New York’s plan to reopen

New York’s “Pause” order, which forced non-essential businesses to close their offices and storefronts, is scheduled to end on May 15. Gov. Andrew Cuomo has been discussing his 12-step plan to gradually reopen the state soon after the order lifts.

But is the state ready to reopen at all? Probably not.

On Monday, Cuomo said that the executive order may need to be extended further for other parts of the state with higher COVID-19 infection rates. "We have to learn the lessons, we have to move forward and we have to be smart because if you are not smart, you will see that infection rate go right back to where it was," Cuomo said during a press conference. "We will be right back to where we were 58 days ago, and nobody wants to do that."

Companies will only be able to reopen in regions of the state where hospitalizations and death rates have been in decline for at least two weeks, per the Center of Disease Control’s guidelines. The state will then assess the results of the region’s reopening before allowing other regions to reopen. On Thursday, the governor also discussed the possibility of lifting some social distancing measurements after May 15, in some upstate regions, with New York City following suit a few weeks later.

Many residents of upstate New York have been aggressively pushing for the state to begin returning back to normal, as upstate has seen considerably fewer infections per capita and has been far less affected than downstate. Despite that eagerness, there’s a lot that needs to happen before the state can safely begin to reopen. 

New York is seeing a considerable decline in coronavirus hospitalizations and has made it past the virus’ peak, but it still needs to ramp up its testing abilities, hire contact tracers and figure out a better way to isolate infected individuals. If it pushes ahead and reopens too soon, the state could potentially face a far worse resurgence of the infectious disease in the coming months, according to public health experts. 

While the state has made considerable progress gathering more of the supplies it needs to combat the virus, such as masks and tests, it still needs more. Since New York’s outbreak began, state officials have been calling upon the federal government and President Donald Trump to provide it with the funding it needs to purchase and manufacture the supplies it needs. Last week, Trump agreed to help the state obtain the supplies it needs to increase its testing capacity but even the agreed-upon goal of 40,000 tests per day is far below expert estimates of how many tests would be needed to safely reopen.

The federal government’s latest COVID-19 stimulus bill contains $25 billion for states nationwide to obtain tests, but some say that is not close to enough funding. And on Tuesday, Trump threatened to withhold future funding from all states with sanctuary cities, unless they agree to comply with federal immigration policies and hand residents over to ICE, making the state’s ability to expect much needed funds more precarious. “Testing won’t work if it’s impossible to get. Testing won’t work if it’s too hard to get,” Cuomo said on Tuesday.

The state’s ability to ramp up its testing capabilities will dictate its ability to implement an effective contact tracing program that would identify, track and isolate COVID-19 cases. Singapore, Taiwan, South Korea and New Zealand have all used widespread testing and comprehensive contact tracing to contain their COVID-19 outbreaks. As a result, they all have seen fewer deaths per capita than the U.S. 

Last week, New York announced that it was in the beginning stages of creating a test and trace program with the help of former New York City Mayor Michael Bloomberg, who will be manning the project. On Thursday, Cuomo said that the state would need anywhere between 6,400 and 17,000 contact tracers. That same day, New York City Mayor Bill de Blasio also announced that the city will be hiring 1,000 contact tracers immediately, but that’s still far below the number needed. And hiring contact tracers will no doubt be a more arduous task than state officials realize. Currently, there are fewer than 2,000 professionally trained contact tracers in the country and it typically takes about a year to train tracers. However, states across the country are working to expedite training to set up expansive contact tracing programs.

Another problem facing the state is its lack of designated quarantine and isolation centers in which to place sick individuals or those who have been exposed to the virus. On Tuesday, Cuomo said that creating isolation centers is a part of its plan to reopen. China did this in February, as its number of coronavirus cases began to climb, creating 20 quarantine centers where it sent its sick to recuperate to prevent further spreading the virus. This significantly helped curtail the virus’ spread and prevented individuals from infecting whomever they may have been living with.

Even if the state does manage to suppress the virus through social distancing measures and minimal testing, it’s likely the virus will return with a vengeance this fall, according to The Atlantic. In 1918, the U.S. assumed that its influenza pandemic had ended in the spring but it returned in the winter and the spring of 1919, causing far more damage than it had initially. The only way the virus will ever be completely eradicated or controlled, is if a vaccine or more dramatically effective treatments, such as antiviral drugs or immune system fortifying treatments become available.

While New York may have fumbled in its response to the outbreak initially, it can avoid creating a further strain on its hospitals and residents by preparing for future outbreaks as soon as it’s able. It can stockpile ventilators, personal protective equipment and testing materials. It can ensure that it has enough hospital beds and intensive care unit beds, so that, when another outbreak occurs, it will be ready. The state has released a few details regarding its plans for future outbreaks that would include creating “regional control rooms” that would monitor hospital capacities, rates of infection, how much PPE is available and how well businesses have been observing the state’s COVID-19 safety guidelines. Cuomo said on Tuesday, that if any problems arise the control rooms have “an emergency switch that we can throw.”

“If the hospital system exceeds 70% capacity or rate of transmission of the virus hits 1.1%, those are danger signs,” the governor said, noting that the state’s current rate of transmission is about .08%, meaning that for 10 people infected with the virus, an additional 8 will get it. (If the rate exceeds 1%, then the virus spreads to larger and larger numbers of people, as was the case before the shutdown of all nonessential businesses, schools and so on.)

Neither the city nor the state, however, responded to a request for comment regarding their preparedness for a second wave of infections.