66% of recent admissions to New York were patients who were staying at home.
Yesterday (5/5/20), Governor Andrew Cuomo reported on results of studying patient information of recent Covid 19 admissions to New York hospitals. The data was from 1300 patients who were admitted for Covid 19 at 100 hospitals across the state. It was very surprising that the majority of these patients were adhering to the stay-at-home policy. The results raises the question of how beneficial stay-at-home polices actually are.
A granular look at the results provide the following:
83% of the patients surveyed were either retired (37%) or unemployed (46%).
17% were employed.
4% said they were taking public transportation.
18% of the patients came from a nursing home.
The vast majority of the patients were over the age of 51.
The ethnic distribution is provided in the table below.
| Ethnicity | % Population | % Covid Infected |
|---|---|---|
| White | 55 | 38 |
| Latino/Hispanic | 19 | 17 |
| Black | 14 | 21 |
These results are opposite to what was expected. It was expected that a high percentage of the new covid 19 patients would be essential workers (not stay-at-home) or those that took public transportation. Those that were employed and/or taking public transportation were the least effected people. It was unexpected that 83% of the patients would be retired or unemployed.
New York has ‘flattened the curve’ by showing decreases in infections, deaths and hospitalizations. For instance, for the entire New York state, there were 15,021 hospitalizations on May 22 and there were 8656 on April 6.
Public transportation was not associated with new covid 19 cases. This result is in line with Japan’s low infection and death rate despite running a fully operational and heavily used mass transportation system.The Japan Experience: No mass shutdown. No mass isolation. Fewer cases and fatalities. What can we learn? The results also suggest that blacks may have a higher risk factor as blacks had 21% of the new infections but are only 14% of the population. The number of patients coming home from nursing homes is also very high. These are people who are at the most at risk and should be the most protected.
A warning that this study was based on only 1300 patients but it raises important questions. A larger number of patients would have to be surveyed to confirm these surprising results. Also, there needs to be more granularity to the data. For instance, the type of dwelling, single family home, apartment, condo, number of people in the same residence etc.
This is not an argument against stay-at-home policies. The study is too small and not detailed enough to come to this conclusion. However, it does indicate that it may not be as simple as ‘stay-at-home and you won’t get infected’. In fact, this study suggests that in this group of patients, if you stayed-at-home you were more likely to be infected. Perhaps this is not an ‘all or nothing’ policy. Unclear why stay at home does not appear to be currently effective in NY but Japan with no stay-at-home policy has low infection and death rates. Only a larger, better designed study will answer this question.
For now, this is another piece of the puzzle.
