Is Monthly Week-Long Shutdown in NYC Way Forward After Covid?
How does NYC move forward after Coronavirus? What does the new normal look like? I’m not an elected official, but this question has been keeping me up at night.
NYC has several unique characteristics that make Coronavirus particularly devastating. The city is dense. People are social. Virtually no one has cars and relies on NYC subway, which doesn’t have proper ventilation. And it is one of the world’s most popular tourist destinations, which means that as long as there’s an outbreak somewhere in the world, it will find its way to NYC.
Warnings abound about a second wave in the fall or winter. We can’t possibly have a repeat of April, but we must move forward. So what do we do?
One solution, I believe, is to do a monthly week-long shutdown. Three weeks of social-distancing off, one week of social-distancing on. I think of it as a kind of a social tax NYC has to pay to make up for high levels of person-to-person contact. A week-long city detox.
Importantly, this can be implemented no matter what the new “open” for NYC is. The idea is simply to alternate in predictable cycles between a less-open state and a more-open state.
Is one week sufficient? The following is taken from https://www.statnews.com/2020/03/09/people-shed-high-levels-of-coronavirus-study-finds-but-most-are-likely-not-infectious-after-recovery-begins/
The researchers found very high levels of virus emitted from the throat of patients from the earliest point in their illness — when people are generally still going about their daily routines. Viral shedding dropped after day 5 in all but two of the patients, who had more serious illness. The two, who developed early signs of pneumonia, continued to shed high levels of virus from the throat until about day 10 or 11.
From another study at https://www.nature.com/articles/s41591-020-0869-5
Assuming an incubation period distribution of mean 5.2 days from a separate study of early COVID-19 cases1, we inferred that infectiousness started from 2.3 days (95% CI, 0.8–3.0 days) before symptom onset and peaked at 0.7 days (95% CI, −0.2–2.0 days) before symptom onset (Fig. 1c). The estimated proportion of presymptomatic transmission (area under the curve) was 44% (95% CI, 25–69%). Infectiousness was estimated to decline quickly within 7 days.
From these quotes it seems likely that a week is sufficient to cover most cases. The bad news is that there are outliers who will shed the virus longer. However, those who continue to shed the virus longer are also likely to develop noticeable complications and would know to self-isolate. Social distancing is primarily needed to cover asymptomatic cases, which are the majority for Covid-19.
Why do it monthly? The virus has been circulating in NYC from January, possibly even December. It took about three months for it to build up to the current devastating levels. Imagine if we shutdown for one week in the beginning of January, and then again in February, and again in March. The curve would almost certainly look a lot flatter. Of course, back then no one would agree to losing a week’s worth of revenue. But now we know what happens, and one week doesn’t seem so bad.
One of the main benefit to having a short, cyclical shutdown is that it’s predictable. You can plan for it, the same way you plan for a weekend. Stores can plan for it. Employees can plan for it. Schools can plan for it. A functioning economy needs predictability.
A week-long shutdown will also discourage tourists from visiting NYC during that time. If we want NYC to continue being open to tourism, we must also mitigate the impact of viruses being brought-in from the outside. It’s obvious that tourists coming to NYC for a two-week vacation will not self-quarantine for two weeks. So unless NYC is somehow able to test every single person coming-in, a periodic shutdown is the only other way to lower the impact of infection spread from the outside.
We should address the elephant in the room. NYC has been shutdown for almost two months by now, and while the numbers have dropped significantly, they are nowhere close to zero. Part of the reason for that is that it’s impossible to maintain a shutdown that is both strict and extended. People have to shop for groceries and many still have to take the subway. The level of social activity in NYC while shutdown still exceeds that of a typical suburban city on a normal day. Should NYC opt for a shutdown that is stricter, but shorter?
It’s clear that testing at scale sufficient for NYC will not happen anytime soon, if ever. It’s also clear that without testing NYC can’t reopen. And it is also clear that an extended shutdown is not sustainable economically or mentally.
If NYC can’t reopen but also can’t continue to be shutdown, what do we do? Perhaps we should be exploring options that do both.
