This article is from the source 'nytimes' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at https://www.nytimes.com/2020/04/10/nyregion/new-york-coronavirus-death-count.html

The article has changed 22 times. There is an RSS feed of changes available.

Version 10 Version 11
How Many People Have Actually Died From Coronavirus in New York? How Many People Have Actually Died From Coronavirus in New York?
(32 minutes later)
In the first five days of April, 1,125 people were pronounced dead in their homes or on the street in New York City, more than eight times the deaths recorded during the same period in 2019, according to the Fire Department.In the first five days of April, 1,125 people were pronounced dead in their homes or on the street in New York City, more than eight times the deaths recorded during the same period in 2019, according to the Fire Department.
Many of these deaths were probably caused by Covid-19, but were not accounted for in the coronavirus tallies given by Gov. Andrew M. Cuomo during his widely watched daily news conferences — statistics that are viewed as key measures of the impact of the outbreak.Many of these deaths were probably caused by Covid-19, but were not accounted for in the coronavirus tallies given by Gov. Andrew M. Cuomo during his widely watched daily news conferences — statistics that are viewed as key measures of the impact of the outbreak.
On Thursday, Mr. Cuomo said 799 people in New York had died from coronavirus in a single 24-hour period — more than 33 an hour — bringing the state’s total to 7,067.On Thursday, Mr. Cuomo said 799 people in New York had died from coronavirus in a single 24-hour period — more than 33 an hour — bringing the state’s total to 7,067.
But epidemiologists, city officials and medical personnel say those numbers are likely to be far below the city’s actual death toll.But epidemiologists, city officials and medical personnel say those numbers are likely to be far below the city’s actual death toll.
The data on deaths of people in their homes or on the street shows that the state’s statistics don’t tell the whole story. Here’s what we know:The data on deaths of people in their homes or on the street shows that the state’s statistics don’t tell the whole story. Here’s what we know:
Mr. Cuomo said on Wednesday that the official death count numbers presented each day by the state are based on hospital data. Our most conservative understanding right now is that patients who have tested positive for the virus and die in hospitals are reflected in the state’s official death count.Mr. Cuomo said on Wednesday that the official death count numbers presented each day by the state are based on hospital data. Our most conservative understanding right now is that patients who have tested positive for the virus and die in hospitals are reflected in the state’s official death count.
The city has a different measure: Any patient who has had a positive coronavirus test and then later dies — whether at home or in a hospital — is being counted as a coronavirus death, said Dr. Oxiris Barbot, the commissioner of the city’s Department of Health.The city has a different measure: Any patient who has had a positive coronavirus test and then later dies — whether at home or in a hospital — is being counted as a coronavirus death, said Dr. Oxiris Barbot, the commissioner of the city’s Department of Health.
“To date, we have only been recording on people who have had the test,” she said on Thursday morning.“To date, we have only been recording on people who have had the test,” she said on Thursday morning.
A staggering number of people are dying at home with presumed cases of coronavirus, and it does not appear that the state has a clear mechanism for factoring those victims into official death tallies.A staggering number of people are dying at home with presumed cases of coronavirus, and it does not appear that the state has a clear mechanism for factoring those victims into official death tallies.
In the last three days, 766 people were found dead in their homes, bringing the total for the first eight days of April to 1,891, according to the city’s medical examiner’s office. It’s likely that many have not been counted in the current tally.In the last three days, 766 people were found dead in their homes, bringing the total for the first eight days of April to 1,891, according to the city’s medical examiner’s office. It’s likely that many have not been counted in the current tally.
Paramedics are not performing coronavirus tests on those they pronounce dead. Recent Fire Department policy says that death determinations on emergency calls should be made on scene rather than having paramedics take patients to nearby hospitals, where, in theory, health care workers could conduct post-mortem testing.Paramedics are not performing coronavirus tests on those they pronounce dead. Recent Fire Department policy says that death determinations on emergency calls should be made on scene rather than having paramedics take patients to nearby hospitals, where, in theory, health care workers could conduct post-mortem testing.
It is almost impossible to say how many of those 1,125 patients who died at home or in street in the first five days of April had coronavirus — some may have been previously tested before their death and either were never admitted to a hospital or had been sent home.It is almost impossible to say how many of those 1,125 patients who died at home or in street in the first five days of April had coronavirus — some may have been previously tested before their death and either were never admitted to a hospital or had been sent home.
But the discrepancy between the Fire Department numbers from this year, at the height of the epidemic, compared with those of last year suggests that many of those who died probably were infected.But the discrepancy between the Fire Department numbers from this year, at the height of the epidemic, compared with those of last year suggests that many of those who died probably were infected.
“The driver of this huge uptick in deaths at home is Covid-19. And some people are dying directly of it, and some people are dying indirectly of it, but it is the tragic ‘X’ factor here,” said Mayor Bill de Blasio on Thursday.“The driver of this huge uptick in deaths at home is Covid-19. And some people are dying directly of it, and some people are dying indirectly of it, but it is the tragic ‘X’ factor here,” said Mayor Bill de Blasio on Thursday.
Some of the deaths of people at home or in the street were unrelated to the virus.Some of the deaths of people at home or in the street were unrelated to the virus.
We also don’t really know how each of the city’s dozens of hospitals and medical facilities are counting their dead. For example, if a patient who is presumed to have coronavirus is admitted to the hospital, but dies there before they can be tested, it is unclear how they might factor into the formal death tally.We also don’t really know how each of the city’s dozens of hospitals and medical facilities are counting their dead. For example, if a patient who is presumed to have coronavirus is admitted to the hospital, but dies there before they can be tested, it is unclear how they might factor into the formal death tally.
There aren’t really any mechanisms in place for having an immediate, efficient method to calculate the death toll during a pandemic. Normal procedures are usually abandoned quickly in such a crisis.There aren’t really any mechanisms in place for having an immediate, efficient method to calculate the death toll during a pandemic. Normal procedures are usually abandoned quickly in such a crisis.
For example, when someone died at home six months ago, a fairly straightforward process began: Paramedics, if they were called, would pronounce the person dead on scene or transport them to the hospital, where doctors would pronounce them dead, certify the death and issue a cause.For example, when someone died at home six months ago, a fairly straightforward process began: Paramedics, if they were called, would pronounce the person dead on scene or transport them to the hospital, where doctors would pronounce them dead, certify the death and issue a cause.
The body would be taken to a funeral home or to a morgue — if an autopsy was merited. The death would be certified by an attending doctor or by the city medical examiner’s office.The body would be taken to a funeral home or to a morgue — if an autopsy was merited. The death would be certified by an attending doctor or by the city medical examiner’s office.
Or, if someone died at a hospital, a doctor would certify the death and the body would be taken by a mortuary service or to the morgue. Family doctors, too, could certify the death.Or, if someone died at a hospital, a doctor would certify the death and the body would be taken by a mortuary service or to the morgue. Family doctors, too, could certify the death.
During the coronavirus pandemic, these procedures are inconsistent at best. Doctors are struggling to certify deaths quickly enough. The medical examiner’s office, which would normally only be involved if a death was suspicious or required further study, is now in charge of picking up and storing bodies until the pandemic abates.During the coronavirus pandemic, these procedures are inconsistent at best. Doctors are struggling to certify deaths quickly enough. The medical examiner’s office, which would normally only be involved if a death was suspicious or required further study, is now in charge of picking up and storing bodies until the pandemic abates.
Paramedics are not transporting unresponsive patients to hospitals unless they immediately find a pulse. Bodies are piling up in hospital morgues and freezer trucks lined with makeshift shelves because the institutions are overloaded with the dead and dying. Few, if any, of these facilities are doing post-mortem testing.Paramedics are not transporting unresponsive patients to hospitals unless they immediately find a pulse. Bodies are piling up in hospital morgues and freezer trucks lined with makeshift shelves because the institutions are overloaded with the dead and dying. Few, if any, of these facilities are doing post-mortem testing.
Updated June 30, 2020
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.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
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.
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.
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.
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 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.
“We are doing everything we can to expand the city’s morgue capacity, and help people collect the bodies of their loved ones in a timely manner,” said Aja Worthy-Davis, a spokeswoman for the city’s medical examiner’s office.“We are doing everything we can to expand the city’s morgue capacity, and help people collect the bodies of their loved ones in a timely manner,” said Aja Worthy-Davis, a spokeswoman for the city’s medical examiner’s office.
Both that office and the Department of Health, she said, “are working together to better understand how to appropriately include non-healthcare facility, natural-cause deaths into the citywide fatality count.”Both that office and the Department of Health, she said, “are working together to better understand how to appropriately include non-healthcare facility, natural-cause deaths into the citywide fatality count.”
About 120 morgue workers and soldiers from the U.S. Army, the National Guard and the Air National Guard are working in shifts around the clock, driving rented vans around the city to pick up the bodies of as many as 280 people a day who have died at home and have probably not been part of the official death count.About 120 morgue workers and soldiers from the U.S. Army, the National Guard and the Air National Guard are working in shifts around the clock, driving rented vans around the city to pick up the bodies of as many as 280 people a day who have died at home and have probably not been part of the official death count.
Fifteen four-person teams overseen by Office of the Chief Medical Examiner perform the grim work during each 12-hour shift, a task normally handled by 14 workers, according to Ms. Worthy-Davis.Fifteen four-person teams overseen by Office of the Chief Medical Examiner perform the grim work during each 12-hour shift, a task normally handled by 14 workers, according to Ms. Worthy-Davis.
Counting the dead after most disasters — a plane crash, a hurricane, a gas explosion, a terror attack or a mass shooting, for example — is not complex.Counting the dead after most disasters — a plane crash, a hurricane, a gas explosion, a terror attack or a mass shooting, for example — is not complex.
A virus raises a whole host of more complicated issues, according to Michael A.L. Balboni, who about a decade ago served as the head of the state’s public safety office, and now heads an association of for-profit nursing homes in the New York City area and a crisis management consulting company.A virus raises a whole host of more complicated issues, according to Michael A.L. Balboni, who about a decade ago served as the head of the state’s public safety office, and now heads an association of for-profit nursing homes in the New York City area and a crisis management consulting company.
“A virus presents a unique set of circumstances for a cause of death, especially if the target is the elderly, because of the presence of comorbidities,” he said — multiple conditions. For example, a person with Covid-19 may end up dying of a heart attack.“A virus presents a unique set of circumstances for a cause of death, especially if the target is the elderly, because of the presence of comorbidities,” he said — multiple conditions. For example, a person with Covid-19 may end up dying of a heart attack.
“As the number of decedents increase,” Mr. Balboni said, “so does the inaccuracy of determining a cause of death.”“As the number of decedents increase,” Mr. Balboni said, “so does the inaccuracy of determining a cause of death.”
Dr. Barbot said the city is intent on doing everything possible to get an accurate death count.Dr. Barbot said the city is intent on doing everything possible to get an accurate death count.
“I think that as a city, it is part of the healing process to be able to grieve and mourn for all of those that have passed because of Covid-19,” she said.“I think that as a city, it is part of the healing process to be able to grieve and mourn for all of those that have passed because of Covid-19,” she said.
But it’s unclear how the city the medical examiner’s office will meet that goal.But it’s unclear how the city the medical examiner’s office will meet that goal.
It is almost impossible to grasp the full scale of a highly contagious pandemic like Covid-19 in real time, said Dr. Howard Markel, a professor of medical history at the University of Michigan who has researched past epidemiological events in New York City.It is almost impossible to grasp the full scale of a highly contagious pandemic like Covid-19 in real time, said Dr. Howard Markel, a professor of medical history at the University of Michigan who has researched past epidemiological events in New York City.
“You have an idea of what numbers are, but you don’t have an exact source,” he said. It takes extensive, retroactive research, testing and academic study to even estimate the toll of a biological crisis like Covid-19, he said.“You have an idea of what numbers are, but you don’t have an exact source,” he said. It takes extensive, retroactive research, testing and academic study to even estimate the toll of a biological crisis like Covid-19, he said.
But, Dr. Markel said, debates over official death counts are arguably unimportant in the midst of the city’s crisis.But, Dr. Markel said, debates over official death counts are arguably unimportant in the midst of the city’s crisis.
“Even if we’re underestimating deaths and cases, particularly in the New York situation, there are enough of both to tell us this is very serious,” he said. “It’s already all hands on deck, and I think that’s appropriate.”“Even if we’re underestimating deaths and cases, particularly in the New York situation, there are enough of both to tell us this is very serious,” he said. “It’s already all hands on deck, and I think that’s appropriate.”
Alan Feuer contributed reporting.Alan Feuer contributed reporting.