Question: How’s our weekly New York check-in looking?
Answer: Glad you asked! We checked out New York’s data back in last week’s Q&A of 4/2 where we saw some glimmers of hope — the rate of hospitalization increase was slowing. We also saw some unfortunate trends — the daily numbers of deaths and the case fatality rate were steadily increasing. It’s one week later with another week of social distancing under our belts — about 3 weeks total of widespread social distancing in New York. So, let’s check back in with our three tracking indicators — daily # hospitalized patients, daily # icu patients, daily # deaths — and one more visualization for good measure.
First some good news. As you’ll see in Figure 1, the daily number of patients hospitalized and in ICU is growing at a much slower rate. You can really see the curves leveling off. This would be what we’d expect after three weeks of social distancing! Yay! The numbers hospitalized are also much lower than multiple models had predicted. Double yay! What we’re doing seems to be working!
Now some bad news. As you’ll see in Figure 2, the number of daily deaths is high — a dispiriting trend. To date, at least 7,844 New Yorkers have died due to COVID-19 — and this is all within about a 3 week period. Meanwhile, the case fatality rate is still increasing by the day (Figure 3). As of 4/10, the case fatality rate is: 4.6%. In other bad news, New York City is reporting much higher numbers of deaths at home — 258 deaths on Monday compared with a typical of 25 — that are likely attributable to COVID-19, but not yet captured in reporting data. This news also presents a challenge for understanding hospitalization numbers — are sick people too afraid to go to the hospital? If so, that could be one bad reason that we’re seeing hospitalization and ICU patient numbers leveling-off. That’s mere speculation and I’ll have to dig further into that issue for a different Q&A. The fact that deaths are still quite high while hospitalized patients and ICU patients level off is to be expected as deaths are a lagging indicator (e.g. you would only see deaths begin to level and drop several days to weeks after hospitalizations level and drop).
Because I don’t want to end with bad news, let me close with mixed news (because nothing can be straightforward with this damn virus!) The good news is that New York is now testing at a higher rate per capita than anywhere else in the United States, even more than South Korea, and the daily testing continues to increase. Yesterday, New York conducted 26,336 tests! The bad news is that 40% of tests are still coming back positive (Figure 4). This means that we are still far from conducting enough tests to identify everyone infected. Epidemiologists suggest that a rate of 1 positive test for every 10 tests administered represents a benchmark of a testing system that is able to capture all infections. This type of system is especially important for communities that are easing social distancing — such communities require extensive testing, contact tracing, and case quarantine in order to minimize the risk of community transmission.
Figure 1: Daily Number of Hospitalized and ICU Patients in New York State Is Increasing at a Slower Rate
Figure 2. Daily Deaths Due to COVID-19 in New York State Have Exceeded 700/day over the Last Four Days
Figure 3. Crude Fatality Rate in NYS is Increasing by the Day; 4.6% as of 4/10
Figure 4. NYS Testing Continues to Increase and Positive Cases Continue to Be a Large Proportion of All Tested (40%)
