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As COVID-19 ravaged New York in March 2020, officials at the city Department of Health and Mental Hygiene began plotting out where the virus was striking hardest across the five boroughs.
A map of fatalities, broken down by ZIP code, was ready to go online in the first week of April as New York neared the expected peak of deaths, according to people familiar with the matter and to emails reviewed by THE CITY.
“I think that the reality of this scenario is we need to be transparent to the highest level,” one top health department doctor wrote in an April 5, 2020, email, two days before coronavirus fatalities reached their apex.
But City Hall did not approve public release of neighborhood-level death data until May 18. New York City saw 12,923 confirmed and 3,399 probable deaths from the coronavirus between April 5 and May 18, 2020.
The emails provide a window into Mayor Bill de Blasio’s management of pandemic information in the harrowing early weeks of the COVID crisis — a glimpse revealed at a moment when his Department of Health once again demands the trust of New Yorkers as new variants, including Omicron, spread.
On Monday, the mayor announced a broad vaccine mandate for all private-sector employees — calling the move a “pre-emptive strike” against another possible wave of infections.
“We can talk about all the other tools and we will, but vaccination is the central weapon in this war against COVID,” he said.
“It’s the one thing that has worked every single time across the board on a strategic level. It’s the reason New York City is back in so many ways.”
Nearly 35,000 New Yorkers have died of COVID-19 since the first death was confirmed in early March 2020.
Transparency Call Squelched
When New York faced its first COVID wave that spring, longtime city health department staffers believed it was vital to release information about where people were dying — even with caveats of imperfect data and a rapidly changing situation, according to people familiar with the matter and to the emails reviewed by THE CITY.
But information languished after being approved by the health department, which couldn’t publish anything without City Hall’s OK, those familiar with the matter said.
City Hall officials, though, blamed the delay in releasing the granular fatality data on a split within the health department, where, they said, some officials contended that ZIP code-level maps could create a stigma in hard-hit communities and a false sense of safety in other neighborhoods.
At that point, the virus was surging: Hundreds of New Yorkers a day were dying of COVID-19, with 815 people succumbing on April 7 — the deadliest day for the city during the pandemic’s so far 21-month toll.
Using borough-level fatality data then available, THE CITY had revealed on April 3, 2020, that Bronx residents were dying at a rate double that of the city, spurring calls for focused help and resources. When the city’s first fatality map was finally released on May 18, 2020, it showed that COVID largely slammed poor neighborhoods hardest.
Meanwhile, Dr. Oxiris Barbot, then the health commissioner, was battling behind the scenes with de Blasio over the city’s response to the unprecedented health crisis. De Blasio also clashed frequently with then-Gov. Andrew Cuomo.
Danielle Filson, a spokesperson for de Blasio, responded to THE CITY’s inquiries with a statement:
“City Hall swiftly delivered critical information to New Yorkers, and did so with accuracy and integrity,” she said. “We led the nation in our response to the pandemic — holding daily press conferences while setting up a testing and vaccine infrastructure that has kept New York City safe.”
Michael Lanza, a spokesperson for the city’s health department, said keeping New Yorkers informed proved an essential part of the agency’s pandemic response.
“The early days of the pandemic brought unprecedented challenges to our city and the health department and sister agencies responded as quickly as possible to issue guidance and data that was accurate and up-to-date,” he wrote in a statement.
But health department staffers said they were shut out of many conversations as the city launched its COVID response last year. And when it came to publishing information — from health alerts to data on who was getting sick, and where — everything had to be cleared by de Blasio’s office.
“We would send up data and it would take a long time to see the light of day,” said one former health department employee. “There were big hallelujahs whenever anything went live.”
In early April 2020, Dr. Demetre Daskalakis, then a deputy commissioner within the division of disease control, emailed other health department staffers requesting a map of deaths.
“I think that the reality of this scenario is we need to be transparent to the highest level,” he wrote on April 5 to other health department staffers. The Department of Health sent the map and other data to City Hall for final approval.
Emails sent later that month showed the release was still waiting for approval from City Hall. At his televised news conferences, reporters repeatedly pressed the mayor for the geographic breakdown of fatalities.
“On the deaths by ZIP code, absolutely need to get that out, want to get that out,” he said when asked at a May 12 news conference.
“Again, a very sad topic, but we are going to always provide transparency.”
The ZIP code-level data was released six days later, showing the disparate effect the pandemic had in neighborhoods across New York City — devastating some sections while sparing others.
The highest death rate initially was in the ZIP code that includes the Starrett City housing development in Brooklyn, an area that counted 76 fatalities by that point — a death rate of 612 people per 100,000 residents, the data showed.
Other neighborhoods, among them the Financial District and Battery Park City in Lower Manhattan, hadn’t logged any COVID-related deaths by then.
The health department was initially unable to provide necessary context about fatalities, including “probable deaths” — victims who never tested positive for COVID but had symptoms consistent with the virus, City Hall officials said.
However, a draft of an April 13 health department press release that was never issued showed a clear explanation of the “probable deaths.”
“Behind every death is a friend, a family member, a loved one. We are focused on ensuring that every New Yorker who died because of COVID-19 gets counted,” Barbot was quoted as saying in the scrapped press release, which was reviewed by THE CITY.
Daskalakis, who left the health department last year, did not respond to a request for comment. Barbot, who left last year after multiple reports of her feuding with the mayor, also didn’t respond to a request for comment.
She has publicly slammed de Blasio, telling a BBC documentary crew last year that the mayor’s delays in the early days of the pandemic — especially with ordering closures across the city — “cost thousands of lives.” But her critics said she did not make the full threat of the virus known, and they faulted her leadership style.
Speaking recently on a podcast about her days at the start of the pandemic, Barbot said it was “a master class in making decisions with imperfect data.”
“One of the challenges that was certainly present from the very beginning was communicating that to the public in a way that didn’t scare the bejesus out of people,” she said.
Barbot added: “One of the things that I was very mindful of was being transparent with New Yorkers about what we knew, what we didn’t know, and to share with them that as information became available, as new data points became known, that we would adjust our strategy to meet that new reality.”
That new reality was often changing — and required open communication that sometimes ran into bureaucratic logjams, former health department officials said.
Doctor Advice Delayed
In mid-April 2020, health department officials drafted an advisory for patients on how they could get medical care for non-COVID illness as the city was mired in lockdown, according to emails shared with THE CITY.
The notice — which would have been published online and sent to a network of health care professionals in New York City — advised doctors on how to tell patients with severe symptoms for non-COVID illness to promptly seek medical care. The notice also called on New Yorkers to donate blood, if they were able.
But the advisory wasn’t released until May 29, which upset health department officials who wanted to provide immediate guidance to doctors and others providing care, emails showed.
The health officials believed at the time that the pandemic would have an adverse toll on other sick patients who were afraid to seek outside medical care or couldn’t due to the dangers of the virus.
The officials were right: The city’s excess deaths, including pandemic-related fatalities, spiked by nearly 35,000 in the year ending this past June, compared to the previous fiscal year.
A City Hall official said the advisory was released after review and approval from state-level stakeholders — highlighting a frequent issue during the pandemic as the city dealt with an often-combative Cuomo administration, the official said.
“We continue to prioritize transparency and release more data than any other locality,” Filson said in a statement.