On a sunny Saturday in March, New York Governor Andrew Cuomo said he was horrified to find people were still gathering in city parks. “It’s insensitive, it’s arrogant, it’s self-destructive, it’s disrespectful, and it has to stop now,” he said. He was right that the packed parks defied social distancing guidelines intended to slow the outbreak of the coronavirus, but the public scolding would have benefited from a little self-awareness: Both state and city responses to the pandemic had dragged, even as it was clear that New York City would be hit especially hard. Cuomo’s stay-at-home order came a day after California’s, a state with only a fraction of New York’s confirmed coronavirus cases, and it wasn’t until this week that New York City playgrounds officially closed. To date, the rapid spread of the virus has pushed the hospital system to capacity and killed nearly 1,400 people in the city alone.
Even prior to the coronavirus outbreak, New York City—the most densely populated area in the United States at 27,000 people per square mile—often seemed to hang by a thread in terms of its ability to accommodate a population of more than 8.5 million. The disintegrating subway system, literally held together with zip ties in places, malfunctions almost daily under the strain of an average weekday ridership of 5.4 million people; rush-hour commuters know well what it’s like to let multiple packed trains go by or sardine into an overstuffed car. Manhattan sidewalks are often so crowded that it’s impossible not to brush shoulders with passing strangers. I’ve never lived in another place where I had (or even thought) to buy movie tickets in advance.
In this constant jostle, it’s sometimes tempting to view the city’s problems through the lens of overpopulation. Anti-immigration activists have explicitly tried to stoke that sentiment in the past to rally support for their agenda. “Adding more people hurts already severely suffering New Yorkers. More people mean more competition for jobs, affordable housing, public transportation, quality education, police protection and social services,” wrote one last year. Even Democratic politicians have occasionally skirted such territory: This January, Brooklyn borough president and likely mayoral contender Eric Adams came under fire for remarks that seemed to blame the lack of affordable housing on newcomers rather than public policy. “Go back to Iowa, you go back to Ohio,” Adams said in a Martin Luther King Jr. Day speech. “New York City belongs to the people that were here and made New York City what it is.”
While the city’s high density presents a number of challenges—chief among them, now, how to slow the transmission of a highly contagious disease—its fundamental shortcoming isn’t an excess of people so much as it is an infrastructure weakened by decades of disinvestment and a lopsided distribution of resources. The coronavirus has stretched medical gear, hospital beds, and even the city’s 911 system to their limits. But scarcity, even in the case of a pandemic, isn’t inevitable; it’s almost always a condition created at some point through the prioritization of profit over human life.
A harrowing report in The New York Times published earlier this week found that the current ventilator shortage—which is now forcing some New York doctors to practice “medical rationing,” the clinical term for deciding which patients live and which die—is at least partly the result of a corporation’s cost-benefit analysis. More than a decade ago, in the wake of the H1N1, or swine flu, outbreak, the U.S. Department of Health and Human Services contracted a small manufacturer to produce up to 40,000 affordable and efficient ventilators for use in the event of a future outbreak. But the company was eventually bought by a much larger outfit that decided the project was not profitable enough and effectively abandoned it. The contract was canceled shortly thereafter. “The stalled efforts to create a new class of cheap, easy-to-use ventilators highlight the perils of outsourcing projects with critical public-health implications to private companies,” the Times noted. On Wednesday, government officials confirmed that the federal stockpile of emergency medical equipment (which the contracted ventilators were once meant to join) was nearly depleted.
A similar predicament underlies the New York hospital system, which is now so overwhelmed that emergency makeshift hospital annexes have taken over the Javits Center (before this year, most notably the site of Hillary Clinton’s ill-fated 2016 election-night party) and even a section of Central Park. A 1,000-bed Navy hospital ship is also currently docked on Manhattan’s West Side. The surge in demand is the result of several factors—the quick spread and deleterious effects of the virus, the difficulty of maintaining six feet of distance in such close quarters, perhaps even too many nonchalant parkgoers flouting social distancing recommendations in the early days of the outbreak (as Cuomo crankily worried, despite his own culpability). Yet it’s also the end point of a cruel calculus that dictated the closures of over a dozen hospitals in the city. Between 2003 and 2017, at least 16 hospitals in New York City shuttered, many as the result of state budget cuts to Medicaid reimbursements. As Ross Barkan wrote in The Nation, Cuomo, who’s been anointed in the press as a kind of anti-Trump pandemic hero, “presided over a decade of hospital closures and consolidations, prioritizing cost savings over keeping popular health care institutions open.”
In predictable New York spirit, a number of those hospitals were demolished and turned into luxury housing following their closures. The former St. Vincent’s Catholic Medical Center in the West Village is now Greenwich Lane, a luxe complex where Starbucks CEO Howard Schultz and Jon Bon Jovi own units. Long Island College Hospital in Brooklyn, which closed in 2013 despite protests by hospital employees and neighborhood residents, was converted by real estate developers into “Brooklyn’s first beaux-arts skyscraper,” a high-end building that includes amenities like a “fitness duplex with yoga atelier” and “rooftop lounge with cabana seating.” (Bill de Blasio, who was running for mayor at the time of the LICH protests and even arrested at one demonstration, initially opposed the closure of the hospital, but ultimately abandoned the fight after taking office.)
That’s all in the context of the city’s ongoing dearth of affordable housing. As businesses and workplaces close and unemployment continues to spike, more and more of New York’s 5.4 million renters—two-thirds of the city’s residents—will be squeezed to make rent payments. Though in March, Cuomo issued a 90-day suspension of evictions, housing advocates worry that such a measure doesn’t grasp the full scope of the problem, which started well before the outbreak and will continue long after. According to a report last year from the comptroller’s office, the cost of housing, food, and transportation rose at nearly twice the rate of average incomes between 2005 and 2017; New York’s rents, currently the second-highest in the nation, are unlikely to decrease after the threat of the coronavirus has subsided.
There’s no way to retroactively undo the steps that led to our present crisis, but understanding that they happened as the result of political decisions that coddled the market at the expense of people will be critical for rebuilding city life after the pandemic. When New York one day resumes its usual pace, it will still, for example, have to contend with the fact that nearly 70,000 people in the city are homeless while an estimated 247,977 apartments remain vacant or “scarcely occupied,” and one in four luxury units remain unsold. If the city is increasingly uninhabitable, both in an outbreak and beyond, it’s not because there are too many people.