Andrew Cuomo, governor of the US state hit hardest by the coronavirus pandemic, announced that three regions of the state would begin resuming economic activity suspended under the “New York Forward Reopening Guide.” The plan, which divides the state into 10 regions, is based on regions fulfilling seven criteria related to hospital capacity, hospitalizations, testing and contact tracing.
Cuomo’s guidelines, while at first glance relatively rigorous, leave open multiple avenues for inviting a second wave of infection. It must be stated that any plan which does not aim for the eradication of the coronavirus is tacitly accepting tens or hundreds of thousands of additional deaths in the US over the coming months until therapeutics or a vaccine are developed, or almost everyone has been infected. The best that can be said for a plan such as Cuomo’s is that it will more or less intelligently manage a second wave that is inevitable if the virus is not eradicated.
The plan appears, with some caveats, to be more concrete and science-based than the wholly inadequate guidelines put forward by the White House to justify a return to work nationally. Even the vague White House guidelines have been flaunted by states rushing to reopen.
Concretely, the seven criteria a region must reach before beginning to reopen businesses are: a 14-day decline in hospitalizations, a 14-day decline in hospital deaths, fewer than two per 100,000 residents hospitalized on average daily, at least 30 percent of hospital beds free, at least 30 percent of ICU beds free, 30 per 1,000 residents tested monthly, and at least 30 contact tracers per 100,000 residents.
According to Cuomo, these criteria are based on guidelines from the US Centers for Disease Control and Prevention (CDC). However, even the White House directives call for a sustained decline in cases and influenza-like illnesses before initiating reopening, something lacking in New York Forward.
The Fingers Lakes, Mohawk Valley and Southern Tier regions are slated to enter phase one on May 15, under the plan. All three areas are less densely populated than the lower Hudson Valley, Long Island and New York City, which have been the hardest hit, although they do include the medium-sized city of Rochester.
Overall there have been 21,835 deaths, out of 338,485 cases statewide, with daily deaths recently hovering just under 200. This does not count the 5,000 additional deaths counted by New York City as probably due to COVID-19, nor the thousands of deaths above the norm caused directly or indirectly by the pandemic but not counted in either tally.
In phase one, regions will be able to reopen construction, manufacturing and curbside select retail. If after two weeks, conditions still look positive, then additional businesses, such as other retail and real estate, can reopen. The third phase includes restaurants, and only in the fourth phase do “arts, entertainment and recreation,” as well as education, return.
No doubt a key cause of concern for the Cuomo administration is that all areas reach phase four by the fall so the state’s universities can reopen under the plan’s rubrics, whether or not that is a safe choice.
The two-week waiting period, while appearing cautious, is in all probability far too little time to see the consequences of the slackening of public health measures. The virus that causes COVID-19 has an incubation period of up to two weeks before showing symptoms, to say nothing of asymptomatic cases, and it can take days or weeks after that for symptoms to worsen to the point of prompting hospitalization.
Given the delay between infection and testing positive, as well as between infection and hospitalization, the fact that there is no criterion for the increase in cases could prove to be fatal as the state ramps up economic activity. In other words, a region could be well into phase two or phase three of the reopening plan before it becomes apparent that even initiating phase one was a grave error.
Moreover, the reference to restarting these various industry groups is somewhat misleading. While many areas of economic life have been restricted due to shutdowns caused by the pandemic, other industries have been labeled “essential” and have remained open. These range from genuinely essential retail, such as grocery stores and pharmacies, to logistics (distributing essential and nonessential items alike) and certain construction projects.
Construction, which would be allowed under phase one, was only belatedly suspended in the state, with so many loopholes that there are 7,516 active construction sites in New York City alone, according to the city’s Department of Buildings. These include a Target store in Queens and a new building for Columbia University’s business school, and the number of sites has been tracking upward for weeks. Construction is dangerous even in normal circumstances, to say nothing of the impossibility of socially distancing on most worksites during the pandemic.
There is nothing concrete in the reopening criteria regarding provision of personal protective equipment (PPE) or testing at certain workplaces. Shortages of PPE have turned nursing homes and hospitals into deadly transmission sites for the virus. The testing goal, while high compared to other countries with smaller outbreaks, is not enough to guarantee rapid testing before entering workplaces or retail locations on a regular basis, as recommended by public health experts. Instead there will merely be an “advisory board” set up to suggest guidelines to be followed by industries.
Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University and professor of health policy and management at Columbia’s Mailman School of Public Health, along with virologist Joseph Fair, a senior fellow at Texas A&M University and the Smithsonian Institution, issued a document at the end of April stressing in particular the need for testing at workplaces.
They suggest that for economic activity to be remotely safe, retail workers need to be tested “at least weekly,” and restaurant workers would ideally “be rapid-tested at the beginning of every shift.” Barbers and hairdressers “should be rapidly tested for coronavirus at least weekly,” and every customer should be tested before entering.
Such a vigorous testing regime has not been established anywhere in the state, even in the areas that meet Cuomo’s tests per capita requirement. No doubt the gap would widen even more as industries begin to reopen.
One must also note that dividing the state into regions and letting the regions proceed separately, while making sense at first glance, is a mistake. These regions are not self-contained, and people will likely travel from a harder-hit region to one opening up, potentially spreading the virus.
This is not a hypothetical. The University of Maryland estimates that more than 62,000 people traveled into Georgia from out of state after its partial reopening at the end of April. The upcoming Memorial Day holiday poses this risk directly to the scenic regions reopening.
For that matter, New York State is by no means self-contained. It is often analyzed as part of the tri-state area, which also includes New Jersey and Connecticut. While Cuomo had initially announced plans to cooperate with other governors in the region to coordinate their reopening (as they coordinated shutdown plans), the other states in this “coalition”—New Jersey, Connecticut, Pennsylvania, Delaware, Massachusetts and Rhode Island—are at varying stages in their own reopening plans.
New Jersey, which has the second-highest case and death figures in the country, with 140,743 cases and 9,508 deaths as of this writing, has announced only vague “principles” to guide lifting measures. Other states in the “coalition” have either not adjusted their lockdown orders or have made slight adjustments, in the absence of a blueprint such as New York’s.
The regions that Cuomo is proceeding to reopen may serve as trial balloons for reopening more densely populated areas of the state. If it turns out that resuming construction and retail is a deadly miscalculation, for example, it is easier to reverse these measures—and less of a public-relations disaster—if it happens in Rochester instead of New York City.
The consequences of allowing the coronavirus to spread, even at a slower pace, are still unknown. Reports have emerged in recent days of as many as 100 cases and five deaths in New York due to a COVID-19-related inflammatory disease in children, who were initially thought to be less at risk from the pandemic.
Cuomo’s decisions are being driven not by public health, but by corporate profit. He understands, better perhaps than any other American politician, that the pandemic needs to be contained to some extent to restore confidence and prevent an even wider economic collapse. However, if he can keep deaths at a level that doesn’t threaten the interests of the ruling class he represents while restoring a measure of capitalist profits, that is a price he will pay. The working class will have another answer.