With a dramatic spike to 3,615 cases as of Thursday evening, New York City is now unquestionably the epicenter of the COVID-19 pandemic in the United States. New York Governor Andrew Cuomo and New York City Mayor Bill de Blasio have both announced new measures and proposals to deal with the novel coronavirus crisis and have quarreled about whether to institute a “shelter-in-place” order.

Most of New York state’s 5,711 cases are concentrated in and around the largest city in the US. In addition to the cases in New York City, there are 550 cases on Long Island, 798 in Westchester County and 53 in Rockland County. There are also 742 and 96 cases in neighboring New Jersey and Connecticut, respectively.

As of this writing, COVID-19 has killed 33 in New York, nine in New Jersey and two in Connecticut.

The case numbers are universally considered significant underestimations of the true number of those infected with COVID-19, especially in Connecticut. After several weeks of community spread in the region, testing is still wholly inadequate, and as testing finally begins ramping up, cases which could have been diagnosed days or weeks ago are being confirmed.

New York City alone went from 2,400 cases Thursday morning to over 3,600 midday as new tests results came in. According to Cuomo, there are probably “tens of thousands” of unknown cases, which would include people with mild or no symptoms who are still spreading the disease as well as people with severe symptoms who have yet to be tested.

The governor estimates that New York will peak in cases in 45 days, at which point patients will need 110,000 hospital beds and 37,000 intensive care unit (ICU) beds with ventilators, compared to the current capacity of 53,000 beds and 3,000 ventilators. It is clear that in a matter of weeks the healthcare system will be completely overwhelmed, and thousands could die, comparable to the current situation in Italy, and that is assuming that the situation is not worse than Cuomo predicts.

Cuomo told CNN Wednesday, “We don’t have the capacity in the hospitals. We don’t have the ventilators. You can’t find enough ventilators.”

New York City Health Department guidelines have indicated that even healthcare workers who have had a “known high-risk exposure to a patient(s) with confirmed COVID-19” could continue working without a mandatory quarantine so long as they “take extra care to monitor your health.”

Given that the virus has an incubation period of up to 14 days and that asymptomatic people with COVID-19 can spread the coronavirus, this is a medically irresponsible position determined by a lack of healthcare workers rather than epidemiology.

Indicating the growing spread of the virus, logistics and tech giant Amazon confirmed the first case of COVID-19 among its warehouse workers at its recently opened Woodside, Queens facility. Late Wednesday night, workers at the facility walked out, demanding hazard pay, sufficient disinfecting if a case is discovered, childcare and expanded sick leave. A petition to that effect has received hundreds of signatures from Amazon workers in the US, Poland, Italy, Spain and Slovakia.

In a sign that the virus is spreading to the most vulnerable, reports have emerged that a resident of a city homeless shelter has tested positive for COVID-19, and social media postings indicate staff have as well.

At least eight inmates and four guards at the notorious Rikers Island have tested positive for or exhibited symptoms of COVID-19. Prisoners are especially vulnerable to the virus. Most Rikers inmates are awaiting trial, i.e., are still legally innocent, but are being held on bail.

Ross MacDonald, the chief physician at Rikers Island, published a series of impassioned posts on Twitter addressed to “the judges and prosecutors of New York: We who care for those you detain noticed how swiftly you closed your courts in response to #COVID19. … We cannot socially distance dozens of elderly men living in a dorm, sharing a bathroom. Think of a cruise ship recklessly boarding more passengers each day.”

After MacDonald warned that “[a] storm is coming,” Rikers officials announced they would release a few dozen inmates.

The response of the government—from Republican President Donald Trump at the federal level to Governor Cuomo and Mayor de Blasio at the state and local level, both Democrats—is best characterized as malign neglect. The universal concern in the ruling class is not for the fate of the thousands and even millions who could die from COVID-19 but for the fate of the markets and big business.

As a result, the center of world finance is facing a situation where it could become one of the major epicenters of the pandemic, in the way that Wuhan, China was and Iran and Italy currently are.

The response of the state and local governments has been to gradually implement measures to facilitate social distancing, thereby reducing the spread of the disease. However, given the immense lag between confirmed cases and actual infections, which allowed for extensive undetected community spread in the region, these measures generally have a reactive and inadequate character, such as belatedly closing New York public schools with merely hours’ notice.

On Wednesday, Cuomo announced that most businesses, with the exception of certain essential industries, must have at least 50 percent of their employees work remotely. With cases skyrocketing, he announced the next day that at least 75 percent must work remotely.

Cuomo signed a pathetic measure to provide additional sick leave to workers, with only 14 minimum days guaranteed to employees at businesses with more than 100 workers, five days at medium-sized businesses with 11-99 employees or a substantial net income and only unpaid sick leave at small businesses with fewer than 10 workers.

The state has also banned gatherings of more than 50 people, following guidance from the Centers for Disease Control and Prevention (CDC).

In an almost farcical measure, Trump hailed the deployment of a US Navy hospital ship, the Comfort, to New York Harbor, announced Wednesday. The ship is currently undergoing repairs and may not reach New York for weeks. The Comfort, one of the largest hospital ships in the world, has 1,000 beds, a drop in the bucket when compared to the 110,000 Cuomo predicts are needed, and it is not set up to deal with infectious diseases.

Meanwhile, de Blasio has announced his support for a “shelter-in-place” order similar to that instituted in San Francisco, which has ordered people to remain indoors except for essential trips, such as to get groceries. De Blasio indicated such a directive could come before the end of the week. California Governor Gavin Newsom announced Thursday the expansion of similar rules to cover all 40 million people in the state.

Cuomo has opposed such a move, stating, “It’s not going to happen.” Downplaying the threat posed by the coronavirus, he claimed, “Misinformation, emotion, fear, panic [are] truly more dangerous than the virus.”

On the other hand, Dr. Cornelia Griggs, in a New York Times opinion piece, bluntly stated, “The sky is falling. I’m not afraid to say it. … We are living in a global public health crisis moving at a speed and scale never witnessed by living generations. The cracks in our medical and financial systems are being splayed open like a gashing wound. No matter how this plays out, life will forever look a little different for all of us.”

Griggs, a pediatric surgery fellow in a New York hospital, calls for more equipment, research, social distancing and public support. However, these demands will not be granted by the ruling class based on moral appeals. To provide the necessary measures and equipment to address this pandemic, workers need a political program of action.