New York City officials know Covid-19 cases will climb this fall. The question they are watching as the city moves to reopen is, just how much?
For months, the city’s Department of Health and Mental Hygiene has been working with academic groups at Columbia University and New York University. The academic teams have been asked to model case numbers, help predict needed hospital resources and to advise the city on how to open up workplaces, schools, restaurants and more.
The disclosure Tuesday of a Covid-19 case at the New York offices of JPMorgan Chase & Co. is likely just the latest example of what will happen as businesses push to get workers back to the office, and people begin going back to school and returning to restaurants and gyms.
In interviews, experts from two academic groups working with New York described what’s likely to be a significant increase in cases this fall, but with the opportunity to stop the worst with careful public-health measures like masks and social distancing.
“If you do these types of phased reopenings, there are going to be certain increases in transmission activity,” Columbia University’s Jeff Shaman, who is part of a team working with the city to predict the path of the outbreak. “Every model will tell you you’re going to see increases in cases.”
The city is likewise planning for a resurgence, according to a top adviser to the mayor, while trying to restore as much normal business as possible.
“Even independent of having any mathematical backing for this, we have been planning around the assumption that there will be resurgences of this infection,” said Jay Varma, senior advisor for public health in the New York City Mayor’s Office.
That likely means continued social distancing practices, mask-wearing and limited capacity, said Scott Braithwaite, a professor at NYU’s Grossman School of Medicine who has led the other academic effort advising the city.
“Forget about normalcy,” Braithwaite said in a telephone interview. “If things were back to normal, quote unquote, and we weren’t social distancing we weren’t wearing masks, a hundred people coming in one day could restart a disastrous wave.”
The infection at JPMorgan’s 383 Madison Ave. building came a week after workers began returning following the Labor Day holiday, and shortly before a deadline for senior traders to come back to their desks. The bank, which has been among the most aggressive in pulling people back to the office, has now sent some Manhattan workers home, Bloomberg reported Tuesday. The decision was an echo of steps taken by workplaces around the city when cases first started expanding in the spring.
While JPMorgan has moved ahead, Americans have expressed caution about reopening too quickly. A September Kaiser Family Foundation poll found that an even number of Americans thought the worst of the outbreak was yet to come, versus already behind them. The poll split along party lines, with Democrats being more pessimistic.
Chasing the Outbreak
The groups at Columbia and NYU began working with the city at the start of the outbreak. In weekly meetings, they’ve helped project how many hospital beds would be needed, how many cases were likely happening despite limited testing, and what the coming weeks would hold.
The Columbia team has been led by Wan Yang, an epidemiology professor, and Shaman, the director of the climate and health program at the university’s Mailman School of Public Health.
The work was confidential at first, Shaman said, but the researchers pushed the city to allow them to discuss it publicly. “People have a right to see this,” Shaman said.
One of the Columbia models, released in June as the city was beginning to reopen, predicted tens of thousands of additional hospitalizations by the end of the year, though the estimates vary widely based on how quickly services were opened and how effective public-health measures are.
“It’s inherently crude. We just don’t know the nuance of what’s going to happen,” Shaman said. “You open up more, you’re getting it worse.”
Varma said the models have been useful in decision-making, but aren’t to be taken as hard estimates.
“Infectious-disease models are not really designed to predict the future,” Varma said. “What they’re designed to do is to give you information to help you change the future.”
New York City is currently reporting around two hundred new cases a day, according to the Department of Health and Mental Hygiene. That’s likely only a portion of the actual infections, though the number has been coming steadily down since a peak of more than 5,000 cases a day in April.
The city is also testing in schools. As of Monday, the city had found 55 positive Covid-19 cases out of 17,000 school teachers and staff who had been tested, for a positivity rate of 0.32%, Mayor Bill de Blasio said during a Monday news briefing.
The city has been weighing how to get people back to their regular lives, while also limiting new cases, Varma said. Across the border in New Jersey, the state this month reported a rise in cases as it has reopened indoor dining, theaters and prepared to bring children back to school.
“To be honest, the models that we’re looking at are not necessarily other parts of the United States,” he said. “They are places like South Korea, Singapore and Hong Kong, other large, dynamic, multicultural, international cities of global importance that have shown tremendous success and in beating down this disease.”
Social-distancing measures play a crucial role, said Braithwaite. Early on in the outbreak, his group built models under two scenarios, one in which people followed public health guidelines and social distancing measures, and one in which they didn’t.
“Under that scenario, we were having hundreds of thousands of deaths in New York City. And under the scenario where people did pay attention to social distancing, you were having tens of thousands of deaths,” he said.
So far, there have been 27,750 confirmed and probable Covid-19 deaths in New York City, according to the health department.
“It seems like it’s going to be tens of thousands, which is a big enough problem, but it’s one-tenth of what it would have been otherwise,” Braithwaite said. “In the modeling world, we’re very aware of what could have happened: as bad as things were, that things could have been ten times worse.”
Shaman is more pessimistic.
“We are presenting data to them that are suggesting this is problematic,” he said, though he noted the city was engaged in a very difficult balancing act between controlling cases, and reopening schools and preventing businesses from going bankrupt.
Reopening is good for the city, but it’s also good for the virus, Shaman said: “There’s a huge potential for growth, even in a place like New York City, because 75% to 85% of the population has yet to be infected.”
— With assistance by Henry Goldman