The Recurrence of COVID-19 in New York State and New York City: Surfing the Second Wave (SpringerBriefs in Public Health) 3030886182, 9783030886189

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SPRINGER BRIEFS IN PUBLIC HEALTH

Deborah Wallace Rodrick Wallace

The Recurrence of COVID-19 in New York State and New York City Surfing the Second Wave 123

SpringerBriefs in Public Health

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Deborah Wallace • Rodrick Wallace

The Recurrence of COVID-19 in New York State and New York City Surfing the Second Wave

Deborah Wallace Independent Disease Ecologist New York, NY, USA

Rodrick Wallace The New York State Psychiatric Institute Columbia University New York, NY, USA

ISSN 2192-3698 ISSN 2192-3701 (electronic) SpringerBriefs in Public Health ISBN 978-3-030-88618-9 ISBN 978-3-030-88619-6 (eBook) https://doi.org/10.1007/978-3-030-88619-6 © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Preface

Our previous book (COVID-19 in New York City: An Ecology of Race and Class Oppression) analyzed and described the early stages of first wave’s decline in the national epicenter. The first wave originated outside New York City, of course, but only turned into a national pandemic because of the rapid increase in infection density within New York City, particularly the Bronx. The Bronx became the epicenter of both the counties of the metropolitan region and of the national network of metropolitan regions. New York City and its four central boroughs receive and send travelers at all geographic scales: between neighborhoods, between metropolitan regional counties, between cities, and between many countries. The size and density of its population have acted as engines for many epidemics, such as AIDS, tuberculosis, and violence (Wallace and Wallace 1998). The Bronx has the lowest median household income of all 62 counties of New York State, the second lowest percent of adults with college or higher degrees, the highest percent of Latinx, and the worst general public health by such measures as life expectancy, premature mortality rate, and prevalence of chronic conditions. The previous book described the history of public policies and real estate practices that generated this health outcome in the Bronx. It is really no mystery that COVID-19 was turned into a regional and national epidemic in the Bronx. The root cause is the abuse and neglect of the Latinx subpopulation that forms over half the Bronx population. We admitted only ZIP Code areas in the four central boroughs that had over 10,000 residents. The Bronx had 24 such areas, and Manhattan 35. Manhattan and the Bronx have similar populations (1.4–1.7 million residents). Out of the 24 Bronx areas, 14 (58%) had cumulative COVID mortality rates over 200 per 100,000 by the end of May 2020, whereas only seven (20%) of the 35 areas of Manhattan had such high rates. Only one area of the Bronx (4%) had a cumulative mortality rate below 100; 15 (43%) of the 35 areas of Manhattan had cumulative mortality rates below 100 at the end of May. By the end of May, the Bronx had become the epicenter of COVID (coronavirus disease) mortality for the entire 24-county metropolitan region. Percent positive rates during the April crest had reached over 30% in some ZIP Code areas, even v

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Preface

though testing remained highly biased by race and class (Wallace and Wallace 2021). During the early weeks of the first wave, testing was limited to only those with symptoms. By mid-to-late April, test kits became more widely available, and the public was encouraged to get tested. However, from then to now, many more tests have been given in wealthy white areas. Historically abused and neglected, the Bronx ZIP Code areas had significantly lower rates of testing than the Manhattan areas and still have lower rates as of this writing (December 2020). The stupidity of neglecting the borough with the highest rates of positive tests, cases, and deaths is staggering. In their zeal to protect wealthy white residents of Manhattan, the authorities forgot the essence of epidemic diseases: they are contagious and spread from areas of concentration. As Greg Pappas famously stated of AIDS: “Concentration is not containment.” The high incidence areas of Queens were not agglomerated geographically enough to form a true epicenter for other boroughs and counties. Only the Bronx oozed into a solid mass of high incidence with only one ZIP Code area as an exception. The Bronx has a bit under a million and a half residents. It connects with counties to the north by commuter rail and highways. It connects with other boroughs by several subway lines, regular and express bus lines, and highways. The famous RFK (Robert F. Kennedy) Bridge (Triborough Bridge) connects the Bronx with Manhattan and Queens. It sends workers to the other boroughs and to the other counties. Workers from other boroughs and counties come to the Montefiore Medical Center, Albert Einstein Medical Center, the many nursing homes in Riverdale and other neighborhoods, the colleges, the Bronx Zoo, and the New York Botanical Gardens. Residents of other boroughs and counties come to the Bronx to use these facilities as well as the houses of worship, museums, and culinary outlets, such as the Italian delis and restaurants of Arthur Avenue. Residents of other boroughs and counties also visit the Bronx for illegal drugs, illegal guns, and sex. Allowing the Bronx to reach high incidence of COVID infection shows the extreme stupidity and discriminatory priorities of the elected officials at the municipal and state levels. They generated the first wave with abuse and neglect. Control of COVID within New York State during the first wave could occur because all the “hot spots” were within the state. Controlling hot spots with testing, lockdown, requiring masks and physical distances, and asking people to stay home really reduced the first wave of COVID in New York State to low levels by midJune from very high levels in April. The governor made frequent television news conferences and won an Emmy for them. He also won an award from the National Academy of Medicine for his handling of the first wave. During the summer, the infections exported from New York State to states further west and south were simply not controlled. In fall, infections returned to New York State at its borders with Pennsylvania, New Jersey, Connecticut, and the Great Lakes where ports connect with the Midwest. As Chap. 2 will show, NYS counties neighboring high infection counties in other states exceeded the 3% positive test threshold of concern well before the other NYS counties. From them, the exceedance of threshold spread rapidly across the state, eventually reaching the boroughs of New York City. The Bronx again rose to dominate the boroughs in

Preface

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percent positive tests. The second wave of positive tests peaked during Christmas week 2020 (Dec 24–Dec 31). In this book, we follow the spread among the 62 counties of the state and among the 152 ZIP Code areas that qualified for inclusion in the previous book (in one of the four central boroughs and with a resident population over 10,000). We have a caveat: the State and City have different systems for counting percent positive tests. They remained consistent within themselves during the months of this study (late October 2020–late January 2021), but comparison between the two systems is not proper. When we report on the boroughs as counties, we use the State data; when we report on the ZIP Code areas within the boroughs, we use the City data. Our findings support the statement of Thomas Frieden, former director of the CDC (Centers for Disease Control and Prevention): health authorities have only hours to days to prevent a highly contagious invading disease from going into epidemic process. New York, NY, USA New York, NY, USA

Deborah Wallace Rodrick Wallace

References Wallace D, Wallace R (1998) A plague on your houses: How New York City was burned down and national public health crumbled. Verso, London and New York Wallace D, Wallace R (2021) Covid-19 in New York city: An ecology of race and class oppression. Springer Briefs in Public Health, Cham

Contents

1

The Sixty-Two Counties of New York State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

2

The Second COVID Wave Washes Over New York State . . . . . . . . . . . . . . . .

9

3

Socioeconomic/Demographic Context of Big Apple’s Four Main Boroughs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

4

The Second Wave Storm-Surges Across New York City. . . . . . . . . . . . . . . . . . 39

5

Discussion of County Data from the Second Wave of COVID-19 . . . . . . . 57

6

Parsing Meaning from the 152 ZIP Code Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

7

What Is to Be Done? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

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About the Authors

Deborah Wallace received her Ph.D. in symbiosis ecology from the Columbia University in 1971. In 1972, she became an environmental studies manager at the Consolidated Edison Co. and participated in pioneering environmental impact assessment. She became a manager of biological and public health studies at the New York State Power Authority in 1974 and remained there until early 1982. In 1980, she completed a Mini-Residency in epidemiology at the Mt. Sinai Medical Center. In the mid-1970s, she also founded Public Interest Scientific Consulting Service that produced impact assessments of massive cuts in fire service in New York City. She also probed the health threats that plastics in fires posed to firefighters and became an expert witness in litigation for plaintiffs in large fires fueled by plastics. During 1985–1991, she worked for Barry Commoner at the Center for the Biology of Natural Systems in Queens College. During 1991–2010, she tested consumer products and services for their environmental and health impacts at the Consumers Union. She retired in 2010 but continues data analysis, research, and scientific publications. Her first paper was published in 1975, and her latest publication, a book on COVID-19 in New York, in 2021. Rodrick Wallace is a research scientist in the Division of Epidemiology at the New York State Psychiatric Institute, affiliated with Columbia University’s Department of Psychiatry. He has an undergraduate degree in mathematics and a Ph.D. in physics from Columbia and completed postdoctoral training in the epidemiology of mental disorders at the Rutgers. He worked as a public interest lobbyist, including two decades conducting empirical studies on fire service deployment, and subsequently received an Investigator Award in Health Policy Research from the Robert Wood Johnson Foundation. In addition to material on public health and public policy, he has published peer-reviewed studies modeling evolutionary process and heterodox economics, as well as many quantitative analyses of institutional and machine cognition. He publishes in the military science literature and in 2019 received one of the Trench Gascoigne Essay Awards from the United Kingdom’s Ministry of Defence. xi

Chapter 1

The Sixty-Two Counties of New York State

New York State retains some of its might in finance, culture, food processing, and politics. It had been a major manufacturing power, the center of American garment design and creation, the spine of the book and publishing industry, and the most populous of the states. Its largest municipality, New York City, boasted the largest population of any American city; the highest concentration of millionaires, musicians, artists, literati, and outre thinkers; the Broadway stage, opera companies, classical orchestras, art museums, universities, and other institutions big and small such as the Algonquin Table; and numerous revolutionary and intellectual developments, labor union innovations, art movements, and movements that pushed back against the quasi-monopolies that themselves arose in New York City’s financial milieu. The relationships between New York City, the counties of the metropolitan region, the hamlets along the Hudson River and in the upstate mountains during the Gilded Age through the prosperous post-war era smacked of colonialism. The wealthy had summer homes upstate, on Long Island, and along the various lakes (Great and small). The wealthy of the great manufacturing centers of Northern and Western New York State such as Buffalo and Rochester would mingle with the wealthy from the City at locations in between such as Saratoga Springs, Lake George, and the picturesque towns along the Hudson. The great wealthy also had summer homes on Long Island, especially near the end of the Long Island Railroad. Writers of the Gilded Age through the Unstable Age (the 1920s–1930s) such as Edith Wharton and F. Scott Fitzgerald tried to parse the social relationships in that top tier of wealth, rigid hierarchy, and dubious ethics and morals. The petit wealthy of New York City itself would vacation at Coney Island and the Rockaway Peninsula where luxury hotels and fine restaurants would cater to this not-so-top but still wealthy tier. Reader, meet the counties of New York State in all their socioeconomic glory (Table 1.1). Population, one of the most basic county characteristics, does not have a nice bell-shaped curve (“normal distribution”), as the wide gap between © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 D. Wallace, R. Wallace, The Recurrence of COVID-19 in New York State and New York City, SpringerBriefs in Public Health, https://doi.org/10.1007/978-3-030-88619-6_1

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1 The Sixty-Two Counties of New York State

Table 1.1 Statistical descriptions of SE factors of 62 NYS counties Mean Median SD Minimum Maximum

Mean Median SD Minimum Maximum

Mean Median SD Minimum Maximum

Population 313767 86687 541368 4416 2.56E+06

Population density 3014 119 10803.5 3 69464

Poverty rate 12.96 12.75 3.50 5.80 27.30

College % 27.89 24.55 9.37 15.90 60.80

Unemploy19 3.85 3.75 0.47 2.80 5.60

Median income 60464 55890 14355 38085 111240 %White 86.78 91.65 11.65 44.70 97.30 Unemploy20 6.38 5.8 2.21 4.40 17.50

Med. gross rent 924.5 799 285.4 639 1738 %Black 6.95 4.40 7.19 0.70 43.60

“rent stress” 0.1859 0.1715 0.0508 0.0828 0.3934 %Latinx 8.18 4.20 9.31 1.70 56.40

%2020 Trump 50.85 53.75 12.73 12.30 71.60

the average (313767) and the median (86687) shows. The standard deviation is immense: 541368, and the minimum (Hamilton County) and maximum (Brooklyn) differ by three orders of magnitude: 4416 and 2.5599 million. We see a similar pattern for population density, people per square mile. The average and median differ greatly: 3014 and 119. The standard deviation is about three times the average and a hundred times the median: 10803.5. In one county (Hamilton), only three people per square mile rattle around the landscape, whereas in New York County (Manhattan), over 69000 people per square mile jam the streets and buildings. The New York City metropolitan region’s New York State counties concentrate over half the entire population of the state in the southeast corner. Besides the five boroughs (between eight and nine million people as of the last American Community Survey of 2018), Suffolk, Nassau, and Westchester counties add about another three million. The Census Bureau’s Journey to Work data on commuting shows that an impressive percent of workers in these large counties plus Rockland, Orange, and Putnam pour into New York City on normal workdays. New York City’s outsize population and socioeconomic relationships with very large numbers of workers generates friction and unstable power relations with the State and with the polities to the North and West within the State. The counties show only small diversity with respect to race/ethnicity. Nearly all have large white majorities (over 80%). Only the Bronx has a population that is less than half white. Indeed, outside the counties of population centers such as New York

1 The Sixty-Two Counties of New York State

3

City, Buffalo, Yonkers, Albany, and Rochester, most counties have white majorities over 90%. The Bronx has the highest proportion of Black population and is the only county with a majority Latinx population (56.4%). New York City contains two counties of very high and very low higher educational attainment. In Manhattan, 60.8% of adults over 25 have four-year college degrees or higher; in the Bronx, only 19.8% do. Orleans County has the dubious distinction of the lowest educational attainment: 15.9% adults have college or higher degrees. New York State, thus, has greater diversity in educational attainment than in race/ethnic composition. Percent of the population that lives to be over 65 years old is a public health indicator, although the CDC benchmark now for prematurely lost years is 75. The counties do approach a normal distribution for percent of population over 65; the average (19.17) is not terribly different from the median (18.95). The standard deviation also indicates a strong centrality to the data: 2.94, much less than the average and the median. The minimal percent of 65 and up is 13.3 (Bronx) and the maximal, 31.9 (Hamilton). Finally, let us talk money. The average median household income ($60464) is slightly higher than the median ($55890). The standard deviation ($14355) is much less than either average or median and, thus, hints at a strong centrality to these data. The Bronx has the dubious honor of lowest median household income ($38085), and Nassau County achieved highest rank ($111240). Average and median poverty rates are nearly identical (12.96% and 12.75%, respectively). The two counties with extremes in median household income also show extremes in poverty rates: 5.8% in Nassau County and 27.3% in the Bronx. We also devised a crude metric for rent stress, namely median gross rent divided by monthly median income. Median gross rent average and median show a difference that indicates a skewed normal distribution: $924.5 and $799, respectively. The minimum median gross rent is $639 (Cattaraugus County) and the maximum $1738 (Nassau County). Although the Bronx has the lowest median household income and the highest poverty rate, its median gross rent is well above even the average of $924.5, namely $1176. Unlike most counties in New York State, the housing in the Bronx is heavily dominated by rental units. The only county with a higher “rent stress” is Steuben (0.39 rent stress), only slightly higher than that of the Bronx (0.37), but in terms of either absolute population or percent of the population that lives in rental units, the Bronx dwarfs Steuben County. The major socioeconomic factor with data showing deep impact from the COVID-19 pandemic is unemployment rate. Table 1.1 displays October 2019 and 2020 unemployment rates by county, not adjusted seasonally. Figure 1.1 displays the geography of the 2019 and 2020 rates. These data were downloaded from the NYS Department of Labor website. Only six counties had unemployment rates below 5% in 2020; whereas in 2019, only the Bronx had an unemployment rate above 5%. Only 16 counties suffered less than a 40% increase in unemployment rate between 2019 and 2020. All five boroughs of New York City had increases over 100% with the Bronx, Brooklyn, and Queens suffering increases over 200%. Surrounding counties (Westchester, Suffolk, and Nassau) also showed high unemployment rates

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1 The Sixty-Two Counties of New York State

Fig. 1.1 Unemployment rates in 2019 (a) and 2020 (b) by county. White: 4% or less crosses: 4.1–5% Stipples (dots): 5.1–6% Stripes: 6.1–7 % Black: over 10%

1 The Sixty-Two Counties of New York State

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of 7%, 6.3%, and 6.7%, respectively, and increases of 89%, 80%, and 97%, respectively. The five boroughs and these three other counties account for well over half the population of New York State. One county stood out from the rest, Tompkins county. The adult population enjoyed high educational attainment with 53% having four-year college degrees or higher. The unemployment rate remained below 5% in 2020 and had not exceeded 40% rise between 2019 and 2020. Yet the median household income was close to that of the state as a whole and the poverty rate was slightly higher than the median for the state. Tompkins has a different racial profile from the surrounding counties: 77% white, 10% Asian, 5% Black, 5% Latinx, and a mix of the remaining 3%. The surrounding counties are over 90% white. This example should serve as a warning not to judge simply by statistics. When one looks up Tompkins County, one finds that it is home to Cornell University, Ithaca University, and Ithaca Community College. Educational institutions are the primary employers in Tompkins County. The repeated appearance of certain counties such as the Bronx, Hamilton County, and Nassau County hints that the socioeconomic factors interact to produce a socioeconomic ecology of New York State, resting on the county level. Indeed, many SE factors show significant associations over the 62 counties (Table 1.2). Counties with high populations and a high proportion of Latinx in those populations also have high proportions of Black residents, for example. Not surprisingly, percent adults with four-year college degrees or higher associate significantly with median income; the multivariate regression that explains 85% of the pattern of percent adults with higher degrees also shows negative associations with percent Latinx and percent white but positive associations with population density and poverty rate. The multivariate regression that explains 88% of the pattern of percent Latinx in the county populations includes positive associations with percent Black, the rent stress index, population density, and poverty rate but negative associations with percent adults with higher degrees, median income, and median gross rent. The R-squares of the multivariate regressions range from 0.48 for median gross rent up to 0.92 for percent Black, if we overlook the swamping of all other SE factors by percent white in explaining the pattern of percent over 65 which yields an R-square of only 0.33. Even if we include this non-multivariate result, the R-squares show strong connections between the SE factors and indicate that New York State has a SE system of interacting economic, social, demographic, and political factors. Thus, the repeated appearance of those particular counties as either very high or very low for individual SE factors reflects this structure. The Bronx with its high poverty rate and low median income also has a low percent of adults with higher degrees and a low percent of the over 65 in its population. Nassau county with its high median income also has a high percent of adults with higher degrees, high median gross rent, and low poverty rate. The 62 counties of New York State divide up into 31 rural and 31 non-rural counties. The US Census defines a rural county as one with over 50% of its population not living in cities or suburbs. The rural counties differ greatly from the non-rural in most SE factors (Table 1.3). Racial composition and educational attainment show the largest differences in the medians. The only SE factor in

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1 The Sixty-Two Counties of New York State

Table 1.2 Selected SE associations Associations with %Black SE factor College % Latinx % Population White % Over 65% Poverty

R-sq 0.1319 0.7599 0.5598 0.881 0.3016 0.1052

P 0.0022