Chaos, Arrogance, and Missed Opportunities in New York's Early Response
https://www.nytimes.com/2020/04/08/...tion=click&module=Top Stories&pgtype=Homepage
A 39-year-old woman took Flight 701 from Doha, Qatar, to John F. Kennedy International Airport in late February, the final leg of her trip home to New York City from Iran.
A week later, on March 1, she tested positive for the coronavirus, the first confirmed case in New York City of an outbreak that had already devastated China and parts of Europe. The next day, Gov. Andrew M. Cuomo, appearing with Mayor Bill de Blasio at a news conference, promised that health investigators would track down every person on the woman’s flight. But no one did.
A day later, a lawyer from New Rochelle, a New York City suburb, tested positive for the virus — an alarming sign because he had not traveled to any affected country, suggesting community spread was already taking place.
Although city investigators had traced the lawyer’s whereabouts and connections to the most crowded corridors of Manhattan, the state’s efforts focused on the suburb, not the city, and Mr. de Blasio urged the public not to worry. “We’ll tell you the second we think you should change your behavior,” the mayor said on March 5.
“Flu was coming down, and then you saw this new ominous spike. And it was Covid. And it was spreading widely in New York City before anyone knew it,” said Dr. Thomas R. Frieden, the former head of the Centers for Disease Control and Prevention and former commissioner of the city’s Health Department. “You have to move really fast. Hours and days. Not weeks. Once it gets a head of steam, there is no way to stop it.”
Dr. Frieden said that if the state and city had adopted widespread social-distancing measures a week or two earlier, including closing schools, stores and restaurants, then the estimated death toll from the outbreak might have been reduced by 50 to 80 percent.
“New York City as a whole was late in social measures,” said Isaac B. Weisfuse, a former New York City deputy health commissioner. “Any after-action review of the pandemic in New York City will focus on that issue. It has become the major issue in the transmission of the virus.”
Mr. Cuomo has been praised for his informative daily news conferences, where he not only focuses on the facts of the pandemic but also seeks to rally the public’s support for efforts to curb the spread. Mr. de Blasio has also made outreach a priority.
Still, Mr. Cuomo has at times acknowledged the difficulties in fighting the outbreak.
“I am tired of being behind this virus,” he said on March 31. “We’ve been playing catch-up. You don’t win playing catch-up.”
Bruce Farber, the chief of infectious diseases for two hospitals within Northwell Health, the largest hospital system in New York, said that by late January, it was apparent that cases would soon begin appearing in the United States. He said he and his colleagues realized, as they reviewed the strictly limited federal testing criteria during a Feb. 7 meeting, that many infected people would not be identified.
Only those with a fever severe enough to require hospitalization and who had traveled to China in the previous 14 days could get tested, Dr. Farber told them, reading from the C.D.C. guidelines.
“It was that moment that I think everybody in the room realized, we’re dead,” Dr. Farber said.
New York City, at the start of the outbreak, relied on 50 disease detectives to trace the rapidly rising cases of unconnected infected people, city officials said.
By comparison, in Wuhan, China, where the pandemic began, more than 9,000 such workers were deployed. New York City added to its original 50 only after the outbreak began to accelerate.
Because of the limits on testing, said the mayor’s press secretary, Freddi Goldstein, “all the detectives in the world would have been useless.”
While only about 100 cases of the coronavirus had been confirmed in the whole state, the city’s surveillance system was, by the end of the first week in March, signaling a spike in influenza-like illnesses at emergency rooms. A few days later, the number of police officers calling out sick jumped noticeably, as did calls to 911 for fever and cough.
“This is an enemy that we have underestimated from Day 1,” Mr. Cuomo said on Monday. “And we have paid the price dearly.”