The Coronavirus Outbreak

By Michael Schwirtz and Lindsey Rogers Cook

Race and income are the key factors that decide who dies from Covid-19 and who survives, city data shows.

The ZIP code that includes Spring Creek Towers, a subsidized housing development in Brooklyn better known as Starrett City, had the highest death rate from the coronavirus in New York. 
The ZIP code that includes Spring Creek Towers, a subsidized housing development in Brooklyn better known as Starrett City, had the highest death rate from the coronavirus in New York. Credit...Dave Sanders for The New York Times

By Michael Schwirtz and

New data released Monday sheds light on one of the biggest questions about the toll the coronavirus has taken on New York: Where are people dying?

Neighborhoods with high concentrations of black and Latino people, as well as low-income residents, suffered the highest death rates, while some wealthier areas — primarily in Manhattan — saw almost no deaths, according to the new data, which was published by the New York City Health Department.

“We may all be in the same storm, but we’re not all in the same boat,” said Inez Barron, a city councilwoman whose Brooklyn district includes the ZIP code with the highest death rate in the city.

The data, which was current as of Monday, includes only deaths of people who had tested positive for Covid-19, the disease caused by the novel coronavirus. Probable cases of the virus among those who had not been tested account for 1 in 4 deaths.

The death rate in the 11239 ZIP code — a community of about 13,000 people — is the city’s highest, and almost 40 percent higher than in the area with the next highest rate. It is home to many older and African-American residents and includes Starrett City, a sprawling low- and middle-income housing complex on a peninsula jutting into Jamaica Bay.

Although the area has the city’s highest concentration of people over age 65, it was unclear why its death rate is so high. The total number of confirmed deaths there was 76.

Ms. Barron, the city councilwoman, said the people she represents have long been underserved by the city and live in conditions that make it difficult to control the spread of the disease.

“We might have instances of multigenerational families in Starrett City, and one person who is sick doesn’t have the luxury of going out to Long Island or going to their vacation home,” she said.

While the vast majority of the city’s deaths have been people 65 and older, the overwhelming difference between the neighborhoods that suffered most and least has been race and income, not age.

Of the 10 ZIP codes with the highest death rates, eight have populations that are predominantly black or Hispanic and include every borough except for Manhattan.

Most of the neighborhoods with the lowest death rates are in Manhattan, and each has a six-figure median household income. The group also includes some of the richest ZIP codes in the city, the same areas that emptied out when the virus hit New York. All but one is majority white.

The neighborhoods in the bottom quarter for death rates have double the income of the group in the top quarter. On average, the most affected areas are also more populous.

The Bronx has the highest rate for coronavirus cases, hospitalizations and deaths. And in each measure, Manhattan has been the least affected.

The three whitest ZIP codes in the Bronx — around Pelham-Throgs Neck and the Northeast Bronx — show among the lowest death rates in the borough.

  • Updated May 12, 2020

    • There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.

    • If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

    • Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.

    • The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

    • Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

The same trends with race and income can be seen in Manhattan. A ZIP code stretching over Central Harlem and Morningside Heights had the borough’s highest death rate; the neighborhoods are 90 percent black and Hispanic and one of the poorest areas in Manhattan.

Across the city, a median of 6 percent of residents have been tested for the virus.

In the ZIP codes with the highest rates of death, a median of 38 percent of the tests came back positive; in the areas with the lowest rates, about 25 percent came back positive — suggesting that if more tests were done, the death rates in the hardest-hit areas could be even higher.

The rate of deaths at public housing projects mirrors that of the city overall, suggesting that fears the pandemic might disproportionately affect residents in buildings operated by the New York City Housing Authority have not borne out, according to a Health Department analysis.

As of last week, 943 residents of city housing projects who had tested positive for Covid-19 had died. In its analysis of death rates in NYCHA buildings, which house about 400,000 New Yorkers, the Health Department also included deaths of people presumed to have had the virus, which added another 298 cases.

In all, 7,818 public housing residents have tested positive for the disease.