CityWatch: Flatlined hospitalization numbers in New York state ‘troubling’

CityWatch: Flatlined hospitalization numbers in New York state ‘troubling’

24 Apr    Finance News

The number of COVID-19 patients walking into hospitals across New York state has stubbornly flatlined at roughly 1,300 a day—at first glance, disappointing news given social-distancing measures are about as drastic as they could be in the state. 

“This is still not great news,” said Gov. Andrew Cuomo at his daily news briefing on Friday. “Number of people coming into the hospital, number of new infections, is slightly down, but that’s basically a flat line and that is troubling.”

Daily hospitalizations across the state peaked in the first week of April, when more than 3,100 sick patients inundated hospitals in a single day, before heading into a choppy decline over the past three weeks, according to an official three-day rolling average. There are one third as many people walking into hospitals everyday with COVID-19 than at the peak, but progress has stalled as thousands of new cases continue to be diagnosed everyday. 

Strict social distancing measures and testing, the highest of any state in the U.S., stymied the virus’s exponential spread. But further recovery and any reopening of the economy will depend on how strictly New Yorkers continue to adhere to those social distancing orders—even as they’ve now officially been stuck at home for a month.

“How fast is the decline, how low is the decline?” Cuomo said. “It is purely dependent on what we do. Are we socially distancing? Are we testing? How fast do we reopen? How do we reopen? You answer those questions and you will determine what the rate of decline is.”

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With schools and most businesses closed, nonessential travel halted, playgrounds padlocked and limits on how many customers can enter grocery stores and pharmacies at one time, there’s little else the state can do in terms of enforcement of social distancing, Cuomo has said. The latest enforcement rule came last Friday, when he issued an executive order requiring people to cover their faces in public when unable to socially distance. 

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But still hospitalizations have remained stubbornly high. Since Thursday, more than 8,000 had tested positive for coronavirus, slightly higher than the same period last week. In total, more than 271,000 people have tested positive for the coronavirus in New York state and 16,162 have died. 

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“Several of the models initially projected COVID-19 projections as a bell curve,” said Dr. Thomas Tsai, assistant professor of health policy at the Harvard T.H. Chan School of Public Health. “Realistically, what’s been happening instead of a peak is a plateau, which means there will likely be a continued number of cases and hospitalizations and, unfortunately, deaths.”

It can take days or weeks for someone infected with COVID-19 to come down with symptoms and potentially even longer before they decide to head to the hospital, making daily hospitalizations a lagging indicator. 

“Hospitalizations today were likely transmissions that happened several days or even a week or two ago,” Tsai said. 

And while a plateau can feel disappointing, Tsai said it’s all the more reason to double-down on measures that are working, such as social distancing. 

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A stable rate of hospitalization is also much better than a rising one, said Dr. Robyn Gershon, a professor of epidemiology at New York University’s School of Global Public Health. It could also be a sign that hospitals, with more capacity than a few weeks go, have expanded treatment to those earlier in the disease, before they reach a critical need.

“I think it’s probably a good indication they’re trying to watch those cases earlier,” Gershon said.  

Certainly, there’s some indication that intensive-care cases are declining, as the number of new patients on ventilators has plummeted. On Thursday, there were 118 more people extubated than intubated at hospitals across the state. 

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And in New York City, Mayor Bill de Blasio presented promising data on Friday that showed a more dramatic improvement at the city level this week. Daily hospitalizations across the five boroughs dropped to 176, de Blasio said at a news briefing. That’s less than half the number of coronavirus patients who walked into hospitals a week ago. The percentage of tests coming back positive for New York City residents has also fallen markedly since last week. 

“We have just plain good news,” de Blasio said, calling it a good day. 

The divergence between the state and the city comes as hotspots outside of New York City continue to battle against the spread. In Suffolk County, home to the Hamptons, more than 1,000 people have tested positive since Thursday, about the same as the Bronx and double the number of new cases in Manhattan. The number of daily infections in Suffolk marked an uptick from earlier in the week, when that figure was down in the 700s. 

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Parts of the Hudson Valley also continue to see a high number of new cases each day, especially by population. Orange County has recorded 339 new cases since Thursday; and more than 21,000 people have tested positive in total—or about one in every 20 residents. 

Better testing is also expected to help push the curve down. The state has ramped up testing to about 20,000 a week, a number the governor said this week he plans to double to 40,000, including diagnostic tests that show an active infection and antibody testing that shows someone has recovered. 

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“It’s getting warmer, more people are going to be coming out of their homes. That’s going to happen naturally. Watch that spread,” Cuomo said. “Testing gives you those numbers on an ongoing basis.”

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