April 17 - COVID-19 in Westchester County, NY

The White House Coronavirus Task Force issued their "Guidelines for Opening Up America" yesterday. In order to begin the phased opening, states (or regions) must meet several "gating" criteria. Depending how you interpret them, Westchester could be ready soon OR Westchester is still many weeks away.

I have two minor problems with the plan.  First, the plan places no value on antibody testing for reopening.  What if random testing in Westchester finds that 50% of the population carries antibodies? That would lower the risk of reopening Westchester.  It also means the virus is much less deadly than thought (0.1% mortality).

Second, it puts too much weight on a reduction in cases and too little on hospital utilization.  Who cares if cases go up if they are not clogging the hospitals? For example, people under 30 are seldom hospitalized with the virus.  If they contract the virus as they return to work or school, who cares? They add immunity to the community in preparation for the scenario where a vaccine is not found.  (Remember...there is no vaccine for HIV or swine flu or...)

Gating Criteria for Cases
The guidelines recommend: "Downward trajectory of documented cases within a 14-day period OR Downward trajectory of positive tests as a percent of total tests within a 14-day period (flat or increasing volume of tests)"

Westchester, NYC, and Nassau County do not meet the first part of that criteria. See below. 

New Cases Trajectory

If you plot the NYC data based on 'Date of Swab' (as NYC is now doing) the trend is not yet clear as reporting lags by up to 5 days.

NYC Case Trajectory - recent data is incomplete

The State of New York certainly does not meet the criteria.  Most areas outside of NYC are still on an upward trajectory.  But the major driver for the increase in cases is the huge increase in testing.

NYS Case Trajectory - Yellow bars

The second part of this gating criteria gives the option of looking at the trajectory of the percent testing positive (instead of new case trajectory).  Looking at the results below, you could maybe argue that Westchester has a downward trajectory for this criteria over that past 14 days.

Percent Testing Positive Trajectory

It will be interesting to see how the NY Governor interprets these criteria.  He has already stated we are closed for another four weeks without even giving a criteria for opening.  Arghh!!!  We might revolt like Michigan. Our Mayor (Yonkers) has stated that 40% of the Yonkers deaths were in nursing homes and that the majority of the deaths in Yonkers were of people over 70 with underlying conditions.  It seems too obvious what we need to do!!!

Bergamo, Italy

I continue to use Bergamo as a comparator to Westchester.  It is the same size and same distance from country's biggest city (it borders Milan).  Some of the images are grim such as this article on the procession of caskets to the crematory ovens. I have not seen that in Westchester. Lombardy (the Milan region including Bergamo) is targeting May 4 for 'return to work,' but the criteria appear to be based on testing, of which there is not enough.

Westchester vs. Bergamo