A year ago, New York City and the rest of the nation had an opportunity.

Early research was showing that the COVID-19 vaccines not only reduced the chances of severe disease by 95%, but that the drugs blocked infections by almost the same degree, too. This early effectiveness rivaled some of the best vaccines ever developed — ones that tamed scourges such as measles, polio and whooping cough. It created a window where, at least mathematically speaking, the United States could eliminate COVID-19 locally if enough people took the vaccines fast enough.

Thursday, New York City reported 40,000 deaths due to the pandemic. That tally is about 10,000 more fatalities than a year ago — half of which were recorded during the latest winter surge when the omicron variant rose to dominance. The mark comes the same week as the second anniversary of New York City's first reported death from COVID-19.

“This tragic milestone is certainly not a number, it represents human beings who are no longer with us,” Dr. Ashwin Vasan, who started this month as NYC Health Commissioner, said in an emailed statement to Gothamist. “It is difficult to comprehend their loss without also reflecting on what those individuals meant to their friends, families, loved ones and to our city as a whole.”

It’s hard to conceptualize just how intense this last wave has been. New York City alone recorded 1.1 million cases since infections began rising again at the beginning of November. That’s half of all the cases recorded by the five boroughs throughout the entire pandemic.

In terms of fatalities, one in eight New Yorkers killed by the coronavirus — about 5,400 people — lost their lives in 100 days or so.

Much of this tragedy was driven by the omicron variant, which posed a bigger risk to unvaccinated people due to its highly transmissible nature — but also eroded some of the protection for those with immunity, too.

Suddenly, booster shots became necessary for everyone, according to public health officials. That was especially true for at-risk groups — like older adults and the immunocompromised — that were more vulnerable again, even if they were fully vaccinated. The same applied to people who had recovered from infections with the previous delta or other earlier variants. Omicron’s mutations were just too potent.

The problem didn’t only refer to simply catching omicron.

The latest data from the U.K. Health Security showed that two doses of a COVID-19 vaccine do not offer the same protection against death with omicron. According to the data, after 25 weeks, two doses only lowers the chances of a COVID death by 59% for people older than 50. Get a third dose and the protection is restored to 95% efficacy, data showed. A similar pattern also applied to hospitalization.

Vaccine effectiveness against mortality with the omicron variant for those aged 50 years and older in the U.K., as of March 17, 2022.

Vaccine effectiveness against hospitalization after the second and booster doses after infection with the delta variant (black squares) and omicron variant for recipients of two doses of Pfizer (BNT162b2) vaccine as the primary course and then Pfizer or Moderna (mRNA-1273) as a booster, as of March 17, 2022.

Health experts said this message about the waning of two-dose protection had not gotten through, as people were returning to normal activities even as booster rates were low.

“I think if you ask the average person, ‘What percentage of the population is boosted?,’ they may not know,” said Bruce Y. Lee, a public health policy expert at CUNY and executive director of the research group PHICOR.

Health department data show only 36% of New York City residents are boosted, despite eligibility having been open for months. The COVID-19 vaccines have prevented a tremendous amount of suffering. A study by Yale University and the city’s health department estimated that the shots averted about 48,000 deaths, 300,000 hospitalizations, and 1.9 million cases through early March. Staying up to date with boosters will be key to retaining this protection.

Lee said that public messaging needs to also provide a clearer emphasis on the benefits of getting boosted rather than just discussing how many shots people get.

“We are more interested in protection rather than the actual number of doses,” he said.

On Wednesday’s episode of the Brian Lehrer Show, Manhattan Borough President Mark Levine called for a concerted effort to get booster shots into arms. He said the city’s Test and Trace corps should pivot its contract tracing resources, which are winding down this spring, to a booster initiative.

“We have the staff for that because we have our Public Health Corps and we have a 2,000-strong contact tracer workforce, which is now transitioning off contact tracing,” said Levine, who used to chair the City Council’s health committee. “[They] could be redeployed to go door to door to those people who got their first shots, but not yet their boosters.”

Levine said this push is needed because a more contagious, sister variant of omicron — called BA.2 — is threatening to extend this winter wave or cause another spike just as New Yorkers begin to partake in crowded activities again, like St. Patrick’s Day or working from offices.

On Thursday, Gov. Kathy Hochul announced a plan to distribute 20 million at-home COVID tests to congregate settings such as public housing, schools, nursing homes and food banks. The effort came as the New York State Department of Health reported that the statewide case rate increased for a third consecutive day.

It is in the memory of those we have lost that we continue to fight this pandemic with everything we have.
Dr. Ashwin Vasan, NYC Health Commissioner

The jump appeared to be due in part to confirmed infections rising in New York City, where the health department is showing that the seven-day case rate has been rising in Brooklyn for close to a week.

A backslide wouldn’t only be dangerous due to COVID itself. This perpetual cycle of intense surges takes its toll on social and mental well-being, studies have shown.

One study published Wednesday, led by the Centers for Disease Control and Prevention, said that mental health emergencies increase in the period immediately following a COVID-19 surge.

“We must address the toll of these losses on our collective mental health,” said Health Commissioner Vasan, citing the COVID-19 death toll. “Yet despite this grief, we also feel determination to and readiness to respond with vaccination, boosters, testing and rapid treatment options, to prevent any further needless suffering and loss. It is in the memory of those we have lost that we continue to fight this pandemic with everything we have.”