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Positive COVID Tests and Hospitalizations More than Doubled In New York After September 1st

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The number of COVID-19 positive tests and hospitalizations in New York State has sharply increased since September 1st.  The number of daily positive tests identified on October 28th was 1,739, compared with 677 on September 1st – an increase of 157%.  Current hospitalizations increased from 457 to 1,042 during the same period – an increase of 128%.  Hospitalizations tend to lag case increases because most people are diagnosed several days before hospitalization if needed.

The increase in daily hospitalizations confirms the increase in positive tests as an indicator that the true COVID-19 infection rate in New York State is increasing.  The data is provided by the Covid Tracking Project and is computed using seven-day rolling averages to smooth random fluctuations.

New York’s increase at the state level reflects the national increase in COVID infections and hospitalizations.  New daily positive test results increased from a low of 34,210 in September to 74,096 on October 28th, based on the seven days rolling average – an increase of 117%. Daily hospitalizations increased from a low of 29,309 to 42,621 – an increase of 45%.

Hospitalizations increased more slowly at the national level than did daily positive test rates.  Although part of the increase in positive tests is likely to have been the result of the fact that 45% more tests were performed in late October than at the beginning of September,  the increase in hospitalizations shows that the number of cases in the nation is increasing in the nation, not just the number of positive tests.

Although New York has seen a sharp increase in the number of COVID infections, the State’s infection rate is still among the lowest in the nation.  Only Maine, Vermont, Hawaii, Alabama, and New Hampshire have lower rates.

New York’s COVID-19 Increase is Widespread

The increase is not confined to a few hotspots. In 85% of New York’s 61 counties, positive test rates increased.  The number of New Yorkers living in counties with infection rates of 10 per hundred thousand – the level at which New York has been requiring visitors from other states to quarantine – increased from 1,317,000 on October 10th to 4,093,000 on October 26th.

The largest concentration of counties with high infection levels was in the Southern Tier: Chemung – 65 per hundred thousand residents, Tioga with 45, Broome with 39, Cortland with 32, Schuyler with 19, Chenango with 17, Steuben, with 15 and Tompkins with 14.

The Hudson Valley was also hard hit – including Rockland County with 25 per hundred thousand residents, Westchester with 22, Ulster with 16,  Orange – 12, and Columbia – 10.

The recent spread of high concentrations of COVID cases shows how micro-level hot-spots can lead to larger regional outbreaks. In the Hudson Valley, the initial concentration of cases was limited to Rockland County, but 16 days later, almost all of the remaining counties in the region were seeing sharp increases in cases.  Similarly, in the Southern Tier, the State initially identified a small hot-spot in Broome County, and again, cases have grown rapidly in the sixteen-day period after October 10th.  The spread of cases suggests that the state’s recent micro-targeting approach of limiting tight controls on interactions to small geographic areas has been ineffective in controlling the spread of the virus.

Conclusions

Controlling the spread of the COVID-19 epidemic has proven to be a daunting task.  While national leadership in the United States has been weak, with muddled messaging, a laissez-faire attitude towards critical supply management, and an unwillingness to impose national standards for controlling potentially disease-spreading interactions, the United States is not alone in facing difficulties in controlling COVID.  As I write, European countries are re-instituting harsh limitations on business activities and personal interactions because of spikes in infection rates.   Though better leadership at the Federal level could reduce COVID’s impact, we face a sustained period of high levels of infection and mortality regardless of who is in charge in Washington, D. C after this Fall’s election.

Those who point to the introduction of effective vaccines as a solution to the threat posed by COVID must recognize that even under the best scenario, it will take many months to inoculate enough of the population to reduce infection levels to the point where social controls like the use of masks and physical distancing can be relaxed.  Leading public health experts believe that we are more than a year from that point.

Although New York’s COVID infection rates have been increasing of late, the State continues to be better off than most of the country.  The State has benefited from clear COVID policy articulation by the Governor and local leaders during the Spring spike and relatively long periods of limitations on business services that resulted in very low infection rates during the Summer.

But, as in other states and countries, it will be difficult to maintain the conditions that prevented the spread of the disease over the past several months.  Service businesses need to resume more normal activities to survive as going entities.  People find it more difficult to refrain from close social interactions with family and friends as the length of time that they cannot see them increases.  The advent of colder weather makes it impossible to dine and interact in other ways outdoors, where the potential for the spread of disease is lower.

The desire to allow businesses to return to normal operations and the unwillingness of some members of the public to submit to controls on personal activities makes the application of effective policies that will retard the spread of COVID difficult for political leaders.

Governor Cuomo’s decision to limit the imposition of strict controls on business activities to small areas of the state that saw increases in COVID cases in late September and early October may have resulted from the Governor’s desire to limit the economic damage that could result from the imposition of controls over a wider geographic area.  Unfortunately, the policy appears to have been ineffective in preventing the spread of the disease.

All of these factors point to the reality that we face greater challenges in controlling infection rates as we move towards the holiday season in November and December.  Governmental leaders will face difficult trade-offs in making decisions about policies to protect public health because of the negative impacts they could have on the livelihoods of many of the people who the policies would be intended to protect.

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