Tales Of Two Cities: Coronavirus Outcomes Differ Between Bay Area, New York City

Apr 1, 2020
Originally published on April 2, 2020 3:54 pm
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MARY LOUISE KELLY, HOST:

Social distancing, flattening the curve - they are phrases that a month ago didn't mean that much to most Americans. Now we hear them multiple times each day. Is social distancing working? When will the curve begin to flatten? They're questions that are asked over and over by officials, journalists, all of us living through this pandemic. We are going to spend the next several minutes trying to answer those questions about two parts of the country where the curve seems to be progressing very differently - California and New York. I'm joined now by NPR's Rebecca Hersher and John Ruwitch.

Welcome, you two.

JOHN RUWITCH, BYLINE: Hello.

REBECCA HERSHER, BYLINE: Hello.

KELLY: Hi, so, Becky, you first. We keep hearing in New York the curve is going up and up and up. Is that holding true today?

HERSHER: Yes, we're seeing a lot of coronavirus cases in New York. Nearly 50,000 people have tested positive. Nearly 2,000 people have died in the city. Hospitals are full of people with severe cases of COVID-19. Some doctors and nurses are starting to get sick. And as the governor of New York, Andrew Cuomo, said today, New York is still climbing the mountain.

KELLY: John, where you are in California, the curve is also going up but not quite so dramatically.

RUWITCH: Yeah. That's right. I mean, so far, California is not experiencing anything like what's happening in New York. The caseload here is a fraction of New York's today. Gavin Newsom, the governor of California, announced that there were just over 8,100 confirmed cases in the state. And it's America's biggest state - right? - with about 40 million people. One thing to note is that California has been behind New York in terms of testing, so we don't really have the full picture. But experts and the government here are keeping track of hospitalizations and numbers of people in ICUs as sort of the key indicators. And those numbers are lower than New York's, too.

KELLY: And where you are in California, the Bay Area specifically, was one of the earliest parts of the country to issue a shelter-in-place order. So let me get to the why question. Is that early shelter-in-place order one possible reason why cases there seem to be progressing more slowly?

RUWITCH: Yeah. Doctors I've talked to here think the shelter in place has potentially been a big part of it. People here have certainly been taking it seriously - and it's worth noting - for over two weeks now, which is the outer limit of what people think the incubation period is for this virus. I'm in a town about 30, 40 minutes south of San Francisco. I'm on the balcony now, actually, overlooking the southern part of the San Francisco Bay. And this is anecdotal, but the visibility has been great over this - during this shelter-in-place period. But also, the 280 freeway, which is a major artery between San Jose and San Francisco, has had noticeably less cars on it.

I spoke with George Rutherford. He's a professor of epidemiology and biostatistics here at Stanford. He says things could look a lot worse here for sure, but there's just not enough data yet to say that we're out of the woods. Here's what he had to say.

GEORGE RUTHERFORD: Preliminary, very preliminary indications are that things seem like they're going in the right direction. But it could all change quickly, and we want to make sure everybody keeps doing what they've been doing.

RUWITCH: To that end, the counties and cities around the Bay Area here have just extended shelter in place through early May.

KELLY: All right. I'm going to try to suppress my jealousy at the view you are enjoying there looking out over the ocean. The view, at least, sounds really good. Becky, let me flip back to you and ask about what is driving the trajectory there in New York, which is also under stay-at-home orders. So how does that factor in?

HERSHER: Yeah. New York did issue its stay-at-home order slightly later than California and especially almost a week later than the Bay Area. And that may matter. It's too soon to know, though. What epidemiologists have told me about what's happening in New York - what's definitely important that we already know is important is the density. So you can just imagine people are living in buildings with a lot of other people, right? New York City, Manhattan, even the outer boroughs - they're extremely dense. And there's a huge reliance on mass transit.

So people - they're packed closer together. They're sharing more surfaces - elevator buttons and door handles and railings. Like, imagine getting food without a car, without touching anyone or anything. It's really hard. And authorities are trying to crack down. They announced today that they're closing city parks, trying to keep people more separated. But at the end of the day, when you live that densely packed, it's difficult to control the spread. And so when you look at the curve - and it's going up really steeply - that's part of what you're seeing.

KELLY: And you get some of the issues of just enforcement in a city like New York, where people are living in - a lot of them living in small apartments. And I was watching press briefings today where they were talking about closing playgrounds, as you mentioned, closing parks and just the difficulty of keeping people out, keeping people from congregating.

I want to flip to both of you with - for your take on this question before we go, which is that all of these projections for what might happen to the curve and when it will flatten - the projections are based on models. The models are only as good as the data fed into them. What are some of the assumptions for each city? Becky, you go first.

HERSHER: So one of the big things that the leading nationwide model assumes is that states that haven't put strict social distancing measures in place will do so within a week from now. And that's a big if, right? We can't say what governors will do. The other thing is it assumes that all states will keep the measures in place until June 1. That's a really long time. You know, the White House's guidelines have only been extended until the end of the month. And so that's a big assumption that's baked into all of these curves that we're looking at.

KELLY: And, John, how about in California?

RUWITCH: Yeah. In California, it's a similar situation. I mean, there's - the governor was speaking earlier today about preparing for a two-thirds increase in the number of hospital beds. And they showed various charts about which direction the epidemic will go. It's all dependent on people sheltering at home and hunkering down, basically. And as he said, you know, it's actions that are really going to affect the way this goes, not projections.

KELLY: All right. That is NPR's John Ruwitch reporting from a balcony in the Bay Area and Rebecca Hersher reporting on what's happening in New York.

Thanks so much, both of you.

RUWITCH: Thank you.

HERSHER: Thanks.

[POST-BROADCAST CORRECTION: In this report, the school affiliation for George Rutherford is misidentified. He is a professor of epidemiology and biostatistics at the University of California, San Francisco.] Transcript provided by NPR, Copyright NPR.