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“Micro-clusters” of Covid cases are now the focus in New York City’s battle against the pandemic. After a devastating spring in which COVID-19 took over 20,000 lives across its five boroughs, city public health officials and legislators have taken the fight against the virus to the streets. The health department now monitors micro-clusters as they pop up in city neighborhoods. As zip code areas are too imprecise in a metropolis of nearly 8.4 million people, officials track micro-clusters block by block and shut down hotspots to choke off the virus before it has a chance to set the city on fire again. Using a “focus zone” system, the city enforces aggressive lock-down restrictions on gatherings and businesses in hotspot red zones, and when a red zone is densely populated, more moderate restrictions are imposed in adjacent orange or yellow “buffer zone” areas to isolate the hotspots and prevent the virus from spreading to nearby neighborhoods.

Governor Cuomo’s micro-cluster tracking strategy allows for flexible, rapid responses to sudden outbreaks. As Thomas Tsai, a health policy expert at Harvard’s T.H. Chan School of Public Health, explained to Stat News: “Social distancing policy is not an on/off switch — this is a dial that needs to be calibrated to the temperature.” In the same article, Ana Bento, a disease ecologist at Indiana University elaborated, “The idea is to… from what we know, create more efficient and evidence-based types of lockdowns. In different cities and in different states, these lockdowns may look very different from each other.”

In a city of nearly 8.4 million people—fertile ground for any epidemic—wresting control away from the virus entails a mammoth, intensive, and a constantly vigilant Test & Trace Corps comprised of doctors, public health professionals and community advocates. New York City currently has over 200 free COVID testing centers at hospitals, health centers, and pop-up locations located across all five boroughs. The state testing program has achieved considerable penetration, administering over 700 daily tests per every 100,000 residents. During August and September, 45-50,000 residents were tested every day, and since cases started to surge in late October, as many as 58,000 people have been tested in a single day (NYC testing figures).

New York City is using a neigborhood-based "micro-cluster" strategy to keep down its Covid curve.
NYC Mayor Bill DeBlasio explains the city’s Track and Trace system.

Positive cases and micro-clusters are monitored and aided by a team of over 4,000 contact tracers. Every day, the Test and Trace Corps sends about 500 COVID-positive New Yorkers a “Take Care” package with PPE and other equipment for a 10-14 day quarantine: a medical-grade mask, sanitizing wipes, hand sanitizer, thermometer, two at-home testing kits for contacts, and a pulse oximeter to monitor their oxygen levels. If they are unable to isolate themselves at home, those testing positive are provided with temporary quarters in a local hotel. At present, the Corps has a 98% compliance rate (i.e., in 98 out of every 100 positive cases the patients are complying with quarantine guidelines and staying indoors alone).

How has the city been faring in its block-by-block micro-cluster battle? With April’s images of refrigerated morgue trucks still fresh in their minds, many New York residents continue to accept the restrictions of social distancing, but exceptions are inevitable in a city containing a multitude of diverse neighborhoods and cultures. Like their counterparts all over the US, NYC officials are contending with “COVID Fatigue,” complacency, and expressions of heated resentment by residents and businesses in locked down neighborhoods. Overall, the zone-based lockdown program seems to be working, but the system may be sorely tested by the current surge and the approach of winter. “We’re all heartened at the fact that this is working,” Jackie Bray, deputy executive director of NYC Test & Trace Corps, told the Washington Post, but “We’re clear-eyed [about] how hard this is going to be to sustain through the fall and the winter.”​​

But is the system working? New York City cases more than doubled between November 2 and November 22. Governor Cuomo and Mayor de Blasio once again closed public schools on November 18, indoor dining is no longer permitted in the city (many argued that dining inside restaurants should have ceased earlier), and an emergency hospital has been reopened on Staten Island to reduce the pressure on other area hospitals.

Updated November 24, 2020.

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Koren Thomas

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