Health Care

Is New York City ready to relax COVID-19 safety measures?

As New York City eases some of its COVID-19 protection measures, health experts and lawmakers look to prepare for future waves.

New York's Excelsior Pass vaccine check.

New York's Excelsior Pass vaccine check. Office of Former Gov. Andrew Cuomo

New York City is officially open, and you no longer need a special key to access its restaurants, theaters and clubs. Mayor Eric Adams said this week that he plans to end the city’s so-called “Key to NYC” program that requires people to show proof of COVID-19 vaccination before dining indoors, seeing movies or frequenting other indoor venues like gyms and museums.

The rollback of the proof-of-vaccination requirement is set to be accompanied by the end of a mask mandate in New York City public schools, both of which are set to go into effect on March 7, assuming that no unforeseen spikes in COVID-19 cases occur between now and Friday, when Adams said he would make a final decision on ending the two measures. For now, Adams has said that he plans on keeping other vaccine mandates in place, including those for municipal employees and private sector employees working in-person. Earlier, Gov. Kathy Hochul announced that the state would lift its own mask mandate in schools, following new CDC guidance suggesting that most parts of the country don’t need to have mask mandates in place.

The end of the Key to NYC program was praised by some members of the business community, though some private establishments might choose to keep their own vaccine requirements in place. With COVID-19 cases and hospitalizations decreasing – and nearly 77% of city residents fully vaccinated – Adams said that it makes sense to suspend the requirement now. “New York City’s numbers continue to go down day after day, so, as long as COVID indicators show a low level of risk and we see no surprises this week, on Monday, March 7 we will also lift Key2NYC requirements,” he said in a statement on Monday. “This will give business owners the time to adapt and will allow us to ensure we are making the best public health decisions for the people of New York.”

Some health experts agree that it makes sense to loosen some of the city’s restrictions now. Anna Bershteyn, a professor in the department of population health at the New York University Grossman School of Medicine, said that she considers protective measures and restrictions as belonging in three buckets: things we should do all of the time, things we should do some of the time, and things we should try to avoid as much as possible. Things we should do all of the time include workplace vaccination mandates and ensuring clear air exchanges in indoor places. Measures we should try to avoid unless absolutely necessary include school closures. But steps that might come and go based on the current threat of COVID-19 could include things like the Key to NYC’s proof-of-vaccination requirement, she said. “I do think that having to show vaccination to enter a venue is on that list. I think capacity limits on events are on that list. Mask mandates are on that list,” Bershteyn said. Those tools, she explained, could be re-implemented during periods of more intense transmission. “I think we need to message it to the public that it's not like masks are gone forever. Don't delete your vaccine passport app. It's something that's going to have to come back in the intensity of the next wave. And then we'll be able to relax again in between waves.”

Others are more cautious about getting rid of the proof of vaccination mandate. “I personally would have preferred that this requirement remain in place for at least a few more weeks,” said Wafaa El-Sadr, a professor at the Columbia University Mailman School of Public Health. El-Sadr said that while New York City is currently in a good place with managing the spread of COVID-19, visitors and tourists from other locations could pose a risk. “Making a lot of changes at the same time can be tricky,” she said, adding that she would like to observe the effects of easing other measures like mask mandates before taking the step of lifting the Key to NYC requirement.

A point on which there seems to be some agreement across the board is that as the city faces the likelihood of new waves of COVID-19 – and possibly worse variants – restrictions like mask and vaccine mandates might not be gone for good, and it would benefit the city to lay out clear benchmarks for when more restrictions are needed. 

City Council Member Keith Powers was one of several lawmakers who called for the city to set a more defined set of benchmarks for when certain COVID-19 protective measures should be rolled back or re-implemented. Powers said that New Yorkers would identify with a tiered or color-coded system – akin to the state’s previous microcluster approach – to explain what restrictions are in place and why. “Based on what the numbers show, you would see the colors change and therefore different protections put in place,” Powers suggested. “So if we see a new variant and a major uptick in COVID numbers, that would call for different protections. In a moment like right now, when they drop, you see a much more relaxed environment around some of the protections.”

New York City Council Member Lynn Schulman, who chairs the health committee, also said that the time is right to ease restrictions such as the Key to NYC program. “New York is experiencing the lowest COVID numbers since the start of the pandemic and it seems a good time to begin reducing restrictions, especially for restaurants and other recreation venues which have suffered greatly,” Schulman wrote in a message to City & State. “With that, it is important to always follow the science, and explore creating guidelines for future health care measures based on case levels and other appropriate criteria.”

Spokespeople for Adams did not comment on whether the mayor will create such a system, but noted that he is in contact with his public health team every morning and the city is constantly updating its data on COVID-19 cases, transmission and other metrics. 

Bershteyn, the NYU professor, said that it might benefit New York City to have a more clearly defined system for when protective health measures are put in place or rolled back, but noted that it’s not a simple task to create such a system. Where to put those benchmarks is potentially going to change, because with each wave, the virus could have different (levels of) severity, it could interact with vaccines in different ways, different levels of effectiveness,” she said. For example, a “moderate” level of transmission of one variant might trigger the reinstatement of a mask mandate, but with a more intense variant, a mask mandate might be needed with even “low” levels of transmission. Until those variants hit, it won’t be clear what those benchmarks should be.

El-Sadr suggested that New York City could tie its restrictions to the new guidance from the U.S. Centers for Disease Control and Prevention. Unlike previous guidance from the agency, the definition of “low,” “medium,” and “high” risk is now calculated based on new COVID-19 hospitalizations, the percentage of hospital beds occupied by COVID-19 patients, and new COVID-19 cases per 100,000 people. The CDC now advises that only “high risk” areas need to require residents to wear masks. Less than 30% of the country lives in areas that currently fall into the “high risk” category.

Though the plans to drop the Key to NYC vaccine mandate and school mask mandate were announced after the CDC released this new guidance, spokespeople for the mayor did not say that the end of the mandates are explicitly tied to the CDC’s new criteria. “Tying those decisions to something established, like for example the CDC metrics that have been put in place, I think that would be very wise,” El-Sadr said. “I think it behooves the city to say, ‘Okay, we're going to anchor our decisions to these measures.’ And therefore, it's clear, it's transparent to everybody.” 

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