Health and Science

Cuomo Warns Cluster Effect to Be New Norm for a Year as Hotspots Drive Hospitalizations to Highest Level Since June

Jennifer Millman
New York Governor Andrew Cuomo wears a protective face mask as he arrives to speak during a daily briefing following the outbreak of the coronavirus disease (COVID-19) in Manhattan in New York City, New York, U.S., July 13, 2020.
Mike Segar | Reuters

Even as officials tout hesitant signs of progress in New York's COVID cluster battle, new data shows the alarming impact the hotspots have had already. And the cluster effect will likely be an issue for months to come, the governor says.

Statewide hospitalizations hit 923 Tuesday, the highest total since June 25; they've more than doubled in the last month, and Gov. Andrew Cuomo says cluster areas have driven about 70 percent of the increase in admissions.

He is oversampling the cluster areas in an effort to stamp them out, which has prompted higher daily case totals as well in recent weeks -- and warned in a telebriefing with reporters Monday that flare-ups will be the norm for a year or longer -- until an effective vaccine is widely available and administered.

"The virus, unlike what the president says, the virus is going to stay. The virus is going to flare up in places," Cuomo said Wednesday. "What states have to do, because the federal government is doing nothing, we have to develop a sophisticated capacity to find those mini-clusters where the cases are flaring up and immediately attack them."

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The governor unveiled the restrictions late last week for clusters in Brooklyn, Queens and Rockland, Orange and Broome counties. They apply to varying degrees based on a color-coded scheme that assesses risk by geographical proximity to the cluster. The governor has said he remains hopeful the restrictions will curb the outbreaks; if they do, they won't be in place for much longer.

But they have to be enforced. Cuomo said it has come to his attention that certain red and orange zone schools were operating in person when they are required to be closed under his latest slate of restrictions. Dissatisfied with ongoing local lack of enforcement, Cuomo said the state was taking three actions: First, a notice will be sent to local governments in New York City and Rockland and Orange counties about enforcement priorities, especially when it comes to closing schools and religious gatherings. The state will withhold funds from local governments that fail to enforce the laws, Cuomo warned Wednesday.

All red zone schools will also receive a letter to the effect they should be closed. If they violate that order, Cuomo says the state will withhold funding there as well. Schools that have been identified in violation will be served Wednesday with a notice mandating their closure and notifying them funds will be withheld effective immediately until "the matter is resolved to our satisfaction," Cuomo said.

The harshest restrictions apply to red zone areas, where mass gatherings are banned, indoor dining shelved, nonessential businesses shuttered and capacity caps reinstated on houses of worship and schools moved all remote. Those red zone areas affect just 2.8 percent of the state's population, Cuomo has said. Yet that same 2.8 percent of the population accounted for 12.3 percent of all positive tests statewide Monday and 17.6 percent of all positive cases over the last week.

The positivity rates in those red zones increased a bit Tuesday over Monday, climbing to 4.13 percent from 3.7 percent — but that's still down from a 6.13 percent average last week and 6.91 percent the week before that. Meanwhile, the statewide positivity rate excluding those red zones is 0.9 percent. New York City's remains similarly low on a seven-day rolling average but has ticked up lately.

New York City is also seeing its highest COVID hospitalizations in months, with state data confirming 450 in the five boroughs as of Tuesday, the highest number since June 29. Both Cuomo and Mayor Bill de Blasio have indicated small measures of progress -- the hotspots' positivity rate in the city isn't increasing as consistently as it was and the citywide rolling infection rate isn't either. But with some of the lower numbers hinging on weekend reporting, which tends to see lower testing numbers overall, it may take a few more days to determine a trend.

As the mayor said, this week will be telling. He expects to have a fairly solid idea by Friday if the new measures are helping. Any potential relaxing of restrictions would be coordinated with the state when the timing is right, de Blasio said.

"I believe we can contain the situation, and even if we see it crop up in some other neighborhoods, we have the pieces in place to contain it," the mayor said on CNN late Tuesday. "But this is the week we have to do it. This is the week where we have to turn the tide and make sure there is not a second wave, because, Lord knows, this city was the epicenter and we will not let that happen again."

Even without the clusters, Cuomo had warned it may be impossible for New York state to sustain its low infection rates through fall. Fall means chillier weather, which means more indoor activities. It means flu season. It means schools -- if they can manage to safely stay open.

Public schools across the state have reported more than 1,400 teacher and student positivites since Sept. 8, which was well before in-person learning returned in New York City. Since Sept. 1, state labs have reported nearly 3,800 positives among children ages 5 to 17, though there may be some duplication between lab reports and the data reported by schools.

New York City schools have reported more than 300 cases from on-site transmission in schools, though Friday's first day of mandatory testing in yellow school zones yielded just one, at a high school in the Bronx. De Blasio described those results, which came of more than 1,750 tests across 50-plus schools, as highly encouraging.

"It did take us a few weeks to get the school year going, but now it's going full bore all over the city. You know, we have 1,600 schools and except for some temporarily closed in those particular zones, the vast majority are up and running, and running well," the mayor said. "So, the schools have been a positive point ... We're getting overwhelmingly good results from testing in schools."

New Jersey has confirmed at least 16 separate public school outbreaks and nearly 60 cases as of Gov. Phil Murphy's last report. Asked last week about whether recent upticks could prompt new restrictions on indoor gatherings as they have in New York, Murphy said that "everything is on the table."

Like New York, New Jersey has seen some of its highest new daily case totals and hospital admissions in months in recent days. Connecticut is also facing its highest COVID hospitalizations since June, though the 172 as of the state's last report is much lower than the neighboring tri-states' totals. As of late, Fairfield County has consistently had one of the state's highest hospitalization levels.

At the same time the tri-state governors combat new upticks at home, they face the ongoing threat from out-of-state travel. The COVID numbers are once again increasing nationally and globally. America reported its highest daily case number in nearly two months on Friday, which was the same day the World Health Organization reported a new daily case record worldwide.

Echoing the words of Cuomo and de Blasio, U.S. infectious disease expert Dr. Anthony Fauci urged Americans Tuesday to return to focusing on the "fundamentals" in order to stem the tide: mask up, wash hands, socially distance.