The recent debate between Governor Cuomo and President Trump about if, when, and who can or should declare a quarantine around metro-NYC is reminiscent of the debate between Cuomo and Mayor DeBlasio about who should impose travel restrictions around NYC.  That 3-day delay will have cost thousands of American lives when the COVID-19 pandemic scorecard is finally tallied.  This most recent debate threatens to exact an even greater tribute from the American citizens that these officials all swore to protect.

The epidemic in metro-NYC is out of control and lags the critical timeline that China and South Korea followed.  It’s been 16 days since NY crossed the threshold of 500 deaths on March 14th that caused China to impose Draconian quarantines on Wuhan city and then Hubei province.  Without strict quarantines, the incremental travel restrictions and social distancing recommendations have helped a little but it was not until Cuomo announced statewide shelter-in-place rules on March 20th that the free-flowing coronavirus finally slowed its rampage through the entire metro-NYC area.  The slowness to act allowed much of NJ and certain portions of CT to become heavily infected.  The infection now needs to be managed on a tri-state basis and only full cooperation between the Mayor, the Governors, and President Trump can really work to contain the wildfire.  And yet they are wasting time bickering about who gets to captain this listing ship.  

Governor Cuomo should be commended for quarantining New Rochelle, NY.  However, it turned out to be too little, too late because under testing led him to draw a box that was too small — the infection had already spread beyond the boundaries of New Rochelle.  Until wider testing is completed, a general quarantine with wide enough boundaries is the only way to stop the virus in Metro-NYC and shield the rest of the country.  NY state has made some progress in ordering wider testing of its residents so that now 0.9% of New Yorkers have been tested for the virus, the best of all states in the US — matching the thoroughness of South Korea.  But NY needs to do more because more of its citizens appear to be infected than in South Korea.  Currently, 0.31% of NY residents have been infected whereas only 0.02% of South Koreans have been infected.  Testing is way behind where it needs to be in NJ and CT where only 0.4% and 0.3% respectively of their population have been tested.  Without wider testing, the only solution is to quarantine the entire metro-NYC area.  After testing expands further and we can gain more confidence that every infected person and their contacts in the metro-NYC has been identified we can then transition to a more targeted quarantine where only those identified as confirmed and suspected are ordered to stay in 14-day quarantines. 

The graph below shows the rapid exponential growth in confirmed COVI-19 cases in NYC compared to China.  But it also appears to show that the doubling time in NYC has slowed to 4.3 days, but part of this slowdown has been due to the temporary bulge in cases in the prior week due to catch up testing.  If NYC broadened the testing protocol this curve might accelerate again as we count milder and asymptomatic cases.  This week’s data should allow us to tell whether the infection rate has slowed for real or not.  If nothing is done the virus is certain to produce more infections (33,768 as of 3/29) and more deaths (678 as of 3/29) in NYC than all of China.   This would constitute an avoidable tragedy greater than 9/11 that the mayor, the governors, and the president will all live to regret.