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One thing I’ve noticed in this thread is the effort to explain why Florida now has roughly the same amounted of lab confirmed cases as New York and yet vastly fewer deaths. This is mostly a misunderstanding. To a very limited degree higher fatalities are likely due to ... https://twitter.com/joshtpm/status/1287521833449906178
2/ an improved standard of care during the outbreak in Florida - better understanding of how to treat the disease and hospitals not overwhelmed. But the big difference is that the number of cases aren’t remotely similar. The key is **lab confirmed** cases. For most of the ...
3/outbreak in New York testing capacity was extremely limited. Most cases were never diagnosed. If we had July testing capacity in March and April it’s likely that New York’s daily cases count at the peak would have been 5 to 10 times higher. And probably closer to 10x.
4/ One reason we know this is simply from the death toll itself. But we know it in more direct ways too. From March 28th to April 15th test positivity in New York averaged 47%. Wildly higher than any other state has ever been at. More concretely, post outbreak serology ...
5/ tests estimated that roughly 20% of NYC’s population of 8.7 million had been infected. So we’ll over 2 million people. That’s just in New York City. It doesn’t count the near suburbs to the north and Long Island. Many cases are being missed in today’s Crisis States too.
6/ But the multiples are radically different. People are drawing various conclusions from this misunderstanding - that covid is now less lethal, that the deaths are still coming, that NY just botched the situation, etc. But again, the premise is false. Vastly more people were ...
7/ in New York than any of the other states like CA, FL, TX, etc. now why that was the case is another question. There are three big reasons. The first and most important is that the lack of testing meant that the outbreak raged out of control for weeks before anyone actually ...
8/ knew it was happening or was doing anything about it. Genomic analysis now strongly suggests that the New York outbreak began late in the second week of February. So if we’d had the daily testing charts we would have seen the trend line arching up in ...
9/ the middle of February. But no meaningful efforts to combat it started until six weeks later, around March 20th. Why? No testing. No one knew what was happening. The other cause was a failure of government leaders, particularly Bill Deblasio but also governor Cuomo.
10/ The writing was on the wall but deblasio firmly resisted shutting down or even closing the schools. For most of those six weeks you can’t really blame them because they had no way of knowing what was happening because of the testing failure at the national level.
11/ But even without testing, they likely should have shut everything down a week earlier than they did. That would have made a big difference. Again: DeBlasio. The third factor is population density. New York has by far the highest population density of anywhere in the ...
12/ United States. It’s possible to control covid in super high population density cities. NY is showing that now but so have Hong Kong, Tokyo and many other cities. But if you let a full blown outbreak run free with basically zero mitigation for six weeks the consequences ...
13/ in a city with such density and subway and bus use is going to be catastrophic, which of course it was.
14/ Should be obvious but NY largely had to confront covid with no good tools and very limited knowledge. The present crisis states had pretty solid roadmaps for mitigation, though still few effective medical interventions, and basically chose to ignore the roadmap.
