COVID-19 - Part 2: New York is the Epicenter of the World

As of this writing, New York State contains approximately 33% of all cases in the United States and 10% of all cases in the world.

By Anthony Lee, MD

Faculty, Harvard Medical School

As we make our way through this pandemic, the large number of cases in the United States has caught our attention and prompted much discussion. Part 2 of this series will not only update the first article, "COVID-19: Tracking the Changes," but will describe the trends of cases and deaths and their rates of change. It will also differentiate between New York State and the rest of the United States.

To recap: we have been following the pandemic in Italy, New York State, New York City, Massachusetts, Sweden, the United Kingdom, Ireland, Northern Ireland, and Belgium in terms of cases per 100,000 population and deaths per 100,000 population, as well as the rates of change of these numbers.

Last week we looked at the number of daily new cases and the number of daily deaths to see if they were increasing or decreasing. We looked at the numbers for hard, non-ideological proof.

Read Part 1 of Anthony Lee, MD's research, tracking changes in the spread of COVID-19

Superimposed on the charts were markers indicating when designated locations enacted social distancing or lockdowns and showed the effects of these measures on the number of new daily cases and daily deaths.

Although the popular media tends to treat the United States as a single location, if we separate New York State from the rest of the United States, two different stories emerge.

This article will view the number of cases and deaths on a per 100,000 population basis to describe the density of cases and reveal the true severity of the pandemic in a specific location.

As of this writing, NYS contains approximately 33% of all US cases and 10% of all cases in the world. The US has roughly 583,500 cases with a population of 331 million people, or 176.2 cases per 100,000 people. In contrast, NYS has roughly 195,000 cases with a population of 19,540,000. This represents a very disturbing 998 cases per 100,000 people, which is significantly worse than the US combined.

If we isolate NYS from the rest of the US, the number stands at 124.7 cases per 100,000 people. In contrast, Italy has 159,516 cases and a population of 60,480,000, or 263.8 cases per 100,000 people. In other words, from the perspective within a particular location, NYS is nearly 4 times as severe as Italy, and Italy is roughly twice as severe as "the rest of the United States".

Separating NYS from the rest of the nation achieves two things. First, it provides a more accurate picture of what is happening in most of the US and shows that the overall situation is not apocalyptic. Second, and more importantly, it allows us to focus on the true severity of what is happening in NYS. This will help us make decisions about how to deal with the pandemic's true epicenter.

Below are the updated charts. "The rest of the United States" is represented by the label "US-NYS (US minus NYS)". Because of time differences, US data lags behind that of Europe and the UK. Therefore, plots are likely to be limited to the day before a report is published. In some cases, late reporting from European countries and the UK may also limit plots to the day before.

Cases

Graphic showing COVID-19 Cases per 100,000 of population

Figure 1. Cases per 100,000 population by location and correlated rate of change.

Figure 1 shows the effects of lockdowns and social distancing. It took Italy 12 days to finally flatten the curve of daily new cases. This trend has been continuing for the last 23 days, producing the trailing edge of the pandemic in Italy.

It took Belgium 11 days to reduce the number of daily new cases, and they have also continued on a downward trend for the last 15 days.

Ireland required 7 days of lockdown to reduce their daily new cases. This trend continued over the next 4 days, but then a new surge of cases occurred. The same holds true for Northern Ireland, where 6 days of lockdown reduced the number daily new cases. This trend continued over the next 5 days, but then a small surge of cases emerged.

Sweden maintains a low and flat trajectory despite loose social distancing. This might be accounted for by lack of testing.

The UK and "the rest of the US" (as defined above) remain on low and flat trajectories due to their respective social distancing policies.

NYS and NYC cases are rising dramatically, even in the face of a shortage of testing. Testing has increased in Massachusetts over the last 3 weeks and is reflected in the figure. In the weeks leading up to lockdown protocols NY has been about 5-8 days behind Italy, while Massachusetts has been around 21-23 days behind.

Although NY and Massachusetts started social distancing at the same time, Massachusetts had a roughly 2-week head start ahead of NY. However, this margin has narrowed to about 6 days. Interestingly, the curve of Massachusetts now seems to shadow that of NYC with similar slopes and slope changes.

Deaths

Graphic showing COVID-19 Deaths per 100,000

Figure 2. Deaths per 100,000 population by location and correlating rate of change.

Figure 2. shows rising deaths by location.

In the rates-of-change chart, the number of daily new cases flattened are delineated by date.

From the point of delineation rightward, we see when daily deaths begin to decrease. This lag time varies with locations. Italy's lag time was 7 days. This hasn't reliably occurred yet in Belgium. Although we see a decrease in deaths in Ireland, this is most likely temporary, as the country has seen a surge of new cases; and death plateaus follow new case plateaus. The same is true for Northern Ireland.

I will update numbers and discuss their implications in future installments.

Sources of data: Worldometer.com, Spectrum News NY1, Massachusetts Department of Public Health, HSC Public Health Agency

COVID-19 From Perspective of a Healthcare Professional | Why The Metaphor of War Is Inaccurate

How do we contextualize an unprecedented moment in American history?

As a healthcare worker with more than three decades of training and clinical work under my belt, I have a few thoughts about this moment in American history:

The Metaphor of War is Inaccurate

This is an undeclared war against the coronavirus. What healthcare workers are going through is war. With such strictly limited resources, we must apply wartime strategies to care for as many people as possible.

As our Mayor, Bill De Blasio, said in today's briefing, "this is a war with many-many fronts. The only way to get through it is to use our military, all HCP (Health Care Personnel). [To create] a national enlistment of all doctors and nurses and move them to areas of need as it arises around the country."

De Blasio is urging the president to enlist all doctors and nurses across America. Indeed, we're not only at war, we are on a battlefield.

In wartime, people hunker down together - especially those most vulnerable. Not so with this virus. Social distancing causes even the sick to care for themselves in isolation, as they check in with others by phone.

The "mask or no mask" question

On the streets and in grocery shops, neighbors in self protection mode aggressively condemn each other for not standing the mandatory 6 feet apart. After close to three weeks of social distancing, why only now are we being asked to wear non-medical masks when going outside.

As a nurse, when I hear the word droplets, I follow precautions, I wear a mask. Any health care worker who doesn't receive the flu vaccine is required by law to wear a mask from the beginning of flu season in October through May or June in all patient areas in the hospital - elevators, patient rooms, hallways, and in clinic.

However, during these perilous times and with supplies stretched thin, the medical field is our first priority. The public has been repeatedly asked to spare PPE (Personal Protective Equipment) for medical people.

Healthcare Workers Are To COVID-19 as Fireman and Police Were To 9/11

Doctors and nurses working frontline without proper PPE is like rushing into a burning building in a tee-shirt, jeans, and bare feet. Are we being asked to do something that was not asked of our firefighters on 9/11?

But every evening at 7pm in NYC, #Clappingforcarers erupts in a massive round of global applause. What a profoundly glorious acknowledgement of Health Care and Essential Workers. Walking home from my ten hour shift at an Upper East Side hospital, I stand on 3rd Ave overwhelmed with this outpouring of gratitude that brings tears to my eyes. I am in awe of how life affirming this is. And how many beautiful people are recognizing our bravery and duty to care.


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We Don't Know What We Don't Know

We don't know. We don't know how this virus works in the body . . . how long it takes an individual to fully recover and no longer shed it. We don't know when it will be safe to socialize again.

On Monday, the US Navy hospital ship Comfort sailed into the west side docks with 1,000 beds. As of Thursday, they've only filled 20 beds due to a tangle of military protocols and bureaucratic hurdles. Frustration is growing because this isn't relieving our overburdened hospitals at all.

But here's the don't-know-what-we-don't-know of it, the world's top researchers do not fully understand how this pathogen works although we're months into the existence of this virus.

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The Trick To Renovating Your Bathroom In No Time

Block Renovation's got you covered.

Home renovations can be a nightmare - Having to find and coordinate meetings with designers and contractors, sourcing and scheduling materials, not to mention having to sacrifice your home for weeks.

Update: During April, save $2500 per room when you virtually plan your renovation.

The stress and expense of it all makes you wonder if it's even worth it. Plus, we've all heard the inflated costs that continue to increase throughout the project.

Thankfully, Block Renovation makes the process so seamless with their technology, network of contractors, and sourcing of material that you can plan your whole renovation virtually from the comfort of your couch.

With Block, you get the whole package of at home consultations (in-person or with video), architect-grade designs & drawings, materials sourcing, and a ready-to-build contractor. Their process is 3 times faster than average.

Here are 3 reasons Block Renovation is the place to go for bathroom and kitchen renovations:

Convenient

With Block, the whole process is technology based, you enter details that generates a quote online and a Block Project Planner will quickly get in touch to schedule a video consultation to see your space and hear about your objectives.Block then refines the proposal and sends it within 24 hours.

After a design session either in person or over video, your designer follows up with a package containing everything you need to get your renovation project going - design renders, building approval documents, a build manual, and a construction timeline.

Block orders and schedules the delivery for all materials needed so you don't have to source them yourself or deal with backorders like you would with most renovation projects. The contractors are all vetted and briefed on your project with an up-front timeline.

Fast

Block Renovation is 3 times faster than the national average when it comes to renovation. Their average build time for a bathroom is 4 weeks! Compared to the national average of 16 weeks, which is due to its convenient, seamless process. You can literally apply online in a few minutes, and once you send your videos and photos, they get back to you in 24 hours.

With other renovations, the estimated date of completion can change as complications arise.

Affordable

With most renovation companies, it's likely that the price given upfront is only an estimate. With lots of competition, other companies bid with optimistic numbers that can change along the way.

Block Renovation is completely clear and realistic with price. They are more accurate and reasonable with pricing because they have pre-negotiated rates with their roster of contractor partners.

Block Renovation supports you and your assigned builder from start to finish, ensuring there are no delays. This can save you more than 60 hours of personal time trying to manage and organize the whole project.

There really is no better option than Block Renovation when it comes to high-end bathroom and kitchen renovations.

If you've been dreaming of the perfect new bathroom or kitchen for you, then check out Block and see how quickly they can help you achieve your renovation goals in the most pain-free and affordable way.

The Full Breakdown of the 2020 Candidates' Dance Moves

Because the American people deserve to know

With less than a month left until the Iowa caucuses officially kick off primary season, it seems like we've spent the last decade slowly whittling away at an endless list of candidates.

Many voters have already seen their favorite contenders drop out of the race. Others have yet to figure out which person on a crowded debate stage best represents their interests. Obviously there are a number of axes on which you can compare the candidates, and countless articles that can help you navigate their differing economic policies, their stances on health care, or their various approaches to foreign policy. If those are the factors by which you judge a candidate, you should have no problem finding what you need to make up your mind. People like me are not so lucky.

Obama Dance with Ellen Degeneres

I have always been a single issue voter—consistently casting my ballot for the best dancer. In 2008 and 2012, I had an easy time of it. Barack Obama's blend of smooth and corny dance moves struck a perfect balance for my sensibilities, easily winning out over Mitt Romney's "Gangnam Style" convulsions, or John McCain's high-intensity robot. 2016 presented a more difficult choice. I nearly didn't vote at all, but ultimately decided that Hillary Clinton's stiff Whip and Nae Nae represented the lesser of two evils when considered against Donald Trump's apocalyptic rendition of "Hotline Bling."

Trump Dance SNL

Sadly, some 60 million voters didn't see what I did, and made the wrong call. I won't let that happen again. The American people deserve to see every candidate dance before they go to the polls. Until the DNC finally listens to wisdom and converts one of their debates to a dance off, I've compiled this list so that you can make an informed decision.

Elizabeth Warren

We'll get the top-tier candidates out of the way first. Senator Elizabeth Warren has nothing to hide. She has been the most upfront, transparent candidate when it comes to her big, structural dancing. And while it may not be everyone's first choice in style, you can not fault her fun-aunt-at-a-wedding energy. The latest example of her eclectic blend of fist pumping and hula dancing comes from last night's Brooklyn rally with—recent dropout and competent dancer in his own right—Julian Castro. She probably just needs a couple more glasses of zinfendel from the open bar before she really loosens up.

Bernie Sanders

Bernie Sanders is surprisingly spry. You might not expect a man in his 70s with heart problems to cut a rug, but Bernie is not your average senior citizen. He has the energy of a man half his age, and the timeless consistency of his dancing allows him to keep up with his young supporters.

Joe Biden

Former vice president Joe Biden dances exactly as you'd expect—slow, old fashioned, and "sweet" in a way that's uncomfortably intimate.

Andrew Yang

Silicon Valley entrepreneur Andrew Yang has more than enough spring in his step to keep up with any roomful of middle-aged women on the dance floor. His universal basic dance moves aim to remind us that we all share one dance floor.

Tulsi Gabbard

Congressional representative for Hawaii Tulsi Gabbard doesn't exactly dance—she dance-fights. Just as with her approach to debates or to the war on terror, her Capoeira moves may be a bit more aggressive than some voters want.

Amy Klobuchar

Minnesota Senator Amy Klobuchar is known for her no-nonsense pragmatism. She strives not to make any promises she can't keep, so she will appear to be the adult in the room...but her dancing tells a different story. Klobuchar dances with the energy of a happy toddler who could enter full-blown tantrum mode at any moment.

Marianne Williamson

Marianne dancing

You may be surprised to find that spiritual guru Marianne Williamson is still in the race, but once you see her dance moves, you'll be surprised she isn't the front runner. She is as one with the music as she is with the vibrations of the universe.

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How Community Organizers Chased Amazon Out of NYC

On Valentine's Day, Amazon pulled out of its plan to build a second headquarters in Queens, citing the efforts of citizen protestors and politicians who opposed its imminent arrival.

The moment Amazon announced that it would be building its second headquarters in NYC's Long Island City, people took to the streets.

On November 26th, a coalition of immigrant advocates and anti-HQ2 groups gathered to protest Amazon's involvement with ICE, Paladir, and other organizations responsible for deportations. Citizens marched again on Cyber Monday, launching a " day of action" and flooding an Amazon Bookstore in Manhattan, holding signs aloft and chanting sing-song rhymes about Jeff Bezos. Together, over two dozen community groups organized these protests, including local unions and nonprofits. Following the protests in Manhattan, Amazon workers employed in warehouses in Staten Island made the decision to unionize, citing low pay and impossible performance quotas, and leveraging Amazon's impending move to Queens to draw attention to their case.

Image via The New York Times

Their protests attracted the attention of some of New York City's political officials, such as City Council Speaker Corey Johnson, who initially supported Amazon's entry but denounced it after learning more about the circumstances surrounding the deal. He began to stand with the protestors, complaining that a general lack of transparency and the fact that Amazon bypassed NYC's standard review process mandated further investigation.

In December, a public hearing was held at City Hall, and protestors gathered outside while council members grilled economists and officials who had been instrumental in making the deal with the world's most profitable corporation. "We are not in the business of corporate welfare here at city council," said Johnson.

It was this so-called corporate welfare—the $3 billion in government and tax incentives that Amazon was promised, in exchange for the 25,000 jobs it promised to create—that became the foundations of the anger stewing around the sales conglomerate's impending arrival, anger which resulted in Amazon's decision to pull out of its promise to develop a huge corporate campus in Queens.

Image via Vox.com

The people's anger came from different places, and their protests were haphazard efforts, but their rage had been brewing for a long time, and Amazon's imminent arrival fed a variety of fears about corporate greed and pervasive gentrification, which opponents feared would tear apart places like Long Island City, sucking it clean of culture and community. Amazon's arrival was predicted to catalyze a wave of homelessness; the announcement that it was setting up shop in Long Island City was instantly followed by dizzying spikes in rent—chilling lower-income residents in a city already plagued by stretches of empty storefronts.

Long Island CityImage via AM NY

Protestors cited Amazon's effects on Seattle, Amazon's first home city, as reasons why the conglomerate shouldn't move on with its plan. Some people argue that Amazon made Seattle into a hull, a kind of paper city that existed only to facilitate its metallic corporate heart; and Seattle's homeless corporation did rise in tandem with rising housing prices, making it home to the third-highest number of homeless people in the country, after New York and Los Angeles.

HQ2 opposition united a great deal of unlikely allies—including an unlikely ally in the Wall Street Journal's Editorial Board, who argued that the deal was "crony capitalism at its worst." Their article continued, "Amazon's case is aboveboard, but it still amounts to a company with a market capitalization of nearly $800 billion getting paid to create jobs it would have created somewhere anyway."

Alexandria Ocasio-Cortez was the most visible face of a group of politicians who protested Amazon's HQ2 establishment, and her resistance might have been one of the central reasons for its decision to abandon ship. "It was that the environment over the course of the past three months had not got any better," said Joni Seth, Amazon's head of policy communications. "There were some local and state elected officials who refused to meet with Amazon and criticized us day in and day out about the plan."

Ocasio-Cortez had long denounced Amazon's plans to move into Queens, and she celebrated Amazon's retraction on Twitter. So did other political figures, including Cynthia Nixon. Following the company's Valentine's Day breakup announcement, the actress-turned politician triumphantly tweeted, "The fight against Amazon laid bare their union-busting, corporate welfare, ICE-abetting practices and shows why we need to break up monopolies like Amazon."

In addition to its ties to law enforcement giants, Amazon had also been accused of developing facial recognition technologies to gain information about customers without them knowing; and many protests have cropped up among its warehouse workers, especially in Europe, where employees have staged walkouts against low wages and poor working conditions.

A protestor stops an Amazon truck in Spain.Image via apnews.com

Despite Amazon's shady ethics, many people were not as enthusiastic about the company's foiled New York City dreams, arguing that the demise of HQ2 will compromise what could've been an economic boom for the city, criticizing Ocasio-Cortez's decision to favor ideology over economics. Amazon may have hiked up rents, but rents are high anyway; and its arrival would have created thousands of jobs, including consistent positions for lower-level staff members and service workers.

Plus polls showed that 56% of New Yorkers approved Amazon's arrival, which was initially billed as a triumph by Mayor Bill de Blasio and Governor Andrew Cuomo—both central players in the deal's initial success who believed that the arrival would help NYC solidify its position as a worldwide hub of tech and industry. Bill DeBlasio's tweets following Amazon's decision resembled those of a spurned ex. He also lashed out at Ocasio-Cortez, stating that "a small group of politicians put their own narrow political interests above their community—which poll after poll showed overwhelmingly supported bringing Amazon to Long Island City—the state's economic future and the best interests of the people of this state," the governor said in a statement.

But even so, a great deal of major political figures opposed the deal, including Senator Michael Gianaris of Queens, who initially supported Amazon's arrival but, like Johnson, changed his mind after learning about its policies. Still, Amazon in Long Island City's demise all started with those first street protests, which erupted directly after De Blasio's announcement as politicians remained silent. Ultimately, community members and citizen organizers catalyzed the start of the resistance that led to the downfall of Amazon's Queens campus.

Image via Marketwatch

There's something deeply satisfying about the image of the world's richest man and his behemothic corporation getting kicked out of New York by impassioned Queens residents, ready to unite and fight for the integrity of their home borough. Still, Amazon's departure won't stop gentrification, won't fill up empty stores, and won't bring back the days when young artists could gallivant around Greenwich Village with pennies in their pockets and working-class families could call Manhattan home.

In a way, Amazon's departure is a symbolic victory for its opposition, a tantalizing promise that the people can triumph over corporations. Of course, this move will not deter Amazon from building its global empire, and America's supermassive wealth gap will remain. It just won't be as tangibly visible in New York.


Eden Arielle Gordon is a writer and musician from New York. Follow her on Twitter at @edenarielmusic.

Male, Female, or X? New York City Will Add A Third Option to Birth Certificates

Come Jan. 1, 2019, the non-binary marker will become a NYC milestone


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Along with California, Washington, New Jersey, and Oregon, NYC is moving away from pre-determined gender identification at birth by adding an "X" option to birth certificates along with "male" and "female." This is a huge step towards greater equality and dignity, not only for transgender and nonconforming New Yorkers, but for the next generation, who will now have the ability to start their lives without a label to live up to. As The Source explains, "The option could be used by parents of intersex children or by parents who want their child to be able to choose a gender at a later date," as well.

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