Until a very few days ago, social distancing conjured for most New Yorkers an image of, say, the rich and famous rising above the rest of us as they sashayed up the steps of the Metropolitan Museum for the fashionistas’ Met Ball.
But in this time of coronavirus, social distancing has taken a far more physical, and urgent, meaning. Keep your distance, regardless of social status, class, wealth, race or celebrity. It is as if the public health experts are warning that to protect ourselves and our fellow New Yorkers we all must, immediately, stop doing many of the things that more or less define what it is to be a New Yorker.
The Hard Truth from an Expert
“New Yorkers are very social in general,” said Demetre Daskalakis, who is paid to know our behaviors better than we often know them ourselves. He is Deputy Commissioner for Disease Control at the New York City Department of Health. In a videotaped conversation with fellow doctors at Mount Sinai Hospital, Dr. Daskalakis made clear that curbing some of our basic behaviors had become a public health imperative.
“Everyone who lives in New York knows that we are tough,” said Dr. Daskalakis. “And tough means, ‘I go to work even though I’m sick.’ Not this year, you’re not. This year, stay home! It’s tougher to stay home than to come to work. It’s braver to stay him than to come to work in this scenario.”
The doctor’s point: The global effort to prevent the spread of Covid-2019 has failed. “That ship has sailed,” said Dr Daskalakis. “Probably before we even know there were 100 cases in China.”
The goal now is “mitigation,” reducing the damage by slowing the spread so that the pandemic does not overwhelm medical systems. Dr. Daskalakis showed the other doctors a graphic, also circulating widely on the internet, illustrating two pathways. In one, Coronavirus spreads quickly, peaking with a number of cases far larger than all the hospital beds, breathing machines and intensive care units available. In that scenario people die because they can’t get adequate care.
The other pathway stretches out longer, but has a much lower peak, a “flatter curve” that is hopefully within the medical systems capacity to handle. There will probably be just as many cases of COVID-19, either way. But by spreading them out, medical care can cope better. This is why New Yorkers are being asked to learn the new meaning of social distancing.
Dr. Daskalakis said the virus is already more prevalent in New York City than the number of positive tests is capturing. “It’s already here,” he said. He knows this because the city gets a report every hour on visits to emergency rooms, which serve as family physician and health clinic for many New Yorkers.
Reports of “flu-like symptoms” are rising, while the number of positive tests for the flu is not. “There is something causing illness in New York City and it’s not the flu,” Dr. Daskalakis said. Many of these cases are quite mild, the doctor said, making it all the harder to get New Yorkers to recognize that they are likely carrying a dangerous virus.
“This is why you’re seeing us say, ‘community transmission, community transmission.’ It’s not about the guy coming back from China any more. It’s about the fact that we all have to take care of each other and not come to work when we’re sick.”
Dr. Daskalakis briefed the Mt. Sinai doctors a week ago, Tuesday, March 10. He was preparing them for the shape of things to come. The next day, The World Health Organization declared Coronavirus a global pandemic. Over the seven days since Dr. Daskalakis’ briefing, New Yorkers, starting with his boss, Mayor DeBlasio, have struggled to adapt, sometimes painfully, to his message that we have entered a public health emergency of a sort the city has not faced in generations, if ever.
“Our lives are all changing in ways that were unimaginable just a week ago,” the Mayor acknowledged Sunday evening, without mentioning that Dr. Daskalakis had actually imagined it a week before.
Sunday the Mayor ordered schools and movie theaters closed and restricted bars and restaurants to delivery and take-out orders only. “These places are part of the heart and soul of our city. They are part of what it means to be a New Yorker.”
The City Responds
Elia Kazan, one of millions of immigrants to adopt New York as home, made a movie in 1950 called “Panic in the Streets,” about a public health doctor trying to prevent the spread of plague virus in a gritty city. Panic in the streets has not been the problem here, with the possible exception of Wall Street.
Vital business and tourism spots seemed calmer and emptier as the week wore on. From his cart in Times Square, one coffee vendor said his business was off sharply and that the quiet was an unsettling echo of the days after September 11, 2001. He worried, however, that this would last much longer.
In neighborhoods around town anxiety, gallows humor and makeshift adaptation prevailed. There was also a sense of alarm that New Yorkers were not yet getting the full severity of the challenge.
“NYC has a sense of normalcy tonight” Mark D. Levine, chair of the City Council Health Committee observed on Saturday night. “Lots of bars and restaurants are full. And this is a huge problem. We need everybody to avoid crowds and congested places. To avoid close contact with strangers. To shelter at home if at all possible. We need to end the denial and skepticism.”
From a coffee shop on Morningside Heights, Kyle Pope, editor and publisher of Columbia Journalism Review, reported on Thursday that “people who are supposed to be social distancing are jammed together for remote work.”
Mayor DeBlasio often seemed to be hustling to keep up. He resisted canceling Broadway or the St. Patrick’s Day parade, until the governor did it. He resisted closing the schools, until teachers and parents demanded he do it. He ordered bars and restaurants restricted after Council Member Levine and others railed about their crowds.
It was not so much that everyone was out for themselves – although that could be a conclusion from the run on hand sanitizer and toilet paper – but that everyone was making up their own rules or just had no idea what the rules should be.
The disparities of New York life have been brought into high relief at times. While subway rides in Manhattan were way off, rides from the outer reaches of The Bronx, Brooklyn and Queens barely dropped as lower income New Yorkers struggled to keep working.
The city’s prestigious private universities moved quickly to shutter campus and scatter their students and staff. But the City University of New York moved far more judiciously. “The problem at so many CUNY schools is kids don't have computers or laptops at home and many of them don't have wi-fi at home,” a university exec explained. “If profs put stuff online, they need to go to campus to access it. It's a huge equity issue. Easy for kids at elite Unis to access their stuff but CUNY not so easy.”
CUNY ultimately decided to move classes online but leave campuses open for students who needed them.
Flavors of Leadership
A longing for leadership spread as quickly as the virus. Some of the most decisive leaders were found on the medical front lines. Dr Daskalakis was one. Laura Popper, a well-known East Side pediatrician, was another.
She said her practice has “changed our daily schedule radically” with“zero guidance from any government agency.” In a message being shared on Facebook by the anxious parents of her patients, Dr. Popper wrote: “We have removed all toys, books and stickers from the office. From early morning until mid-afternoon we will only see patients who are cough and fever free. Anyone with a possibility of Corona is asked to stay home. From 4 p.m. until closing, we will see ‘the sick’ kids. From 4 p.m. on, we all wear N95 masks, protective goggles, gowns and gloves. After the last patient has left, we disinfect the entire office.”
Dr. Popper explained that all of these adaptations had been “self-generated.” She sharply criticized President Trump and the public health establishment. “We all need guidance from our leaders,” she wrote.
Others raised this same point after Mayor DeBlasio and transit officials urged New Yorkers to stay calm and move to a less crowded Subway car, or avoid the subway altogether. Mass transit dependent New Yorkers made it clear this advice was about as helpful as counseling passengers aboard the Grand Princess that they should self-isolate in their cabin, but could swim home if they cared to.
“We need to get a doctor to talk to us during this difficult time,”said Sarah Peltz, a midtown receptionist and transit podcaster, who has been working from home in Bay Ridge.“The Mayor should stop talking. He has no medical knowledge and he causes more anxiety and stress.”
The Mayor declared a state of emergency on Thursday, saying "It's going to get a lot worse before it gets better." This directness was the beginning of a shift after he vacillated about postponing the St. Patrick’s Day parade, even though public health literature is replete with how Philadelphia’s failure in 1918 to cancel a major parade accelerated the flu there. Governor Cuomo ultimately pressed the organizers to postpone the march for the first time in its history.
The crisis seems to have brought out the core personalities of the governor and the mayor, even as reflected through their agencies. Governor Cuomo, second of that name to serve, is well known, as was his father, for his self-professed consistency. “The guidance has never changed,” the governor’s special counsel, Beth Garvey stressed, when asked about confusion over quarantine guidance. “The recommendation has always been if you’re exposed or in close contact with someone who’s positive, you should isolate yourself.”
The Mayor, in contrast, is often thought of as, well, less attentive to such detailed purity of thought. “As the situation has evolved so too has our guidance to people,” Patrick Gallahue, spokesman for the city health department clarified, sort of.
On Sunday night the Health Department tweeted that“everyone in NYC should act as if they have been exposed to coronavirus.”
Figuring Things Out
New Yorkers struggled to figure out exactly what is OK, and what’s not OK. There was some reason to worry that the novel coronavirus was confusing that portion of the brain which regulates common sense. This is not the finding of a controlled research study, as yet, but anecdotal evidence abounds.
Jessica Haller of Riverdale was not under quarantine last week, a blessing perhaps to her campaign for City Council. But her children were quarantined because someone in their school tested positive as the result, apparently, of the importation of the virus from a foreign territory known as Westchester.
“I’m not allowed to let people into the house,” said a puzzled Ms. Haller. “But I’m allowed in and out of the house.”
Ms. Haller’s befuddlement was reported to an anxious city by the New York Times. The Times, however, added to the puzzle by publishing along with the story a picture of Ms. Haller with her three children, in the close quarters of their kitchen.
This left the mystery of the photograph, which was credited to Victor J. Blue, a prominent New York based photojournalist “whose work is most often concerned with the legacy of armed conflict, human rights and the protection of civilian populations, and unequal outcomes resulting from policy and politics.”
This photojournalistic purpose has taken Blue to Afghanistan, Syria, Mexico, El Salvador, Honduras, Iraq, India and, now Riverdale, where certainly protection of civilian populations is the question. Blue, reached by email, explained what the Times had not. “The family was under quarantine, and I respected the quarantine,” he explained. “I shot all of those pictures from their back door, leaving open the screen door and shooting from the step. I used my zoom lenses for a variety of angles, and made sure not to step inside.”
Blue, who has braved any number of dangers for his photo-journalism, reported that his precautions are much the same as the rest of us. “So far I have been doing what everyone is doing- washing my hands a lot, and being careful what to touch when I’m working.”
The More Things Change...
By Monday, March 16, the city was well down the road to shutdown even if odd juxtapositions continued.
Manhattan Day School said its sixth through eighth graders were under “precautionary quarantine” after a seventh grader’s sibling tested positive. Yet, right outside, on West 75th St., one of New York’s defining rituals continued as if life was normal. A traffic officer was plastering tickets on cars for violating alternate side parking. Perhaps, a last hurrah? On Tuesday the city said it was suspending enforcment for at least a week.
Only in New York, as Cindy Adams would say, kids, only in New York.
Updated: March 16, 2020, 2:30 p.m.