Zip code 11355 sits deep inside Queens in the Flushing section.  It borders Corona, which is one of the zip codes worst hit by coronavirus.  93% of the citizens of 11355 are minority and its median household income is significantly below the borough’s average.  In fact, it’s about half that of Forest Hills, which is catty-corner to 11355 and home of the famed Forest Hills Tennis Stadium.

Flushing 11355 has had an infection rate that has been 38% of Corona’s: 1,556 per 100,000 vs. 3,962 per 100,000 in Corona.  However, the bigger surprise is that it also has been hit less hard than wealthier Forest Hills, which has seen 2,101 cases per 100,000 (The New York Times, 5/31/2020).  We all know the narrative about how COVID-19 has disproportionately affected minorities and the economically disadvantaged.  Although this is true and very tragic, the 11355 experience flies in the face of that narrative.  And, as always, there’s a tremendous amount to be learned from an outlier that has defied expectations.

The key to unlocking the riddle is the fact that most of 11355’s citizens are of either Chinese or Korean descent.  While our federal government as well as New York’s state and city governments dithered, the Asian-American residents of Flushing prepared for the worst.  They wore face masks, stocked up on Lysol, and closed stores long before the rest of the US was doing these things.  In this pandemic, each day of delay in social distancing has cost many lives.

The Chinese and Korean residents of Flushing heeded the warnings of their overseas brethren.  In fact, you may have noticed Asian-Americans wearing masks long before COVID-19 became a household word.  Periodic Asian pandemics through the years combined with Asians’ more recent memory of SARS (plus MERS in Korea) had put many Asian-Americans on high alert for the next deadly virus that might come out of the woodwork. And to them COVID-19 was a 10-alarm fire.

Slow-moving de Blasio & Cuomo

So why wasn’t the rest of New York on high alert?  And, before I get going, let me say the Trump administration certainly deserves an ignominious mountain of blame for trying to deny the pandemic out of existence.  That doesn’t, however, let New York’s leaders – Mayor de Blasio and Governor Cuomo – off the hook.  It is true that New York had the largest bullseye on its back of any city in the US.  Yes, it had the most visitors from abroad pre-pandemic, especially Europe, and the Trump administration closed off our borders to flights from China but not from Europe; this allowed asymptomatic travelers from Europe to stealthily spread COVID-19 throughout the NY metro area during the fateful month of February.  Also, New York is America’s most densely populated city.  So, yes, the odds were stacked against the Big Apple from the get-go but it didn’t have to get this bad

Just look at the success stories from the West Coast that show what happens when leaders act early and decisively.  See Governor Gavin Newsom in California and the King County (Seattle) Executive Dow Constantine for reference.  And overseas there are impressive COVID handlers like Angela Merkel in Germany and Jacinda Ardern in New Zealand.  You could justifiably argue that these places didn’t have the unique challenges of the Big Apple.  However, that’s a cop-out.  You have only to look at the experience of 11355 smack in the epicenter of the epicenter.

New York certainly has its share of nationally respected public health officials who raised red flags early.  Same on the federal level with top CDC official Nancy Messonier warning on February 25, “We expect we will see community spread in this country. It’s not so much a question of if this will happen anymore, but rather more a question of exactly when this will happen and how many people in this country will have severe illness.” 

Old-school eyes & ears

However, you did not need an army of MD’s and PhD’s to tell you that Rome was about to burn.  All you needed to do was look, listen, and learn from the stories coming out of China and starting to come out of Italy.  A significant minority of the folks in 11355 lack a high school diploma but they excel at listening and then acting. 

A leader who followed the same wise path as the people of Flushing was Mayor London Breed of San Francisco.  According to a fascinating article in The Atlantic, the frightening images coming out of Wuhan captured Mayor Breed’s attention early on. These images showed the region’s hospitals being overrun by coronavirus patients. She said, “A picture’s worth a thousand words—seeing the images of what could potentially happen and then hearing your doctors tell you that we may not have the capacity to handle this situation. That’s when I was just like, Oh my goodness, this is serious.  And we need to basically sound the alarm in a way that helps us to get ready.”  She had this realization in January and declared a state of emergency on February 25.

My theory for the NY delay

Why do we humans often ignore early warnings? There are millions of theories flying around right now why the leaders of New York and other places did.  I suspect there’s a bit of truth in all of them. For instance, making the decision to shut down a city has harsh economic consequences.  We can also cite de Blasio’s and Cuomo’s long-running disdain for each other.  Psychologists tell us that optimism bias causes people to have overly rosy views of the future.  On and on we theorize. So allow me to add Theory 1,000,001 to the mix.

I think a deficit in empathy played a role.  De Blasio and Cuomo were unable to walk in the shoes of Wuhan’s citizens. Mayor Breed could and  instantly said, “hey, that could be us.”  She felt it viscerally before her healthcare experts confirmed it.  Why didn’t New York’s leaders have the same reaction?  Were they not paying attention or did they think that New York and its people were different?

The New York Times described de Blasio’s and Cuomo’s unjustified confidence by saying, “For many days after the first positive test, as the coronavirus silently spread throughout the New York region, Mr. Cuomo, Mr. de Blasio and their top aides projected an unswerving confidence that the outbreak would be readily contained. There would be cases, they repeatedly said, but New York’s hospitals were some of the best in the world. Plans were in place.” 

Some plans. Did they see the same videos and photos Mayor Breed did? Did they really think long and hard about these disturbing images or treat them like just another data point?  These guys had a vivid case study of what happens when you underestimate the lethality of COVID-19. Unfortunately they didn’t heed its lessons when they most needed to.

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