The New York Times - USA (2020-07-26)

THE NEW YORK TIMES, SUNDAY, JULY 26, 2020 0 N 9

Tracking an OutbreakThe New Reality

sionals and untold billions of lost
income and tax revenue may take
years to understand and resolve.
Other neighborhoods are rush-
ing to reopen, while Midtown re-
mains stuck in a purgatorial
Phase Zero, its very purpose — to
bring as many human beings to-
gether as possible — strangling
most hope of a convincing come-
back in the foreseeable future and
offering a sign of what may lie in
store for business districts across
the country.
Upstairs, floors are mostly
empty, as companies reassess
their need for office space, raising
serious questions about the future
of the city’s commercial real es-
tate market. Downstairs, streets
were lined with the creature com-
forts that made working in Mid-
town not only bearable, but even
fun. They are vanishing, and with
them, the men and women who
fed, clothed, poured drinks for and
drove the people in those tall
buildings.
The Men’s Wearhouse below
the former Time & Life Building,
now named 1271 Avenue of the
Americas (its address), remained
boarded up for months. The store
reopened early this month, its role
in offering and tailoring custom
business and formal attire per-
haps never less relevant.
The staffs of the steakhouses
were furloughed months ago. Mr.
Ahmed, the hot dog vendor, look-
ing over what should be prime
real estate outside Radio City Mu-
sic Hall at West 50th Street, said
he was thinking of cutting back to
every other day.
Subway data tells a story as
stark as Mr. Ahmed’s cart. Take
the Rockefeller Center subway
station, a major stop for four train
lines and the point of entry and
exit to the neighborhood for work-
ers from all over.
Last year on June 24, a Monday,
there were 62,312 MetroCard
turnstile swipes as riders entered
the station. On the comparable
Monday this year, June 22, the
number of swipes was 8,032, a
staggering 87 percent decrease.
In jeopardy of extinction, at
least in its known state, is the cor-
porate office culture at large — its
corner suites and cubicles, water-
cooler movie reviews, coffee
breaks, office crushes, shoe-
shines, black cars. Happy hour,
“Mad Men.”
That show was set in part in the
Time & Life Building, which lent a
shorthand nod to corporate chic.
Today, the story of the state of
Midtown can largely be told with a
close look at the block near Rocke-
feller Center where it has stood for
more than 60 years.
“The Time & Life Building set
the new standard, transforming
the west side of Sixth Avenue from

a collection of old tenement-like buildings into a corporate corri- dor,” said Robert A.M. Stern, the modern traditionalist architect whose firm has executed many prominent projects in Manhattan and around the globe. He was not a fan, especially not of the way the building was set back from the street, a departure that became standard practice on Avenue of the Americas, as Sixth Avenue is also known. “It cele- brated itself,” Mr. Stern said. “It was in the era of the glamour of corporations.” The Rockefeller Group, the building’s owner, emptied 1271 Av- enue of the Americas for signifi- cant renovations shortly after Time Inc. moved downtown in

The building reopened last
year, and the law firm Blank
Rome, a longtime tenant in the
Chrysler Building eight blocks
downtown, was among the first to
move in.
Among the first lawyers
through the door was Martin
Luskin, who has spent 41 years
with the firm. His biggest fear,
looking across the street at Rocke-
feller Center, was the holidays
ahead.
“We were petrified, hearing
stories about the tree lighting, and
the weeks before and a couple of
weeks after,” he said. “But in the
end, when you get used to it and
see the excitement in the families
bringing their children to see the
tree, the excitement takes over.
It’s an energizing effect.”
He would grow fond enough of
Rockefeller Center that he be-
came a member at the Rainbow
Room, the gilded and mirrored
destination for Champagne
brunch and chandeliers on the
65th floor of 30 Rockefeller Plaza
(“30 Rock”).
“A client lunch or client drinks
in the evening — that’s my spot,”
he said.
Now, his spot is his home in
Westchester County, staring at cli-
ents on his screen instead of
alongside breathtaking views in
Midtown. The Rainbow Room re-
mains closed. The means of arriv-
al and departure that made the
Rainbow Room unique — the long
elevator ride — would seem to be
a possible liability if a day comes
when cars can carry only four din-
ers at a time.
His colleague Deborah A.
Skakel, also working from home,
said she had found herself missing
her own Midtown rituals. She re-
cently paid a brief visit to the of-
fice and noticed a favorite food
cart, called King Tut, missing.
“You could get a gyro or souvlaki,
but what I got was salad on the
bottom and grilled chicken and
sautéed vegetables,” Ms. Skakel
said.
She would carry her humble
meal to a little office park with ta-
bles and a waterfall under trees.

Both Mr. Luskin and Ms. Skakel showed optimism that Midtown would rebound, just as it has before, from high crime, financial crises and the 9/11 attacks, which struck fear in many people working in tall buildings. But in the short term, those buildings are preparing reopen- ing protocols that will bear very little resemblance to life before the pandemic. Before returning to the office, employees will watch videos that lay out the new world: masks, temperature checks, con- tact tracing questions, a maximum of four to an elevator, with arrows on the floor pointing at the corners. Employees will essen- tially make reservations to enter the building, with a computer re- jecting new arrivals after the maximum number is reached. At street level, the block that once thrived on the appetites and expense accounts of the people above has wilted. The Capital Grille was a popular destination for business lunches

and dinners and drinks — an “up- scale, old-fashioned, kind of clubby steakhouse,” said a bar- tender who has worked there for the past 11 years. Starting in the early afternoon, patrons would enter under a portrait of Henry R. Luce, the legend- ary editor of Time, and linger at the bar for drinks before heading into the dining room for dinner. “Then a nightcap,” said the bar- tender, who declined to be named because the restaurant did not au- thorize him to speak. “ ‘Oh, we’ll have one more while we’re waiting for the car.’ They’ll drop an- other three hundred, four hundred bucks on a corporate card.” The restaurant furloughed all its tipped employees: the wait staff and bartenders. It closed for four months and reopened for sidewalk dining in early July. A lone waiter served six tables along West 50th Street, with no portrait of Mr. Luce in sight. The emptying out of Midtown has had a profound impact on the

Executive Plaza, which opened in 1986 at Seventh Avenue and West 51st Street in what had previously been the Taft Hotel. Its more than 400 apartments, rented out to companies based in the area, including The New York Times, have been temporary homes to countless executives, trainees, foreign correspondents visiting their home bases and Broadway performers — including the Rock- ettes and Santa Claus — needing a short-term place to stay. But since the city shut down in March, many of those corporations, with no one traveling, have not renewed their leases. So the building has pivoted, persuading the owners of the apartments to cut rents for a new kind of tenant. “Young people, millennials, whose leases are expiring else- where, and they’re looking for deals,” said Susanne Miller, the leasing agent for Executive Plaza. “They want to not be on the subway. They want to walk to work.” Mr. Stern, the renowned archi-

tect, said the past was a hopeful in- dicator in this uncertain time. “New York survived the late ’70s, and everybody thought the city was over, rampant crime, near bankruptcy,” he said. “It survives the market crashes of ’ and ’89, it survives the dot-com crash of 2000 or so. It survived

So it will survive. But each
time, each one of those moments
probably can be traced in relation-
ship to new ideas on how to occu-
py existing buildings or how to oc-
cupy new buildings.”
Daniel A. Biederman, executive
director of the Bryant Park Busi-
ness Improvement District, said
that for the sake of the neighbor-
hood’s very identity, Midtown ex-
ecutives who fled the city to work
remotely should feel a moral pur-
pose to come back as soon as
safely possible.
“They’ve almost made the un-
patriotic decision for Midtown
Manhattan,” he said. “We need
them back.”

Lost Swagger Turns

Midtown Manhattan

Into Omen for New York

From Page 1

On a Monday in June, the number of turnstile swipes at the Rockefeller Center subway station was down 87 percent from last year.

PHOTOGRAPHS BY AMR ALFIKY/THE NEW YORK TIMES

Ahmed Ahmed, left, sells about 10 hot dogs a day in Midtown these days. It was once around 400. Right, the Executive Plaza, usu- ally used by companies to house out-of-town visitors, is now pivoting to serve a new kind of tenant: locals who want to walk to work.

A CORPORATE HUB IN JEOPARDY

Joan Murray had been home
with Covid-19 for about a week
when she ran into trouble. She had
a fever of 103 degrees and chills
that sent shivers up and down her
spine. Her oxygen levels were
dropping, and the tightness in her
chest felt “as if somebody had
bound up my lungs with string.”
But the 77-year-old, a retired
registered nurse who lives alone
in Westbury, N.Y., was adamant
that she wanted to fight the illness
at home. “As a nurse, maybe I
knew too much,” she said. “The
last place I wanted to be was the
hospital.”
So the hospital came to her.
Northwell Health, which has
cared for thousands of coro-
navirus patients in its network of
facilities in New York State, sent a
nurse manager to Ms. Murray’s
home in May. Covered head to toe
in protective gear — gown, gloves,
mask, shield and disposable
bootees — she spent nearly eight
hours doing an assessment.
Ms. Murray was dehydrated
and in need of supplemental oxy-
gen. Within hours, she was
hooked up to an intravenous line,
set up in her bedroom to replenish
her fluids. A phlebotomist in an
N95 mask came to draw blood, an
oxygen machine was delivered to
her home, and Ms. Murray was
prescribed a powerful blood thin-
ner to prevent clots.
Over the course of the next
week, nurses dropped by every
day, and a Northwell critical care
physician and lung specialist, Dr.
Gita Lisker, called daily to talk
with Ms. Murray.

“I was always waiting for her call — I would tell her all my trou- bles, and she would reassure me,” Ms. Murray said. “I was like a child at that point, and she was my security blanket.” So-called wraparound home care services were created, on the fly, by Northwell Health to deal with the surge in coronavirus cases that New York experienced this spring. Now this model may help relieve health systems in the Sun Belt and other parts of the United States, where rising num- bers of cases are putting extraor- dinary pressure on hospitals, fill- ing intensive care units and send- ing providers scrambling to hire extra nurses and secure medical supplies. Northwell doctors are already discussing the program with physicians in Miami, where several hospitals have reached capacity. Florida has more than 300, Covid-19 cases, and more than 10,000 new cases were identified on Thursday. The concept of hospital-at- home programs is not new, but they had been used primarily to treat patients with flare-ups of chronic conditions like heart fail- ure. In response to the coronavirus epidemic, Medicare relaxed the requirements for such care. Now patients are considered home- bound if a medical practitioner ad- vises them not to leave the home because of a diagnosis of con- firmed or suspected Covid-19 or a condition that makes them more susceptible to contracting the virus.

In those situations, if a doctor says skilled services are needed, a home health agency can provide them under the Medicare Home Health benefit, officials said. Since the start of the pandemic, some hospitals have switched to at-home services to open up hospital beds for Covid-19 patients or to provide follow-up care after Covid-19 patients are discharged from the hospital. Northwell’s outreach is differ- ent because it focuses on acutely ill Covid-19 patients in the commu- nity. A team of Northwell special- ists uses telehealth to advise doctors and patients in the communi- ty with mild or moderate illness. When necessary, a comprehen- sive health service sends nurses and equipment into the homes of patients with severe symptoms or underlying medical conditions who might need hospitalization without such close monitoring.

Pulmonologists use telemedicine to follow these patients. During New York’s crisis, “80 to 90 percent of the patients who had the virus never went to the hospital,” said Dr. Thomas McGinn, Northwell’s senior vice president and deputy physician-in-chief, who helped create the program. Many Covid-19 patients did not need to be hospitalized, while oth- ers — including some who would have been admitted — simply re- fused to go, he said: “Hospitals were becoming this place that scared everybody.” With a shortage of diagnostic tests, many sick patients were afraid that if they didn’t already have the virus, they’d catch it at the hospital. And they were put off by the knowledge that they’d be cut off from friends and family, because visitors had been barred from health facilities to prevent further spreading of the virus.

At first, physicians were ner- vous about managing patients at home, Dr. McGinn and Dr. Lisker said. Since then, experts have learned a lot and have developed evidence-based protocols that rely on educating patients on how to monitor their temperature fluc- tuations, track their blood oxygen levels using pulse oximeters and report changes to their health care providers. Pulmonologists, experienced in caring for very sick patients with lung disease, consulted with patients over the phone, Dr. Lisker said. “I can have a phone conversa- tion with a patient, and after the first two sentences, I can tell if they’re going to have respiratory problems,” she said. “We’re trained to listen.” Any patient in respiratory dis- tress would be hospitalized, she added. But most patients were

able to ride out their illnesses at home. Between April 27 and June 1, Northwell enrolled 182 patients in its home care program. They ranged in age from 24 to 100, and many had underlying chronic conditions like diabetes or obesity, which have been linked to worse outcomes in Covid-19 cases. Several, like Ms. Murray, were older and lived alone. But they had been carefully screened by their regular doctors; only two eventually needed hospitalization, Dr. Lisker said. The program also provides care for Covid-19 patients who have been discharged from the hospital but have lingering symptoms that require care. Other hospital systems, like Mount Sinai Health Sys- tem in New York, have also created post-discharge programs that provide care across several spe- cialties to Covid-19 patients and evaluate the long-term effects of the disease. Ms. Murray, who has recovered from her illness, said that it was “fortuitous” that the hospital team had intervened when it did, because her condition was deterio- rating. “I don’t know what I would have done otherwise,” she said. Now Northwell is expanding the program, in preparation for potential uptick in cases in New York. “If there is resurgence in New York, on a dime we can get this up and running in huge num- bers, and other cities can do this, too,” Dr. Lisker said. “It’s a win for the patient and a win for the health system.”

HOSPITAL’S WIN-WIN SOLUTION

Some Seriously Ill Patients

Can Be Treated at Home

By RONI CARYN RABIN

When Joan Murray, 77, of Westbury, N.Y., came down with Covid-19, the retired registered nurse insisted on fighting the illness at home. “The last place I wanted to be was the hospital,” she said.

JOHNNY MILANO FOR THE NEW YORK TIMES

The New York Times - USA (2020-07-26)

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