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Brian Lehrer: It's the Brian Lehrer Show on WNYC. Good morning again, everyone. With COVID-19 cases on the rise and holidays where people will be chafing at restrictions ahead, yesterday, Governor Cuomo announced a new way to look at the metrics, the numbers that would trigger further shutdowns. The key metric will no longer be the one we've been hearing about for weeks and months, the positivity rate of COVID tests in a particular region, but rather hospitalizations.

Governor Cuomo: If our hospital capacity becomes critical, we're going to close down that region. Period. We close down a red zone. What is critical hospital capacity? Our formula is if your seven-day average shows that within three weeks, you will hit critical hospital capacity, we close you down.

Brian: I know that wasn't very clear. We will explain it, but indoor dining in restaurants seems like the first thing likely to get shut down under that scenario, perhaps in less than a week.

Governor Cuomo: If after five days, we haven't seen a stabilization in a region's hospital rate, we're going to clamp down on indoor dining. Five days, if the hospitalization rate doesn't stabilize in New York City, we're going to close indoor dining.

Brian: Governor Cuomo yesterday. To talk about why this shift in metrics, why restaurants and bars get hit before other businesses despite their objections, and what to expect going forward, I'm joined once again by Elizabeth Kim, senior editor for Gothamist, who's following all things COVID in New York. Hi, Liz.

Elizabeth Kim: Hi, Brian.

Brian: This is a little confusing so let's go through it. How has the governor defining critical hospital capacity?

Elizabeth: He is defining it as hospitals reaching 90% of their capacity, and this does hospitals in a specific region. For example, if all the hospitals should reach 90% of capacity in New York City, then that would prompt another shutdown of non-essential businesses.

Brian: These are back to the larger regions. This is for all of New York City, for example, not the smaller zones, like the red, orange, and yellow zones within neighborhoods?

Elizabeth: Correct. He would basically take account all the beds that are available in New York City. If we fill them up by 90%, then it would prompt a shutdown, which is akin to what the red zones were. The red zones where basically all non-essential businesses would close and schools would close as well. Although with schools, the governor is allowing schools to reopen under what he calls a test-out option in which schools would expand their testing capacity.

Brian: What are New York City's numbers now in terms of hospital capacity? If cases keep rising at current rates, when would they hit the number to trigger more restrictions?

Elizabeth: According to the state's numbers, currently, 20% of all hospital beds in New York City are available. That means that 80% of them are filled. This is based on a seven-day rolling average. If we're looking at ICU beds, it's 27%, only 27% of ICU beds are currently available. If we were to shrink that bed availability by another 10%, that would trigger the shutdown here in New York City.

Brian: Is there a projection as to when that is likely to happen given the current curve?

Elizabeth: The governor did not talk about that specific projection. What he talked about was this idea that the hospitalization rate, this rate continues to go up, so more and more beds are getting filled. He said yesterday that if this number does not start to flatten or decrease at the end of five days, he will shut down indoor dining.

Brian: Indoor dining would be the first thing to shut down. Then other "non-essential businesses" come at a higher metric or is indoor dining part of a larger shutdown of non-essential businesses, but we all say indoor dining as shorthand?

Elizabeth: No, he is targeting indoor dining first. Basically, there's a lower threshold to shut down indoor dining. Basically, he is saying that if the beds continue to keep filling up at this increased rate, he's willing to shut down indoor dining as early as Monday. In terms of a broader shutdown of non-essential businesses, that won't happen unless we reach 90% capacity. In terms of when that could happen, it's not completely clear, although the governor and also health experts have said that the holidays coming up is not going to help that number. We can see this number increasing. We could see the hospital beds filling up until around mid-January is what the governor said.

Brian: Now, the governor tied this to new CDC guidance on indoor dining as a particular risk, but here's Mayor de Blasio from his regular weekly appearance on NY1's Inside City Hall that he does on Monday nights. This is from last night, starting with host, Errol Louis' question.

Errol Louis: With schools, we changed the educated guest and strategy based on new information and watching what was actually happening in the schools. Shouldn't that same logic be applied to indoor dining? For instance, I haven't seen, maybe you could tell us if you have seen specific evidence suggesting that indoor dining is a vector, is a transmission factor.

Mayor de Blasio: The reality indoor dining in terms of what we've seen from Test and Trace Corps, you're right. We've been very open about that. We're not linking a lot of cases specifically back to specific restaurants, for example. That being said, the experience all over the world has consistently shown the indoor dining, along with gyms and some other activities, are amongst the most sensitive and the ones that contribute the most because of their specific conditions. People are not wearing masks. They are indoors when you're eating and drinking. Obviously, you have your mask off, you're indoors. Often, folks are pretty close together.

Brian: That from last night. The mayor acknowledged in that clip, the contact tracing in New York is not leading back to restaurant exposures very much. Liz, do you know the other examples from around the world that he is referring to there? Do they make it explicit or what the CDC based its guidance on with respect to restaurants?

Elizabeth: We don't even need to look around the world. The CDC conducted its own study in the summer. They found that the data suggests, just within the United States, that people who did indoor dining had a significantly higher risk of contracting COVID. That's been out there for several months now, which is part of the reason why it's really perplexed a lot of public health experts and just even average New Yorkers. Why is there still indoor dining in New York City when we're seeing these increasing hospitalization rates, increasing caseloads?

Brian: I wonder why the contact tracing doesn't show it.

Elizabeth: I spoke to a health official last week about this. This raises a broader question about how effective contact tracing has been in New York City. One of the things he told me that, especially when you're talking to younger people, let's say between the ages of 20 and 35, a lot of them are doing so much socialization that it's very hard for them to pinpoint exactly, "This is where I think I got COVID," because their answers range from, "I attended a small party. I also went to a bar and then I also went to a restaurant." What he told me was basically at this point, it's very difficult for the city to tease out and specifically say, "Okay, we know that restaurants are contributing to X percentage of cases."

Brian: Let's do something on the phones. Let's try something. Listeners, yesterday, if you were listening, we invited people to call in and say, "Where you think you got COVID if you were infected in the last month?" Today, let's try something more specific. If you think you got COVID in a restaurant or a bar or shopping in any store or mall in the last month, call and tell us how and in what place you think you were exposed? Anybody want to do that? 646-435-7280, 646-435-7280. We don't want you to name the place necessarily. We're not trying to vilify and single out individual businesses.

This is anecdotal, not really scientific, but let's see if there are stories out there that seem to back up the policies designed to flatten the curve that restaurant owners are so inflamed about. If you think you've got COVID in a restaurant or a bar or shopping in any kind of store or mall, call and tell us how and in what kind of place you think you were exposed, especially if you've got COVID in this recent wave, let's say in the last month or so. 646-435-7280, 646-435-7280 as we continue with Elizabeth Kim, senior editor for Gothamist, who's following all things COVID in New York. Let's stay on that list because restaurants are barely hanging on.

The bar owner on Staten Island who drove his car into a sheriff's deputy rather than accept a summons is an extreme case it pushed back against these restrictions, but operating for takeout only isn't sustainable for so many establishments. In New Jersey, for example, where cases are still climbing, Governor Murphy said, "Shutting down indoor dining is not on the table yet. Restaurants are limited to 25% capacity indoors and as of a month ago, have to stop serving at 10 PM in New Jersey so there are limits there too." Are Governors Cuomo and Murphy taking different approaches to restaurants?

Elizabeth: It does appear that at least for now, they are taking very different approaches. That's interesting because if you remember, at the beginning of the crisis, the three governors, Connecticut, New York, New Jersey, really tried to say that they were going to do this tri-state approach in which there wouldn't be a patchwork of policies but instead, the three states would together try to have this uniform approach to fighting COVID. Governor Murphy, unlike Governor Cuomo, has not set explicit threshold, at least not yet. He's basically been looking at the hospitalization numbers, he's looking at the infection rates, but he has not wanted to close indoor dining or do any broader shutdowns.

Brian: Let's take a phone call from Dee in Brooklyn, who says she's a contact tracer. Dee, thank you so much for calling in. Welcome to WNYC.

Dee: Hi, Brian, thank you so much. One of the things that I've noticed as a contact tracer is that there's an issue with asymptomatic people who have COVID. As contact tracers, we ask people to think back about exposure they've had either two days from when their symptoms started, two days before when their symptoms started, or if they've never had any symptoms two days before they took their COVID test. We know that COVID can last in the system for many, many weeks, potentially, after you are contagious.

Brian: Exposure.

Dee: Yes, exactly. Someone may have had COVID two weeks ago, like that's when they were exposed and they may have been social and out. Then for some reason, they get tested two weeks after exposure, two weeks after their contagious period, or the number of days after their contagious period. Because the science tells us, well, don't ask, we can't ask about everything you've done for your whole entire life. We're just asking about two days, even for people who were asymptomatic. We're doing our best guess as to when they may have been exposing people.

If you never have any symptoms and you're out in the world, it's possible that you are exposing people a few weeks even before you ever knew you had COVID because of the way that the virus lingers in the system and can show up in a positive test weeks after you're contagious.

Brian: I think you're describing the difficulty of the contact tracers like yourself, actually finding out where the individuals who test positive or get sick have actually been exposed. Is there anything from your experience as a contact tracer that would indicate to you that bars and restaurants or any other indoor establishments, because the bars and restaurants, they say, "Look at the malls," that the malls don't have the same capacity limits that the restaurants have? Yet, they're not being asked to shut down.

Is there anything from your experience as a contact tracer, even if it's just anecdotal, that would lead you to conclude that bars and restaurants either are or on it to particular risks or that any other kinds of stores are?

Dee: To me, the obvious difference between a bar and a restaurant and a store or a mall, is that people are generally wearing their face coverings. I feel like people are doing a better job about covering nose and mouth when they're wearing face coverings. You can't go into a store or a mall or something without a face covering, in general. In a restaurant, in a bar, that face covering is down while you're drinking, while you're eating, when you go to sit down at the table, most of the time. I've been at restaurants a few times in the last couple months, you take your mask off as soon as you're settled.

The potential for spread to happen, even if you're in a small group and what your guests were saying earlier about younger people, they are doing socializing. In the last month or so, I've talked to more young people who have hung out with friends. I think the socialization aspect, the drinking and the loosening and not being quite as careful, it makes sense to me why indoor dining and indoor drinking would need to be restricted as much as I hate for businesses to suffer in that way, just in the way that the virus spreads and from what I hear from the people I talk to, you're much more likely to get it in closed settings like that than in a store with people who have their masks on.

Brian: Dee, thanks for your work as a contact tracer and thanks for weighing in with some of your experience.

Dee: Thank you so much, Brian.

Brian: Let's go next to Jackie in Queens. Jackie, you're on WNYC. Hi.

Jackie: Hi, good morning. Both of my nephews in their early 20s just came down with COVID two weeks ago working at a pretzel store I won't name inside of a mall, and their store does rapid testing. They sent them both home, they actually worked together, but they didn't even close the store down and continue to sell the pretzels they made that morning. Very frustrating on my end.

Brian: Why are you confident enough to say that they got it working in the pretzel store as opposed to anywhere else they might have been?

Jackie: They're staying home outside of that because they live with my brother who's in his 50s and they're trying to minimize their risk. They actually don't work the same shift. One came down with it and then a few days later, it wasn't actually on the same day, they both were sent home but again, the store was never closed. They didn't tell anyone else in the mall or any of the stores. I just don't understand how they can keep the store open and sell food.

Brian: Jackie, thank you very much for that disturbing story. Elizabeth Kim from Gothamist, what's the policy, if there is a policy, about what a store or a restaurant would have to do if there seems to be a COVID cluster? I realize that's just two people, but maybe in a little pretzel stand in a mall, it's a pretty small space and maybe a significant number of their employees. Is there a city policy for what has to be done in the case of what Jackie said, notifying other people other stores in the mall which he says they didn't do or anything else?

Elizabeth: I don't know that there is an explicit city policy. Obviously, there's the Test and Trace team. They basically have so many cases before them that I don't know how long it would even take or if they could necessarily get to this particular store and these particular individuals and begin this process of investigating the cases there and asking the store to close down. It's a very good question. It's an issue that we've heard a lot of anecdotal stories about employees who say that they have either learned of someone else, a coworker getting exposed, but that the company or the store has continued to operate, even though there has been a positive test.

Brian: Dimitri in the West Village, you're on WNYC. Hi, Dimitri.

Dimitri: Hi, how are you? How's everything going?

Brian: Pretty good, and yourself?

Dimitri: Good. Good. Good.

Brian: Go ahead. You called to say that you do go to restaurants regularly? Are you there? Dimitri in the West Village disappeared. Dimitri, once, Dimitri, twice. Whatever, I guess we lost Dimitri. Who else? How about Lucy in the Bronx? Lucy, you're on WNYC. Hello.

Lucy: Hi, Brian. How are you? Mine is not a recent COVID. I did say [unintelligible 00:19:39], but I know exactly where I got it and it applies to this conversation is because I owned a gymnastic school. That is the only place I could have gotten it and it is where I got it.

Brian: A gymnastic school. How many people would have been in there at a time?

Lucy: This was early on and it was out in a religious orthodox Jewish neighborhood. I had a lot of kids in there at the time at that point. This is in February. I know that I had it. I'm one of the long haulers. I had it bad. Some of the children had been to a big Washington DC conference with Israel where it was running rampant. I know exactly where I got it without having to do any contact tracing because that's the only place I ever go is to work.

Brian: Where does this leave you in terms of watching these policy debates about what should be open and what should be closed?

Lucy: I am so against gyms being open. When the governor gave gymnastic schools a special dispensation, they got open before other gyms because it was considered a low-risk sport, I wrote letters. I was very upset because yes, it's a low-risk sport, it's not a lot of contact, you can't put a mask on an athlete who is doing gymnastics. It's not possible. That's where it's spreading. I don't mean that's the only place it's spreading, but gyms are just so unsafe.

Brian: Right. Lucy, thank you very much for your call and I'm sorry you're a long hauler. I hope you feel better over time. Liz, we're going to run out of time in a minute. What's the next step here? This always seems to keep shifting under our feet, right? The mayor has gotten so much criticism over the months for being inconsistent and going back and forth on one thing, on another thing. Now, the governor who's gotten a lot of kudos but also criticism for his response to COVID is shifting the criteria for when things close. I have to say, it makes sense to me. I never thought the positivity rate was the most accurate measure of anything because it depends on who is getting tested.

If in a particular neighborhood or a particular city, a lot of people are getting tested, that's going to push down the positivity rate to below maybe what we should be alarmed by because so many people are getting tested as a matter of course in a place where not that many people are getting tested. It's going to be the sick who are going to go out so the positivity rate is going to look higher. Since it's that dependent on people's individual choices and not on something really hard, concrete, measurable like hospital ICU capacity and hospital bed capacity which is now going to, it seems to me that this shift makes sense.

Elizabeth: You're right. It's complicated because the state measures positivity in a different way than the city does. We've had two different numbers being reported to us since the spring and it's confusing. More and more public health experts are telling me that they don't even focus on the positivity rate anymore. They are looking at exactly what you said, the number of hospitalizations and the discrete caseloads. In some ways, this simplifies things a lot more. Now, we're looking at the hospitalization rate and I think for a lot of New Yorkers, that's an easier number for them to wrap their head around. I think it gives a greater sense of urgency too.

We can kind of see, if we're saying that hospitals are approaching 75% of capacity, I think people discretely understand what that means and why it's so important to begin shutting down again.

Brian: Elizabeth Kim, senior editor for Gothamist who's following all the things COVID in New York, thanks a lot.

Elizabeth: Thank you, Brian.

Brian: Brian Lehrer in WNYC, much more to come.

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