London Daily

Focus on the big picture.
Saturday, May 31, 2025

Why New York has been hit so hard by coronavirus

Why New York has been hit so hard by coronavirus

New York state reached a tragic milestone this week: It now has more Covid-19 patients than any country in the world, aside from the United States.
The state's total of 181,026 cases, as of April 11, is higher than Spain's (161,852 cases) and Italy's (152,271), countries with populations many times larger than New York.

The disease is killing New Yorkers disproportionately. Of the 20,389 deaths in the United States, 8,627, or 42%, have occurred in New York. Its mortality rate is 4.7%, compared with 3.4% in the rest of the country, according to CNN's figures based on data from the Johns Hopkins University Center for Systems Science and Engineering.

New York City and its suburban counties - Nassau, Suffolk, Westchester and Rockland - are responsible for 93% of the statewide case count. Furthermore, in New York City, the Covid-19 death rate is about 6% higher than most countries.

Why does New York seem to be having a different epidemic from most other parts of the country?

Is the reason simply population size and density? New York is by far the nation's most populous city, with more than 8 million people, twice as many as Los Angeles. But New York also has eight or nine times more cases than any other city -so what gives? No other city or county has a fraction of the cases of New York City.

A caution on numbers: Counting cases and mortality rates is difficult because most counting is done by county or borough or parish rather than city, and city of residence may differ from city of diagnosis or death. Even so, New York City is off the charts.

How about population density? Covid-19 spreads most easily when people are packed together - in churches or cruise ships, in outdoor events like concerts or Mardi Gras, or perhaps in small apartments with multiple roommates or large families. New York's population density, about 27,000 people per square mile, is easily the highest in the country, though it's nowhere near the top for cities across the globe. Many cities - in Asia, for example - have a density of nearly 40,000 people per square mile.

The density explanation may explain some of the difference, but not all of it. New York's densest borough is Manhattan, while relatively sprawling Queens sits at fourth out of five. But Queens has more than twice the cases and twice the rate of cases as Manhattan.

Maybe it's because so much testing is being done in New York. If you test more, you find more, and if you find more, you test even more. It is likely that more tests, and more tests per population, are performed in New York than elsewhere in the United States, and that the New York rate stacks up favorably to countries with aggressive testing programs, such as Iceland and South Korea and Germany, but comparative information is sketchy. The split between tests performed by public versus private labs has made accurate tracking just about impossible, despite the heroic efforts of such groups as Covidtracking.com, Worldometers, and Our World in Data.

Furthermore, the current advice - stay home if you are sick but stable and don't be tested - introduces additional uncertainty. This pales in comparison to the clear evidence of deaths at home likely due to Covid-19 but never diagnosed. So yes, New York City probably is testing at a brisker pace than elsewhere and yes, this may contribute to the high case numbers, but we will never have an accurate picture.

The high number of cases and rates likely do derive in some modest amount to each explanation above - plus the fact that the epidemic has been in New York City a week or two longer than many other places. A more mature epidemic is always a larger epidemic.

More concerning is the elevated mortality rate in New York City. As has been well documented, some of this is due to the tragic overwhelming of the city's hospitals. We will never know just how many people died due to the country's inept preparation for the pandemic, but the impact surely was, and still is, substantial.

Still, a mortality rate of about 6% is quite high, even though most countries, particularly in western Europe, have seen mortality rates rise as the pandemic drags on. As patients who have hung on for weeks have begun to die, and the rate of new cases has slowed, this tilts the proportion of fatal cases.

New York City also has had a very male outbreak; substantially more men have been diagnosed, hospitalized and have died, in keeping with data seen in other countries.

Sadly, the likeliest explanation for the high death rate, though, is the chronically inadequate health care given to minorities and the poor throughout New York City, as in the rest of the country. New York City and New York state have only now released the race distribution of cases and deaths, as well as by zip code, a surrogate for poverty rates. It is clear that severe disease has not been distributed equally by race and ethnicity.

Black and Hispanic New Yorkers represent 51% of the city's population, yet account for 62% of Covid-19 deaths. They have twice the rate of death compared with whites, when adjusted for age. This likely is due to both a higher proportion of black and Hispanic New Yorkers being diagnosed with severe disease and a higher rate of death among those who are known to be infected.

This disparity likely is the result of several factors. Co-morbid conditions, such as hypertension and diabetes, are strongly associated with death from Covid-19 and are more common in black and Hispanic communities. But what causes high rates of poorly controlled hypertension and diabetes? Lack of appropriate health care. People who cannot easily find good health care for reasons of money, time, location, or trust may be more likely to stay at home undiagnosed and spread the virus - as well as experience potentially fatal delays in diagnosis and treatment.

The explanation is the same for New York City as for Italy, New Orleans and probably Iran: the virus exploits weaknesses in health and health care, be it advanced age or co-morbidity or access to care.

Hopefully, the Covid-19 pandemic will force us to reckon honestly with the many shortfalls that have been exposed and build a fair, forward-thinking approach that allows doctors and nurses to care for people in need. Failure to do this will only further darken the memory of those who have died and the hearts of those who remain.
Newsletter

Related Articles

0:00
0:00
Close
Satirical Sketch Sparks Political Spouse Feud in South Korea
Indonesia Quarry Collapse Leaves Multiple Dead and Missing
South Korean Election Video Pulled Amid Misogyny Outcry
Asian Economies Shift Away from US Dollar Amid Trade Tensions
Netflix Investigates Allegations of On-Set Mistreatment in K-Drama Production
US Defence Chief Reaffirms Strong Ties with Singapore Amid Regional Tensions
Vietnam Faces Strategic Dilemma Over China's Mekong River Projects
Malaysia's First AI Preacher Sparks Debate on Islamic Principles
White House Press Secretary Criticizes Harvard Funding, Advocates for Vocational Training
France to Implement Nationwide Smoking Ban in Outdoor Spaces Frequented by Children
Meta and Anduril Collaborate on AI-Driven Military Augmented Reality Systems
Russia's Fossil Fuel Revenues Approach €900 Billion Since Ukraine Invasion
U.S. Justice Department Reduces American Bar Association's Role in Judicial Nominations
U.S. Department of Energy Unveils 'Doudna' Supercomputer to Advance AI Research
U.S. SEC Dismisses Lawsuit Against Binance Amid Regulatory Shift
Alcohol Industry Faces Increased Scrutiny Amid Health Concerns
Italy Faces Population Decline Amid Youth Emigration
U.S. Goods Imports Plunge Nearly 20% Amid Tariff Disruptions
OpenAI Faces Competition from Cheaper AI Rivals
Foreign Tax Provision in U.S. Budget Bill Alarms Investors
Trump Accuses China of Violating Trade Agreement
Gerry Adams Wins Libel Case Against BBC
Russia Accuses Serbia of Supplying Arms to Ukraine
EU Central Bank Pushes to Replace US Dollar with Euro as World’s Main Currency
Chinese Woman Dies After Being Forced to Visit Bank Despite Critical Illness
President Trump Grants Full Pardons to Reality TV Stars Todd and Julie Chrisley
Texas Enacts App Store Accountability Act Mandating Age Verification
U.S. Health Secretary Ends Select COVID-19 Vaccine Recommendations
Vatican Calls for Sustainable Tourism in 2025 Message
Trump Warns Putin Is 'Playing with Fire' Amid Escalating Ukraine Conflict
India and Pakistan Engage Trump-Linked Lobbyists to Influence U.S. Policy
U.S. Halts New Student Visa Interviews Amid Enhanced Security Measures
Trump Administration Cancels $100 Million in Federal Contracts with Harvard
SpaceX Starship Test Flight Ends in Failure, Mars Mission Timeline Uncertain
King Charles Affirms Canadian Sovereignty Amid U.S. Statehood Pressure
Trump Threatens 25% Tariff on iPhones Amid Dispute with Apple CEO
Putin's Helicopter Reportedly Targeted by Ukrainian Drones
Liverpool Car Ramming Incident Leaves Multiple Injured
Australia Faces Immigration Debate Following Labor Party Victory
Iranian Revolutionary Guard Founder Warns Against Trusting Regime in Nuclear Talks
Macron Dismisses Viral Video of Wife's Gesture as Playful Banter
Cleveland Clinic Study Questions Effectiveness of Recent Flu Vaccine
Netanyahu Accuses Starmer of Siding with Hamas
Junior Doctors Threaten Strike Over 4% Pay Offer
Labour MPs Urge Chancellor to Tax Wealthy Over Cutting Welfare
Publication of UK Child Poverty Strategy Delayed Until Autumn
France Detains UK Fishing Vessel Amid Post-Brexit Tensions
Calls Grow to Resume Syrian Asylum Claims in UK
Nigel Farage Pledges to Reinstate Winter Fuel Payments
Boris and Carrie Johnson Welcome Daughter Poppy
×