COVID-19: From 799 deaths in one day to vaccine being 'passport' to normalcy

A year ago this week, Long Islanders went about their normal daily routines. They traveled in packed Long Island Rail Road cars to jobs in Manhattan. They met friends for drinks in crowded bars. They gathered with generations of family for big Sunday dinners.

Then came March 5, 2020, when Gov. Andrew M. Cuomo announced Long Island's first COVID-19 case. The governor assured residents that "there is no reason for undue anxiety."

But as the number of cases rose, businesses were ordered closed, millions of New Yorkers were told to work from home, and everyone was urged to practice social distancing. In the past year, COVID-19 has killed more than 48,000 New Yorkers, including more than 6,000 from Long Island.

Today, vaccines offer hope of a return to normalcy, yet the future remains uncertain. With a vaccine shortage and some reluctant to take the shots, it’s unclear when there will be enough people protected against the virus to dramatically limit its spread, and more contagious variants of the virus could cause spikes in cases. The virus remains unpredictable — just as it was a year ago, before it led to the worst pandemic in more than a century.

"Especially in the spring of last year in New York, this was a horrible event, with so much illness and so much death," said Dr. Mark Jarrett, chief quality officer of New Hyde Park-based Northwell Health. "I think 2021 is certainly going to be better than 2020. But it’s not going to be the same as 2019 yet."

More than 16% of New Yorkers — about 3.2 million people — have received at least one dose of vaccine, but demand still greatly outpaces supply, and it's unclear when all Americans who want the vaccine will be able to get it. President Joe Biden said Tuesday he believes enough vaccine will be produced for all adults by the end of May.

Initially called 'pneumonia of unknown cause'

COVID-19 first emerged in December 2019 in the Chinese provincial capital of Wuhan, where doctors reported cases of what the World Health Organization initially called "pneumonia of unknown cause." On Jan. 21, 2020, a Seattle-area man who had returned from Wuhan became the first confirmed U.S. case.

The early fear in the United States was focused on people of Chinese ancestry. Anti-Asian hate crimes and harassment grew.

The first confirmed case in New York, in Manhattan, was March 1. Four days later, Long Island's first verified case came: Miguel Chamaidan, 43, of Uniondale, who at the time said he knew nothing about COVID-19 and did not know how he contracted the virus.

Health officials later said the virus was surely circulating in the state before then.

Testing for the coronavirus was severely limited in the critical early weeks because an initial Centers for Disease Control and Prevention test turned out to be faulty, there were shortages of test-kit materials, and initially only the CDC lab in Atlanta could analyze test samples.

The lack of testing "made a huge difference" in health officials’ ability to control the spread of the disease, said Dr. Gregson Pigott, commissioner of the Suffolk County Health Department.

"We didn’t know who was COVID-positive," he said. "You can’t implement true public health strategy based on guesswork. You actually have to know where the disease is."

Not knowing who carried the virus meant authorities didn’t know who to quarantine, which close contacts of theirs to notify of their potential exposure, and how widely the virus was spreading beyond those returning from abroad, Pigott said.

At a March 5 news conference announcing Long Island’s first case, Nassau County Executive Laura Curran told residents not to be alarmed.

"If you live on Long Island, you can go about your daily routine, your normal behavior," she said.

'There was so much we did not know.'

Laura Curran, Nassau County Executive

Curran said in a recent interview that, early on, "There was so much we did not know." The county’s health commissioner, Dr. Lawrence Eisenstein, said officials did not want to panic the public with speculation.

"We tried very hard to stick to what was known, proven information, and that would change very frequently," he said.

Pigott said that "Given what we know now, there was definitely a lot of superspreader stuff happening" in early and mid-March, in places like crowded trains and events.

Outbreak started during flu season

As more and more COVID-19 cases were identified in New York, "There was probably some warranted panic" among the public, recalled Dr. Adam Berman, associate chair of emergency medicine at Long Island Jewish Medical Center in New Hyde Park. "People just started showing up in the ED [emergency department] with symptoms that they probably would have stayed home for had it been the year before, because they would have just thought they had the cold or the flu, but they worried because they knew about COVID."

The initial outbreak occurred during the flu season, complicating the detection of the coronavirus, because some of the most common COVID-19 symptoms also were flu symptoms, he said.

Fearing a lockdown, Long Islanders cleared stores of toilet paper, frozen meals, canned food and hand sanitizer.

Nassau, Suffolk and other counties and cities closed schools. Cuomo began imposing restrictions, starting by ending in-person classes on SUNY and CUNY campuses, then closing venues such as gyms and movie theaters, limiting restaurant service to takeout and delivery, and instituting rules on the number of employees allowed in workplaces.

SEE PHOTOSScenes from the pandemic

Finally, warning that without drastic action there would be "a total overwhelming of our hospital system," the governor closed the state’s economy, except for essential businesses, effective March 22.

Long Island roadways became eerily quiet. Lines wrapped around grocery stores, amid capacity restrictions. Sports arenas went dark, and concerts were canceled.

President Donald Trump downplayed the severity of the crisis, assuring the public the virus would soon "disappear," inaccurately comparing it to the flu and opposing calls for a national shutdown.

By late March, COVID-19 patients were filling Long Island hospitals. At Mount Sinai South Nassau hospital in Oceanside, the number of coronavirus patients rose nearly tenfold in the week after March 21, from 23 to 217.

At Long Island Jewish, which had the most COVID-19 patients of any of Northwell's 19 hospitals, "cases grew exponentially," recalled Michael Goldberg, executive director of the hospital. The hospital, which typically has 583 adult beds, peaked at more than 900 patients.

At NYU Langone Hospital-Long Island in Mineola, "In effect the entire hospital was converted into an intensive care unit," because the large majority of patients had COVID-19 and most "were very, very sick, requiring, for the most part, an ICU-level of care," said Dr. Barry Rosenthal, chairman of the hospital’s emergency department.

Two large tents were set up outside for patients who had COVID-19 symptoms not considered serious enough for hospitalization, he said.

"We were sending patients home who were sick, but not sick enough to require an ICU level of care, who, in not the setting of COVID, we might have admitted," Rosenthal said. They were told to monitor themselves and return if their condition didn’t improve, he said.

At South Nassau, Nydia White, the nurse manager for critical care, said the lack of effective COVID-19 treatments, especially early on, made nurses feel "helpless."

'You feel like all your tools have been taken away from you and you can’t save them. It crushes you.'

Nydia White, nurse manager for critical care at Mount Sinai South Nassau hospital

"You feel like all your tools have been taken away from you and you can’t save them," she said. "It crushes you."

By late March, hundreds of New Yorkers were dying every day of COVID-19. Some hospitals put refrigerated trailers in their parking lots as the number of corpses grew so fast that funeral homes and cemeteries couldn’t keep up.

On April 9, the state reached the grim peak: 799 deaths in a single day.

Many deaths were in nursing homes

Many deaths, especially in the early weeks, were in nursing homes. The state on March 25 issued a directive requiring nursing homes to accept coronavirus patients from hospitals. It was rescinded May 9.

Cuomo critics said the directive caused many deaths, while the governor contends the virus was brought into nursing homes primarily by staff members.

A January report by Attorney General Letitia James stated the Cuomo administration may have underreported the number of COVID-19 nursing home deaths by as much as 50%. That came after families of nursing home residents and legislators from both parties had been alleging for months that Cuomo deliberately downplayed the number of deaths, a charge the governor denied. More than 15,000 New York nursing home residents have died of COVID-19, according to state data revised after James' report.

Overall, deaths and hospitalizations declined after the early and mid-April peaks, a result, in part, of the effectiveness of social distancing and other precautions, said Dr. Susan Donelan, medical director of health care epidemiology at Stony Brook Medicine.

As numbers improved, the state began reopening the economy. By June 10, Long Islanders could again dine in restaurants, although at first only outdoors, and they could shop inside stores and get their hair cut, with restrictions. Later, schools resumed in-person learning.

Outdoor dining in June at Cafe Buenos Aires in Huntington and Claudio’s in Greenport included masked waiters and dividers between bar stools. Marc Siegel, owner of Blum's Swimwear & Intimate Apparel in Patchogue, in front of his store in May as it offered curbside pick-up. Credits: Linda Rosier; Corey Sipkin; Newsday/Steve Pfost

Even so, many businesses closed because of the pandemic, or are barely hanging on. Social isolation and the fear of COVID-19 led to a sharp increase in Americans reporting symptoms of anxiety disorder or depressive disorder, from 11% of those surveyed in the first half of 2019 to 41% in January 2021, according to a Kaiser Family Foundation analysis of federal data.

The frequency of alcohol use increased 14% between the spring of 2019 and the spring of 2020, a research letter published in JAMA Network Open found. Fatal drug overdoses rose nationally and locally, up at least 50% in Nassau County in early 2020 compared with early 2019, law enforcement and health authorities said.

The percent of positive coronavirus test results hovered at about 1% or below for most of the summer. By Sept. 19, there were 55 people with COVID-19 in Long Island hospitals — 75 times lower than the 4,108 at the April 10 peak.

But, Rosenthal said, "Nobody was shocked when the numbers went up."

As public health officials had predicted, infection rates, hospitalizations and deaths began creeping up as the weather turned cooler, reaching post-spring peaks in early January, after weeks of holiday gatherings.

Hospitalizations began falling again after the holiday surge, but not until after thousands more New Yorkers had died of the disease.

Latino, Black populations hit hard

Many of those dying were people of color. Nationwide, Black and Latino people were about three times more likely to be hospitalized for COVID-19 than whites, and they and Native Americans were about twice as likely to die, according to the CDC.

On Long Island, some of the highest coronavirus positivity rates are in communities with large Latino and Black populations.

'People want to feel safe when they go out, and you’re really not going to feel safe unless you’re vaccinated.'

Dr. Gregson Pigott, commissioner of the Suffolk County Health Department

There are 111 cases per 1,000 residents across Suffolk County, but 162 in Brentwood. Freeport's rate of 118 per 1,000 is above Nassau's rate of 110. New York's Health Department did not respond to requests for death numbers by community.

"Everybody lives on top of each other," said Miguel Turell, president of Uplift our Towns, a nonprofit that focuses on Brentwood and Central Islip. "If someone gets sick, you can’t quarantine on the other side of the house when you’re in a two-bedroom apartment."

In addition, people of color are more likely to have public-facing jobs that could expose them to the virus and underlying conditions that put them at higher risk of severe COVID-19, and are less likely to have access to routine primary care to manage their health, said Dr. Brian Harper, a former Suffolk County health commissioner and chief medical officer and vice president for equity and inclusion at the Old Westbury-based New York Institute of Technology.

Nearly 92% of New Yorkers who have died of COVID-19 had at least one underlying medical condition, with high blood pressure and diabetes the most common, according to state data. At Long Island Community Hospital in Patchogue, as many as 30 people who use the hospital’s dialysis center have died of COVID-19, said Dr. Dean Babich, chairman of the medicine department.

Mutations of the coronavirus are a growing threat, experts say. The CDC warns that the more contagious "U.K. variant" may become dominant in the United States by the end of the month and could lead to more COVID-19 cases, hospitalizations and deaths.

Another highly contagious virus mutation, the South African variant, is now on Long Island.

The vaccines remain among the only bright spots in a year that saw COVID-19 claim more than 500,000 American lives. They were developed faster than scientists had predicted, and they are more effective in preventing disease than many had imagined.

The federal government granted emergency authorization to Johnson & Johnson's vaccine on Saturday, and on Tuesday, Biden announced that rival drugmaker Merck had agreed to help manufacture it. Vaccines from Pfizer-BioNTech and Moderna received authorization in December. The added J&J supply means there will be enough vaccines for all adult Americans by the end of May, although actually inoculating all eligible people will take longer, Biden said.

Curran: Vaccine passport back to 'normal'

Curran views vaccines as "our passport back to the land of normal." But the variants could increase the percentage of vaccinated people needed to reach herd immunity, when the virus no longer spreads widely, said Cheryl Healton, dean of the New York University School of Global Public Health.

Experts have put that number at between 70% and 90%. Polls show that roughly a third of Americans do not plan on getting vaccinated.

"I think that number will come down as more and more people are vaccinated," and those reluctant to receive the vaccine see it’s safe and effective and is protecting people against infection — and allowing those who are vaccinated more freedom, Pigott said.

'People want to feel safe when they go out, and you’re really not going to feel safe unless you’re vaccinated.'

Dr. Gregson Pigott, commissioner of the Suffolk County Health Department

"People want to feel safe when they go out, and you’re really not going to feel safe unless you’re vaccinated," he said.

Healton said that, even though the spread of COVID-19 probably will subside, the virus probably will never be eradicated, and she predicts regular booster shots may be needed to keep up with virus mutations.

"I think most people now believe COVID will be with us permanently," she said.

With Matt Clark

By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.