We Need New Public Health Guidance

Local and Federal Officials Have Lost the Script

Before you jump into today’s newsletter, I hope you check out my column that ran in the Guardian this week about America’s ludicrous healthcare system. Next week, I should have another column up in the Guardian about New York City’s future. I’ll let you know when it runs. I also wrote, in Gothamist, about the push to unseat Eliot Engel, war hawk.


Last week, as people gathered in huge crowds outside Manhattan bars and restaurants, Governor Andrew Cuomo threatened to roll back New York City’s reopening and lock down the county, or the whole city, once more. If the city wasn’t willing to enforce the law, he vowed to step in to revoke liquor licenses and impose new penalties. Bars and restaurants are only supposed to be open for takeout and delivery. They can’t, within city limits, put out the patio furniture.

Cuomo’s action is one I would have been sympathetic to a few weeks ago, when I understood why Mayor Bill de Blasio dispatched the police to break up a mass funeral in Williamsburg under similar pretenses. COVID-19 has ravaged the city. More than 20,000 have died from the highly contagious virus, which has no cure. Coronavirus has not vanished, despite the progress New York has made in recent weeks. It spreads, unchecked, across America, and there is no reason to think that new and deadlier waves won’t occur. New York may be done with coronavirus. It may not be. The virus is a deadly mystery we don’t yet understand.

But Cuomo’s heavy-handedness—and the scolding of revelers by various politicians—doesn’t make sense any longer. For two weeks, Democratic politicians in New York and across America actively encouraged people to mass gather. I personally share the goals and aims of the Black Lives Matter protesters and I’ve reportedly skeptically on the police for many years now. The protests have been, from a policy and consciousness standpoint, quite successful. In New York, 50-a was repealed and the police chokehold was outlawed. The movement to reduce funding for the NYPD has now gone mainstream, migrating from the fringe to the mainstream in a few short weeks.

From a public health standpoint, the protests have pushed New York, and perhaps large swaths of America, into a new phase of confronting coronavirus. Though some doctors and public health officials have argued that protesting is a relatively safe activity because it’s outdoors and most people wear masks, congregating always carries the risk of spreading COVID-19. The only way to keep the curve flat and hope the virus diminishes before a vaccine arrives is to enforce social distancing. Thousands of people clustering together, no matter how well-intentioned, are not following the guidance laid out by most public health officials and politicians since the pandemic took hold.

The unintended consequence of politicians encouraging and joining marches that were in violation of their own shutdown orders—in many places, only gatherings up to 10 were technically allowed—is that other people will want to go outside for their causes too. It doesn’t matter that marching against police brutality is more noble than reopening a restaurant. What matters is perception and consistency. New Yorkers spent three months being told that to cluster in any kind of group, indoors or out, was to invite death. Now, after tens of thousands marched through city streets throughout June, aggrieved business owners want to know why they can’t open up. Some politicians are literally breaking the locks on playgrounds the city has shuttered. New Yorkers want to know why they can’t go to their city beaches. Why can’t they go to their mosques, churches, or synagogues? Their demands have validity now. If those marches were deemed acceptable from a standpoint of public health, why not other outdoor activities? What does the science say?

The mass protests could have been catastrophic in terms of spreading coronavirus, but it appears they weren't. Hospitalizations and deaths aren’t spiking. We don’t know exactly why. Are masks just that effective? Is coronavirus less contagious in warm weather? Did so many New Yorkers get infected that such an explosion in new cases is just not possible any longer? Will New York endure a second wave when the weather cools in the fall? As I’ve said, there is so much we don’t comprehend. What we can deduce, at least, is that if protests are safe, other kinds of outdoor activity—masks, of course, mandatory—are probably permissible.

Protesters for other causes won’t be deterred, either. If marchers want to mass gather for women’s health, against war, for economic justice, or against a statue, they’ll be able to, and shouldn’t be deterred any longer. There is no public health guidance that can proclaim one type of protest safer than another, as long as everyone is wearing masks. Let the reopening begin.

A darker question revolves around what comes next. With Democratic politicians collectively embracing protests against police brutality as a proper violation of the shutdown orders that were imposed, political capital has been lost to impose a second lockdown if COVID-19 returns with force. It will be far harder to tell people of all political persuasions to go inside. We are now onto new phase, one that seems to have more in common with Sweden every day: we’ll live our lives, take our risks, and see what happens. Maybe masks are enough. We know hygiene is incredibly important. The trajectory of coronavirus will be the real test. So much of the success in terms of preventing mass death has been tied to early action; it’s why California and Washington State avoided the catastrophe that befell New York. Cuomo dithered on imposing a shelter in place order and New Yorkers suffered the consequence of his incompetence and ignorance.

What we’ve learned, through this whole ordeal, is how poor guidance from local and federal officials can be fatal. It wasn’t just Donald Trump and Andrew Cuomo. Masks were actively discouraged in the early days of COVID-19, with even the revered Dr. Anthony Fauci admitting that he warned people away from wearing masks over fears that there would be an N95 shortage, even though cloth masks and scarves are still fairly effective at stopping the spread. Similarly, the U.S. Surgeon General’s February 29 tweet to “STOP BUYING MASKS!” will probably live in infamy, effectively tricking people into thinking they could remain healthy and keep others safe by merely engaging in good hygiene and staying home most of the time. “I am worried that telling people to wear masks will strain already weak supplies that are needed by doctors and nurses,” Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, said at the beginning of April. “If we are able to fix that supply chain, I’d feel less worried about this. But some of the shortages initially were due to members of public and medical staff raiding medical offices’ and hospitals’ supplies for home use.”

This could have been avoided if public health officials simply told Americans, from the outset of the pandemic, they could buy cloth masks or make their own. Even the Vox story Nuzzo is quoted in strikes an even-handed, almost skeptical tone toward universal mask wearing, telling the reader it’s healthy and fine but the PPE shortage needs to be addressed first, as if every person must don an N95 mask to reduce the spread. We know this is not the case. Just as with the sudden whiplash of public health officials toward the nature of mass gathering—Nuzzo, of Johns Hopkins, was one of those epidemiologists telling people to get out in the streets and march for a good cause—Americans must grapple with the muddled messaging they’ve received about mask-wearing and social distancing since the arrival of COVID-19. As late as March, Andrew Cuomo was still comparing coronavirus to the flu.

What New Yorkers and Americans need is clear, consistent public health guidance for how to move forward in a world where coronavirus has no cure. It’s not enough to demand people stay indoors unless a cause is worthy enough to bring them outside. It’s not enough to say outdoor dining will be acceptable next week but playgrounds won’t be. It’s not enough to say it’s permissible to hold press conferences again but not funerals. Cuomo and de Blasio should, with their public health officials, collaborate on policy that all New Yorkers can easily understand and apply to their lives. I’m doubtful this will happen. Instead, we’ll be left with the absentee leadership we’ve grown used to, doomed to fend for ourselves and hope for the best.