How different would New York City's experience during the first wave of 2020's coronavirus pandemic have been if public officials had better and more timely information about how many people were really being infected by it?

That's a fascinating question raised by the Empire Center's Bill Hammond's retrospective analysis of the pandemic's impact in New York. In that analysis, Hammond features a chart comparing the information public officials had on the number of confirmed COVID-19 cases with the Institute for Health Metrics and Evaluation's improved estimates of how extensive coronavirus infections likely were in reality in early 2020. Here's a slightly modified* interactive version of the chart:

Compared with the official count produced by the New York State Department of Health (NYSDOH) in early 2020, COVID-19 infections were much more numerous and peaked much earlier in the IHME's improved estimates Hammond describes what the chart shows:

As seen in Figure 1, the state’s outbreak likely began by early February, a full month before its first laboratory-confirmed case [2]. The estimated number of infections soared to more than 60,000 per day on March 19, which was six times higher and three weeks earlier than shown by the state’s testing data.

A second attempt to model the first wave of New York’s pandemic estimated that it began on Jan. 19 and reached a peak infection rate of almost 100,000 per day on March 24 [3]. These estimates indicate that the curve had already begun to bend – that is, the rate of increase had begun to slow – before Cuomo issued his stay-at-home order effective March 22 – likely because individuals and businesses were spontaneously limiting their activities in reaction to official warnings and news coverage.

Hammond explains how better knowledge of the true picture for the spread of COVID-19 infections could have shaped the response of both New York's governor and the state's public health officials:

The virus’s rapid spread in February and early March of 2020 shows the importance of detecting outbreaks early and responding quickly. If officials had become aware of this surge even a week or two sooner – and notified the public – they almost certainly could have avoided swamping hospitals and saved thousands of lives.

If they had merely known when the wave reached its peak, they might have avoided mistakes in late March.

For example, Cuomo and his administration would have had less cause to worry about a looming shortage of hospital capacity. They could have avoided spending time and money to build emergency hospital facilities that went largely unused. And they might never have issued the March 25 directive transferring Covid-positive patients into nursing homes – a decision that likely added to the high death rate in those facilities and contributed to Cuomo’s political downfall. [6]

Here's an example of the official data and modeled projections they did have in early 2020. The following chart is taken from the Institute for Health Metrics and Evaluation (IHME)'s 25 March 2020 projections showing its estimates of the minimum, likely, and maximum number of additional hospital beds that would be needed in the state of New York to care for the model's expected surge of coronavirus patients.

This chart presents just one of several coronavirus models whose projections were being combined and presented to Governor Cuomo by consultants from McKinsey & Co. to assist their ad hoc public health policy making. Had New York state government officials instead known the daily number of new COVID-19 infections had already passed its peak, they almost certainly would not have reached the point of panic they did. Panic that resulted in their creating one of the worse public health outcomes in U.S. history.

Unlike those now mostly-former New York state officials, the IHME is at least learning from its mistakes in modeling 2020's coronavirus pandemic.

Previously on Political Calculations

• Governor Cuomo and the Coronavirus Models
• Coronavirus Deaths and Nursing Home Admission Policies
• The Biggest Math Story of 2020
• Visualizing ICL's Pandemic Model's Failures

References

Hammond, Bill. Behind the Curve: The Extreme Severity of New York City's First Pandemic Wave. Empire Center. [PDF Document]. 30 August 2023.

Institute for Health Metrics and Evaluation. COVID-19 estimate downloads. March 25, 2020. [ZIP folder]. Accessed 15 October 2023.

Footnotes from Behind the Curve

[2] https://www.healthdata.org/covid/data-downloads.

[3] David García-García et al., “Identification of the first COVID-19 infections in the US using a retrospective analysis (REMEDID),” Spatial and Spatio-temporal Epidemiology, Vol. 42, August 2022. https://www.sciencedirect.com/science/article/pii/ S1877584522000405#fig0001.

[6] For more on the Cuomo administration’s handling of the pandemic in nursing homes, see the Empire Center’s August 2021 report, “ ‘Like Fire Through Dry Grass’: Documenting the Cuomo Administration’s Cover-up of a Nursing Home Nightmare.” https://www.empirecenter.org/publications/like-fire-through-dry-grass/

Other Notes

* We altered the dimensions of the chart and the line thickness for the IHME estimate of infections. We also added the options for downloading a copy of the chart and sharing it on social media.