Mayor Eric Adams has focused on antiviral treatments and at-home testing as coronavirus cases surge again.
In what was a typically busy week for Mayor Eric Adams, he met with the model Gigi Hadid at Netflix’s studio in Brooklyn. He visited a college to promote a new degree in video game design. And he visited the State Capitol in Albany to push for the renewal of mayoral control of schools.
But as New York City entered the high risk level for the coronavirus, Mr. Adams did not hold any public events to warn residents about the surge in cases.
Mr. Adams has insisted that he would not bring back mask and vaccine mandates and would instead focus on antiviral treatments and at-home testing.
While many American cities long ago jettisoned public health precautions, New York City and other Democrat-led cities like Los Angeles and Philadelphia had taken a more cautious approach to combating waves of the virus. Now, even as cases and hospitalizations rise again, those cities may resemble the rest of the nation by focusing on a return to normalcy and personal responsibility.
In New York, rather than raising alarm about the city’s heightened risk level, Mr. Adams has repeatedly emphasized that his infection in April was mild, in part because he took the antiviral Paxlovid.
“I think that the reason we are here and we are not seeing drastic actions is because we’ve done an amazing job of telling people — vaccines, boosters,” Mr. Adams said at a recent news conference. “When I was hit with Covid, it was just a tickle in my throat. I was still able to exercise, didn’t have any breathing issues, no pain.”
Mr. Adams, a Democrat who took office in January, appears to be weighing several factors: He has not called for mandates because hospitalizations and deaths have risen more slowly than in previous waves, because of a possible political cost to embracing restrictions that have fatigued the public, and because he is concerned about the impact on restaurants, tourism and the city’s economic comeback.
But some health experts have criticized the mayor’s approach and fear that letting the virus spread broadly could hurt the city’s most vulnerable residents. They believe the city should bring back mask and vaccine mandates, but acknowledge that it would be politically difficult to do so.
The city is now logging more than 4,000 cases per day, a figure that is likely much higher because most home tests are not counted in the official tally. As of Tuesday, more than 770 people in the city were hospitalized with Covid and 84 were in I.C.U.s.
Mr. Adams said this week that he did not plan to bring back mandates unless the hospital system was reaching a “state of emergency,” or trending in that direction. The new alert system Mr. Adams approved in March recommends instituting a mask mandate for public indoor settings at the current risk level.
Health experts have argued that waiting until hospitals and health workers are overwhelmed would be too late. Some elected officials like Mark Levine, the Manhattan borough president, support bringing back a mask mandate for most public indoor settings.
“I want this to be a city that can turn on and off protective measures when we hit a surge,” Mr. Levine said. “I would like to see us do more and push harder right now.”
On a call on Thursday with Anne Williams-Isom, one of Mr. Adams’s deputy mayors, community groups and disability advocates expressed strong support for a mask mandate for indoor spaces, according to someone who participated in the call. Ms. Williams-Isom said she would convey their message to the mayor.
Mr. Adams’s approach mirrors the tone of other leaders like Gov. Kathy Hochul and President Biden who are eager to move past the pandemic and to focus on economic recovery. Gov. Philip D. Murphy in New Jersey has also resisted bringing back mandates and removed a mask mandate on New Jersey Transit trains that travel into the city.
Ms. Hochul, who recently tested positive for the virus, has kept a mask mandate on public transit in place, but she has not set broader restrictions despite a major surge in upstate New York. Ms. Hochul faces an additional political calculation — she is in the middle of her campaign for a full term as governor and needs support from more conservative corners of the state.
Many business leaders support the mayor’s approach, including Kathryn Wylde, president of the Partnership for New York City, an influential business group.
“New Yorkers have demonstrated that they have the good sense to follow safety protocols, including masks where it’s appropriate,” she said. “To reverse progress made on reopening the city would be a blow to the recovery but also seems unnecessary at this point.”
The city’s health commissioner, Dr. Ashwin Vasan, issued an order on Monday strongly recommending that all residents wear medical-grade masks in offices, grocery stores, schools and other public indoor settings citywide. A day later, he announced that the city had hit the high alert level, which was triggered by rising hospital admissions.
Mr. Adams said the city was settling into a “new norm” as variants arrive.
“If every variant that comes, we move into shutdown thoughts, we move into panicking, we’re not going to function as a city,” Mr. Adams said on Wednesday.
But former Mayor Bill de Blasio and his health commissioner, Dr. Dave Chokshi, who stayed on during the first months of the Adams administration and crafted the new alert system in March, have made public comments encouraging Mr. Adams to be prepared to return to mandates.
“I’d say this as a friendly reminder to keep those strong tools available,” Mr. de Blasio said in a radio interview last week. “You may need them real soon.”
Mr. de Blasio, who oversaw the city’s response during the worst waves of the virus, held near-daily virtual virus briefings, sometimes inviting outside health experts like Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at the Columbia Mailman School of Public Health, and Dr. Celine Gounder, an infectious disease expert at New York University. He rolled out some of the most aggressive health measures in the country, including a vaccine mandate for city workers and private employers that is still in effect.
Mr. Adams has relied on a handful of key advisers to form his virus response: Dr. Vasan, an epidemiologist who formerly led a mental health nonprofit; Dr. Mitchell Katz, the head of the city’s hospital system; Ms. Williams-Isom, deputy mayor for health and human services; Dan Weisberg, first deputy schools chancellor; and Dr. Ted Long, executive director of the city’s test and trace corps. The group meets nearly every morning on a virtual call to discuss the latest data.
Mr. Adams said that the message from hospital and school leaders was clear: “They’re all saying the same thing. They say, ‘Listen, we got this. We’re not overwhelmed.’”
But Dr. Chokshi, the former health commissioner, said in a recent interview that during each new wave of cases in the city, elected officials and New Yorkers often had “collective amnesia” about how to respond.
“People would say, ‘Well, it’s only cases increasing, let’s see what happens to hospitalizations,’” he said. “To me, as someone who’s steeped in this, and particularly to understand the epidemiology, it’s hard not to have your head explode when you feel the public, and in many cases, the political conversation, go in those circles. And you’re like, ‘Wow, when are we going to learn.’”
Some health experts agreed that it would be difficult at this point in the pandemic to reinstate broad mandates unless the health system became seriously overtaxed. At the same time, having an alert system but not following through on its recommendations can confuse the public and weaken trust, particularly if the change is not carefully explained.
“It absolutely makes sense to pick a set of indicators and use that to decide what steps you’ll take,” said Dr. Jay Varma, who served as a senior health adviser to Mr. de Blasio. “There is value to putting out a weather report, but you have to be clear about how you’re using it.”
Short of mandates, several experts said, the Adams administration should be doing more to convince people of the gravity of the current moment, even among those vaccinated and not personally afraid of dying from the virus. For example, a refreshed public health campaign could focus on the importance of wearing masks to protect the vulnerable, the risks of long Covid or the increased risk of cardiovascular disease after Covid-19.
Mr. Adams has focused on offering free home delivery of antiviral medications like Paxlovid and distributing millions of home tests to public school students and at libraries and museums. His administration says it has distributed 35,000 antiviral treatments, which have prevented nearly 2,000 hospitalizations.
The city has led the nation in vaccination rates, but booster rates have stalled. An estimated 88 percent of adults in the city are fully vaccinated; only 46 percent have received a booster dose.
New Yorkers who have disabilities and weakened immune systems worry that the city’s new approach is not keeping them safe. Emily Ladau, a disability rights advocate who lives on Long Island and frequently visits the city, said that few people are wearing masks because the mayor had not clearly delivered the message that they are important.
“There’s a huge difference between masking and a lockdown,” she said. “I don’t think it should be that hard to put a mask on and protect the people around you.”
Joseph Goldstein, Sharon Otterman and Dana Rubinstein contributed reporting.