Monday, April 27, 2020

Seattle and New York: A Tale of Two Cities.

The article, by Charles Duhigg in The New Yorker is long and detailed and comprehensive. It addresses a question I have occasionally raised: how has it happened that New York State, under the much lauded leadership of Gov. Andrew Cuomo has become the epicenter of the coronavirus outbreak? How has New York State become the nation’s leader in coronavirus deaths? 

If people still believe that Cuomo and New York City Mayor de Blasio are portraits in great political leadership, it shows how propaganda can create reputations out of nothing.

So, Duhigg compares the New York leaders with those in Seattle, Washington. He finds, unsurprisingly, that the Seattle response was more effective, by a great deal.

He offer this observation about the situation in the state of Washington:

Today, Washington State has less than two per cent of coronavirus cases in the U.S. At EvergreenHealth, hospital administrators have stopped daily crisis meetings, because the rate of incoming patients has slowed. They have empty beds and extra ventilators. The administrators remain worried, but are cautiously optimistic. “It feels like we might have stopped the tsunami before it hit,” Riedo told me. “I don’t want to tempt fate, but it seems like it’s working. Which is what makes it so much harder when I look at places like New York.”

In New York City and State the response was radically different:

The initial coronavirus outbreaks in New York City emerged at roughly the same time as those in Seattle. But the cities’ experiences with the disease have markedly differed. By the second week of April, Washington State had roughly one recorded fatality per fourteen thousand residents. New York’s rate of death was nearly six times higher.
There are many explanations for this divergence. New York is denser than Seattle and relies more heavily on public transportation, which forces commuters into close contact. 

In Seattle, efforts at social distancing may have been aided by local attitudes—newcomers are warned of the Seattle Freeze, which one local columnist compared to the popular girl in high school who “always smiles and says hello” but “doesn’t know your name and doesn’t care to.” New Yorkers are in your face, whether you like it or not. (“Stand back at least six feet, playa,” a sign in the window of a Bronx bodega cautioned. “covid-19 is some real shit!”) New York also has more poverty and inequality than Seattle, and more international travellers. Moreover, as Mike Famulare, a senior research scientist at the Institute for Disease Modeling, put it to me, “There’s always some element of good luck and bad luck in a pandemic.”

On the one hand, it was about effective communication.

It’s also true, however, that the cities’ leaders acted and communicated very differently in the early stages of the pandemic. Seattle’s leaders moved fast to persuade people to stay home and follow the scientists’ advice; New York’s leaders, despite having a highly esteemed public-health department, moved more slowly, offered more muddied messages, and let politicians’ voices dominate.

In New York City the incompetent leftist Bill de Blasio botched his job:

New York’s mayor, Bill de Blasio, has long had a fraught relationship with the city’s Department of Health and Mental Hygiene, which, though technically under his control, seeks to function independently and avoid political fights. “There’s always a bit of a split between the political appointees, whose jobs are to make a mayor look good, and public-health professionals, who sometimes have to make unpopular recommendations,” a former head of the Department of Health told me. “But, with the de Blasio people, that antagonism is ten times worse. They are so much more impossible to work with than other administrations.” In 2015, when Legionnaires’ disease sickened at least a hundred and thirty New Yorkers and killed at least twelve, tensions between de Blasio and the Health Department came to a head. After de Blasio ordered health officials to force their way into buildings in the Bronx to test cooling towers for contamination, even though the outbreak’s source had already been identified, the officials complained that the Mayor was wasting their time in order to brag to reporters that he’d done everything possible to stamp out the disease. When the deputy commissioner for environmental health, Daniel Kass, refused City Hall’s demands, one of the city’s deputy mayors urged the commissioner of health, Mary Bassett, to fire Kass. She ignored the suggestion, but Kass eventually resigned. He later told colleagues he felt that his rebellion had made coƶperation with City Hall impossible.

“Dan Kass is one of the best environmental-health experts in the country,” Bassett, who now teaches at Harvard, said. “New York has one of the best health departments in the United States, possibly the world. We’d all be better off if we were listening really closely to them right now.”

So, compare and contrast, especially the way that de Blasio and Cuomo were minimizing the risk at a time when Washington State officials were sounding alarms::

In early March, as Dow Constantine was asking Microsoft to close its offices and putting scientists in front of news cameras, de Blasio and New York’s governor, Andrew Cuomo, were giving speeches that deĆ«mphasized the risks of the pandemic, even as the city was announcing its first official cases. De Blasio initially voiced caution, saying that “no one should take the coronavirus situation lightly,” but soon told residents to keep helping the city’s economy. “Go on with your lives + get out on the town despite Coronavirus,” he tweeted on March 2nd—one day after the first covid-19 diagnosis in New York. He urged people to see a movie at Lincoln Center. On the day that Seattle schools closed, de Blasio said at a press conference that “if you are not sick, if you are not in the vulnerable category, you should be going about your life.” Cuomo, meanwhile, had told reporters that “we should relax.” He said that most infected people would recover with few problems, adding, “We don’t even think it’s going to be as bad as it was in other countries.”

And, of course de Blasio and Cuomo often talked at cross purposes:

On March 17th, de Blasio told residents to “be prepared right now for the possibility of a shelter-in-place order.” The same day, Cuomo told a reporter, “There’s not going to be any ‘you must stay in your house’ rule.” Cuomo’s staff quietly told reporters that de Blasio was acting “psychotic.” Three days later, though, Cuomo announced an executive order putting the state on “pause”—which was essentially indistinguishable from stay-at-home orders issued by cities in Washington State, California, and elsewhere. (A spokesperson for de Blasio said that City Hall’s “messaging changed as the situation and the science changed” and that there was “no dithering.” A spokesperson for Cuomo said that “the Governor communicated clearly the seriousness of this pandemic” and that “the Governor has been laser focused on communicating his actions in a way that doesn’t scare people.”)

Eventually, New York caught up:

Today, New York City has the same social-distancing policies and business-closure rules as Seattle. But because New York’s recommendations came later than Seattle’s—and because communication was less consistent—it took longer to influence how people behaved. According to data collected by Google from cell phones, nearly a quarter of Seattleites were avoiding their workplaces by March 6th. In New York City, another week passed until an equivalent percentage did the same. Tom Frieden, the former C.D.C. director, has estimated that, if New York had started implementing stay-at-home orders ten days earlier than it did, it might have reduced covid-19 deaths by fifty to eighty per cent. Another former New York City health commissioner told me that “de Blasio was just horrible,” adding, “Maybe it was unintentional, maybe it was his arrogance. But, if you tell people to stay home and then you go to the gym, you can’t really be surprised when people keep going outside.”

New York had more than twenty times the fatalities than Washington:

More than fifteen thousand people in New York are believed to have died from covid-19. Last week in Washington State, the estimate was fewer than seven hundred people. New Yorkers now hear constant ambulance sirens, which remind them of the invisible viral threat; residents are currently staying home at even higher rates than in Seattle. And de Blasio and Cuomo—even as they continue to squabble over, say, who gets to reopen schools—have become more forceful in their warnings. Rasmussen said, “It seems silly, but all these rules and sohcos and telling people again and again to wash their hands—they make a huge difference. That’s why we study it and teach it.” She continued, “It’s really easy, with the best of intentions, to say the wrong thing or send the wrong message. And then more people die.” 

When you look at the de Blasio and Cuomo leadership, you start thinking that Fredo’s brother is not going to be running for president any time soon.

4 comments:

Sam L. said...

I live in Washington, but nowhere near Seattle. My wife has a son who lives there, and he's working from home.

"Rasmussen said, “It seems silly, but all these rules and sohcos and telling people again and again to wash their hands—they make a huge difference." What is/are "sohcos"?

Anonymous said...

comparing Seattle and nyc? I lived most of my life in Seattle, med school in NYC, I know both.
The density and society are completely different.
Seattle:
Social Distancing: What do you call asking your coworker of 10 years to dinner for the first time? stalking

I saw my neighbor of 30 years across the alley, who I have not spoken with in 10 years I said "Hi" He replied, "No need to get clingy due to the virus!"

When social distancing ends, no one in Seattle will notice!

Ignatius Acton Chesterton OCD said...

I would never live in New York City. I can last a visit as in NYC long as I can in Las Vegas — and for different kinds of mental trauma.

Ignatius Acton Chesterton OCD said...

Anonymous, please elaborate. I hav Eno idea what you’re talking about. Are the people of Seattle just completely disconnected from each other? I always felt that way about NYC.