Recent reports show that President Trump would like to reopen the national economy within a few weeks. The Washington Post reported that “President Trump — concerned with the sagging economy — has sought a strategy for resuming business activity by May 1.” More recently, the President said that he expected some states to reopen before May 1st.
Will New York be ready to restart normal business activity soon? The data shows that while the worst may be over, as Governor Cuomo said recently, large numbers of new cases continued to be identified throughout the state. The continuing level of new infections shows that the state is not yet ready to relax current restrictions.
As in the past, the number of new Coronavirus cases remains highly concentrated in the New York City Metropolitan area. Both Nassau-Suffolk and the Lower Hudson region had small declines in the number of new cases in the most recent seven day period compared with the prior period. New York City had about seven thousand more identified new cases in the past seven days than in the prior period. The downstate area had 64,000 new cases during the seven days ending on April 13th.
In upstate New York, the Albany-Schenectady-Troy metropolitan area and the Utica-Rome area had more cases in the most recent seven day period than in the prior period. The Syracuse, Rochester and Buffalo-Niagara Falls areas had fewer identified new cases in the most recent period than in the earlier period. Together, these metropolitan areas had more than 1,400 new cases during the most recent seven days. It should be recognized that changes in the number of reported cases is likely to have been affected in changes in testing availability. In the Albany-Schenectady-Troy area, testing was made available to certain non-hospital patients at mobile sites for the first time.
In the downstate area, almost 190,000 cases had been identified as of April 13th. Upstate totals were far smaller, but Albany-Schenectady-Troy and Buffalo had about 1,000 cases or more. Rochester had nearly 1,000 cases. Syracuse had nearly 700. Utica-Rome had about 250.
While the rate of infection has slowed statewide and decreased over the past week in some metropolitan areas, it is likely that the decline in cases will be more prolonged than the increase that took place over the past month. Several sources of infection continue to exist. Essential workers can be exposed to possible infection from contacts with other workers. Individuals who are staying at home may be exposed to the virus from shopping trips for groceries, gasoline or prescriptions, or from contacts with delivery people. Because asymptomatic people can infect others, people can become infected from those who they live with. And, a few people will not comply with the State’s requirements, and will infect others. These factors will slow the decline in cases caused by the Governor’s work at home order. New Coronavirus cases in New York’s metropolitan areas are likely to continue to develop through May 1st and afterward.
Challenges to Implementing a Successful Reopening Strategy
While the prevalence of cases is important, so is the need for a strategy that can be implemented successfully. The strategy must at its core be based on public safety calculations. Because few people in the population have acquired immunity to the virus, strategies must be developed to minimize potential exposure and possible disease spread. Factors to be considered include:
- The number of people who are infected, the rate of infection and whether infections are increasing or decreasing.
- The availability of materials needed to test workers and to care for those who are ill such as tests, personal protective equipment, etc.
- The organizational capacity of institutions that would implement required procedures.
More specific issues involve:
- Implementation of mitigation requirements for masks, gloves, temperature readings, employee and customer spacing, etc. Who is responsible, and how enforced?
- The creation and implementation of testing protocols for workers and the general public. How much testing? Who gets tested? Who does testing? Who pays?
- Establishment of contact tracing for those who have been infected and those who have been exposes. Who is responsible? How is tracing accomplished?
- The number of direct interactions that employees of companies are likely to have with others. Which businesses are permitted to open and when? How are they to be monitored? Who is responsible for monitoring compliance?
- The potential for spread in different environments – including workplaces, dining, entertainment and recreational venues and at commercial establishments. How are types of establishments to be prioritized? What kinds of monitoring and feedback mechanisms should be established?
Developing strategies on paper is not enough, because they are of no value if not implemented well. But, to do so, organizational resources must be identified and mobilized. And, needed supplies – like testing media and personal protective equipment must be acquired and made available at the needed scale. Given the scope of the pandemic, these will be formidable challenges, and will take time to implement. With weak Federal leadership, the challenges will be even greater.
Because reopening will expose more people to infection from Coronavirus, any strategy carries the likelihood that new infection hot spots may develop. In fact, the CDC expects the disease to rebound in some places after social distancing requirements are relaxed. Effective feedback mechanisms – disease tracking, testing and contact tracing must be in place to prevent a resurgence that could overwhelm health care facilities.
Governor Cuomo, along with Governor Newsom of California have begun to describe in public phased reopening strategies that consider these factors. The Federal Emergency Management Agency and the Center for Disease Control have developed a draft strategy that was leaked to the Washington Post, though it has not yet been accepted by the White House. Each of these strategies creates a phased approach that gradually reopens the economy, with safeguards to reduce the likelihood of a full blown recurrence of infections.
All of this points to the reality that as Governor Cuomo has stated, reopening New York for business will be an incremental process, one which cannot begin as soon as we would like. The risks of relaxing current social distancing requirements too soon, before government can structure and implement appropriate public health mechanisms to control the incidence of new infections are simply too great to justify reopening quickly on a wide basis.