We’ve Stopped Counting the Dead

Thank goodness for this dismal weather. Freezing rain makes confinement more bearable.

From the look of the streets, sleet and freezing rain also make it easier for the New Yorkers – who otherwise have continued to be out in large numbers – to stay in; that, or the increasingly dire situation is finally registering, as not only the case count but now the number of deaths also begins to exhibit exponential growth.

This morning’s Democracy Now! has an excellent round-up of the weekend’s news, but, to summarize: The Governor was dismayed to learn what anyone living in New York has been aware of all along – that people have continued to throng New York City’s parks even as this crisis has deepened – and has given the City an ultimatum to come up with a plan to address the probem; Comptroller Stringer announced that the City is facing $6 billion in lost revenue owing to the pandemic; and, while progress continues not to be made in DC, that hasn’t stopped the Department of Justice from seeking worrying new emergency powers.

Further afield, in an ominous development, Gaza registered its first confirmed cases of COVID-19, and my heart is with people there, as on Riker’s Island, where the case number has spiked in recent days. Italy recorded a staggering / heartbreaking 793 deaths in a single day. (Note: the infographic here, shared with us by our friend Neha – one of the thousands of healthcare workers currently performing heroic service everyday in NYC –– shows, under “Average Disease Deaths per Day,” a count of 88 for COVID-19, well behind that for the world’s most deadly disease, tuberculosis, which kills more than 3,000 people a day on average; the infographic is dated exactly one week ago.) India’s authoritarian Prime Minister called for a day-long “Janata Curfew” that was capped off – following the PM’s call – with a country-wide spectacle of pot-and-pan banging that devolved, in many places, into festivities very out of step with the need for social distancing. Meanwhile – in two hints of how pandemic threatens to undermine social movements – in Delhi, a “vigilante” (no doubt a supporter of that same Prime Minister) threw a petrol bomb at the now-much-reduced and socially-distant gathering of protesters at Shaheen Bagh who have been heroically demonstrating for months against the BJP’s neofascist Hindutva agenda, and in North America, across Wet’suwet’en territory, TC Energy continues its efforts to construct the Coastal GasLink Pipeline in spite of the global crisis.

In China, progress continues to be made “towards restarting the economy and allowing most people to return to something closer to normalcy than lockdown,” while in a United States sliding rapidly into paralyzing country-wide crisis, the New York Times has followed Tomas Pueyo in charting a course towards “stop[ping] the virus” with “harsh steps”, and Politico asked a bunch of thought leaders to opine on how the pandemic “Will Change the World Permanently.”

In another sign that, even with drastically ramped up testing, we are failing, New York has stopped testing people “except in cases where a test result would significantly change the course of treatment“; the Post reports that “Mayor de Blasio [has assembled an] elite ‘wartime’ coronavirus crisis team”; work is now underway – by FEMA and the Army Corps of Engineers – to convert the Javits Center into a 2,000 bed hospital complex, moving New York State 2,000 beds closer (from a baseline of ~53,000) to the projected 110,000 beds that will be necessary at the peak of the crisis here (so once that monumental work is done, we’ll be halfway there); the Federal Government may be sending essential medical supplies to New York State, but let’s see; and in the silver linings department, most New York City buses are now essentially free (while the MTA’s budget is in free-fall) and the Governor – never known to be a cycling enthusiast – is calling for the closure of some NYC streets to ease the process of social distancing.

New thing we should probably all know: Sudden loss of smell may be a sign of otherwise asymptomatic COVID-19 infection, so, please, keep your nose out for it.

Lockdown wears on all of us here, but also already starts to feel normal (as a similar state of isolation is for millions of elders). Mostly, we brace ourselves for the coming trauma, and worry that many people in many other parts of the United States do not seem to be heeding our warning calls. Stop and think about that number above for a minute – 110,000 hospital beds necessary at the peak of the crisis. Right now, New York City has ~20,000 hospital beds. New York State has ~3,000 ICU beds, roughly two-thirds of which are Downstate, and the Governor projects needing ~20,000 to 40,000 at the crisis’s peak; the State has ~10,000 ventilators (the need for which should align pretty closely with the need for ICU beds). Think about these numbers, and then work backwards. Estimates of the percentage of people requiring hospitalization vary, but 20% seems to be the prevailing number thus far; so to require 110,000 beds at once, maybe subtract out 10,000 for all the reasons for which people usually need hospital beds, and then take 100,000 and multiply by five. That would mean that the Governor is expecting a wave of 500,000 people to be / have been all infected more or less in the same week-long window. It’s my view that this may have already happened.

I’ve been working to estimate the total number of cases of COVID-19 in NYC, and to project how many hospitalizations we might expect in the coming weeks, and my admittedly-rough estimates align with those that seem to be informing the Governor’s thinking. As of yesterday (March 22nd), around 2,000 people had been hospitalized across New York State with confirmed cases of COVID-19 (and I suspect a similar number of COVID-19-positive individuals had been hospitalized, unrecognized, for flu-like symptoms, pneumonia, etc.); by this time next week, I’m confident we’ll have seen tens of thousands of hospitalizations. (I plan / hope to formally write-up these projections, but in the meantime, anyone interested can follow along on Instagram; I’ve been posting regularly on Insta stories – not a great medium for this work, but the one most readily at hand for now.)

Our healthcare system is already in crisis in New York City; we’ve been hearing harrowing stories from friends who are physicians (stories that sound a lot like this one), and the situation is similarly deteriorating in other hotspots of the pandemic around the country. A friend’s friends’ friend died in New Orleans last week. She was 39. So far, that’s as close as I’ve come to this, but it’s only a matter of time before we all come closer.

Perhaps the threat of COVID-19 to millennials in the US has something to do with vaping; perhaps with different strains or mutations of the virus; perhaps more studies are required (as this one lists a number of its own limitations); perhaps all the reportage on this phenomenon has simply been part of a public health effort to get millennials to stop behaving so recklessly. Certainly, the New York City data paints a striking picture of who is most frequently being diagnosed with the disease to date and invites consideration of why.

If you’re looking for a way to support front-line healthcare workers, the New York State Nurses Association has this petition up urging the Governor to implement their COVID-19 Action Plan. I think we’re all searching for and learning how we can contribute to this struggle, but supporting New York’s nurses is certainly a fine step. The title for this piece was drawn from the (translated) words of an Italian nurse. Where she was a week ago, we will be soon.