As of Oct. 5, we have surpassed 35 million cases of COVID-19 and nearly 1.1 million deaths worldwide. In the United States alone, we’ve recorded an estimated 7.5 million positive cases and nearly 210,000 COVID-19 related deaths. Meanwhile, in New York City, the number of positive cases has been steadily increasing for over a week and now the seven-day average is above 3% in several zip codes. The city’s public schools just reopened to in-person classes, and indoor dining at 25% capacity just started.
These steps toward normalcy, however, will be very short-lived as the cases continue to increase, and infectivity is spiraling out of control due to those who still refuse to wear masks and maintain physical distancing and continue to congregate in large groups. Instead of playing catchup, we need leaders to step up and make hard decisions for the benefit of the greater good. We need leaders who will lead us with real, proactive solutions.
From a public health perspective, we should certainly not be surprised by these spikes in COVID-19 cases. When we increase population density, the likelihood of spread will increase, especially when safeguards are not followed. Even more caution must be taken as research has shown that asymptomatic persons are also infectious. We need for everyone to follow the precautions such as frequent hand-washing (or use alcohol-based hand sanitizer), observing face-mask requirements when indoors, and keeping physical distancing in effect. It only takes a handful of persons breaking preventative protocols to be the vector for spreading this virus and increasing the rates throughout communities.
One of the most troubling aspects of the recent spike in cases is that our leaders continue to hesitate to act proactively and to stop oscillating. The back-and-forth produces even more frustration and loss of credibility in our overall leadership as work schedules must be abruptly changed to meet the new restrictions. Using the NYC Department of Education as an example, from the very beginning, leadership should have implemented virtual learning for all students through the end of the year. We already knew and expected for rates to increase due to a variety of factors.
Sure, it would be hard for some parents to figure it out, but at least they could have a consistent plan for three months rather than prepare, change, then change again at the last minute, open the schools and then change back to remote learning anyway. This instability can be very taxing for parents of children in the school system even with two parents in the household as not everyone can work remotely.
Another example of reactive leadership is indoor dining in New York City. It reopened just a few days ago and will probably be closed again soon due to the increasing infectivity rates in many communities throughout New York City.
COVID-19 does not respect zip codes. By this, I mean that closing only specific zip codes or infectious zones defined in other ways won’t work. People are mobile. Thus, even with the newly imposed restrictions, the rates will end up increasing in all areas, not just the specific ones. In turn, rates in surrounding zip codes could also increase. At this point, it would be better to implement any restrictions on all of New York City for at least 30 days. Doing piecemeal closures only in certain zip codes will be very disruptive for businesses, schools and households.
This is a public health emergency and as such, there needs to be strong coordination and collaboration between the public and private sectors. Every person needs to do their part and follow the established precautions. If we had all done that up to this point, we would not be having this discussion. It only takes a few persons to disrupt us all.
Contreras is assistant director of the Center for Disaster Medicine and assistant professor, Institute of Public Health, and adjunct professor at Metropolitan College of New York and adjunct associate professor at John Jay College of Criminal Justice. He also works as a paramedic in New York City.
