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As the national debate over reopening continues and the political blame game over the disease intensifies, it's worth considering the scale of New York's outbreak. There is nothing like it anywhere else in the country — and almost nothing like it in the rest of the world.
The story of the coronavirus in America is overwhelmingly the story of the coronavirus in New York and its surrounding suburbs. Any account of how we got to this place, with deaths nationally headed toward 100,000, must center on Gotham, which was seeded with the virus early and then seeded much of the rest of the country.
Nearly 20,000 people have died in New York City, or 0.25 percent of the population. If the city were a country, it'd rank sixth in the world in total deaths, behind France and ahead of Brazil.
In New York City, according to a New York Times report, deaths have been more than 300 percent above normal. In New Jersey, intimately connected to New York, deaths have been 90 percent above normal. Otherwise, no other state is close. In the rest of New York state, deaths have been 9 percent above normal.
The next worst hit state is Massachusetts, with deaths running nearly 25 percent above normal. There are four other states in the teens, and the rest are at 10 percent or below, with 14 states below normal.
A Financial Times analysis of hard-hit places has only Bergamo, Italy, and Guayas, Ecuador, running ahead of New York in percentage of excess deaths — not Madrid, London or Ile-de-France.
The epidemic started early in New York. According to one model, the Big Apple had its first 10 cases at the end of January or by the middle of February. By the time it had its first confirmed case on March 1, there may have been as many as 10,000 undetected cases.
The city was getting seeded constantly from abroad. A study published by medrxiv.org concluded that "introductions from Europe account for the majority of cases found in NYC in the first weeks of March 2020." It found "isolates from Italy, Finland, Spain, France, the UK and other European countries from late February."
Then people coming from or through New York spread the disease to the rest of the United States. A New York Times analysis found that the number of cases around the country correlated with how many travelers arrived from New York in early March.
New York's connection to the world, especially Europe, its density and its mass-transit system all made it a potent vector.
So the question of how we could have kept the United States from getting so hard-hit is really how we could have kept New York from getting so hard hit. Every day counted, and better leadership at the federal, state and local levels would have made a difference, but we shouldn't underestimate the difficulties.
President Trump's early travel restrictions on China would have had to be imposed on Europe as well, when no one was contemplating that. New York's leaders would have had to warn people off the subways, shut the schools and torch the Big Apple's economy before any plainly visible metrics justified those measures.
This is why the simplistic shots at Trump, who indeed should have taken the virus more seriously from the beginning, don't work. He's the president of New York, but also of other large, international cities like Los Angeles and Miami that have escaped New York's fate. Has his leadership been better in those places, or do divergent underlying conditions and local decisions account for the better outcomes?
None of this, of course, is to disparage New Yorkers. They have absorbed a gut punch over the last two months with characteristic grit, bravery and spirit. Yet without New York's distinctive vulnerability, the course of the epidemic would look completely different.
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