Just three weeks after discovering its first coronavirus infection, New York City has seen an explosion of cases that look set to make the United States the new epicentre of the disease.
The city itself has seen in excess of 13,000 recorded cases, up from just 5,700 on Friday. To put that in perspective, London – a similar sized city which has seen more than a third of all UK cases – has recorded around 2,400. That’s despite the fact New York has ordered doctors not to test anyone with “mild to moderate” Covid-19 symptoms, to ensure health services are not overwhelmed.
It is dangerous to draw too many conclusions from the number of confirmed cases – they inevitably tell you as much about the testing regime as the situation on the ground. Taken at face value, however, only six countries – China, Italy, Spain, Germany, Iran and France – have recorded more cases than New York.
As striking as the extent of the spread is its speed. In the Bronx there were 96 confirmed cases on 17 March, but 1,999 just six days later. In Queens the number rose from 248 to 3,848.
New York governor Andrew Cuomo conceded the job of public officials now was not to stop the virus but to “slow the spread”, warning his state that up to 80 per cent of people could contract the virus. The confirmed cases alone represent 0.1 per cent of the population – one in 1,000 – and reports are already mounting of stretched hospital services.
While the number of confirmed cases comes with statistical caveats, the number of deaths is more robust. And the rate of Covid-19-related deaths in New York state is fast outpacing anything that we have seen in European hotspots such as Italy, Spain and the UK.
Why has New York been hit so hard? In part it may be simply a matter of the US catching up with the rest of the world. When scientists at Imperial College London warned more than 500,000 people could die in the UK if no action was taken to halt the spread of Covid-19, they also suggested America could see a death toll of 2.2 million. They suggested fatalities there would peak slightly later and lower – due to the population being more spread out – and that cases would cluster around cities, but that the shape of the curve would be the same. All that appears to be coming to pass.
Fingers have also been pointed at the slow and apparently contradictory responses by Donald Trump, and by extension the federal government – leaving states to make their own decisions on preventive measures and social distancing.
But New York also points to something else. The spread of coronavirus around the world has so far been particularly notable in commuter cities – places with highly mobile populations and well-developed public transport networks. The highest concentration of coronavirus cases in the UK is in London, and Italy has more infections and deaths in northern urban areas than in southern rural regions.
Compare the spread of coronavirus in New York to the rest of the US and a less dramatic but similar picture emerges. States with large built-up areas are experiencing greater infection and death rates than their rural counterparts, particularly in neighbouring New Jersey, the rust belt regions of Michigan and Illinois, and, on the other side of the country, Washington.
The experience of Americans who have so far contracted coronavirus – as studied by the Centers for Disease Control and Prevention – has mirrored that of China and Italy. Fewer than 0.2 per cent of Covid-19 cases among people aged under 45 in the US have resulted in death. That rises to between 10.4 and 27.3 per cent for those aged over 85.
Some 45 per cent of all Covid-19 related hospitalisations and 80 per cent of deaths have so far occurred among those aged 65 and over. That doesn’t mean that younger people are immune – around a quarter of those aged 45-54 and nearly one in five aged 20-44 have needed hospital treatment. If the US was ever complacent about the threat, that time has passed; what remains to be seen is how much damage has already been done.