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June 1, 2020

After 2+ months of lockdown, New York City is still seeing new Covid-19 cases. Who's getting sick?

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    New York City has now been under a strict stay-at-home order for more than two months, yet the city and its surrounding areas are continuing to see new cases of Covid-19, leading some to wonder who the latest Covid-19 patients are, the New York Times' Andy Newman reports.

    Your top resources for Covid-19 response and resilience

    Newman notes that, during the two weeks leading up to May 28, "more than 47,000 people in New York, New Jersey, and Connecticut tested positive" for the new coronavirus, including more than "13,000 in New York City alone."

    The growth rate of newly reported cases of Covid-19 in those areas over the past few weeks has slowed when compared with early April, but it's "still considerable," Newman reports. And, given that New York City has been subject to a strict stay-at-home order for more than 10 weeks, the continued growth in new cases of Covid-19 has some wondering: Who's still at risk of contracting the new coronavirus?

    Who's still at risk of Covid-19?

    Officials in early May surveyed hospitals about the latest Covid-19 patients and found that a vast majority of patients were unemployed or retired, had other medical conditions, and, most curiously, had been staying at home in compliance with New York City's order, Newman writes. 

    But data on non-hospitalized patients remains scarce, Newman reports. To get a better understanding of the latest Covid-19 patient population, the Times examined city data and interviewed physicians, hospital administrators, public health officials, Covid-19 patients, and immigrant groups. The findings revealed four key patient populations who are contracting Covid-19—and in some cases, bringing the new coronavirus home to families. 

    Essential workers and their families

    According to Newman, the interviews revealed that many of New York City's newest Covid-19 patients are essential workers. 

    Sylvie De Souza, chief of the ED at Brooklyn Hospital Center, said, "The majority of people, it's health care workers, it's [public transportation] workers, it's postal workers. As opposed to before, it seemed to be people out in the community, and of course a lot of the nursing home patients."

    Javier Valdés, a co-founder of the immigrant advocacy group Make the Road New York, similarly said the Covid-19 patients his organization has been hearing about in recent weeks are "getting sick because they're still out there working—construction, delivery men. It's mostly men."

    Michael Pappas, a family medicine resident at Mount Sinai Hospital, said he believes some essential workers contracted the new coronavirus while at work and then transmitted the virus to people in their homes.

    "I suspect you have patients whose family members may be deemed essential workers, but they are younger and healthier," he said. "So they go out, work, maybe are exposed or get the virus, but general asymptomatic (or even if symptomatic still have to work), then those same essential workers come home and expose an at-risk loved one living with them."

    Immigrants and certain ethnic groups

    A number of immigrants and Latinos are among those who've recently contracted the new coronavirus, Newman reports. According to Newman, data from New York City shows that, during the first six weeks of the city's Covid-19 outbreak, Latinos accounted for 28% of the city's reported deaths linked to the new coronavirus, 30% of the city's reported Covid-19 hospitalizations, and 32% of the city's reported Covid-19 cases. Those percentages increased from April 27 to May 13, with Latinos comprising 37% of reported deaths, 37% of reported hospitalizations, and 42% of reported cases, Newman writes. 

    According to Ramón Tallaj—founder of Somos, a health care network serving almost 800,000 Latino and Chinese New Yorkers—the virus has continued to spread among those who live in multigenerational apartments with people who are fearful of getting tested because of language barriers or their immigration status. Tallaj said, "What we are seeing on telemedicine" is the people who are "getting sick … are stuck at home, immigrants who are living 10 people in one apartment. They don't want to go to a testing site or to an [ED]."

    People in low-income neighborhoods

    Newman writes that, "[a]long with immigrant-heavy neighborhoods in Queens, the Bronx has been the hardest-hit borough of New York City." He notes that, of the 10 zip codes in New York City that have reported the highest rates of new Covid-19 cases over the past two weeks, four were in the Bronx—and two are among the lowest-income ZIP codes in the city. 

    Seniors, and assisted-living and nursing home residents

    Seniors continue to make up a substantial portion of new Covid-19 patients, Newman reports. 

    Pappas said he's noticed "many very elderly patients" with Covid-19 from different assisted living homes and nursing homes throughout New York City.

    Kevin Hu, an emergency medicine physician at Elmhurst Hospital Center, said, "To me, it seems like there are many more elderly patients now. Very few young/healthy are coming in, even for testing" (Newman, New York Times, 5/28).

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