May 16, 2020

GOLD COAST (profanity alert):

Two Coasts. One Virus. How New York Suffered Nearly 10 Times the Number of Deaths as California.: California's governor and San Francisco's mayor worked together to act early in confronting the COVID threat. For Andrew Cuomo and Bill de Blasio, it was a different story, and 27,000 New Yorkers have died so far. (Joe Sexton and Joaquin Sapien May 16, 2020, ProPublica)

In San Francisco, Breed cleaned up her language in a text to California Gov. Gavin Newsom. But she was no less emphatic: The city needed to be closed. Newsom had once been San Francisco's mayor, and he had appointed Breed to lead the city's Fire Commission in 2010.

Newsom responded immediately, saying she should coordinate with the counties surrounding San Francisco as they too were moving toward a shutdown. Breed said she spoke to representatives of those counties on March 15 and their public health officials were prepared to make the announcement on their own. On March 16, with just under 40 cases of COVID-19 in San Francisco and no deaths, Breed issued the order banning all but essential movement and interaction.

"I really feel like we didn't have a lot of good options," Breed said.

In an interview, California Health and Human Services Secretary Dr. Mark Ghaly said it was critical to allow Northern California counties to rely on their own experts, act with a degree of autonomy and thus perhaps pave the way for the state to expand on what they had done. And three days after San Francisco and its neighboring counties were closed, Newsom, on March 19, imposed the same restrictions on the rest of California.

Breed, it turns out, had sent de Blasio a copy of her detailed shelter-in-place order. She thought New York might benefit from it.

New York Gov. Andrew Cuomo, however, reacted to de Blasio's idea for closing down New York City with derision. It was dangerous, he said, and served only to scare people. Language mattered, Cuomo said, and "shelter-in-place" sounded like it was a response to a nuclear apocalypse.

Moreover, Cuomo said, he alone had the power to order such a measure.

For years, Cuomo and de Blasio, each of whom has harbored national political ambitions, had engaged in a kind of intrastate cold war, a rivalry that to many often felt childish and counterproductive. When de Blasio finally decided to close the city's schools, it was Cuomo who rushed to make the public announcement, claiming it as his decision.

"No city in the state can quarantine itself without state approval," Cuomo said of de Blasio's call for a shelter-in-place order. "I have no plan whatsoever to quarantine any city."

Cuomo's conviction didn't last. On March 22, he, too, shuttered his state. The action came six days after San Francisco had shut down, five days after de Blasio suggested doing similarly and three days after all of California had been closed by Newsom. By then, New York faced a raging epidemic, with the number of confirmed cases at 15,000 doubling every three or four days.

Health officials well understood the grim mathematics. One New York City official said of those critical days in March: "We had been pretty clear with the state about the implications of every day, every hour, every minute."

As of May 15, there were nearly 350,000 COVID-19 cases in New York and more than 27,500 deaths, nearly a third of the nation's total. The corresponding numbers in California: just under 75,000 cases and slightly more than 3,000 deaths. In New York City, the country's most populous and densest, there had been just under 20,000 deaths; in San Francisco, the country's second densest and 13th most populous, there had been 35.

The differing outcomes will be studied for years, as more is learned about the virus, its unique qualities, its varying strains, its specific impact on certain populations, and the role of factors like poverty, pre-existing health problems and public transportation in its spread and lethality.

Posted by at May 16, 2020 8:16 AM