New York City was deep in its battle to suppress the first wave of the coronavirus pandemic when it announced an ambitious program to stop the disease from spreading inside cramped apartments: it would offer free hotel rooms for people infected with Covid-19 to safely separate from their families.
But as a second wave bears down on the city — driven in large part by people contracting the disease at home — statistics show that few New Yorkers have made use of the hotel rooms.
Out of 101,929 people infected with Covid-19, tracked by the city’s contact tracers since early June, only 611 have checked into hotels after being referred by tracers, according to data reported by the city, which goes through mid-November.
Others who have used the hotels include New Yorkers who have the virus and called a hotline on their own, people who are quarantining because they may have been exposed by a close contact and some travelers returning from out of state — for a total of about 3,500 stays.
A large majority of New Yorkers who get the coronavirus have instead opted to ride it out at home. And infections passed between family members and roommates appear to be a major source of Covid-19 spread as disease numbers spike: At least one in five cases are tracked to household transmission, according to figures released last week.
“When we talk to people, we tell them unequivocally: Your best option is to come to the hotel,” said Amanda Johnson of the city’s Test & Trace Corps. “We are very outspoken about this, but we are not draconian.”
“People are still going to have some amount of fear, or some degree of concern about leaving their life unattended for 10 to 14 days,” Johnson said. “We’re not coercive. We want to respect people’s autonomy.”
New York’s hotel industry has been battered by the pandemic, with rooms sitting empty across the city as tourism has all but disappeared.
The city announced it would rent out 1,200 hotel rooms to allow sick New Yorkers to isolate themselves, and hoped to expand the number to 3,000 by late summer. But it has never reached even the lower number because there has not been enough demand.
Currently, the city has three hotels reserved with a total of 760 rooms, and 350 were in use as of Thursday. Officials would not release how much the city has spent on the program, despite repeated requests.
The city has contracted to spend up to $893 million in pandemic-related hotel contracts through Dec. 2, according to the comptroller’s office. But that figure includes hotels for people experiencing homelessness, for health care workers and other hotel spending — and it does not represent how much has actually been spent.
“We know that it’s very, very difficult to prevent spread within households,” said Mark Levine, chair of the City Council health committee, who contracted the coronavirus in March, before hotel rooms were available.
“Unfortunately I am proof of this, because I had Covid. I did everything I could to protect my family, and all of them got it. Because we live in a Manhattan apartment,” he said.
Some people don’t qualify for a hotel room because they live alone or have enough space to isolate completely at home.
But anyone who shares a bathroom — common in most New York apartments occupied by more than one person — is eligible for a room. So are people who live with someone at high-risk because of age or medical conditions, or who share rooms.
City neighborhoods where people are living in overcrowded apartments have been among the hardest hit by the pandemic.
“There is almost no awareness of the hotel program among the public, which is the first challenge,” Levine said. “People in multi-generational families often have significant obligations that they don’t feel they can abandon, but the city could help solve that.”
City officials say they’re trying to do just that, and are seeing increased interest in the hotels as the virus roars back. The number of hotel rooms in use typically hovered at 90 to 100 before the recent spike in cases. But the hotels are still used by only a small fraction of people who get sick.
The program offers free transportation, food and medication delivery, pulse oximeters to monitor oxygen and health care workers on site. As the city added perks in an effort to make the program more attractive, guests even get a pair of free pajamas.
Parents who have no one else to care for their kids have the option of bringing children to the hotel, who may stay in suites or adjoining rooms depending on their age.
The city surveyed patients to determine why hotels were proving unpopular, and found that some were spooked by the idea of an isolation facility after seeing images of chaotic, overwhelmed hospitals at the height of the pandemic.
“People thought the hotel was like a hospital, that it was like a clinic,” Johnson said. “They didn’t want to be in that setting.”
Separating infected people from their families has been a key part of the strategy to combat Covid-19 in parts of Asia like South Korea, Vietnam and Hong Kong, where patients have been housed in government-run isolation facilities. But the approach has not caught on in the United States.
Even when precautions are taken, there is a significant risk of passing the disease among family members and others living in the same home.
“It’s very hard to self-isolate when there are common areas in the house — the kitchen, the bathrooms,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. “That’s especially true in New York City, where people don’t have five-bedroom houses.”
The city launched a new ad campaign urging people who develop virus symptoms to isolate quickly.
Some patients have also balked at moving to hotels because they can’t afford to miss work. In response, the city is ramping up efforts to help people access paid sick leave.
“Let’s be real about New Yorkers, they have to work,” Johnson said. “They’re just faced with impossible choices.”