The positive test rate in the city has crept up near 1 percent in recent days.
Coronavirus testing numbers are dwindling. Contact tracers are being invited to apply for other jobs. And the percentage of coronavirus cases the city is analyzing to track variants has fallen.
New York City has been scaling back its efforts to monitor the spread of the coronavirus, reflecting not only a steadily low caseload but also a growing sense that the city, along with the entire country, is starting to leave the pandemic behind.
But some public health experts and elected officials are worried that the de Blasio administration may be pulling back on its surveillance measures too soon, potentially leaving the city ill prepared should more contagious forms of the virus cause new outbreaks.
These experts and officials say that while the de Blasio administration has been right to focus its efforts on increasing the number of New Yorkers who are fully vaccinated, it should be simultaneously maintaining, even expanding, its efforts to track the disease.
“The fear is that with the attention to vaccination, which is our major line of defense, this will result in a de-emphasis on the other tools in the toolbox,” Dr. Wafaa El-Sadr, an epidemiologist at the Columbia Mailman School of Public Health, said last week.
“Even in New York City, there are these embers that can flare up any time,” she added.
One such ember is currently in Staten Island, where four ZIP codes in the borough accounted for more than 100 cases in the last week.
There are other warning signs that the city is not fully out of the pandemic. For the last few days, the daily average test positivity rate in New York City has begun to tick up slightly to near 1 percent. Vaccination rates in a number of neighborhoods remain mired at stubbornly low levels. And the more contagious Delta variant is now the predominant variant in the city.
In an email response to questions, Mayor Bill de Blasio’s office said last week it would be sending mobile testing sites to Staten Island and trying door-to-door outreach to encourage vaccinations in the borough, as part of its strategy to prevent large outbreaks.
Mr. de Blasio’s office said that the low overall case numbers were evidence of its strategy’s success. The city’s seven-day positive test rate has not been above 1 percent in weeks. Hospitalizations continue to decrease, to less than 20 per day on a seven-day average from an average of about 30 a day a month ago.
“Test positivity is becoming a little less valuable as a metric as testing patterns change,” Dr. Dave Chokshi, the city’s health commissioner, said during Mr. de Blasio’s news briefing on Tuesday. “Cases and hospitalizations remain steady at this moment, although we remain concerned about the Delta variant, particularly among unvaccinated people.”
Testing has been the first line of defense during much of the pandemic, particularly as a way to pick up on asymptomatic infections. But the use of testing has been decreasing, both in New York and across the nation.
New York City is averaging 25,000 tests per day on a seven-day average, down from more than twice as many at the end of April. Many people now are getting tested just because their jobs require it, and vaccinated people tend to get tested less. With public messaging focused on vaccination, experts are concerned that fewer unvaccinated people are going in for tests as well.
Mr. de Blasio said on Tuesday that part of the reason for the dip in testing was the end of school. About 1.5 million tests of students and staff were done during the 2020-21 school year, according to city data.
As testing centers quiet, the need for them is reduced. On Monday, for example, all city-run testing sites were closed for the public holiday, a move that would have been unheard-of in the height of the pandemic.
That step struck Mark Levine, the chair of the City Council’s health committee, as a bridge too far. “I think it’s too soon for that type of pull back,” he said last week. “There are so many unvaccinated people in the city, and testing is absolutely essential to stopping the spread among vaccinated people, especially when there are these more contagious variants.”
Last week, the city announced that 44 percent of the positive virus cases it sequenced most recently for variants were of the Delta variety; the variant was first detected in India, where it led to a surge of cases, and has increasingly spread across the United States.
But even that statistic was clouded by the fact that the city’s Pandemic Response Lab had only sequenced 54 cases, a tiny number compared with the 1,500 cases it was sequencing every week in March and April, and the lowest number of cases sequenced since the lab started tracking variants in January.
The mayor’s office said in an email that the city had not purposely pulled back on tracking for variants, but that a variety of issues had led to a decrease in sequencing.
With fewer positive cases citywide, the Pandemic Response Lab has had fewer samples available to them, it said. Also, about half of the available positive samples don’t have enough genetic material of the virus to be sequenced. The city said it also has been examining sequencing done by several private labs, although they do not release that information publicly.
The sequencing shows that the presence of the Delta variant in the city has grown quickly. The current percentage was about double of what it was the week before (22.7 percent).
“They could easily increase the number sequenced, and it would be a wise thing to do right now,” said Dr. Denis Nash, an epidemiologist at the City University of New York.
Nationally, Delta now accounts for about 40 percent of cases, according to Helix, a company that sequences viral DNA for the Centers for Disease Control and Prevention, The Wall Street Journal reported.
As for contact tracing, the city is in the process of shrinking its Test and Trace Corps, which last summer boasted of some 3,000 workers. Last week, the city invited the 1,200 or so remaining frontline tracers to apply for positions in a new Public Health Corps, a $50 million effort charged with doing community outreach to vulnerable and at-risk New Yorkers.
Dr. El-Sadr and Dr. Tom Frieden, a former director of the C.D.C., said that the low caseload makes this the time to double down on contact tracing and do more focused work to identify, test, isolate and vaccinate the close contacts of those who test positive.
City Hall said in its email response that it would maintain the work force needed to contact trace every case and that it has continued to review all of that information.
City officials said that the international and national nature of the city means that it will be extremely hard to get cases to zero. Vaccination, they stressed, is the way forward.
Research shows that people who are fully vaccinated are highly unlikely to be hospitalized or die from Delta. But New York City is lagging behind in its vaccinations of older New Yorkers, with 30 percent of residents over 65 still unvaccinated. There are also large swaths of the city with under 40 percent full vaccination rates, and only 35 percent of adult Black residents are fully vaccinated. Because of such gaps, the risk of increased hospitalizations and deaths if Delta surges is real, said Dr. Frieden.
“New York is trying hard on vaccination but still doesn’t have the results that we need,” Dr. Frieden said.
Masking is another highly contentious issue. Several experts said that with Delta on the rise, it makes sense to promote masking, particularly in crowded indoor situations, for the vaccinated and unvaccinated. But Mr. de Blasio has said the city has no plans to change masking recommendations for now, unlike Los Angeles, where last week health officials recommended residents wear masks in indoor settings. New York State eliminated most virus restrictions in June.
The city noted that it has more tools in place to try to reduce Covid than other major American cities. Among them: in-home testing of people identified as close contacts of people who test positive, and in-home vaccination for anyone who makes an appointment.
Some experts said that the next stage of the Covid fight can no longer rely on voluntary individual efforts by an exhausted population.
Dr. Celine Gounder, an infectious disease physician at New York University, said it was time to get creative with new approaches, such as better wastewater surveillance and environmental surveillance, which would look for traces of the virus on surfaces in neighborhoods and buildings.
“We need to anticipate that this is not over and be anticipating plans in advance,” Dr. Gounder said. “We need to be more forward thinking and more granular.”
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