| New York City accounts for 21% of all U.S. deaths from Covid-19. It didn't have the U.S.'s first outbreak, but it did have the worst. Why? When a cataclysm hits, it's convenient to look for a single point of blame. Depending on your politics, that might be the mayor or the governor, the president, China, or maybe city living itself. The ultimate cause of New York's death count defies any easy answer and won't be understood for years. But there are a handful of factors that contributed to the outbreak, blending together to create a perfect cauldron for the virus. -
The U.S. shut the door to China, but left European travel open for almost six weeks in February and March. In that time, cases in Italy went from two to 15,000. In the last week before the Europe travel halt, 274,000 people arrived from Europe at New York's airports. -
The virus was misunderstood. New York officials told people that only direct, close contact, such as being sneezed on, could spread the illness. "Ride the subway, take the bus," was the advice from the city's health commissioner on March 2. Closed spaces like a subway are now thought to be a significant vector of transmission. -
Density and crowding. New York is built on shared spaces and human interaction. The four densest counties in the U.S. are boroughs of the city. -
The city was slow to act, only issuing stay at home directives on March 20. By the time that happened, the city was well into an accelerating outbreak, with 4,000 new cases that day. -
The state sent sick patients back to nursing homes, raising the risk for other residents. Across the state, there are almost 6,000 confirmed and presumed Covid-19 deaths in the homes. The outbreak isn't over, and in Brazil and elsewhere around the world there are a rising number of cases. New York had the bad luck of being on the early side. What matters now is what it and other cities learn for the next time. --Drew Armstrong | 
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