There is much that we do not know about the course of the Covid-19 pandemic. Because testing has been severely limited, and available only to health care workers and hospital patients in most cases, we don’t know the real extent of the virus in the community. Because the virus is new, and public health interventions are being applied to slow its spread, we don’t know the future timing of the epidemic or its eventual extent.
We do know that as I write this post, on April 3rd, in New York State the virus has infected far more people in New York City, on Long Island and in the lower Hudson Valley than in upstate communities. But, that should not lead us to conclude that the lower level of infection in upstate communities will continue – even with the social isolation measures that the Federal government has recommended, and the more severe limits imposed by the State.
In fact, the shape of the infection curves shows that infections continue to increase at a high rate, even though non-essential businesses have been required to shut down or have their employees work from home. Because the State’s stay at home rules have only been in place for eleven days, it is too early to know how effective the requirements will be in slowing the increase in the number of infected people in New York. But it is certain that the rules will be more effective if more people comply with them.
Extent of Coronavirus Infections
All data presented here is from the New York Times Coronavirus county database.
The chart above shows that the reported infection rate in New York City – 5.5 per thousand residents on April 1st is seven times higher than the rate in Albany County – 0.8 residents per thousand. Other metropolitan counties in upstate New York show lower rates, with Oneida County’s reported 0.2 residents per thousand being the lowest. The chart also shows that the gap between the rate of infection in New York City and the rest of the state has increased over time, reflecting the large number of infections in New York City. Note that some caution should be used in comparing levels and rates of infection in different counties, because the level of testing and reporting criteria and procedures may differ from county to county.
The high rate of infections in New York City and its suburbs has placed extreme stress on the metropolitan area’s hospitals. Because of the number of cases downstate, some hospitals are overloaded, threatening their ability to adequately protect their workers and to take care of patients. To date, though the number of cases upstate is of concern, hospitals in the regions have not been extremely stressed by the caseload of patients infected with Covid-19.
Growth of Infections
The chart above plots the reported infections for each day as a percentage of the number of infections in each county on April 1st. The charts that are more u or v shaped have a higher growth rate more recently, while those that are flatter have a grown more slowly recently. Here, we see a mixed picture – much of the growth in Covid-19 cases in Albany County appeared relatively early – Half of the cases in Albany County were identified by March 22th. In contrast, In Erie County, half the cases were identified by March 28th. Most upstate counties had growth in cases that started later and were more concentrated in the more recent period than New York City or Albany.
The growth of Covid-19 remains highly concentrated in the New York City metropolitan area, with more than 27,000 new cases in New York City over the seven days ending on April 1st. Upstate counties saw reported infection growth numbers that were much smaller – in most cases in the hundreds.
The rate of growth in Erie, Monroe and Onondaga is rapid, though from a much smaller base. So, for example, though the recent growth of cases in Erie County has been relatively great – the number more than tripled in a week, the absolute growth – 431 is but a small fraction of the growth in New York City. In terms of the growth rate, these upstate counties are where New York City was several weeks ago. But, because they have much smaller populations than New York City, they will never have more than a small percentage of the cases in New York City. Still, because the rate of growth in places like Erie County, Monroe County and Onondaga County is high, residents of upstate areas will be at greater risk as the number of cases continues to climb.
Whether the cases continue to grow at a high rate depends on whether there are high levels of compliance with the limits imposed by the state to slow the rate of growth of infection. If not, upstate areas might see rates of infection grow closer to those in the New York metropolitan, and their hospitals might face stresses like those downstate.