Upstate areas are seeing increasing pressure to reopen currently closed businesses as the economic damage from Covid-19 restrictions increases. With millions of New Yorkers unemployed and businesses facing the prospect of permanent closure, there is real need for relief. But reopening should take place in a way that does not lead to significant growth in Covid-19 cases that could overwhelm regional health care resources.
Covid-19 is highly transmissible, and can be spread by asymptomatic people. The disease’s aggressive transmission in communities led public officials to tell people to stay home and when away from home, to stay physically distant from others and wear face masks.
Because of likelihood of greater spread when people again begin to interact, Federal and State guidance has emphasized that reopening should not take place until cases are declining or at a sustained low level and hospital capacity is adequate to handle a surge of new cases. Governor Cuomo has put in place a set of requirements for business reopening that could allow regions to begin the process on May 15th.
As long as Covid-19 is in the community and most of the population does not have immunity, some social distancing regulations will continue to limit activities, in order to reduce the amount of disease spread. Businesses that are permitted to reopen would be required to adopt practices to limit disease spread. Businesses that involve high levels of risk of workplace or customer interaction would be the last to be permitted to reopen. For that reason, places where large groups of people congregate like bars and entertainment are likely to remain closed until a vaccine becomes widely available.
Although upstate New York has had a much lower level of community spread than downstate areas, not one of upstate’s large metropolitan areas meets all of the Federal and State requirements for reopening. Areas with low levels of cases have seen sharp upticks where unanticipated workplace exposure has led to disease hot-spots. An example is an outbreak at an agribusiness that produces hydroponic vegetables in Oneida, in Madison County. Testing found that 139 of 189 workers at Green Empire Farms had Covid-19.
In each metropolitan area, the amount of testing for Covid-19 is lower than is required by the state for reopening in most upstate metropolitan areas, although rates are improving.
(Note that all data is as of May 6th, and is from the New York State Department of Health.) Covid-19 cases in the Albany-Schenectady-Troy metropolitan area have shown a steep short-term decline since April 28th. The five day rolling average on May 6th (42 new cases) is also lower than it was 14 days ago on April 22nd (46). Testing in the metropolitan area reached a rate of 28.3 tests monthly per thousand residents on May 6th – slightly below the minimum required (30) by the Governor’s reopening plan.
New Covid-19 cases in the Buffalo-Niagara Falls area have shown a rather steady increase over time. On May 6th, the five day rolling average was 134, compared with 103 on April 22nd. Monthly testing is reaching 33.7 residents per thousand per month, which exceeds the reopening requirement.
New Covid-19 cases in the Rochester area increased from 35 on April 22nd, using the five day rolling data, to 44 on May 6th. Testing levels in the region (27.9 residents per thousand per month) are also below the state reopening requirement of 30.
Cases in the Syracuse area have risen sharply over the past two weeks, nearly tripling from 23 on April 22nd to 63 on May 6th. Some of the increase is related to the infection hot-spot in Oneida, Madison County. The Syracuse area testing rate was 27.3 per thousand per month as of May 6th.
New cases in the Utica-Rome area have shown a rather steady increase since March. New cases have nearly tripled since April 22nd, when the area had 11 new cases based on the five day average. On May 6th, 30 new cases were identified. Like Syracuse, some of the new cases may be associated with the infection hot-spot in Oneida, which borders Oneida County. The testing rate in Oneida County was 26.5 per thousand monthly as of May 6th.
Each of the upstate metropolitan areas in this group showed increases in new cases over the past two weeks, with the exception of Albany-Schenectady-Troy. Under Federal guidelines, these areas would not be permitted to begin the reopening process given the growth in new cases.
Reported new cases may be increasing, in part because more testing is being done. For that reason, this is an imperfect measure of community spread of infection.
Only Buffalo-Niagara Falls was doing enough testing to meet state requirements as of May 6th. Other metropolitan areas fell short, though the situation is improving, with each area doing more testing than in the past. These areas might reach testing requirements within a relatively short period of time.
The decision to relax current restrictions and allow reopening is a difficult one, because any action will certainly result in trade-offs between increased economic activity and jobs and increased infections and deaths from Covid-19. Overall, New York State is seeing fewer new infections and death, because conditions have improved downstate as a result of the restrictions imposed by the Governor. Relaxing the limits imposed is likely to stop the decrease in new cases and deaths. If reopening results in too much direct interaction, cases and deaths will increase. Given the increasing number of infections in upstate metropolitan areas, opening up businesses now would result in more infection and death, even with social distancing restrictions.
These risks are the factors that have driven Federal recommendations for reopening and continued social distancing, and the Governor’s requirements for New York State. While concerns about the damaging effect of the economy are certainly very real, they must be balanced against the damage to health and increased mortality that removing restrictions too soon would create.