Illustration: Sarah Grillo/Axios

Big cities have taken the biggest hit from the coronavirus, but they're now ahead of the curve in developing the public health infrastructure to manage the crisis in the future.

Why it matters: Communities that can conduct widespread testing and efficient contact tracing will be better able to keep more of their residents alive and reopen parts of their economies. So far, cities and states with large populations and ample resources are at the forefront.

New York City, the worst-hit city in America, is now emerging as a national leader in recovery.

  • New York Gov. Andrew Cuomo announced this week that nursing homes in the state must test staffers twice a week, and New York City is offering hotel rooms to help mildly symptomatic patients isolate without exposing members of their household, per WaPo.
  • Former Mayor Michael Bloomberg committed $10.5 million, along with technical and organizational assistance, to help New York build up a giant contact tracing program.

San Francisco is testing all essential workers through its partnership with Color, a health tech company, and other Bay Area companies.

  • Detroit has also said it’s testing all essential workers, and several other cities, including New Orleans and Seattle, have set up mobile testing.
  • Massachusetts was early to announce a large contact tracing effort, in collaboration with Partners in Health.

The other side: Some smaller areas with fewer cases are also taking important steps. And tech companies say they can help close the gap between wealthy, well-resourced cities and more rural areas.

  • “One of the things that is most fluid is technology,” Color CEO Othman Laraki told me. “It’s really hard to move buildings. It’s really hard to move equipment. But I think technology is a very big part of this.”
  • Adobe, Oracle, Accenture and Splunk are helping people in Tarrant County, Texas, determine whether they are eligible for a coronavirus test and find a testing site, Axios’ Ina Fried reports.
  • North Dakota and South Dakota have launched a new contact tracing app.

The bottom line: This kind of infrastructure doesn't exist everywhere, and opening up without it could be a recipe for disaster.

Go deeper

Aug 21, 2020 - Sports

Kentucky Derby to run without fans as coronavirus cases surge

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The Kentucky Derby will be held September 5 without spectators, Churchill Downs announced Friday.

Why it matters: The state set a record last Wednesday for coronavirus infections confirmed in a single day, per the COVID Tracking Project. Hospitalizations in the state are currently on the decline, but have steadily risen throughout August.

Rep. Butterfield: "It's unthinkable" if transportation continues to suffer amid pandemic

Axios' Ina Fried and Rep. G.K. Butterfield (D-N.C.). Photo: Axios

The federal government must prioritize local and state transportation for the economy to recover from the pandemic, Rep. G.K. Butterfield (D-N.C.) stressed on Friday, calling the alternative "unthinkable" during an Axios virtual event on The Future of Transportation & COVID-19.

The big picture: Many cities have introduced funding cuts to their public transit systems after the pandemic shut down economies. Ridership is still down in many regions, and those cuts affect essential workers the most, Butterfield said.

Aug 21, 2020 - Health

Trump administration blocks FDA from regulating lab-developed tests

Photo: Pier Marco Tacca/Getty Images

The Department of Health and Human Services this week blocked the Food and Drug Administration's ability to regulate lab-developed tests, including for the coronavirus, that have been produced by hundreds of hospitals.

What they're saying: The change prohibits the FDA from overseeing such tests before they're marketed without a detailed rule-making process. HHS said it is taking the action as part of broader Trump administration review of "duplicative actions and unnecessary policies."