on Monday that he would sign an executive order directing the state’s surgeon general to require anyone flying to the state from New York or New Jersey to observe a mandatory 14-day quarantine.
Many coronavirus cases in Florida, especially in counties that include Miami, Fort Lauderdale and West Palm Beach, have been tied to New York, and a recent uptick in travel from the region suggested New Yorkers were flying to Florida to flee restrictions.Many coronavirus cases in Florida, especially in counties that include Miami, Fort Lauderdale and West Palm Beach, have been tied to New York, and a recent uptick in travel from the region suggested New Yorkers were flying to Florida to flee restrictions.
Coronavirus appears to spread from person-to-person through droplets produced by coughing, sneezing and spitting, according to the initial research. It is mostly transmitted by people with symptoms of the virus, but asymptomatic transmission also appears possible.Coronavirus appears to spread from person-to-person through droplets produced by coughing, sneezing and spitting, according to the initial research. It is mostly transmitted by people with symptoms of the virus, but asymptomatic transmission also appears possible.
Updated June 16, 2020Updated June 16, 2020
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
It has spread throughout the world, including in cities and countries that are not very crowded.It has spread throughout the world, including in cities and countries that are not very crowded.
But researchers have noticed that New York City has a similar population and a somewhat similar density to that of Wuhan, the Chinese city where the virus originated.But researchers have noticed that New York City has a similar population and a somewhat similar density to that of Wuhan, the Chinese city where the virus originated.
No American city is like New York, a regional economic hub that is also a magnet for international commerce and tourism, drawing in 60 million visitors a year. Before the onset of the coronavirus ground the city to a halt, more than 3,000 planes were landing at its airports every day.No American city is like New York, a regional economic hub that is also a magnet for international commerce and tourism, drawing in 60 million visitors a year. Before the onset of the coronavirus ground the city to a halt, more than 3,000 planes were landing at its airports every day.
Drawing in travelers and commuters from neighboring states, the city holds about 10 million people at any given time.Drawing in travelers and commuters from neighboring states, the city holds about 10 million people at any given time.
Certainly, there may be other reasons aside from density that cities such as Los Angeles have such a lower rate of coronavirus cases compared with New York, researchers said.Certainly, there may be other reasons aside from density that cities such as Los Angeles have such a lower rate of coronavirus cases compared with New York, researchers said.
Los Angeles has taken longer to implement widespread testing, and it has partially shied away from testing, fearing that it would waste resources. Andrea Garcia, a spokeswoman for Mayor Eric Garcetti, said that there were four testing sites in the city, but the locations were only disclosed to those who qualified for the test.Los Angeles has taken longer to implement widespread testing, and it has partially shied away from testing, fearing that it would waste resources. Andrea Garcia, a spokeswoman for Mayor Eric Garcetti, said that there were four testing sites in the city, but the locations were only disclosed to those who qualified for the test.
On Monday, officials in Los Angeles County said they planned to significantly increase its testing soon.On Monday, officials in Los Angeles County said they planned to significantly increase its testing soon.
Another factor in the differing rates between New York and Los Angeles may be the warmer weather in Southern California, a climate that some early analysis suggests may slow the spread of the virus.Another factor in the differing rates between New York and Los Angeles may be the warmer weather in Southern California, a climate that some early analysis suggests may slow the spread of the virus.
Regions with average temperatures above 64.4 degrees Fahrenheit (or 18 degrees Celsius) account for fewer than 6 percent of global cases so far, according to researchers at the Massachusetts Institute of Technology.Regions with average temperatures above 64.4 degrees Fahrenheit (or 18 degrees Celsius) account for fewer than 6 percent of global cases so far, according to researchers at the Massachusetts Institute of Technology.
Other possible factors include better containment measures, or just the randomness of who happened to contract the virus first, and where they went.Other possible factors include better containment measures, or just the randomness of who happened to contract the virus first, and where they went.
Still, public health experts said that density was likely the biggest reason for why the virus has torn through New York City and not yet hit to the same degree elsewhere. They urged other cities and towns around the country to pay attention.Still, public health experts said that density was likely the biggest reason for why the virus has torn through New York City and not yet hit to the same degree elsewhere. They urged other cities and towns around the country to pay attention.
“New York City is often the first to get hit because of how dense it is, and how many international travelers come through,” said Thomas R. Frieden, the former director of the Centers for Disease Control and Prevention as well as the New York City health department. “The question now is whether the rest of the U.S. will learn from New York and avoid the situation that it is facing and is likely to get worse in the coming days and weeks.”“New York City is often the first to get hit because of how dense it is, and how many international travelers come through,” said Thomas R. Frieden, the former director of the Centers for Disease Control and Prevention as well as the New York City health department. “The question now is whether the rest of the U.S. will learn from New York and avoid the situation that it is facing and is likely to get worse in the coming days and weeks.”
Patricia Mazzei, Adam Popescu and Liam Stack contributed reporting. Susan Beachy contributed research.Patricia Mazzei, Adam Popescu and Liam Stack contributed reporting. Susan Beachy contributed research.