Health experts said the answers are largely specific to the New York metropolitan area – especially its density and population – but they are also a warning to other states who believe they can be spared.
New York is the epicenter for now, but Covid-19 won’t stop there.
High density and size
The first and most obvious explanation for the severity of the outbreak in the region is that New York is the largest and most populous city in the United States, and the corona virus tends to spread to dense locations.
“This proximity makes us vulnerable,”
At any time of the day, New Yorkers pack up on the subway, bump into each other on sidewalks, and brush their knees in bars and restaurants – all while being contagious. They live in crowded apartment buildings, squeeze stairs or climb lifts with neighbors. The transit system connects people in all five districts so that most people don’t have cars that could otherwise separate people.
“We’re used to crowds,” said New York Mayor Bill de Blasio. “We are used to lines. We are used to being close to each other.”
With over 8 million inhabitants, New York City is also the largest city in the country. The high number of coronavirus cases in New York only reflects its size. The state is likely to lead the country in coronavirus cases, even if its infection rate per person is not the highest, said Sepkowitz.
High test rates
Another reason New York has so many confirmed coronavirus cases is that it looks for them.
According to Cuomo, over 100,000 people have been tested for coronavirus in New York. He said Thursday that about 25% of all tests were done across the country from New York.
“We hunt positives,” said Cuomo. “We hunt positives so we can isolate them and reduce spread.”
Widespread testing has made the numbers look bad, but health officials say it’s important to slow the spread of the virus. The more you test, the more you can isolate the people who have the virus and thereby stop the spread.
According to Dr. Arthur Caplan, a CNN medical analyst and head of the Department of Medical Ethics at the School of Medicine at NYU, said testing is only part of the explanation for the high overall scores.
“I think it is true that we have a worse outbreak here if we are only admitted to intensive care units while they are starting to build. It is not just about testing,” he said.
Slow early response
“We will be issuing guidelines very quickly on how to reduce the volume and audience while we are still doing some activity,” said de Blasio at the time.
As the virus spreads exponentially, a delay of just a few days can lead to significant differences.
“It is important to isolate and distance early because the virus is more difficult to jump from person to person,” said Caplan. “If it spreads more slowly, you’ll have enough beds in the hospitals and intensive care units and ventilators to treat the sick.”
“We have international travelers who have been to China and Italy and Korea and came here,” said Cuomo on Wednesday. “And I have no doubt that the virus was here much earlier than we even know it. And I have no doubt that the virus was here much earlier than in any other country. Because these people come here first.”
Still, these steps were too late to prevent the virus from reaching New York due to its heavy journey, Caplan said.
New York’s difficult journey “somehow brought the virus here earlier,” he said. “It started faster here.”
First but not least
For all these reasons, New York City has always had to be a center of rapidly spreading cases. But it is far from the last one.
“We’re only early. We’ll see waves elsewhere,” said Caplan.
“It’s like a stone that is thrown into a pond and curled up,” he added. “Because of the population density, it’s in cities, then in suburbs, and then in rural areas.”
Cuomo has warned that New York is the country’s “canary in the coal mine”.
“It is higher in New York because it started here, because we have global travelers who come here first because we are denser than most other places, but you will see this in cities across the country. And you will in suburban areas across the country, “he said. “We are just a test case.”