N.Y.C. Death Toll Soars Past 10,000 in Revised Virus Count - The New York Times

The city has added more than 3,700 additional people who were presumed to have died of the coronavirus but had never tested positive.

New York City, already a world epicenter of the coronavirus outbreak, sharply increased its death toll by more than 3,700 victims on Tuesday, after officials said they were now including people who had never tested positive for the virus but were presumed to have died of it.

The new figures, released by the city’s Health Department, drove up the number of people killed in New York City to more than 10,000, and appeared to increase the overall United States death count by 17 percent to more than 26,000.

Coronavirus Deaths in New York City

Confirmed deaths

Probable deaths

500

400

300

200

100

March 11

April 1

April 12

March 11

April 1

April 12

Confirmed deaths

500

400

300

200

100

March 11

April 1

April 12

Probable deaths

300

200

100

March 11

April 1

April 12

Source: New York City Department of Health and Mental Hygiene · Note: All data are preliminary and subject to change. Data as of April 13.

The numbers brought into clearer focus the staggering toll the virus has already taken on the largest city in the United States, where deserted streets are haunted by the near-constant howl of ambulance sirens. Far more people have died in New York City, on a per-capita basis, than in Italy — the hardest-hit country in Europe.

And in a city reeling from the overt danger posed by the virus, top health officials said they had identified another grim reality: The outbreak is likely to have also led indirectly to a spike in deaths of New Yorkers who may never have been infected.

Three thousand more people died in New York City between March 11 and April 13 than would have been expected during the same time period in an ordinary year, Dr. Oxiris Barbot, the commissioner of the city Health Department, said in an interview. While these so-called excess deaths were not explicitly linked to the virus, they might not have happened had the outbreak not occurred, in part because it overwhelmed the normal health care system.

“This is yet another part of the impact of Covid,” she said, adding that more study was needed. Similar analysis is commonly done after heat waves and was performed in the wake of Hurricane Maria in Puerto Rico.

“What New Yorkers are interested in, and what the country is interested in, is that we have an accurate and complete count,” Dr. Barbot added. “It’s part of the healing process that we’re going to have to go through.”

The revised death toll renewed focus on shortcomings in testing that have hamstrung city and state officials since the beginning of the outbreak. A limited number of tests have been available, and until now, only deaths where a person had tested positive were officially counted among those killed by the virus in New York.

Where People Died of Coronavirus in New York City

Confirmed deaths

Probable deaths

25

50

75%

25

50

75%

Hospitals

Nursing homes

Residences

Other

Confirmed deaths

Probable deaths

50

100%

50%

Hospitals

Nursing homes

Residences

Other

Source: New York City Department of Health and Mental Hygiene · Note: Showing cases with complete location data only. All data are preliminary and subject to change. Data as of April 13.

Mr. de Blasio decided, after another round of briefings over the weekend, to release the presumptive cases, the people said. Most of the added deaths took place in hospitals, according to the data. Others occurred in nursing homes or other long-term care facilities and in residences.

“In the heat of battle, our primary focus has been on saving lives,” said Freddi Goldstein, the mayor’s press secretary. “As soon as the issue was raised, the mayor immediately moved to release the data.”

New York City is among a handful of places in the country, including Connecticut, Ohio and Delaware, that are beginning to disclose cases where infection is presumed but not confirmed.

In California and Washington — locations of early cases in the American outbreak — officials said they included deaths as connected to Covid-19 only when the disease was confirmed by testing. Louisiana and Chicago followed the same protocol.

The new numbers in New York cover the weeks between March 11 to April 13, beginning at a time when the virus had already been spreading throughout the city and its surrounding suburbs. Mr. de Blasio and Gov. Andrew M. Cuomo shut down large swaths of the city and state by the third week of March.

Coronavirus Deaths in New York City’s Boroughs

Confirmed deaths

Probable deaths

10

20

30%

10

20

30%

Queens

Brooklyn

Bronx

Manhattan

Confirmed deaths

Probable deaths

10

20

30%

10

20

30%

Queens

Brooklyn

Bronx

Manhattan

Source: New York City Department of Health and Mental Hygiene · Note: Showing cases with complete location data only. All data are preliminary and subject to change. Data as of April 13.

New York City has been reporting the probable cases to the federal National Center for Health Statistics for more than a week, health officials said. But Dr. Barbot said that the city would continue reporting only confirmed cases to the Centers for Disease Control and Prevention for its coronavirus tracker, because the agency requested those statistics. “We are more than happy to report on probables,” she said.

The C.D.C., in its guidance to local governments, has recommended that cases of “assumed” coronavirus infection be noted on death certificates since before New York City recorded its first death on March 14.

On Tuesday, the city’s count of confirmed cases went up to 6,589.

The city and the state have at times differed in their counts of the dead in New York City. As of Monday, the state said that 7,349 had died of the virus in the city. City officials have complained that they are at the whim of the state, which has been slow to share the data it receives from hospitals and nursing homes. The state Health Department explained on its website that the discrepancy is caused by the city and state using “different data systems.”

The state Department of Health did not immediately respond to a request for comment on the city’s decision to report suspected cases.

The sheer volume of additional deaths in the city has been felt daily. Emergency responders have seen the number of people dying at home jump significantly. Overwhelmed morgues have filled refrigerated trucks with bodies outside of hospitals.

And on Hart Island, the city’s old potter’s field, the number of unclaimed dead has grown markedly — as many people are buried there in a day now as would have been buried in a week before the pandemic arrived.

While the city has been uniquely overwhelmed by cases and deaths, the newly released data suggested that the toll elsewhere in the nation and the world may be much higher than reported.

“This is quite portentous,” said Andrew Noymer, associate professor of public health at the University of California, Irvine. He said the revised New York figures provided “a sobering reality that confirmed and probable Covid-19 deaths exceed deaths from all other causes.”

Public health officials say that counting the dead from a pandemic disease like Covid-19 presents difficulties because many of those who die are older or suffering from other serious health conditions. And the full effects of the outbreak on mortality in New York City, and around the country, could take many more months to study and understand.

Epidemiologists who study such events said a complete account would include an analysis of the number of the excess deaths.

Such an analysis can be “very hard to do” as an event is unfolding, said Sabrina McCormick, an associate professor of environmental and occupational health at George Washington University, who has studied excess deaths in heat waves. “This virus is moving so fast,” she said.

But, she added, an analysis of excess deaths is “the simplest and most straightforward way of measuring how many people have died from an extreme event” and can offer a more accurate accounting of the actual impact than the daily death counts provided by officials.

• Updated April 11, 2020

  • When will this end?

    This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

  • How can I help?

    Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities. More than 30,000 coronavirus-related GoFundMe fund-raisers have started in the past few weeks. (The sheer number of fund-raisers means more of them are likely to fail to meet their goal, though.)

  • What should I do if I feel sick?

    If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

  • Should I wear a mask?

    The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

  • How do I get tested?

    If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

  • How does coronavirus spread?

    It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

  • Is there a vaccine yet?

    No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

  • What makes this outbreak so different?

    Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

  • What if somebody in my family gets sick?

    If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

  • Should I stock up on groceries?

    Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

  • Can I go to the park?

    Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.

  • Should I pull my money from the markets?

    That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

  • What should I do with my 401(k)?

    Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”