Will Delta Spoil the Summer of NYC?

Bill de Blasio does not seem to remember his own public health training.

You know, from last year, when vaccines were a distant dream and flattening the curve was the holy grail?

Back then the mayor, and other civic leaders, appealed for social distancing, hand washing and, yes, mask-wearing as acts of citizenship to curb the spread of the coronavirus.

Well, that was then. Now, to hear the Mayor tell it, it’s all about vaccines.

“That’s the ballgame,” he explained at his daily briefing. “Because the only way we’re going to stop the Delta variant is vaccination,” he added on “Morning Joe.” “Masks might be helpful on the margins. Vaccination is the only answer.”

The mayor went further at the briefing, claiming that “masks are not going at the root of the problem, vaccination is, so we do not intend a mask mandate. We do intend to double down on vaccination.”

De Blasio, whose handling of the arrival of COVID-19 last year was widely criticized as late and slow, is facing criticism again for his uncertain connection to the best public health thinking.

As the Delta variant spreads, the Mayor is under pressure to act more quickly and aggressively in two ways.

One is to recognize that vaccines are not actually the entire ballgame and that there are still good reason to flatten the curve with non-pharmaceutical measures like masks and distancing.

The other is that the mayor should lean harder into his own commitment to vaccinating the unvaccinated. “An all carrots, no stick approach to vaccination is clearly insufficient,” wrote Council Member Brad Lander, the Democratic nominee for comptroller.

The Right Balance

The mayor, by this argument, should mandate vaccination as widely as possible. Certain to all city workers, which as an employer he has the legal power to do according to both Federal Court rulings and the Federal Equal Opportunity Employment Commission.

By that standard, the mayor was judged too incremental last week when he said that workers in city hospitals and health clinics – but not cops, teachers, firefighters or any number of other city staff – had to get vaccinated or show a negative COVID test to come to work each week.

After just a few days of criticism, the mayor shifted. On Monday he announced that every city worker would be required to show a negative COVID test or be vaccinated effective September 13, the first day of school.

Another aspect of the Mayor’s management of the pandemic was attacked Monday by the health commissioner he had forced out early in the crisis last year. Oxiris Barbot, in a letter from her and other public health doctors, accused the mayor of “indirectly” threatening the health of “the entire city” by moving New Yorkers with nowhere else to live back into congregate shelters from the hotels they were in during the pandemic.

She urged the mayor to accelerate effort to find permanent housing for those in the hotel shelters.

De Blasio is far from the only political leader in the world struggling to find the right balance between encouragement and restriction. The Prime Minister of the United Kingdom, Boris Johnson, lifted virtually all restrictions last week in what public health officials portrayed, unfavorably, as a nation-sized experiment.

The threat of the Delta variant could not be ignored, de Blasio said. But his approach would be “piece by piece,” he said. So as he rejected the sort of mask mandate Los Angles has re-imposed, he announced his new rules for workers at city hospitals and health clinics.

“A good start,” was how Lander diplomatically urged de Blasio to go further. Writing in the Daily News, he noted that San Francisco had imposed a vaccination requirement for all municipal employees and that France had driven a strong increase in vaccination when the vaccinate-or-negative-test rule was applied to everyone who wanted to go to a movie or out to dinner (a particular sensitivity for the French).

“A logical next step for New York would be to require vaccination or weekly testing for other city jobs that interact with the public,” Lander recommended. He noted that only 43 percent of NYPD officers are vaccinated.

As the week wore on there were signs de Blasio recognized the public was not just willing for him to go further, but demanding it.

“We have reached the limits of a purely voluntary system,” he said on WNYC Friday. “It’s time for more mandates, different kinds, different places.”

He would consider rules like the ones adopted in France, but announced nothing specific.

Different Conversation

De Blasio, like so many of us, was planning for a different conversation two months ago as COVID retreated. This was to be the summer of New York, with public concerts, theater reopening and all sorts of reasons to come and celebrate. Even this week the mayor was promoting a series of five public concerts in August, warning New Yorkers and tourists to be here or face “FOMO,” fear of missing out, in internet vernacular.

But the Delta variant may have other plans. In early May, the new variant, first spotted in India, was barely present among the declining number of COVID cases here. Now it is 75 percent of a rising number of cases and hospitalizations. Deaths have remained flat, so far.

While the situation is unsettling, it is as of yet nothing like the horrifying crisis of March and April 2020. Flattening the curve back then was designed to keep hospitals from being overwhelmed. That is still a potential issue, although so far much more in other parts of the country and the world. But even here in New York there continue to be arguments for a new flatten the curve effort to slow transmission.

The rate of vaccination has slowed dramatically, and disturbingly. But as the mayor points out, vaccination has continued at a reduced pace. So every day the city is a bit safer. The more other health measures can slow spread of the virus, the greater the number of vaccinated will be if Delta or a later variant gets out of control at some point.

Masks slow the spread while vaccination continues, argue city Council Member Mark Levine, the Democratic nominee for Manhattan Borough President.

There is a second argument, as well. The three vaccines approved for emergency use in the United States are very effective at preventing serious illness, hospitalization and death. They are not as effective at stopping the spread of the virus.

So in fact, if the mayor’s goal is “to stop the Delta variant,” as he said on “Morning Joe,” the most powerful strategy would be to push vaccines as hard as possible while boxing out the virus with non-pharmaceutical measures.