Seattle's leaders let scientists take the lead. New York's did not.
April 29, 2020 9:08 AM   Subscribe

"The initial coronavirus outbreaks in New York City emerged at roughly the same time as those in Seattle. But the cities’ experiences with the disease have markedly differed. By the second week of April, Washington State had roughly one recorded fatality per fourteen thousand residents. New York’s rate of death was nearly six times higher. The cities' leaders acted and communicated very differently in the early stages of the pandemic."

"Seattle’s leaders moved fast to persuade people to stay home and follow the scientists’ advice; New York’s leaders, despite having a highly esteemed public-health department, moved more slowly, offered more muddied messages, and let politicians’ voices dominate." The New Yorker takes a deep dive into different forms of crisis leadership on display during coronavirus.

Bonus resources: the CDC's Field Epidemiology Manual, and its chapter on Communicating During an Outbreak.
posted by entropone (75 comments total) 39 users marked this as a favorite
 
Very interesting comparison on how the two cities acted/reacted. Thanks for posting!
posted by sundrop at 10:13 AM on April 29, 2020 [2 favorites]


And in a month or so id be interested to compare those approaches with cities in Texas, Georgia and Florida.

Unless we are past the point where data matters to Red State policy makers and their death cult constituencies.
posted by Everyone Expects The Spanish Influenza at 10:38 AM on April 29, 2020 [5 favorites]


From the Seattle perspective, this article lined up with a lot of how I saw things unfold. My wife works for Microsoft. They started with, "Hey, if anyone feels uncomfortable coming in at all and wants to work from home, feel free," which felt like a huge warning flag. They escalated quickly from there. What really stood out early on was when Microsoft said they'd be paying full wages for all the outside vendor support workers on their campus like food service & such.

There are some Seattle-specific things to quibble about--specifically, this city is inexcusably bad about homelessness, and I'm side-eyeing the tone of sympathy for city/county authorities on that score. But on the whole I've been really grateful for the way local & state government has handled all this, which isn't something I say lightly.
posted by scaryblackdeath at 10:58 AM on April 29, 2020 [33 favorites]


The amount of Cuomo-boosting recently has been grinding my gears—he downplayed the severity early on! He cut medicare during a pandemic—so I'm glad to have this less breathless, Cuomo-for-prez take.

His slides are art, though.
posted by Grimp0teuthis at 11:00 AM on April 29, 2020 [42 favorites]


De Blasio is a lame duck and I don't see who among the current crop of contenders would be an improvement. We need expertise and technocrats and instead it's looking like more flim-flam.
posted by 1adam12 at 11:52 AM on April 29, 2020


And in a month or so id be interested to compare those approaches with cities in Texas, Georgia and Florida.

And North Carolina. Gaston County (west of Charlotte) is openly defying the Governor's orders and issuing its own businesses-may-reopen ordinance, effective later today.

Expect this to become a trend across the nation... and protect yourself as best you can.
posted by delfin at 11:59 AM on April 29, 2020 [7 favorites]


Florida reopened some beaches on Apr 17.

Georgia reopened its restaurants.

A whole swarm of other states have shutdowns that expire today or tomorrow, and are announcing "partial reopening" plans. Some are less restrictive than others.

We're going to get to see exactly how effective the various protection measures are, as different states drop different aspects of them.
posted by ErisLordFreedom at 12:17 PM on April 29, 2020


Seattle is not New York though. The population density difference makes me side-eye this quite a bit. Notice that all the states with the largest number of cases tend to now be east coast states, or states with a very large urban population, Mass, NJ, NY, Illinois, Michigan, Connecticut, RI, etc.

I think we've done a pretty good job, but, Seattle doesn't have subways.
posted by Windopaene at 12:24 PM on April 29, 2020 [33 favorites]


That was a very good article.

And in a month or so id be interested to compare those approaches with cities in Texas, Georgia and Florida.

Florida ordered coroners to stop releasing coronavirus death data

posted by shoesietart at 12:25 PM on April 29, 2020 [14 favorites]


From the New York City resident perspective...

The characterization of de Blasio is spot on. He really was that inept and did things like going to his gym in another borough until the day the gyms were closed, delaying on closures despite recommendations, etc. And it's definitely clear that de Blasio and Cuomo are not working well together, but personally I wouldn't fault Cuomo if he's doing it because he thinks de Blasio is an idiot. De Blasio can't even coordinate opening NYC streets in response to park overcrowding.

I think some of what was said about Cuomo was mischaracterized. Cuomo has often said in his daily press conferences that people should relax in the sense of not completely freaking out and subsequently act in self-interested ways - please don't hoard food, please don't flee to rural areas en masse. I've never heard him say it in the context of not preparing, not collecting supplies for hospitals, or not social distancing.

Also, Howard Zucker, a physician and the New York State Commissioner of Health, is at Cuomo's press conferences every day and has been for a long time - as far back as mid-March, but that's just when I started watching the press conferences, so possibly even earlier. Cuomo frequently defers to him on medical matters. So to say "At press conferences, Layton and other physicians played minimal roles while de Blasio and Cuomo, longtime rivals, each attempted to take center stage" doesn't seem right regarding Cuomo.

Regarding Cuomo cutting Medicaid, there's some back story regarding Medicaid reform also at play, but I will say that Cuomo's been fighting for additional funding for state governments constantly (which hasn't come to pass) and the state is broke because we've been pouring a ton of money into paying for this crisis and doing things like paying inflated prices for medical supplies because the federal government was not responding to pleas to coordinate medical supply acquisition at a national level. A lot of things are getting cut. You can't make funds magically appear.
posted by unannihilated at 12:31 PM on April 29, 2020 [12 favorites]


Florida reopened some beaches on Apr 17.

Data point for you to take or leave:

I'm in one of those Florida towns that shutdown-soon-to-reopen it's beaches. Honestly, and by no means am I saying this is the case for larger areas like Jacksonville, Tampa, or, God help us, Daytona or Miami, the beach reopening plan (I hear in the next three days maybe) that many are advocating is really not unreasonable when compared to other activities that are currently underway at least.

Some of those restrictions I'm seeing are
A) Limit hours to a few hours in morning and evening to curtail gatherings/group events. I've heard 9am to 11am and similar in the evening.
B) No stopping, just walking, biking, jogging, surfing, and maybe fishing.
C) No towels or chairs, let alone tents or umbrellas becuase, well, you can't stop anyway.
D) Possibly limiting it to locals only but this, as I understand it, runs afowl of some federal renourishment / funding / grant dollars and is, sadly, a non starter. This would keep folks from flocking in from out of the area and causing a contagion issue so I'm sad about this one.

I mean, sidewalks aren't closed here and the restrictions we are under "Stay at home to stay safe" or whatever, hasn't stopped folks from biking/jogging/walking/strolling etc. In fact the memes about Corona virus behaviors here are really true: it's increased tremendously. Basically a nature trail (still open here, unlike beaches) is way more crowded than the six foot rule accounts for.

So, what I'm saying is that going to the beach here, with some or all of the restrictions in place and following proper procedures, is a lot safer than a nature trail or sidewalk because of the inherent topography because, hell, even on a crowded day here it's really, really easy to keep 6 feet away from a person while walking the beach and the wind and sun is usually rather strong anyway so I can't help but think that disbursment/disinfection is kinda built into the equation as well.

tl;dr - Reasonable beach use, it's odd, opening isn't as awful as it may seem. Also, normal florida-as-bad-actor levels of concern should continue to be applied by the rest of the nation.
posted by RolandOfEld at 12:33 PM on April 29, 2020 [9 favorites]


Seattle is not New York though.

Very much this. New York City has more kids in its public schools than Seattle has . . . people. The entire population of Seattle is about 750K; the NYC public school system alone is 1.1 million kids. The decision to close those schools -- just that one decision -- impacted more people and families than the entire population of Seattle, many of whom rely on that system for things like child care and food security. Let's not even talk about populations in NYC that refuse to pay attention to these orders regardless.

It's all very well and good to say "we did better because we listened to the tech bros," but that's not the whole story by a long shot.
posted by The Bellman at 12:34 PM on April 29, 2020 [29 favorites]


Seattle does have subways; they're not as extensive as New York's. It has a light rail system that connects the airport to the rest of the county.

My experiences with Seattle's rail transit is limited (I've visited Seattle a few times), but it was never crowded the way the SF Bay Area's BART trains are, and I gather NY subways are more complex and more crowded.

But point taken: Seattle is considerably less dense. Seattle has about 8,000 people per square mile; NYC has over 26,000. Even with the exact same reaction as Seattle, NYC would've had more cases (per capita) and more problems, because "8000 people with a few carriers" isn't nearly as contagious as "26000 people with a few carriers" in the same space.
posted by ErisLordFreedom at 12:35 PM on April 29, 2020 [4 favorites]


The population density difference makes me side-eye this quite a bit.

Another thing that’s coming to light with random AB testing, is that the West Coast hasn’t done a lot better than the East Coast (LA county ~4-5% infection rate), it just has a different, less deadly strain of the virus. The current research/deduction is that it evolved on the way from China to Italy, and then travelled to NYC from there. This variant has been found to have up to 270x the viral load of the other (in extremely sick patients), making it both more deadly and more catchy. The fact that LA has about the same infection rate means their response was actually less effective, even though they had fewer reported cases and hospitalizations.
posted by sexyrobot at 12:41 PM on April 29, 2020 [15 favorites]


Our light rail system is not a subway, in any sense of the word IMO. We're working on it, but other than going to the airport, we don't have the track or stations yet for it to be much of a thing. And, while "Seattle" is small, the Seattle Metropolitan Area does have a fair bit of population. But not the density.
posted by Windopaene at 12:41 PM on April 29, 2020 [2 favorites]


Another factor that may have played into differing responses (whether or not it should have): way more West Coast upper middle class and above professionals can relatively readily do (or already do) their jobs from home, so the dislocation was less. The East Coast lawyers have all bolted now, but it took a lot of infrastructure-buildout and the courts are half-closed anyway. People are still freakin' going in at JPM and GS.
posted by praemunire at 12:48 PM on April 29, 2020 [1 favorite]


sexyrobot, got some links for that? Interested.
posted by Dashy at 1:05 PM on April 29, 2020 [1 favorite]


sexyrobot, got some links for that? Interested.

The paper is linked here at r/Virology, but for what it's worth, they don't seem to think too highly of it and I'm inclined to agree. The experiments were done sloppily and there seem to be some missing experimental details.
posted by un petit cadeau at 1:17 PM on April 29, 2020 [9 favorites]


It's all very well and good to say "we did better because we listened to the tech bros," but that's not the whole story by a long shot.

The article in the OP is about listening to the CDC.
posted by entropone at 1:30 PM on April 29, 2020 [11 favorites]


These charts show that density in and of itself is not a factor in transmission, and LA is more uniformly dense at greater distance than NYC is, though NYC has more neighborhoods of higher density than LA.


Density comparision

NYC density comparison

However, NY is such a serious outlier vs anywhere else in the US, that it's hard to compare policy vs density vs anything else given the data we have. Washington state for example has more deaths than Texas and has the same population of just one of TXs' metro areas. Florida, comparatively has also done pretty well given its population.

Socio-economic factors are a much better explanatory variables than density.
posted by The_Vegetables at 1:31 PM on April 29, 2020 [4 favorites]


At the end of March, I (Seattle resident) found myself on a zoom call with a bunch of NYC friends and family, and they were expressing their admiration for what a better job Seattle had done, compared to NYC. I tried to make the argument that we're less dense, so it was easier to contain, and one of the New Yorkers made the point that NYC's density means they actually should have responded even more quickly because the stakes are so much higher. It's hard to argue with that, or with the fact that one city* listened more to epidemiologists than the other.

It's all very well and good to say "we did better because we listened to the tech bros," but that's not the whole story by a long shot.

What on earth? This is not about listening to "tech bros," it's about listening to trained epidemiologists - you know, experts. In this case, the tech bros (ie, the CEO of Microsoft) listened to the scientists and the elected leaders, explicitly NOT the other way around. (It's pretty interesting that they went to Microsoft first and not Amazon. I wonder if they went to Amazon too and Bezos dragged his heels, or if they just went right to Microsoft because they expected they would be more responsive.)

* Nitpick: most of the time when they talk about "Seattle" in this article, they're talking about the county government, not the city.
posted by lunasol at 1:38 PM on April 29, 2020 [27 favorites]


Seattle is not New York though.

Right. NYC having a higher population density means that their response needed to be better than Seattle's for a similar outcome.
posted by Revvy at 1:41 PM on April 29, 2020 [4 favorites]


Seattle is not New York though. The population density difference makes me side-eye this quite a bit. Notice that all the states with the largest number of cases tend to now be east coast states, or states with a very large urban population, Mass, NJ, NY, Illinois, Michigan, Connecticut, RI, etc.

Okay, so compare Seattle to Detroit; it's in one of those states with very large urban populations. Detroit is the 14th largest metro in the US, Seattle is the... 15th. And Seattle is denser, and it has orders of magnitude more transit use. Every excuse NYC has relative to Seattle, Seattle could make relative to Detroit. Yet there are 5 COVID-19 deaths in Detroit today for every one in Seattle. That's a better comparison, although it's understandable that New York would instead be featured in an article in The New Yorker. (Toronto has the same number of deaths as Seattle, despite being the second densest, second most transit-riding metro in North America and having 50% more people than Seattle or Detroit.)

The population density thing is not entirely unimportant, but it's used too much as a cover. What's the population density of a nursing home? Of a choir practice? Of a meat processing plant? Pretty much the same everywhere you go. That list of urban states you list had some of the fastest growth of COVID-19; they all went from 100 cases to 2000 cases in 10 days or less. But so did Louisiana, Texas, Missouri and Indiana. Meanwhile, California, which has plenty of people -- and the second and third densest metros in the US -- took 15 days, as did Washington.

New York City exceptionalism is frustrating to me; it's not that New York isn't different than every other city in North America (although that's also true to a lesser extent for, say, Indianapolis). It's that the conversation generally whizzes by "Well, NYC has subways so that might make a difference, let's consider it in more detail - was the novel coronavirus generally spread by public transit riders" and stops at "Well, NYC has subways so there's no lessons to be learned from any place more than 25 miles from the torch on the Statue of Liberty." Which is a big part of why NYC isn't getting any more subways, because construction there is almost 10 times more expensive than in other large cities.
posted by Homeboy Trouble at 1:41 PM on April 29, 2020 [9 favorites]


I think population density is a bit of a red herring; it's social and political will, and the policies which result from those, which make the difference.

The following density numbers are not directly comparable, since they may or may not include less-populated areas, but it's illustrative to look at the numbers in Asian cities. For reference, NYC's population density is close to 10,700/sq km. If population density is so important, how do you explain Hong Kong (pop. density: 6800/sq km, ~1050 cases, 4 deaths) and Taiwan (pop. density in Taipei-Keelung metro area: 2900/sq km, ~650 cases, 6 deaths)? What about Singapore (pop. density: ~7900/sq km), whose current numbers are ~16,000 cases, 14 deaths? The bulk of those cases are largely attributable to outbreaks in migrant worker dormitories, a second wave which started about a month ago. Somehow it's not surprising to learn that "numbers among Singaporean nationals remain under control."
posted by invokeuse at 1:45 PM on April 29, 2020 [7 favorites]


> The article in the OP is about listening to the CDC.

Though also, critically, about not listening to the CDC:
Riedo remembered that other local researchers had been conducting a project called the Seattle Flu Study. For months, they had collected nasal swabs from volunteers, to better understand how influenza spread through the community. During the previous few weeks, the researchers, in quiet violation of C.D.C. guidance, had jury-rigged a coronavirus test in their lab and had started using it on their samples.
It really can't be overstated how important it was that researchers here in Seattle started widespread testing before anywhere else in the country did it, because they were willing to disobey the CDC and FDA. Without the Seattle Flu Study, we would have been in the dark for days or weeks longer, and all the actions that followed might have come too late.
posted by mbrubeck at 1:50 PM on April 29, 2020 [41 favorites]


De Blasio is a lame duck and I don't see who among the current crop of contenders would be an improvement

I feel ok about Corey Johnson (the City Council speaker), who is definitely running. He has spent most of his tenure pushing De Blasio from the left and I get the sense that he'd be a lot more effective as mayor.
posted by showbiz_liz at 1:51 PM on April 29, 2020 [3 favorites]


The MTA website states over 5 million people ride the New York City subways each day. That is five million people crammed into a steel tube, touching common surfaces such as railings or turnstiles, and exhaling in the general direction of each other. Around 40,000 fans attended the soccer game believed to have accelerated the pandemic in Italy and Spain. New York City basically was playing 125 of those soccer games every day before the lockdown. Considering the subways necessarily continued to operate after the "pause", that vector continues to this day. All that is apart from the fleets of buses, taxis, and ride-sharing vehicles upon which New Yorkers depend to traverse their city.

Further, consider the reality of living in a multi-unit dwelling such as an apartment or condo. Just getting the mail or doing the laundry involves moving in common areas and/or touching common surfaces. Even careful people slip up sometimes, so the risk of transmission is increased in those ares as well compared to someone living in house no matter how assiduously someone practices social distancing.

So, population density definitely makes a difference. The east Asian countries that managed to contain the coronavirus before community spread had the experience of the first SARS in the early 2000's, as well as admittedly less dysfunctional healthcare and political systems. As a result, you can't really directly compare the response of any US city or state to those countries because of the failures at the federal level in the US.
posted by eagles123 at 2:11 PM on April 29, 2020 [3 favorites]


"It's the subways" is a red herring designed to convince you that New York City is a bastion of filth and there is no way that public policy or a coordinated civic response can accomplish anything, that deaths are not preventable so we shouldn't bother trying, and that government should continue to be defunded and drowned in the bathtub. I for one don't allow that kind of far-right talking point into my house and neither should you.
posted by entropone at 2:32 PM on April 29, 2020 [24 favorites]


I think it’s reasonable to compare the Capitol Hill Central Urban Village area of Seattle to a similar density of Brooklyn. Outside this one particular area of king county density falls off by a lot but where I live in Seattle very much reminds me of when I lived in Ft. Greene.
posted by nikaspark at 2:36 PM on April 29, 2020 [1 favorite]


"It's the subways" is a red herring designed to convince you that New York City is a bastion of filth and there is no way that public policy or a coordinated civic response can accomplish anything, that deaths are not preventable so we shouldn't bother trying, and that government should continue to be defunded and drowned in the bathtub. I for one don't allow that kind of far-right talking point into my house and neither should you.

That's one way to interpret it, sure. Considering other national governments with similar cities managed to avoid community spread, it's not an interpretation I share. I assure, you, however, population density and the physical conditions in which a population lives matter very much when looking at the spread of an illness. This is isn't really up for debate. The entire enterprise of public health is predicated upon it. Its part of the reason we started building sewers in the western world. The physical world and its inherent properties exist independent of the political debates of the moment.
posted by eagles123 at 2:40 PM on April 29, 2020 [3 favorites]


That's one way to interpret it, sure. Considering other national governments with similar cities managed to avoid community spread, it's not an interpretation I share. I assure, you, however, population density and the physical conditions in which a population lives matter very much when looking at the spread of an illness. This is isn't really up for debate. The entire enterprise of public health is predicated upon it. Its part of the reason we started building sewers in the western world. The physical world and its inherent properties exist independent of the political debates of the moment.


I agree. "What's the right way to handle pandemic response considering different population density, transit modes, and other key factors in cities?" is a way to frame the issue that allows for consideration and a proper answer. And indeed, it's an important issue! It ought to be addressed in good faith. but "New York City is the epicenter of an outbreak because subways" is not that and it's a message that has been aggressively pushed by dogwhistlers, so I think it's good to say what I see.
posted by entropone at 2:47 PM on April 29, 2020 [12 favorites]


It's pretty interesting that they went to Microsoft first and not Amazon. I wonder if they went to Amazon too and Bezos dragged his heels, or if they just went right to Microsoft because they expected they would be more responsive.

I wouldn't be surprised if the city/county went to both Microsoft and Amazon at the same time. As much as I don't want to spin in favor of one giant tech empire over another, Microsoft has been a better corporate citizen all around on this issue. Again, they were really quick to say they'd do things like keep paying their contract campus support workers. I think that came out only a day or two after their shutdowns went from "work at home if you prefer" to "hey we're shutting the whole campus down."

IIRC Amazon shut down soon after Microsoft as the article notes, but that was also after Amazon had a confirmed case in their Seattle offices. Pretty sure the same holds for Facebook in Seattle, too--early, but not before they had confirmed cases.

The thing that really got me about the characterization of Seattle's approach was the balance of "what's the most extreme thing we can do that people will actually follow," because we really did see that play out here. We watched Governor Inslee go from disappointed dad to "I've had it, I'm serious" dad to hard shutdown orders. For anyone who felt like we should've shut down earlier, it was super frustrating, but the danger hadn't sunk in for most people yet. If he'd gone straight to shutdowns people would have thought it was paranoid overreaction and defied it, and then we'd have had a worse problem.

As for the Seattle vs NYC thing: yes, absolutely, these are wildly different cities. But I felt like the article focused on the differing approaches of their local & state governments and how they worked together, or didn't, and that's worthwhile.
posted by scaryblackdeath at 2:53 PM on April 29, 2020 [7 favorites]


Interesting article, but I'm baffled/horrified that apparently they did not even bother to interview or mention the actual Mayor of Seattle, Jenny Durkan, who has done a great job working with Inslee and Constantine on this.
posted by dancing_angel at 3:14 PM on April 29, 2020 [5 favorites]


Yes, NY's response was too slow, and politicized to boot. But beyond that response, and any "differences in coronavirus strains" issue (nextstrain.org) and its possible impact (which sexyrobot mentioned upthread), New York's population is more vulnerable to this disease than Seattle's:
New York City, pop. 8,398,748, Demographics: White: 42.67%, Black or African American: 24.27%, Other race: 15.12%, Asian: 13.95%, Native American: 0.43%, Native Hawaiian or Pacific Islander: 0.05%"
Seattle, 744,955, Demographics: White: 67.99% Asian: 15.05% Black or African American: 6.99% Two or more races: 6.78% Other race: 2.32% Native American: 0.58% Native Hawaiian or Pacific Islander: 0.29%

New York City's Latinx Residents Hit Hardest By Coronavirus Deaths (NPR, April 8, 2020) Citing data from New York City's health department, [Mayor Bill] de Blasio said Latinos — who make up about 29% of the city's population — represent nearly 34% of the patients who had died of COVID-19 as of Monday. And almost 28% of the city's 2,472 known deaths were among black people, who represent about 24% of the population.
Virus Is Twice as Deadly for Black and Latino People Than Whites in N.Y.C. (NYTimes, updated April 14, 2020) The preliminary death rate for Hispanic people in the city is about 22 people per 100,000; the rate for black people is 20 per 100,000; the rate for white people is 10 per 100,000; and the rate for Asian people is 8 per 100,000. The rates are adjusted for the size and age of the population.
Covid-19’s devastating toll on black and Latino Americans, in one chart (Vox, April 17, 2020) The US health system has failed black and Latino populations for decades. Now they’re paying the price.
New York City's Coronavirus Essential Workers Are Overwhelmingly People Of Color (Buzzfeed, April 21, 2020) “We’re telling you that no one should be out here because it’s dangerous, but we’re sending you out there and we’re not giving out any masks.”
posted by Iris Gambol at 3:23 PM on April 29, 2020 [12 favorites]


so last I checked, deblasioisafuckingclown.com was still available

in case anyone has some time on their hands or whatever
posted by schadenfrau at 3:45 PM on April 29, 2020 [4 favorites]


I found it interesting that they wanted to close things down sooner in Seattle, but thought people would listen better if they took small steps toward it. Especially since I was listening to the recommendations and doing what they said, but not more. I was still riding the bus to work, thinking, if this is dangerous, they'd tell us to stop. We debated it, but my spouse and I decided to send our daughter to school on March 11th, because they were open, and she's not high risk. When they announced that that was the last day, we were relieved. Before that, I was hopeful that extra hand-washing would do it, like we'd been told. I wish they had told us sooner that staying home is advisable for everyone or that cloth masks are great, please wear them for your neighbors.
posted by Margalo Epps at 4:05 PM on April 29, 2020 [4 favorites]


I wouldn't be surprised if the city/county went to both Microsoft and Amazon at the same time. As much as I don't want to spin in favor of one giant tech empire over another, Microsoft has been a better corporate citizen all around on this issue.

The King County health department had been working with a lot of local employers for several weeks prior to the first corporate announcements that employees were to start working from home immediately. The announcement was made at my work (neither of these two companies), and then an hour or so later, a friend who works at Microsoft texted that they had been told the same thing.
posted by Blue Jello Elf at 4:20 PM on April 29, 2020 [4 favorites]


I don't know. I'm not smart enough to get into density discussions or viral loads or whatever, but I was watching The Daily Show with Trevor Noah when de Blasio was on and the Greater Seattle area were already watching the death toll rise at the nursing home (not in Seattle, I might point out, because it's a suburb quite a ways from Seattle proper) it swept through first here and the rising number of deaths that didn't have any contact with Life Care Center. I couldn't believe that a) they were still having live audiences on all the shows and was horrified by it and couldn't understand why that was still happening there and in LA, b) fucking de Blasio was banging on about how they didn't have to interrupt their lives, just be sensible, and kids didn't get the virus so they didn't need to shut down the schools, which made me actually scream at the TV, and c) Trevor made jokes about how if old people get it they should just accept that it's their time to go, and de Blasio laughed uncomfortably but didn't exactly say "don't joke about that," like other people who aren't those worthless senior citizens don't get it, like disabled people or people with chronic illnesses don't matter. You know, eugenics.

And I was ranting at my NYC friends about what a fucking assclown their mayor was, just seething about the whole thing, for days. I thought Washington should have taken a hard line sooner, because people are dumbasses and they were not paying attention. But it just seemed like de Blasio was even more willfully ignoring everything that he should have seen coming, other places were living it, it wasn't like this data wasn't available to him.

In short, fuck you, de Blasio, and fuuuuuck yoooouuu and your eugenicist jokes, Trevor Noah.
posted by kitten kaboodle at 4:23 PM on April 29, 2020 [12 favorites]


as well as admittedly less dysfunctional healthcare and political systems.

Hong Kong would like a word with you.
posted by Big Al 8000 at 4:55 PM on April 29, 2020 [2 favorites]


I take it back about LA doing worse...latest from gov Cuomo ~18% infection rate in downstate NY (by AB survey). As far as the other bit, I found this(SLNYT) about it’s arrival from europe. I’m trying to dig up where I saw a strain map of the US (that nextstrain map is sorta useless here since it treats the whole US as one dot)...
posted by sexyrobot at 5:08 PM on April 29, 2020


I appreciated reading this. One thing the article left out was how Boeing was convinced to shut down. They were the last large employer in the state to announce WFH and production cessation, and they did it just before Inslee announced statewide social distancing and stay at home. They are a famously dysfunctional company now, at risk for and deserving of bankruptcy as a result of the 737 debacle specifically due to the introduction of a hostile managerial culture in the wake of McDonnell-Douglas’ stealth takeover, resulting in the relocation of the company’s executive group to Chicago. Inslee’s apparent kowtowing to this culpable, criminal leadership to me seems to have delayed our state’s response by about ten days. I’m comfortable laying those extra deaths at Inslee and Boeing’s door. That said, Inslee’s leadership has otherwise been exemplary.
posted by mwhybark at 5:16 PM on April 29, 2020 [3 favorites]


If LA was truly doing worse than NYC it would be concerning, as we started shelter in place earlier and have been pretty strict about it. I believe we were also the first city to require wearing masks (in businesses / grocery stores / etc). Of course we had the same problems with testing/etc but IMO Garcetti has been reasonably on the ball about the whole thing (the whole beach thing last weekend is a good example --- LA County was fine, OC beaches were crazy).
posted by thefoxgod at 5:34 PM on April 29, 2020 [1 favorite]


sexyrobot, this FastCompany article from March 30 notes:
Washington state’s outbreaks come from two strains, one likely a man who returned from Wuhan, China, and one from Europe

Most cases on the West Coast are likely connected to the aforementioned Washington man, while East Coast outbreaks include strains from Washington state, China, and Europe.

U.S. long-distance transmissions are continuing, intermingling virus strains from across the country, meaning that strains are not staying local and contained
and links to this strain map on that nextstrain site; "scroll down to the world map, and press “play” to see an animated representation" of the strains' phylogeny and transmission - animated (look directly above the world map, too), there's more info / less of a single-dot effect.
posted by Iris Gambol at 6:45 PM on April 29, 2020 [5 favorites]


Reducing my page view to 90% let me see the two charts side-by-side.
posted by Iris Gambol at 6:47 PM on April 29, 2020


Okay, so compare Seattle to Detroit; it's in one of those states with very large urban populations. Detroit is the 14th largest metro in the US, Seattle is the... 15th. And Seattle is denser, and it has orders of magnitude more transit use. Every excuse NYC has relative to Seattle, Seattle could make relative to Detroit. Yet there are 5 COVID-19 deaths in Detroit today for every one in Seattle.

The world has really changed from when I was younger when someone can say this without any apparent awareness of the key demographic differences between Seattle and Detroit. Considering the different infection and mortality rates by race, it's a wonder that Detroit's not doing even worse.
posted by praemunire at 6:59 PM on April 29, 2020 [10 favorites]


"And North Carolina. Gaston County (west of Charlotte) is openly defying the Governor's orders and issuing its own businesses-may-reopen ordinance, effective later today."

No one defies like Gaston.
posted by Evilspork at 7:03 PM on April 29, 2020 [12 favorites]


NYT published an article about Microsoft's response way back on March 15 which has stuck with me since I read it. In particular, this relevant passage about a leadership call on 2/29 (the day the first US death was reported):
On the call, Brad Smith, Microsoft’s president, said he was concerned that the mysterious spread of a virus was the kind of issue that could lead smart people, without expertise, to make poor decisions.

“I said, ‘This is interesting, but none of us have a Ph.D. in public health,’” Mr. Smith said. “At that point, Colleen said, ‘Well, actually you all don’t really know me, but I have a Ph.D. in public health.’”

Colleen Daly, an in-house specialist who works to improve the health of Microsoft’s work force, had been asked to join the call.
Article goes on to mention that Daly had spoken with some people she knew at the King County health department, provided facts to the rest of the team, etc. Also has a bit more about some of the other factors that supposedly drove Microsoft's original response.
posted by cdefgfeadgagfe at 7:20 PM on April 29, 2020 [13 favorites]


Watching it from the inside as a public health worker and student of healthcare systems, I have a lot of thoughts and theories about how and why things have gone very well here (and things have gone very very well all things considered) and they are mostly very technical and boring and it’s been a 14 hour day and I’m just way too tired. Some of it we deserve credit For, some of it has to do with the economy, some of it the educational institutions here.

But what I really wanted to say that is often overlooked: Seattle is the only place I’ve ever lived where if someone came to you and said “Hey, would you be willing to make a huge sacrifice for the well being of your community?” most citizens would respond “Yes, definitely. What do you need?”

I have no data for this other than the fact that it’s why I live here.
posted by Slarty Bartfast at 9:41 PM on April 29, 2020 [17 favorites]


Sorry, the strain map I saw...I’m pretty sure it was on skynews...I should have taken a picture...was broken down by county (which is pretty rough at this point, so the map was pretty incomplete)...the west coast strain was basically every state up the coast, into MT, ID, AZ, and across the southwest into TX, with the east coast strain being the main one everywhere else in the country.
If the east coast/European strain is deadlier than the original/west coast/Chinese strain, then it deflates a lot of the conspiracy theories about China lying about their numbers. Or at least not lying as much.
(Also, Europe is 2 strains as well...the southern strain ravaging Italy, France, Germany, Spain, Turkey, etc, is the main one that came over to the US.)
posted by sexyrobot at 11:15 PM on April 29, 2020


But yes, I’m pretty sure it was from nextstrain data, just broken down into counties (with maybe a 1/4 reporting, total, with less in less populated areas).
posted by sexyrobot at 11:27 PM on April 29, 2020


If the east coast/European strain is deadlier than the original/west coast/Chinese strain

I'm not saying this claim is impossible but as far as I can tell it's still fairly speculative/not yet replicated beyond that one paper.
posted by atoxyl at 11:41 PM on April 29, 2020 [6 favorites]


Is there not a difference in long term air pollution in Seattle vs New York? Air pollution causes more than half is the pre existing conditions that make COVID19 fatal. It s linked closely with deaths across the country. In Louisiana, black towns that have been crowded by new refineries, and thus have experienced a lot of death, given that people s lungs are trash. And people in St John were calling it "death alley" before COVID, now, I think it has one of the highest death rates in the world. But this is seen as a black issue, and so racism continually obscures it.

This should be easy to look up, I think it s a Canadian lab that has published air quality modelling across the whole continent.
posted by eustatic at 11:59 PM on April 29, 2020 [3 favorites]


Another thing that’s coming to light with random AB testing, is that the West Coast hasn’t done a lot better than the East Coast (LA county ~4-5% infection rate), it just has a different, less deadly strain of the virus.

LA county likely does not have a 4-5% infection rate and there is no evidence the strain there is less deadly.

I'm too tired to really go into detail but Gelman is one of many who noted the problems with the Stanford group's work. The correct confidence interval on the Santa Clara study data includes a zero percent infection rate, and last I saw the LA county study hadn't even revealed their methodology (but best case had similar problems.)

I can't emphasize enough how little people know, and how cautious people should be from drawing conclusions about rushed, overhyped, non-peer reviewed preprints, let alone chaining multiple ones together to try and make larger conclusions.
posted by mark k at 12:11 AM on April 30, 2020 [15 favorites]


Yeah the experts I follow on this seem to think the NYC seroprevalence data plausibly tells us something useful - for one thing the numbers there are so high that they can't all be false positives - but the CA results much less so.
posted by atoxyl at 4:56 AM on April 30, 2020


While there are genetic differences between strains, I don't think there has been evidence of phenotypic differences between them.
posted by atrazine at 5:42 AM on April 30, 2020 [3 favorites]


But what I really wanted to say that is often overlooked: Seattle is the only place I’ve ever lived where if someone came to you and said “Hey, would you be willing to make a huge sacrifice for the well being of your community?” most citizens would respond “Yes, definitely. What do you need?”

I have found it interesting how even the Trump voters I know, some of whom are fully "fake news!" about Covid, are largely complying with the governor's rules. They might think the rules are stupid and useless, but they still comply. I don't know if that is from community-mindedness or it is more of a general pressure to socially conform here that enables this, but the result seems to be pretty good (though far from perfect) compliance across the metro area.
posted by Dip Flash at 6:32 AM on April 30, 2020


Regarding “strains,” here’s an exchange on Twitter last week with biologist Trevor Bedford, who studies viral genetics and co-developed the Nextstrain site:
Q. Do you think IFR is likely to vary meaningfully based on the strain or is largely a lot of unfounded speculation?

Bedford: It’s possible there are strain differences in severity, but we don’t have evidence of this at this point. I want:
1. Reverse-genetics experiments to look at virus phenotype
2. Individual-level comparison of clinical outcomes based on infecting virus

Q. How do we interpret that study out of China which says the strain in East Asia and West Coast is milder than the one in Europe and the East Coast? It seemed very lab-based/speculative.

Bedford: Very speculative. Questions about cell line used as well as quantification of virus. Also, n=2 for “mild” strains. More work here is needed.
posted by mbrubeck at 7:58 AM on April 30, 2020 [5 favorites]


[Mayor Bill] de Blasio said Latinos — who make up about 29% of the city's population — represent nearly 34% of the patients who had died of COVID-19

I would like to see these numbers based on income level rather than race.
What percentage of people living below the poverty line have died? What percentage of 1%ers?
I'd love to see income quintile breakdowns.

What's the death rate among people who have job-based health insurance, Medicare or other public health insurance, and no health insurance? How many people with no insurance/very limited coverage were told to go away/not tested when they first called in with symptoms?

Because statistics like the ones given here are going to feed into damn alt-right "whites are teh superior race" bullshit.

OH LOOK:
Seattle Median Household Income: $93,481; poverty rate 11%
NYC Median Household Income: $57,782; poverty rate 17.3%
posted by ErisLordFreedom at 9:24 AM on April 30, 2020 [1 favorite]


What percentage of people living below the poverty line have died? What percentage of 1%ers?

While death rates by neighborhood poverty will probably come out pretty soon, and will show what you suspect, but it's unlikely that there will be data by personal income level - at least not anytime soon - because nobody is staffed to do that sort of contact tracing in a pandemic.

But you're completely right about the issue of Latinos. The racial disparities in coronavirus cases, hospitalizations, and deaths is much more likely to be driven by social and environmental factors than biological ones. Which is to say, it's the inequality.
posted by entropone at 10:00 AM on April 30, 2020


They might not be able to gather & track individual income levels, but they DO have info about what kind of health insurance each patient has.

Let's see those numbers.
posted by ErisLordFreedom at 10:13 AM on April 30, 2020 [3 favorites]


NYC covid rates and median income by borough:

Bronx:$34k, 2.4%
Queens: $53k, 2.0%
Brooklyn: $41k, 1.6%
Manhattan: $64k, 1.1%
Seattle: $94k. Oddly, I can't even find the city covid rate, just the county rate.

This article nicely shows how within cities, it doesn't vary that much between the high- and low-density regions. On the other hand, compare in that article the rates of these cities against their white/non-white percentages. Basically the poorer, larger, and more non-white the city, the worse it is doing. I'm not sure whether when judged against these basic demographics that Seattle is even an outlier.
posted by chortly at 10:15 AM on April 30, 2020 [5 favorites]


Seattle is the only place I’ve ever lived where if someone came to you and said “Hey, would you be willing to make a huge sacrifice for the well being of your community?” most citizens would respond “Yes, definitely. What do you need?”

My initial response to this was cynical (very Seattle of me) but then I thought about it and one of my reasons for living here is that it's the only place I've ever lived where people will pull over the very second they hear a siren, in case it's an ambulance. Yes, people pull over for ambulances in other places too, but in Seattle it's instantaneous and close to universal. Which is a microcosm of what you're talking about. We have our problems but people take the well-being of their community so seriously here.
posted by lunasol at 10:53 AM on April 30, 2020 [2 favorites]


> Because statistics like the ones given here are going to feed into damn alt-right "whites are teh superior race" bullshit.

Or they feed into the "people of color have to deal stress that white people don't, regardless of income" truth.
posted by The corpse in the library at 11:38 AM on April 30, 2020 [5 favorites]


Or how "It is well-established that blacks and other minority groups in the U.S. experience more illness, worse outcomes, and premature death compared with whites," Harvard Health blog, January 16, 2017, & that

"The AAFP also recognizes the impact of racism within the U.S. health care delivery system, which has historically engaged in the systematic segregation and discrimination of patients based on race and ethnicity, the effects of which persist to this day." - Institutional Racism in the Health Care System, AAFP.org

"Alt-right?" Dude, ditch that fig leaf. White supremacists are going to whitewash, regardless of reality; it's their signature move.
posted by Iris Gambol at 11:55 AM on April 30, 2020 [3 favorites]


Before getting off in the weeds throwing out random statistics about race and density and speculation about different strains of the virus, please look at this graph of the reported deaths per day and understand the story it tells.

This is a logarithmic graph. It is scaled non-linearly so that a fixed distance vertically represents a factor of 10. This is so something that grows exponentially appears as a straight line on the graph.

Notice the dotted line labelled "1.35x daily." This is a rough guess at how fast Coronavirus spreads unchecked. This is scary fast. This is doubling faster than once every three days. And every single place this virus has spread has seen a very similar rate of growth at the outset.

So the big difference between the deaths in New York and the Deaths in Washington? The death rate in Washington follows that line for 2 days. In New York, it parallels that line for 2 weeks longer.

That's it.

That's all you need to explain almost all the difference between the number of deaths Washington State and in New York State. Two weeks of not doing anything effective enough.

Exponential growth is scary y'all. And that's something to keep in mind as the situation progresses. As restrictions get lifted, we will have days to respond to renewed outbreaks, not weeks.
posted by Zalzidrax at 1:41 PM on April 30, 2020 [7 favorites]


Seattle is the only place I’ve ever lived where if someone came to you and said “Hey, would you be willing to make a huge sacrifice for the well being of your community?” most citizens would respond “Yes, definitely. What do you need?”

I feel like this is largely dependent on the issue at hand. Again, Seattle and King County are horrible about homelessness, and it's overwhelmingly due to NIMBY attitudes and a refusal to pay for any such thing. We're only seeing action taken for the homeless here because of the potential of infection there to harm others and drag on the hospital system.
posted by scaryblackdeath at 3:07 PM on April 30, 2020 [3 favorites]


That's all you need to explain almost all the difference between the number of deaths Washington State and in New York State. Two weeks of not doing anything effective enough.

That's one interpretation, but the other is that the two states diverge because they have very different demographics, and since there is no way to diverge in outcome without those curves diverging, the difference in curves is just the effect of different demographics, not the effect of different policies. To figure out the effect of policy requires a model that at least controls for income and race. And the fact that NJ and MA are also near the top of those plots (normalized by population) suggests that there is also a substantial regional effect that is also fairly independent of government response strategy or timing.
posted by chortly at 8:58 PM on April 30, 2020 [1 favorite]


Comparing Seattle and New York is so goddamn dumb I don’t...I mean, New York is nearly an order of magnitude larger in population. And probably economically? Also geographically? I don’t know if there’s a measure for political complexity, but if there is, I bet an order of fucking magnitude matters. The political momentum required to do things like shut down New York is enormous, and it was impossible to generate without data from testing, and we didn’t have testing because the Feds shit the bed. Seattle didn’t need testing to build political momentum because it was discovered when an entire nursing home died and that was quite the story. That’s it.

I’m sure there are people here with specialized knowledge of the political landscape in New York, and I hope they can add stuff. But comparing Seattle to New York seems a little like comparing a fishing boat and an oil tanker. Yeah, one of them takes a little more energy to come to a full stop. That shouldn’t be surprising.

Christ, and I loathe both Cuomo and de Blasio. But I’m betting no one could have shut down New York in early March or late Feb without actual widespread testing.
posted by schadenfrau at 9:49 PM on April 30, 2020 [2 favorites]


That is not to say that the political leadership in New York has been good, or even not clownshoes stupid (de Blasio especially can go clown walk off a short pier), but we could have had the best leaders and they couldn’t have done much in the face of no testing.
posted by schadenfrau at 9:51 PM on April 30, 2020 [2 favorites]


I’m a self-sorting Seattle transplant, who moved here for exactly the reasons that others have pointed to, so yes I’m very biased.

There is no doubt in my mind that this is ultimately a big part of why Seattle has done so well. That our political leaders have performed competently is a reflection of an electorate that won’t tolerate the kind of crap that goes on in some other places, because people here understand that this stuff matters.
posted by bjrubble at 11:09 PM on April 30, 2020


I wonder if much of Cuomo's Tuesday, 4/28 commentary (asking “Where were all the experts?” and insisting that “governors don’t do global pandemics" (NYT, April 28, 2020), at the briefing) wasn't a follow-up to his HBO interview but a reaction to this very New Yorker article (published 4/26). Also:

Mr. Cuomo’s remarks, which also included critiques of news organizations — “Where was The New York Times? Where was The Wall Street Journal?” — bore a passing resemblance to critiques leveled by President Trump at federal agencies and institutions, including the president’s attack on Monday on the “vicious” and “hostile lame-stream media,” in “the midst of a National Emergency.”

(The Times then takes a couple more swipes at the governor before defending itself; the paper would have you know that The Times’s first article on the coronavirus appeared on Jan. 6, out of Beijing, and Two days later, a second story was published out of Hong Kong, the same day the governor delivered his annual State of the State address in Albany, and By late January, The Times was reporting that the lockdown measures imposed in China were most likely too late to prevent an outbreak. Of all the puling, cotton-candy-assed ways to wield that pen...)

Anyway, schadenfrau's right (& Cuomo's not wrong): the mess in the US is the fault of the Federal government. Seattle's good fortune across several axes doesn't change that. I've taken to referring to the current occupant of the WH as "that genocidal maniac" in abruptly-not casual conversation.
posted by Iris Gambol at 11:15 PM on April 30, 2020 [3 favorites]


Cuomo actually addressed this article directly today. He said the main thing to consider was the travel bans. Travel to China was shut down ~2 weeks before travel to Europe, most of which goes through JFK and NWK...during that period of time (remember when no one could find reagents for testing?) 2 million people landed in NYC from Europe. Also, much bigger/much denser/etc. Also from first positive test to total shutdown here: 19 days. Faster than any other city.
posted by sexyrobot at 1:57 AM on May 1, 2020 [3 favorites]


And North Carolina. Gaston County (west of Charlotte) is openly defying the Governor's orders and issuing its own businesses-may-reopen ordinance, effective later today.

Expect this to become a trend across the nation... and protect yourself as best you can.


I live and teach in Gaston County. And it's terrifying to have things opening back up in the states around us, and now in our own community. It feels like early March when I kept insisting to my colleagues that this was going to get bad, and was mostly blown off. My principal actually laughed about it.

I wish I still lived in Seattle.
posted by guster4lovers at 11:19 AM on May 1, 2020 [1 favorite]


Seconding mbrubeck on the importance of the Seattle Flu Study. It allowed us to get a signal earlier in the process than other cities, and it went straight to the epidemiologists who could light a fire under King Co Public Health. I shudder to think what a few more weeks delay in shutting down would have done for our experience. I've already found out my family's had two close calls in early March with ppl who later found out they were sick. My work went remote 3/5, and it seemed jarring and premature then, but I'm thankful for it now.
posted by sapere aude at 5:11 PM on May 1, 2020 [2 favorites]


Update, Seattle Flu Study:

Scientists baffled by decision to stop a pioneering coronavirus testing projectNature; Amy Maxmen; 05/22/2020 • 'Researchers looking to make tests widely available worry as regulators freeze the team that first identified US community spread.'
The Seattle research team that first uncovered COVID-19 spreading in US communities has been asked to stop testing for the disease. The decision by the US Food and Drug Administration (FDA) to prevent the SCAN [Seattle Coronavirus Assessment Network] project from analysing nose swabs sent from people’s homes—and reporting the results— is likely to be temporary. But it deflates local and national public-health initiatives.

The project, which is backed by philanthropist Bill Gates, has already navigated a regulatory thicket and won key approvals from state authorities. The FDA’s request to pause testing on 12 May frustrates many researchers developing diagnostics that can be conducted partially or fully outside hospitals. The SCAN group was the first to roll out such tests in the United States and — as importantly — to partner with local health authorities to deploy the diagnostics strategically. As businesses begin to reopen in the United States this month and next, many people argue that the kind of testing that SCAN provided is needed more than ever.

“The Seattle group was literally the only group that has really figured out these logistics, and was trying to scale this, and now you want to shut them down?” asks Sri Kosuri, co-founder of Octant, a biotech start-up in Emeryville, California, that is developing tools to diagnose COVID-19. “It blows my mind,” he says.
posted by ZeusHumms at 8:14 AM on May 26, 2020 [1 favorite]


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