New York City’s Covid-19 test positivity rate is 15 percent, an intensity not seen since January. Transmission levels of the virus, according to federal guidelines, are high in every borough. Even hospitalizations, while far below previous peaks, are rising again, as the most transmissible Omicron variant yet, BA.5, spreads through the city and nation.
Earlier in the pandemic, such news might have been met with a mix of foreboding and fear. Now, New York is meeting the moment with more of a “meh.” As New York City enters its sixth wave of the virus, few seem inclined to get themselves into high alert mode again.
Not the government. Nor many of the people.
“At this point I am not worried,” said Carla Hernandez, as she and her two children sat on a blanket in the shade of a tree Thursday in a park in the Queens neighborhood of Corona, once the epicenter of the pandemic. “We know there’s a pandemic, but we have to keep moving.”
The city is logging about 3,700 cases per day, though experts estimate the true number of infections is as much as 10 times higher with most people testing at home. More than 1,100 people were hospitalized with Covid in city hospitals as of July 8, the most since February.
Experts are still urging the government to try to reduce transmission, and people to protect themselves. The C.D.C. and the city are recommending the use of high-quality masks whenever indoors in a public setting, as well as in crowded outdoor settings.
Denis Nash, an epidemiologist at the CUNY Graduate School of Public Health, thinks the public has become inured to the numbers, but that it shouldn’t be. “There needs to be a lot more masking, and a lot more higher quality masking,” he said. “In grocery stores, and other public places, it should be the norm at times like this. But I know there’s not the political will, or the will in society, to do it.”
Across the city, many New Yorkers — from the unvaccinated to the boosted — said that neither BA.5’s prevalence nor its worrisome attributes — including its ability to override immunity from past infections and vaccines — had them dramatically rethinking risk.
Omneisia Evans, a substitute teacher who also works as a brow technician and bracelet-maker, said that her anxiety over Covid had gradually been replaced by other fears — about crime, inflation, burnout at work. “I’m hearing about monkeypox now,” said Ms. Evans, 39, who lives in Brooklyn’s East New York neighborhood.
She was glad to relegate Covid to something like the past. “In New York City, at some point, we have to get back.”
That sentiment essentially became official city policy in January when Mayor Eric Adams took office. He rolled back Covid restrictions and some of the public health infrastructure devoted to Covid-19.
About two weeks ago, Mr. Adams dropped the city’s color-coded alert system just as its levels would have hit high again, saying he wanted to recalibrate it. The city is shutting down most of its stand-alone brick-and-mortar Covid testing locations, saying that people prefer home tests anyway. Masks are no longer required at Broadway shows; and even in one of the few places they are required, on the subway, compliance hovers near 50 percent in many cars.
“In the last month or so the city has moved into a ‘Pandemic? What pandemic?’ phase,” said John Moore, a virologist at Weill Cornell Medicine in Manhattan.
Wilfredo Hernandez, an unvaccinated bricklayer who lives in Bushwick, described his evolution on Covid as going from fear to acceptance to happy forgetfulness as he’s watched neighbors return to normal activities.
“Seeing everything open up, it alleviates stress,” said Mr. Hernandez, 44. “That Covid thing to me, right now it’s out of mind.” He said he had not heard anything about BA.5.
For much of the pandemic, New York was more cautious than most of the nation about reopening and loosening virus restrictions. But as new waves of cases hit with increasing frequency, many New Yorkers came to feel protected enough by vaccines and prior infections — even as some of their more concerned neighbors still wear masks, eat outdoors, and avoid crowded gatherings.
The mayor himself sometimes does not follow his own masking advice, as a glance at his Twitter feed shows. Public warnings about the increasing case numbers have been muted.
The Adams administration hasn’t enforced a private employer mandate that required nearly everyone working in the city to be vaccinated, and it ended the requirement for proof of vaccination to enter bars and restaurants. The city also ended its massive contact tracing program, and stopped offering hotel rooms to people with Covid who needed somewhere to isolate.
Instead, the city has built out a relatively efficient and centralized method for distributing Paxlovid, an antiviral medicine that protects against severe symptoms. Recently it began prescribing Paxlovid at mobile testing sites as well, a first-in-the-nation step that is expected to reduce disparities in terms of who has access to the medication.
As of July 4, 82,700 courses of Paxlovid have been dispensed in New York City since December, a period during which several million New Yorkers are believed to have been infected. Tens of thousands of courses remain available across the city, according to a spokesman for the city’s Health Department.
The city has also focused on giving out free at-home Covid tests — about 35 million of them to date.
“Our goal is to make sure whatever we put in place is going to stem the infections, keep down our hospitalization, and most importantly, keep down those who die from Covid,” Mayor Adams said on Thursday, summarizing his approach. “When we look at our numbers, we are at a good, stable place.”
Dr. Nash, the epidemiologist, pointed out that since April, there have been thousands of hospitalizations and almost 700 deaths from Covid in New York City. “That’s a lot of deaths,” he said. “It’s just happening over a longer period — it’s kind of like a slow burn compared to BA.1,” the first Omicron variant.
While the probability of dying from Covid has dropped precipitously, the risk of developing long Covid or cardiovascular disease following infection is another reason to try to avoid Covid infection, health experts say.
“We don’t know enough about the factors that will predict your likelihood of getting long Covid or not,” said Dr. Jay Varma, an epidemiologist who previously worked for City Hall on New York City’s pandemic response. “So effectively every new infection that you get is rolling the dice.”
The city’s approach has been in step with the White House’s, which is also focused on providing wider access to at-home testing and treatment. But soon, New York City may move away from the C.D.C.’s warning system criteria: It is considering making it even harder for Covid hospitalizations to trigger a higher alert level.
A city official told The New York Times that the Adams administration is focused on monitoring the number of people who are hospitalized “because of” Covid, rather than those who are hospitalized “with” Covid, and the first figure could be central to determining triggers for a new alert system. The idea is that someone hospitalized for a car accident, who then incidentally tests positive on arrival, is less of an indication of a wave’s severity than someone hospitalized for severe Covid symptoms.
But experts, and the city’s own Department of Health, say that there is no clear-cut definition to distinguish the two categories. Some cases are easy to categorize, as with a person with a broken arm who tests positive for Covid with no symptoms. But others — such as a patient with heart failure, which could have been worsened by Covid — are not.
“It’s difficult to sort out,” said Dr. Bruce Farber, the chief of infectious diseases at Northwell Health, the state’s largest health system.
All Covid cases in the hospital still require isolation and other measures that strain hospital resources, putting the onus on the exhausted health care system to deal with the outcomes of transmission unchecked by other measures. That too has come to feel normal.
“I think we all know that the public is not interested in masking,” Dr. Farber said. “They’re not terribly interested in boosters. They’re not terribly interested in vaccinating their children. That’s very disappointing to somebody in public health, and I think it’s somewhat foolish, but nevertheless, it’s a fact of life. And so you just deal.”
Wafaa el-Sadr, an epidemiologist at Columbia Mailman School of Health, said that in some ways, it is not surprising the public is less concerned. For many people who had Covid, it wasn’t as bad as they feared. Few people know anyone hospitalized for Covid anymore. And treatments are available for those who do get sick.
As the old goal posts of stopping the virus through herd immunity and vaccination vanish, public health experts are struggling to recalibrate their messaging and policies for this new stage of the pandemic. Now, their job is to somehow convince people to take precautions against a virus they are no longer deathly afraid of catching.
The government should remind people that there are still some people who can get very sick, Dr. el-Sadr said. They could also focus on the risk of long Covid, and the inconvenience of getting ill for days.
“Don’t throw away the mask, keep the mask with you because you have to be nimble,” she said, of the sort of message she wished she was hearing more of. “You have to be adept at measuring the situation around you.”
Nate Schweber, Emma G. Fitzsimmons and Michael Gold contributed reporting.