New York just legalized marijuana

“With New York’s law, 15 states and Washington, DC, have now legalized marijuana for recreational purposes, although DC doesn’t allow recreational sales. (South Dakota voters approved a ballot initiative to legalize cannabis in November, but that measure’s future is uncertain as it’s caught up in legal battles.)”

Cuomo’s Vaccine ‘Fix’ Is Still a Tangled Mess of Rules, Restrictions, and Fines

“Cuomo presented area hospitals with a double bind: Fail to use all of your vaccines and be fined up to $100,000, or vaccinate people out of order and be fined $1,000,000. Inoculating health care workers first may sound sensible on the surface, but that evaporates when you consider that logistical externalities often prevent providers from corralling such employees in perfect time. (The Moderna and Pfizer vaccines can last for several months while frozen, but after thawing they have a very short shelf-life.) If those hospitals strayed and found an alternative candidate outside the mandated plan, they would have met financial ruin.

That threat is not an empty one: At least one hospital is under investigation for daring to vaccinate school officials before their time came.

Cuomo has claimed that such rules are necessary to prevent shady providers from constructing vaccine bribery schemes and pushing their friends to the front of the line. That concern may not be utterly groundless, but there is no evidence of widespread inoculation fraud. Compromising the health of New Yorkers seems an inept response to a negligible risk. The benefit of keeping the state’s senior citizens alive surely trumps such a worry.

New York’s graduation to tier 1b is a step in the right direction—now 3.2 million more people can receive the vaccine without health care providers worrying about their careers ending. But the state is still excluding large swaths of senior citizens in favor of “critical infrastructure workers,” such as grocery attendants. Those workers are providing a vital service, but many are also young and healthy, with much less risk of dying should they contract COVID-19.”

“people have been known to ghost their vaccine appointments even as doses are nearing expiration, something that no health practitioner can foresee. As I wrote last week, the D.C. Department of Health permits providers to pull aside any willing recipient if they have surplus vaccines that would otherwise go to waste. New York’s regulations on who may benefit from those extra doses will likely still cause some to end up in the trash.”

How New York Gov. Andrew Cuomo failed, then succeeded, on Covid-19

“Cuomo and other New York leaders were initially slow to react to the coronavirus, letting the pathogen spread rapidly through the population before the state closed down. Some of that was due to a lack of understanding of the disease early on, but there were also steps Cuomo and others, experts argued, should have known to take even back then.

But once New York’s leaders and the public acted, they did a lot of things right, from social distancing to testing to masking.”

“nursing homes. A New York State Department of Health advisory memo was widely interpreted by the facilities as forcing them to take Covid-19 patients from hospitals, potentially worsening the spread of the disease.
Cuomo’s office has rebuked the criticisms, arguing that it acted on the best evidence and expert advice it had at the time. To the extent the state was slow to recognize the threat of Covid-19, officials claim it was due to federal missteps and inaction that hindered testing early on in the crisis, leaving the state, one adviser said, “flying blind” and unable to detect its full epidemic before it was too late.”

“The state’s late success as much of the country continues to struggle with a second coronavirus wave offers a lesson to the rest of the US and world: Covid-19 is not something that can simply be vanquished in a matter of weeks or months. It requires continued and sustained vigilance.

Unfortunately, it’s a lesson that only came about after Cuomo and state leaders oversaw and learned from the worst Covid-19 outbreak in the country and one of the worst in the world.”

“On March 1, New York state reported its first Covid-19 case. On March 2, Cuomo acknowledged that community transmission within the state “is inevitable.” By March 3, the state confirmed the first case of community transmission. At that point, the state’s first big outbreak took off in New Rochelle. On March 5, New York City Mayor Bill de Blasio said that “you have to assume [the virus] could be anywhere in the city.” Each of these events could have served as early red flags for aggressive action.

It became increasingly clear, too, that the coronavirus was spreading not just in far-flung places like China and Iran, but in the West too. Italy was struck hard first by March, leading to haunting stories of overflowing hospital wards, patients turned away, and a growing death toll. Spain, Belgium, and France soon followed with big outbreaks and climbing death tolls.

Cuomo and other New York leaders started to mobilize. They began holding regular news conferences, warning of the virus and threats. They started to close down parts of the state, including in-person teaching at schools and large gatherings, while recommending people work from home if possible.

Even then, the messaging was muddled. Cuomo on March 2 told reporters, “We have been ahead of this from Day 1.” De Blasio on the same day tweeted that he was “encouraging New Yorkers to go on with your lives” and “get out on the town despite Coronavirus” — offering a movie recommendation for The Traitor.”

“Cuomo was vocally skeptical of a stay-at-home order. Asked about de Blasio’s comments advocating for a “shelter-in-place” order, Cuomo on March 19 suggested such a move was unnecessary, arguing, “I’m as afraid of the fear and the panic as I am of the virus, and I think that the fear is more contagious than the virus right now.” Behind the scenes, the mayor and governor reportedly bickered about the order, with Cuomo remaining resistant.

Meanwhile, the San Francisco Bay Area issued the country’s first regional stay-at-home order on March 16, which went into effect the next day, and California issued an order on March 19 that went into effect the same day.

On March 20, Cuomo acquiesced — issuing a stay-at-home order for the whole state that would take effect two days later.

A few days of delayed action may not seem like a long time. But exponential growth means cases of Covid-19 can double in a couple of days, quickly spiraling out of control — making early action key to nipping the problem in the bud before it explodes out of control. Tom Frieden, who served as the director of the Centers for Disease Control and Prevention under President Barack Obama, told the New York Times that the state could have reduced its death toll by 50 to 80 percent if it locked down a week or two earlier.”

“Cuomo’s office questioned whether the state could have acted quicker. A week before Cuomo issued a stay-at-home order, the state had reported around 50 Covid-19 cases a day and zero deaths. By the time of the order, there were nearly 1,000 cases and 10 deaths a day. Without that level of spread, the public may have been skeptical of drastic measures.”

“New York may have gotten unlucky, too. Its position as a major international hub, its density, and its widespread dependence on public transportation made it uniquely vulnerable to Covid-19. These factors — considered upsides to New York in most other situations — were out of Cuomo’s control.
The virus also initially spread when we simply knew less about it. We didn’t know what parts of lockdowns would be effective, or that outdoor spaces, for example, were comparatively safer. We had much less research on the benefits of masks. And it was still unclear how this virus would affect the US in particular.”

“Cuomo’s second big mistake came after the state started treating Covid-19 as a serious threat. On March 25, his administration issued an advisory that effectively forced nursing homes to take in Covid-19 patients from hospitals after they supposedly recovered. The rules barred nursing homes from demanding a coronavirus test prior to the transfer. In general, nursing homes interpreted the rules to force them to take in Covid-19 patients.
The idea was to limit hospital occupancy — a huge point of concern, as the coronavirus strained hospitals worldwide, including in New York. But critics say the advisory pushed Covid-19 into some of the most vulnerable places in the state.”

“Cuomo and the New York State Health Department have pushed back against the claims. Cuomo has described the criticisms as “political.” The New York State Health Department released a report suggesting Covid-19 was spreading in nursing homes prior to the advisory and largely due to infections among staff, not formerly hospitalized patients.

But experts have been highly critical of the state’s report, arguing its shoddy methodology wouldn’t make it into a reputable scientific journal.

Experts told me that, overall, New York’s nursing homes were likely to suffer Covid-19 deaths once there was a big outbreak in the state, even if Cuomo’s administration hadn’t issued the advisory — a reflection of longstanding problems with infection control in these facilities.

Still, they argued that the advisory likely made things worse. Even the state’s report admits that some patients who were transferred back to nursing homes were infectious, although it’s not clear how many and which led to more infections.”

“While New York did some things very wrong, it was also true that Trump and the federal government often didn’t help — and, with their own failures and inaction, actually made it much harder for New York and other state and local governments to respond to the coronavirus pandemic.”

“The situation has improved dramatically in New York since the spring. Today, the state is in the bottom three for daily new cases, with a rate of 3 per 100,000 people. Its test positive rate is the third lowest in the country at less than 1 percent — an indication of a controlled outbreak.

Experts say Cuomo and other leaders in the state deserve a lot of credit for such outcomes. New York dramatically scaled up testing — with the third-highest testing rate, when controlling for population, among all states. It built up a contact tracing system. It imposed a masking mandate. It has, in general, adhered closely to expert advice and empirical data as it’s evolved and shifted.

Perhaps most importantly, Cuomo resisted what many other states did not: reopening too quickly. The state imposed strict regional metrics that localities have to meet to reopen, and it’s stuck with them. New York City still hasn’t allowed indoor dining or bars, both of which present a huge risk for Covid-19 transmission.

It’s a sharp contrast to California Gov. Gavin Newsom (D). He was the first in the country to close down his state but, under pressure from local and private actors, allowed counties to reopen more quickly, getting waivers that effectively allowed them to ignore the standards the state previously set. That allowed indoor dining, bars, and other risky indoor spaces to reopen — until cases exploded in California, forcing Newsom to eventually reel back.”

“There are factors beyond policy that have helped New York. Because the state suffered a massive outbreak in the spring, there’s likely some element of population immunity making it more difficult for cases to spread too widely as long as people follow some precautions. The public has helped, too, remaining cautious even as the state has reopened; a New York Times analysis, for example, found New York had some of the highest rates of mask-wearing in public of any state.

“Once we did [act], it’s truly an incredible testament to New Yorkers that we have been able to do what was needed to get where we are today,” Nash, of the City University of New York, said.

New York’s success in the aftermath of a deadly outbreak shows the need for continued and sustained vigilance. It’s not enough to merely push down cases and test positive rates — as many states did early in the summer — people also need to stay cautious and keep the spread of the virus from getting out of control again. Resisting temptation, such as with reopening risky indoor spaces like bars, is crucial.

The unfortunate reality is Covid-19 won’t go away until a vaccine or similar treatment is widely available.”

3 Ways New York Botched the Coronavirus Response in March

“”Frieden said that if the state and city had adopted widespread social-distancing measures a week or two earlier, including closing schools, stores and restaurants,” the Times reported, “then the estimated death toll from the outbreak might have been reduced by 50 to 80 percent.””

We are your future’: Will all of America become like New York?

“New York is both the country’s most populous city and its most densely populated. Vinetz said both the city’s high density and the fact that it is densely populated across a large region could be exacerbating factors. Vinetz also cited the city’s status as a hub for global travel as a factor that could be contributing to the outbreak there.”

“there are too many unknowns to draw firm conclusions at this point, and residents of the rest of the country should not assume they will avoid New York City’s fate”

” interviews with New York residents and officials suggested that both the New York lifestyle – replete with shoulder-to-shoulder public transportation, frequent dining out because of the limits of apartment living, and reliance on crowded city parks for daily recreation – as well as a certain stubbornness in curbing it may have contributed to New York’s high infection rate.”

““Hong Kong, Singapore and Tokyo also have density and nowhere near the kinds of outbreaks we have,” Hendrix said. “Density also requires good governance coupled with reinforced strong social norms to counter the spread of contagious disease. What you’re seeing today is the fruit of a slow government response to a crisis.”

While Cuomo and Mayor Bill de Blasio have been ahead of the federal government in issuing calls for social distancing, an early spate of mixed messaging from elected officials may have led some New Yorkers — especially those who perceive themselves as young and healthy — to take unnecessary risks.”

“Less than three weeks ago – March 5 – de Blasio took a subway ride to show his confidence in the safety of the city’s transportation system and his administration told the city’s 4.3 million straphangers that they were safe riding in jam-packed subway cars as long as no one coughed or sneezed directly on them.”

“Cuomo claims that the high rate of cases is correlated to testing at “the highest per capita level in the United States.””