A Pfizer-BioNTech COVID-19 vaccine booster shot is prepped to be administered...

A Pfizer-BioNTech COVID-19 vaccine booster shot is prepped to be administered at Freeport High School on Tuesday. Credit: Newsday/Steve Pfost

It may now be safer to be in New York City, once a global epicenter of the COVID-19 pandemic, than on Long Island, according to state statistics and medical experts.

Long Island’s COVID-19 positivity level is more than double the rate in New York City, even though it is mainly suburban compared to the dense urban environment of the city, state data shows.

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Long Island’s COVID-19 positivity level is more than double the rate in New York City, state data shows.

Nassau and Suffolk counties combined on many days are producing nearly the same number of new COVID-19 cases as New York City, even though the city has nearly triple the population.

Some medical experts attribute New York City’s better performance to stricter vaccination rules and more widespread use of masks.

Nassau and Suffolk counties combined are also on many days producing nearly the same number of new COVID-19 cases as New York City, even though the city has nearly triple the overall population.

The seven-day average for positivity in testing for the virus was 5.17% on Long Island in test results from Tuesday, while it was 1.94% in New York City.

That translates into Long Island having a rate 2.5 times higher than New York City, which many residents fled after the pandemic started in March 2020 for fear of getting infected.

Long Island on Tuesday also generated 1,505 new cases of COVID-19, compared to New York City’s 1,825. Long Island’s population is 2.9 million, around one-third of New York City’s 8.8 million, according to the 2020 Census.

The total number of people who died of COVID-19 on Tuesday was nearly the same in both regions: eight in New York City and seven on Long Island.

Those latest fatalities on Long Island marked a grim milestone, as the region surpassed 10,000 deaths overall from COVID-19. At the same time, the first confirmed case of the omicron variant was reported in the United States, from a person in California who recently traveled to South Africa.

Stricter rules on vaccinations

Some medical experts said Wednesday that New York City’s better performance on COVID-19 is due to stricter vaccination rules and more widespread use of masks.

The city requires people to show proof of COVID-19 vaccination to enter everything from restaurants to Knicks games to movie theaters. On Long Island, there is no such requirement.

Plus, there appears to be a stronger culture of wearing a mask in the city, infectious disease experts said.

"I don’t think anybody is particularly surprised" by the city’s better numbers, said Dr. David Battinelli, vice president and chief medical officer at New Hyde Park-based Northwell Health.

With no requirement on Long Island to show proof of vaccination to enter restaurants, for instance, "There are people left and right running around indoors without masks on who are not vaccinated," he said.

Battinelli added that "the majority of the spread [of the virus] continues to be unvaccinated [people] to either other unvaccinated or vaccinated individuals." He also noted that "many, many more people wear masks in New York City than on Long Island, especially the further out east you go."

Normadeane Armstrong, a professor of epidemiology and public health at Molloy College in Rockville Centre, said the difference in cases between New York City and Long Island is due to practices in masking and social distancing, as well as vaccination rates.

"Before we had a vaccine, the numbers were high. Once masks were implemented, the numbers went down," she said.

"Once the recommendations on masking and gatherings were loosened, the numbers went up. When the vaccination was first available, the numbers went down again, but now that people aren’t getting vaccinated and masking as much, the numbers are going up again."

Armstrong said many restaurants on Long Island do not ask for vaccination status.

"You see the difference in the commute between New York City and Long Island," she said. "On the subway, everyone is wearing a mask. But that’s not always the case on the Long Island Rail Road."

New York City requires people to show proof of vaccination to enter bars, nightclubs, cafeterias, fast food restaurants, coffee shops, gyms, pools, movie theaters, museums, music and concert venues, professional sports arenas including Madison Square Garden and the Barclays Center, indoor stadiums, performing arts theaters including Broadway, bowling alleys, arcades, aquariums, zoos and pool halls.

Long Island does not have similar local government-mandated requirements.

New York City also has required all city employees, including police, firefighters and EMTs, to get vaccinated, get an exemption, or lose their paychecks. Nassau and Suffolk counties have not followed suit.

New York City does not require people to wear masks in indoor public locations, but Mayor Bill de Blasio said he is strongly recommending it — especially now witht the omicron variant.

The offices of the county executives and health departments in Nassau and Suffolk counties did not immediately respond to requests for comment on the better performance in New York City, and whether they are considering adapting similar measures.

De Blasio said the city’s requirements are the reason for the lower COVID-19 levels. Speaking Wednesday morning on MSNBC’s "Morning Joe," he urged universal mandates for the coronavirus vaccine.

"The bottom line is — and I would say this to every mayor in America, every governor, every CEO — it's time for mandates. It's time to make this across the board, because that's what gets us out of the COVID era once and for all," de Blasio said.

Once the U.S. epicenter of pandemic

New York City was initially the epicenter of the pandemic in the United States and one of the main hot spots in the world. Today, it appears safer than not only Long Island, but all regions of the state, with the lowest positivity level.

The seven-day average in the Finger Lakes region on Tuesday was 10.46%, for instance, while it was 9.54% in the North Country.

The positivity average is based on the number of tests administered and the number that show the person has COVID-19, meaning they test positive.

A total of 188,906 test results from throughout New York on Tuesday were reported to the state. Of those, 9,462 were positive. The daily positivity level — or percent of those testing positive out of the total — was 5.01%. The seven-day statewide positivity level was 4.37%.

One medical expert said the gap between New York City and Long Island could be due to more intensive testing here, meaning more cases get picked up.

The numbers are "a little scary, but I think it may be methodologic as much as real," said Dr. Leonard Krilov, chairman of pediatrics and chief of Pediatric Infectious Disease at NYU Langone Hospital — Long Island.

But he also said New York City seems to be attacking the problem more vigorously.

"They’re much more attentive to having people wear masks when they’re not at their table [in a restaurant], or screening for people being vaccinated," Krilov said.

"I think it may also be, ‘Did we loosen up a little bit quicker than the city?' I’m not sure. But I think it’s a number of factors," he said.

Krilov noted that when he goes in for his morning coffee at Starbucks, "Other than the employees, I’m almost always one of two people wearing a mask that go in there. I don’t understand why one would kind of take a chance."

With Matthew Chayes

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