Why New Orleans Pushed Ahead With Mardi Gras, Even as It Planned for Coronavirus – The New York Times

ATLANTA Twelve days before New Orleans celebrated Mardi Gras Day, the citywide pre-Lenten bash that would pack thousands of visitors onto the streets, Sarah A. Babcock, the director of policy and emergency preparedness for the city health department, prepared a list of bullet points about the troubling disease that had already sickened thousands in China but had only infected 13 known patients in the United States.

The chance of us getting someone with coronavirus is low, Ms. Babcock advised community health providers, according to internal emails obtained by Columbia Universitys Brown Institute for Media Innovation and reviewed by The New York Times.

The projection proved to be terribly off base, as New Orleans would soon erupt into one of the largest hot spots for the coronavirus in the U.S., with one of the nations highest death rates. Experts now believe that the multiweek Mardi Gras festivities likely served to accelerate the spread of the highly contagious disease in the New Orleans area.

In recent days, city officials, including Mayor LaToya Cantrell, have pushed back forcefully against any suggestion that they had erred by not canceling the celebrations. And they have found support among public health experts, who note that no major events were being canceled around the country in the run-up to Mardi Gras Day, on Feb. 25, when there were still only 15 confirmed cases of the coronavirus in the country.

I think we all were thinking that this was not going to be a huge issue, quite frankly, and then exponential growth started, said Dr. Carlos del Rio, Chair of the Hubert Department of Global Health at the Rollins School of Public Health of Emory University.

At the time, he added, I think the mayor would have been executed if she would have said, Lets cancel Mardi Gras.

Still, the emails, more than 2,200 pages in all, offer insight into how one major American city began planning in mid-January for the viruss eventual arrival, even as it continued to prepare for its signature annual party.

The plans were predicated on a misunderstanding one seen not just in New Orleans of how widely the virus had potentially already spread in the city and across the country.

Dr. Jennifer Avegno, director of the New Orleans Health Department, said that the citys focus before Mardi Gras was on visitors who might bring the virus with them. But there was no way for us to know if we had community spread, she said, because we could not test for it.

There was also a tragedy of timing: It was on Mardi Gras Day itself, as floats were rolling through the streets, that the Centers for Disease Control and Prevention issued its starkest warning up to that point that the virus would almost certainly spread in the U.S., and that cities should begin planning social distancing measures.

Ms. Cantrell, in a March 26 interview on CNN, defended the decision not to cancel Mardi Gras, noting that no red flags had been raised by federal officials at that point. On the day before Fat Tuesday, in fact, President Trump had tweeted: The Coronavirus is very much under control in the USA.

When its not taken seriously at the federal level, its very difficult to transcend down to the local level in making these decisions, Ms. Cantrell told CNN. But when the experts told me that social gatherings would be an issue, I moved forward with canceling them.

That was long after the last Mardi Gras floats had passed through the city.

On Friday, the C.D.C. released a report stating that Mardi Gras had occurred at a time when canceling mass gatherings was not yet common in the United States. It also described Louisianas elevated number of cases and its temporarily high population density because of an influx of visitors during Mardi Gras celebrations in mid-February.

The Mardi Gras season officially began this year, as it does every year, 12 nights after Christmas, when a 150-year-old carnival krewe, the Twelfth Night Revelers, held an elegant society ball. The next day, Chinese authorities thousands of miles away announced they had isolated the new coronavirus that had been sickening residents of Wuhan, the capital of Hubei Province in China.

By mid-January, according to the internal New Orleans emails, city and state officials were circulating and digesting the latest updates on the disease from the federal government, which advised them to look out for patients with a fever and symptoms of a lower respiratory illness, like a cough or shortness of breath, as well as a history of traveling from Wuhan.

On Jan. 21, Ms. Babcock circulated a statement among colleagues meant for the news media that said the departments emergency preparedness team had been monitoring the coronavirus for the past few weeks and began weekly conference calls with the CDC last week.

At this time, the note continued, the CDC is only recommending screening at airports that receive flights directly from Wuhan, China.

On Jan. 23, Chinese authorities closed off Wuhan, and its 11 million residents, in an effort to curb the spread there. Two days later, Dr. Avegno, the head of the New Orleans Health Department, told colleagues that the uptick in cases in China was coming fast and furious.

From that point, the emails show, the city appeared to go into a more concerted coronavirus preparation mode.

William T. Salmeron, the chief of Emergency Medical Services for the city, told his colleagues that workers should take routine exposure control precautions as they would in dealing with any respiratory illness. Those included getting the travel history of anyone with symptoms, giving patients surgical masks, and moving up to gloves, gown, protective eyewear and an N95 mask if travel history risk factors warrant.

At this time the potential risk of infection in the US is LOW, he wrote.

Collin M. Arnold, director of the citys homeland security office, sent an email to Dr. Avegno and other city officials on Jan. 27, suggesting they should probably get together and discuss public safety concerns during Mardi Gras and on the parade route.

The New Orleans Police Department, he said, had been asking about personal protective equipment and general concerns (they shake a lot of hands and come in contact with a lot of people on the route every day). He suggested putting together a guide sheet for all responders that would offer them common sense mitigation tasks.

That same day, Tyrell Morris, the executive director of the citys 911 service, told city officials about a questionnaire and worksheet that the International Academies of Emergency Dispatch was suggesting they use for all suspected coronavirus patients.

Dr. Emily Nichols, the medical director for the citys emergency medical services, suggested they add a question asking suspected carriers whether they had been within six feet of another person thought to be infected with the virus.

In late January, the city health departments emergency preparedness branch emailed local health care facilities with updates on an active shooter training set for Jan. 30 at Lambeth House, a retirement community in Uptown New Orleans. Lambeth House would eventually emerge as the site of one of the worst outbreaks in the South, with at least 13 residents dying from Covid-19.

The city was alive to the possibility of the virus arriving by air or by sea.

On Jan. 28, Mr. Salmeron proposed a meeting of city, state and airport officials to discuss emergency response actions to ill passengers arriving at the local airport. The president of the Louisiana Maritime Association reminded city officials that the Coast Guard would review incoming ships to the port of New Orleans.

A multiagency meeting was scheduled for Feb. 5, with Ms. Babcock telling state health officials that the city was trying to make sure that everyone is prepared for coronavirus before Mardi Gras.

The day of the meeting, the mayors office posted a news item on the citys website noting that the federal government had not recommended screening at Louis Armstrong New Orleans International Airport, and had begun rerouting all flights with passengers from China to one of 11 other airports where screening was taking place.

Our publichealth and health care systems are ready for Mardi Gras, it said, and the coronavirus poses a very low risk to the Carnival celebrations.

In an email sent Feb. 26, the day after Mardi Gras Day, Dr. Avegno made it clear that, while the city was taking the coronavirus threat seriously, officials were not yet planning to call for strict measures to limit its spread.

Im a little hesitant to put in the social distancing stuff but since CDC mentioned it, we probably should she wrote. I added some words to make it more clear we werent going to run around willy-nilly quarantining people, but would be following state/federal guidance.

Daily sit reps, or situation reports, began going out to New Orleans officials beginning March 3. While acknowledging the spread of the virus was a rapidly evolving situation, the city did not recommend any closures because the state had no confirmed cases.

A few days later, on March 9, the first presumptive coronavirus patient in Louisiana was identified in New Orleans a resident of nearby Jefferson Parish who was in a city hospital. Reports began surfacing of people in other states, including Arkansas, Texas and Tennessee, who had been to Mardi Gras and were testing positive for the virus.

The next day, Ms. Cantrell canceled a number of beloved street-level events that have traditionally served as raucous addenda to Mardi Gras parades celebrating St. Josephs Day and St. Patricks Day, and Super Sunday, in which the citys Mardi Gras Indian tribes display their beaded and feathered suits.

By March 16, three people had died from complications of Covid-19 in Louisiana and there were 136 confirmed cases in the state. Gov. John Bel Edwards ordered the closures of bars, gyms, and cinemas, and limited restaurants to takeout and delivery service.

Dr. Avegno said city and state officials had moved as quickly as they could once they realized what they were facing.

We shut down parades, we shut down schools within a week, completely changing our way of life, Dr. Avegno said. I cant think of anything more drastic than shutting down the bars of New Orleans.

Over the next several weeks, the virus continued its unabated spread across Louisiana.

By Monday, state officials had reported more than 10,500 coronavirus cases in Orleans Parish and the adjacent suburb of Jefferson Parish. Across the state, at least 840 residents infected with the coronavirus have died.

Richard Fausset reported from Atlanta and Derek Kravitz, a data journalist at Columbia Universitys Brown Institute for Media Innovation, from New York.

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Why New Orleans Pushed Ahead With Mardi Gras, Even as It Planned for Coronavirus - The New York Times