NY hit its COVID-19 apex, but the virus isn't going away

On Saturday, Gov. Andrew Cuomo announced that New York has reached the apex of COVID-19 hospitalizations, as new hospitalization numbers continue to decrease, but that doesn’t mean the state’s lockdown will soon be over. Without proper widespread testing with fast results and comprehensive contact tracing for the infected, or a vaccine, the state will continue to have outbreaks. And it’s unlikely that the virus will ever be completely eradicated, according to public health experts. 

There are only four ways the state can really suppress the virus, Sherry Glied, the dean of New York University’s Robert F. Wagner Graduate School of Public Service, told City & State. The first option is herd immunity, when a high percentage of the population develops an immunity to a virus. This can happen if an individual contracts a virus and recovers from it or if they receive a vaccine for the virus. Experts have estimated that 40% to 70% of the general population would need to become immune to COVID-19 to reduce its spread. The second is developing a vaccine. The third is developing a dramatically more effective treatment for the virus, such as antiviral drugs that can eradicate the virus quickly, similar to drugs used to treat the flu. Other options include immune system boosting therapies or developing an effective drug cocktail with existing medication to tackle the virus. While researchers are busy trying to figure out what will extinguish the virus, it’s likely that many will become infected with the disease as they assess what treatments work. 

The fourth option is rapidly deployed widespread testing. Of all those options, Glied believes that the most realistic and effective option for New York to pursue is testing. If you can “test quickly and accurately,” then you can begin allowing some restrictions to lift, according to Glied. But she warns that once another outbreak occurs then the state would need to return to being on lockdown. 

On Friday, Gov. Andrew Cuomo said that without large-scale testing lockdown measures cannot be lifted. “Even with our high capacity and high performance on testing, it's still not enough,” Cuomo said during his daily briefing on Friday. “It's not enough if you want to reopen on a meaningful scale and reopen quickly.”

South Korea is currently able to contain COVID-19 with a national program to test anyone who might have contracted it, including everyone seen in recent days by anyone who has tested positive.

Any hope of ever getting close to completely eradicating the virus relies on better medical treatment and a vaccine, without which the state will not be able to return to normal. “Once you get things under control, with a lot of targeted surveillance, there are ways of locally relaxing restrictions and returning to some level of activity,” Aris Katzourakis, a professor of evolution and genomics at the University of Oxford, told Time. Targeted surveillance means that individuals can be surveilled by the government by hacking into their phone’s data or using facial recognition technology to track their movement. This would be necessary to trace contacts of anyone who tests positive. “It will never be the same, until there is a cure or a vaccine. ‘Returning to normal’ simply isn’t something we should expect to see for a very, very long time.”

While a vaccine probably won’t be available for another year or so, efforts are being made across the globe to find more effective medical treatments for COVID-19. “One of the perversely positive things about this being a global pandemic is that there are scads of researchers everywhere around the world,” Glied said. “And scads of patients everywhere who are willing to try new drugs because there isn't anything (available now). Perhaps toward the summer we will start to see some more effective treatments that could change things some.” 

Even if the virus does appear to have been successfully suppressed, it’s very probable that we’ll see its return this fall and it will be even more disastrous, according to The Atlantic. This is exactly what happenedduring the influenza pandemic in 1918. It was presumed that the virus had been stamped out in the spring before it wreaked even more havoc upon its return in the winter and in the spring of 1919. 

And if the virus resurfaces, lockdown restrictions will once again need to go into effect. Stephen Kissler, a research fellow at Harvard University, told The Atlantic that “we need to be prepared to do multiple periods of social distancing.” 

It’s doubtful that the virus will ever be eliminated, as people continue to travel throughout the country, according to Glied. “We don't think we can actually eliminate the virus in the United States, because there's just too many people moving all over the place within the country,” she said. “We certainly cannot eliminate the virus in New York City, as long as there are people moving around the country.”

Aside from frequent lockdowns, mental health issues may become a more prominent issue in the future, due to social distancing and other lockdown measures. “The one thing that I think about are people who suffer from mental health conditions: people who suffer from depression and anxiety disorders and other kinds of mental health conditions.” Dustin Duncan, an associate professor of epidemiology at Columbia University, told City & State. “How do you know if social distancing really impacts them? I would say it probably impacts them to a large degree.”

One outcome of this public health crisis, however, might be that people will start to realize the importance of public health. After 9/11, anti-terrorism became a major priority in New York, as well as nationally, so it’s possible that the COVID-19 pandemic could result in prioritization of public health. Duncan also hopes that this crisis will make medical research more of a priority moving forward. “I think research is an incredible system that allows us to answer questions that improve society,” Duncan told City & State. “And I think that through research, we could determine who's at risk and understand the many different aspects of the coronavirus and (other) diseases more broadly.”