Omicron Is Spreading Fast. Can N.Y.C. Do More to Slow It Down? – The New York Times
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Mayor Bill de Blasio says he doesn’t want to impose new government restrictions. But some health experts say more must be done.
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Joseph Goldstein and
As the fast-spreading Omicron variant tears through New York City at a rate not seen since the early days of the pandemic, city officials and health experts are wrestling with an agonizing question: What more can be done to stop its spread?
Mayor Bill de Blasio has made it clear that he expects the city to weather the ordeal with few new government interventions and believes vaccination is the key strategy. But some public health experts say that the effort to flatten the curve should also emphasize social distancing, restrictions on large gatherings and more stringent mask-wearing rules. Still others say that the steep rise of Omicron may be inevitable and that the city should prepare by bolstering already strained hospital staffs.
“There are indications in South Africa that it’s not as severe or putting people in the hospital at the same rate,” said Dr. Jeffrey Shaman, an epidemiologist and disease modeler at Columbia University. “But we don’t know what that number quite is. Is it a third as likely? Is it a tenth as likely?”
Here are some key questions regarding the new surge:
Not long ago, city officials thought an Omicron surge was still a way off. But by late last week, the signs of its rapid spread were everywhere. Lines outside testing sites kept growing longer. The test positivity rate doubled in three days. Cases soared to record numbers.
By Monday, New York City had 15,245 new cases, about four times the number it had just one week earlier. Most of those seemed to be Omicron: Over the course of last week, the new variant made up 92 percent of new cases in New York, New Jersey, Puerto Rico and the United States Virgin Islands, according to a Centers for Disease Control and Prevention estimate released Monday. However, other estimates have been lower.
Public health officials are now predicting a continued steep increase in Omicron cases over the next few weeks, followed by a steep decline, similar to South Africa’s experience with the variant.
“I have never seen an organism as infectious as Omicron,” said Dr. Tom Frieden, a former city health commissioner and former C.D.C. director. What has happened in New York over the past week, he added, was more of a “flash flood” than a “wave.”
Mr. de Blasio has announced that the city will open 23 new testing sites by the end of the week, in an effort to shorten hourslong wait times at many clinics and walk-up sites. The federal government is also opening new testing sites in the city, President Biden announced Tuesday.
Nearly 130,000 people got tested on a recent day in New York City, not including many at-home tests. That is more than at any previous point in the pandemic.
The city has also announced plans to distribute 500,000 at-home tests and a million free KN95 masks. Dr. Isaac Weisfuse, a former senior New York City health official, said that was a good idea but “a drop in the ocean.”
Mayor-elect Eric Adams said Tuesday that he was canceling his indoor inauguration ceremony, but the New Year’s Eve celebration in Times Square that marks Mr. de Blasio’s last moment in office is still on for now.
Mr. de Blasio has not yet canceled large events because of the surge. A Billy Joel concert where all attendees were required to have at least one vaccine dose went ahead on Monday night at Madison Square Garden. Masks were not required for fully vaccinated attendees, the concert website said.
In interviews, public health experts offered differing opinions on whether new government restrictions were needed.
Professor Shaman said he understood that many people were tired of social distancing and unlikely to accept new restrictions. Still, he said he thought City Hall should be taking more forceful action, including urging people to work from home if they can and closing schools temporarily.
“We don’t quite know what this variant is going to do with people,” he said, noting that with so many unknowns — including what fraction of infected people would require hospitalization or later suffer from long Covid — it made sense for New York City to take decisive steps.
Some epidemiologists said that given Omicron’s transmissibility and ability to evade immunity, there was little New York City government could do at present to effectively slow its spread.
Dr. Stephen Morse, a professor of epidemiology at Columbia University, urged people to get their boosters and avoid large gatherings where possible.
“A lot of people are going to get infected,” he said.
Dr. Howard Markel, who directs the University of Michigan’s Center for the History of Medicine and has written about epidemics in New York, said that it would be sensible to cancel large gatherings — such as sporting events and performances with large audiences — if the number of Covid-19 patients in intensive care units began to climb. He also suggested instituting restrictions if hospitalizations of children, many of whom remain unvaccinated, began rising.
Dr. Weisfuse said he anticipated that large events would thin out and many venues would close on their own accord in the days ahead, as people voted with their feet.
Several Broadway shows have already announced they will go dark through Christmas, and the Radio City Music Hall Christmas Spectacular has shut for the season. JPMorgan Chase, CNN, The New York Times and other employers are encouraging or mandating workers who don’t have to be in the office to work from home until 2022.
Some shows and restaurants will make a judgment call and decide to close, Dr. Weisfuse said. “Or their staff will be out sick and everyone will be a contact of everyone else and businesses will start to send people home.”
The holiday season. With planned end of the year gatherings, the new Covid surge is prompting worries and cancellations. The Times asked experts to share some holiday guidance, as well as some tips on using at-home virus tests (if you can find any). Here is what to do if you test positive for the coronavirus.
The Omicron variant. The highly transmissible Covid version appears to be less severe than previous variants, according to new studies. Research also suggests many non-mRNA vaccines offer almost no defense against infection, though the Pfizer and Moderna boosters, which are mRNA-based, most likely provide strong protection.
New treatments. The Food and Drug Administration authorized in short succession the first two pill treatments for Covid-19 from Pfizer and Merck. The new drugs, which can be taken at home with a doctor’s prescription, will be available to some Covid patients who are at higher risk of becoming severely ill.
Biden’s new plan. President Biden announced new steps to confront the surge in Covid cases, including setting up new testing sites and buying 500 million rapid tests to distribute free to the public. But experts warned the measures would not stop an Omicron surge, and it could be weeks until enough tests are available.
Around the world. After infections skyrocketed to record levels in South Africa, new cases have started falling, suggesting its Omicron wave may have peaked. In Europe, the Netherlands, Britain and Denmark adopted tough restrictions, while France, Spain and Italy are taking a more measured approach.
Greenwich Village/SoHo in Manhattan had the highest rate of new cases citywide as of Tuesday, skyrocketing to 2,489 new cases per 100,000 residents in the past week, compared with fewer than 200 new cases per 100,000 at Thanksgiving, according to city data. To put that in perspective, Rhode Island, the state with the highest transmission level as of Tuesday, has one-third that transmission rate. Nationally, the average seven-day case rate per 100,000 people is 315, according to the C.D.C.
Most of the other neighborhoods with the highest rates of transmission as of Tuesday were also in Manhattan, including Gramercy Park/Murray Hill; Chelsea/Clinton; and Lower Manhattan. Greenpoint in Brooklyn and the Upper East Side in Manhattan were also in the top 10. The transmission rate in Manhattan is now the city’s highest, instead of below the city average, as it was through most of the pandemic.
While higher rates of testing among the well-off are a key reason this is happening, that is not the only reason, city officials and epidemiologists said. There is clearly also a lot of virus circulating, as indicated by the high positivity rates in these areas.
Dr. Jay Varma, a senior adviser to Mr. de Blasio, said Tuesday on WNYC that New York “has always been the most vulnerable city in the United States for any emerging infectious disease outbreak” because of its high rates of international travel and density. Those factors helped explain its return as the nation’s virus epicenter.
Higher than average vaccination rates have not prevented the surge, because Omicron can break through that immunity. Still, vaccinations, especially with boosters, are believed to protect against more serious illness.
“Breakthroughs are common with Omicron, but the vaccines are still doing what they need to do,” Dr. Jennifer Lighter, a pediatric infectious disease specialist at the N.Y.U. Grossman School of Medicine, said.
Covid-19 hospitalizations in the city have been rising over the past month, reaching about 270 new admissions a day. In all, some 1,500 patients with Covid-19 are currently hospitalized in New York City, and 200 are in intensive care units. But hospitalizations are so far rising at a much slower pace than cases.
While Covid hospitalizations across Northwell Health’s 19 hospitals in the New York City area are increasing, they still remain at about half of what they were at this time last year, said John D’Angelo, the system’s chief of integrated operations.
Still, a steep rise in hospitalizations, if it comes, would most likely not be seen for another week or two, he said. And public health experts warn that any rise in hospitalizations will hit a health care system whose staff is already stretched thin.
“The biggest concern is the impact on the health care system,” Dr. Mary Bassett, the state’s health commissioner, said in an interview Tuesday. Even if Omicron proves more mild that earlier variants, “a small fraction of a big number is a big number, and we just don’t know what that number will be.”
At St. Barnabas Hospital in the Bronx, about 50 employees — out of nearly 3,000 — are out sick with Covid-19, or at home because a relative was sick, said Dr. Eric Appelbaum, the chief medical officer. He said he expected that number to climb dramatically in the next few weeks, perhaps to 5 or 10 percent of his staff. He noted that the hospital — like many others in New York and around the country — already had a staff shortage.
“This is the calm before the storm,” he said. “This wave, I’m much more concerned about staffing rather than the total number of beds available.”
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