Lessons for India from ground zero New York10 min read . Updated: 16 Apr 2020, 08:52 PM IST
- What are the learnings from the US megacity for India, should covid-19 unleash its fury across the country?
- New York did well in calling out deficiencies ahead of time, which allowed the city to scale up quickly. Some of the new hospitals are not utilized fully, but the city has created the capacity
NEW YORK : New York is now a transformed city—its bustle and energy seem alien. It has the look of an abandoned ghost town. Lights continue to flash at Times Square, but almost all stores and shops are boarded up or locked, and the city has the feel of post-apocalypse dystopia. As of 15 April, there were 111,424 cases of coronavirus in the city with an estimated 10,899 deaths.
“I have never seen anything like this before. It is sad to see a city that is known for its nightlife and exuberance, which is always on the go and caffeinated, to be so quiet. It is a fundamental change, and there are no rules to follow to deal with something like this," said Surbhee Grover, a strategy consultant in New York who has lived here since 2002.
Ask US President Donald Trump, who has made characteristic flip flops. He initially ignored covid-19, then underplayed it, and chided critics saying they were exaggerating its impact. He reluctantly imposed lockdowns, second-guessed his cautious experts, boosted questionable cures (such as his latest obsession, hydroxychloroquine, whose effectiveness is neither known, nor is it safe for some patients), called it the “Chinese" virus, blamed the media, and is now withholding funds for the World Health Organization, and insisting on having his name printed on every cheque going to American citizens as relief.
In contrast, some state governors have acted sensibly and practically. New York’s Andrew Cuomo, for one, has acquired gravitas that has gained fame far beyond the US. Some blame Cuomo for not acting quickly enough, but his transparently clear responses and warnings are an object lesson in crisis communication. He sugar-coats nothing; he says what is expected; and he does what he says he would do.
New Yorkers like that attitude. Arnab Sen, chief executive at Reventics Inc, a company that works with physicians and hospitals by using technology to improve healthcare billing, told Mint: “The intensity and level of spread of covid-19 has been very rapid. While initially New York may have seemed slow, it has been very proactive since. This is a city with high density and a lot of tourists. It is highly cosmopolitan with people from all parts of the world. All that makes it unique."
New York prepared early. When it saw the spike in cases on the West Coast, realizing how intertwined the city is with the world—some 140 million people pass through the three major airports servicing the greater New York area annually—its leaders knew it was vulnerable. But New York is also a city that celebrates individual freedom. New Yorkers resent restrictions; they believe in a 24x7 lifestyle.
Cuomo and mayor Bill de Blasio began preparing the population by making increasingly gloomy predictions and suggesting the imminence of restrictions in public remarks from February. Once March began, Cuomo’s tone got increasingly agitated about the potential outbreak, and he warned people with rising intensity that he was going to have to take stern steps. But he needed their help and cooperation to make it work. The city would change, he cautioned. Life will be different.
Cuomo’s messages were transparent and devoid of emotion. His news conferences were realistic. The frequency and daily announcements have been exemplary, Sen says. “It helped people become more aware. You can’t impose diktat here, this is not China. You can’t have a curfew, this is not India. You can quarantine, but it is based on self-awareness and education. It worked," he said.
Cuomo wanted everyone to stay at home but mass transit would continue. (That’s how essential workers, including nurses and doctors, commuted). Shops which weren’t essential would have to close. Grocery stores, supermarkets, pharmacies, laundromats, and liquor stores would remain open, and restaurants offered pick-up and delivery services.
The city’s communication strategy will one day be taught in universities. Once March set in, posters appeared in the city urging people not to congregate, to stay six feet apart, to practise social distancing, and to wash hands frequently.
On a given day, New Yorkers receive between two and six announcements on their phone from the government, if they sign up to receive the messages. Some are routine announcements to lift the spirits of the beleaguered city, but many contain links to the city’s website offering practical help, such as school meals being distributed free and where students can collect them even if schools have closed.
For New Yorkers who can’t get food, the city delivers meals-on-wheels. The city and the New York Taxi Workers’ Alliance worked together to develop a protocol to ensure that restaurant workers would fill the boot with food to be distributed; the driver would plan his route; the customers would pick up the food from the boot; there would be no physical contact, and the driver would earn $15 an hour.
Covid-19 affects everyone, the messages stress. While some orthodox Jews defied instructions and continued to congregate, some were arrested, but there was no scapegoating, and the city’s feisty radio stations did not vilify the community for defying social distancing norms—a lesson crucial for India, where some broadcast media have used terms like “jihad" to describe the Tablighi Jamat congregation.
The medical issues
New York did well in calling out deficiencies ahead of time, which allowed the city to scale up quickly. Sen says Cuomo kept saying there were no ventilators loudly to make sure everyone understood the city’s limits and it drove home the point to the White House that the city needed more.
New York also set up temporary hospitals. Some of the new hospitals are not utilized fully, but the city has created the capacity. The landmark Central Park, New York’s lung surrounded by expensive real estate and museums, now has a 68-bed field hospital with 10 intensive care unit (ICU) beds and ventilators, and the harbour has a navy hospital ship that can accommodate 500 cases.
While the supply of masks to hospitals has increased, a more poignant, even macabre, shortage is in morgues. One hospital in Brooklyn has space for only nine bodies in its morgue. Blaring ambulance sirens wail with metronomic regularity— on my quiet street, I hear the siren at least every 15 minutes. Hospitals are overwhelmed. At the Brooklyn Hospital Center trucks use forklifts to place bodies in vans. Wyckoff Heights Medical Center has a makeshift morgue in a refrigerated trailer.
Hospitals want bodies to be taken away quickly to make place for more deaths. Funeral directors are trying to stop the flow in; they do not have space to hold more bodies either. Funeral services are getting shorter and relatives and friends can toss flowers only from a distance. Companies that offer refrigerated trucks on rent have either said no—they don’t want to take the risk of holding the bodies in their trucks—or raised the rent because of increased demand. It is gruesome and tragic.
One physician who made the ultimate sacrifice was Madhvi Aya, three years my senior at school in Mumbai. She worked long hours in the emergency room as a senior physician assistant at Woodhull Medical Center in Brooklyn. She had trained as an anaesthesiologist and internist in India. She got infected in the emergency room and neither her husband, nor her 18-year-old daughter were able to meet her.
Her last communication with her family was through texts. “She was always there for us," her husband Raj told The New York Times. But when she got sick, no one was next to her, he said. (He has a weak heart, making him vulnerable to the virus and so he could not be with her).
The taxi victims
There have been other Indian victims. Most taxi drivers in New York are first-generation immigrants, and nearly half of them are from South Asia. The New York Taxi Workers’ Alliance estimates that of the nearly 30 taxi drivers who have died since the outbreak, perhaps half are from South Asia, and include, among others, Nepalis and Punjabis.
There are a little over 50,000 people licensed to drive taxis in New York, and once you add the drivers of ride-hailing services like Uber and Lyft, the number rises to over 100,000. About 23,000 are members of the union.
One of its founders, Javaid Tariq, told me: “Taxi drivers are hard-working and they earn to save money. The first person anyone travelling from abroad meets in New York is the taxi driver," he said, and this makes them more likely to get exposed to the virus than other New Yorkers. “The vulnerability begins at the airport."
The first taxi driver known to have died of covid-19 was a Nepali man in his late 40s. He had taken a passenger to Westchester, north of New York, in mid-March. Westchester was one of the early hotspots in New York State. The passenger was coughing a lot, Tariq says, and after dropping him, the driver went home as he was tired. He got fever soon and stayed home for less than a week. He was admitted to a hospital and died within days.
“The drivers are scared of the pandemic —what will happen to the families they supported, in some cases in India, Pakistan, and Bangladesh?," said Tariq.
Taxi drivers are particularly vulnerable, because they have no choice but to go to work. “If you don’t go, you don’t get any money," Tariq added. “They have to pay for the car’s lease, their own rent, and other expenses. Even if we tell them that life is worth more than going to work, we aren’t offering them a practical solution."
“Taxi drivers are caught in a bad place," said Biju Mathew, also a co-founder of the union. “They are considered an essential service, which means the city wants them on the road, whereas they would be safer off the road during the pandemic."
The business impact
While Cuomo announced statewide lockdown on 20 March, Vijay, an investment banker in New York, says his office had been encouraging working from home from 1 March. (He did not give his full name nor identified his employer because he is not authorized to speak to the media). Vijay has lived in the US since the mid-1990s. “Once New York realized the gravity, there were no half-measures," he said.
New York has worked, and its people have complied with severe restrictions, ironically, because the restrictions do not cripple all activity. Businesses that matter in everyday life are open, many till late hours. Supermarkets are getting restocked daily. Products ordered from online retailers turn up when expected. The city and state government promises only what it can deliver and manages to deliver much of what it has promised.
However, Vijay no longer sees Bangladeshi immigrants in his area who ran small businesses and shops. “I have not seen them in a month; I don’t know where they have gone," he said.
Sure, there are shortages, for which the anger is directed at Trump. At Union Square a sculpture has emerged of a naked Trump. Notoriously independent-minded New Yorkers are obeying rules that constrict them because there is basic trust in the government, and even if inadequate, there is some unemployment benefit for those who are suddenly out of work. How long this will go on remains to be seen.
In 1985, Hurricane Gloria had lashed the city with winds of enormous power shaking older buildings. I had recently graduated and lived in the city, barely able to stand straight as the wind pushed me around. Seeing me walking with some effort, a cop laughed and said, “It is only a hurricane." I laughed. It is a tough town.
As India braces for the full fury of coronavirus, it is clear that not all of New York’s practices can be replicated. But transparency, consistency, and honesty in communication, managing expectations and anticipating needs, establishing services to meet needs of those who are vulnerable, and reassuring the city that this too shall pass, will be crucial building blocks in halting the march of the virus.
Salil Tripathi is a writer based in New York.