NYC’s COVID alert level ticks down to ‘medium’ amid drop in known infections

Mayor Adams touted Tuesday that New York City’s coronavirus alert level has ticked down to “medium” following a drop in known infections and hospitalizations — but a key variable is left out of that picture since the city doesn’t have a system for tracking at-home test results.

The downgrading to “medium” comes just over a month after the city reached the “high” alert level on the Adams administration’s color-coded COVID-19 risk chart.

Adams said in a statement Tuesday afternoon that the new designation is a result of the city’s COVID curve continuing to trend in the right direction — with the seven-day case average now at 240 per 100,000 residents and the seven-day hospitalization average at 9.8 per 100,000 residents.

“Day after day, New Yorkers are stepping up and doing their part, and because of our collective efforts we are winning the fight against COVID-19,” he said. “We’re grateful to New Yorkers for their continued attention and vigilance as we’ve made our way through to the other side of this wave.”

However, the data cited by Adams only paints a partial portrait, as it does not encompass COVID-19 cases detected via at-home tests, which are increasingly common in this stage of the pandemic.

“We know that the official case numbers are a large under-estimate of the amount of COVID-19 in the city,” said Dr. Jay Varma, who served as former Mayor Bill de Blasio’s top pandemic policy adviser.

Varma, who’s currently the director of Weill Cornell Medicine’s Pandemic Prevention Center, pointed to a May study from a team of New York University researchers who estimated that the city’s case count was 31 times larger than the official tally during this spring‘s omicron surge due to a lack of at-home test data.

Still, Varma acknowledged that the Adams administration’s risk level adjustment is warranted since it takes the hospitalization rate into account, which he described as a more “reliable” metric.

“That said, New Yorkers need to understand that the risk of being infected is still quite high,” he said, “so, if they want to avoid being infected, the same guidance as always applies: do as much as you can outdoors, wear a high-quality mask when you are sharing indoor air with others, and make sure you are up to date on your vaccinations.”

Some U.S. cities and counties, including New York’s Albany and Tompkins Counties, have developed systems for residents to self-report positive results for at-home tests.

Patrick Gallahue, a spokesman for the city Health Department, said there are no plans to set up a similar data collection structure in the Big Apple. “The reasons are that there is no way to ensure an at-home test was properly conducted and no requirement exists that New Yorkers report their positive results to us,” he said.

Instead, Gallahue argued that at-home tests are a quick and easy first step for New Yorkers experiencing symptoms.

“Expanding our testing capacity with at-home tests gives more New Yorkers the critical information they need to quickly determine their status and take the appropriate precautions,” he said, noting that the city has distributed more than 16.5 million at-home tests this past month.

Varma said he agrees that it is “very difficult for public health agencies to receive, verify, and manage data from at-home tests.” However, he suggested that the city could take a page from the United Kingdom, whose public health system routinely tests a sample of residents to estimate infection risk beyond official case counts.

“Think of it like an opinion survey done continuously, but with testing incorporated. The UK system … produces data that is extremely useful for assessing community risk,” he said.

While official infection and hospitalization metrics are improving in New York, the pandemic is not over.

According to Department of Health data, 22 residents across the state died from COVID-19 on Friday, including nine in the city alone.