Monday, March 23, 2020

COVID-19 Pandemic, Governor Cuomo Announces Initial Delivery of Equipment and Supplies for Javits Center Temporary Hospital


Federal Administration Has Deployed Hundreds of Thousands of Masks, Gloves, Gowns and Face Shields to New York

Former Secretaries to the Governor Steve Cohen, Bill Mulrow & Larry Schwartz Join Governor's COVID-19 Task Force — Tasks Mulrow & Cohen with Developing 'NYS Forward' Plan, Strategy to Restart the Economy Following 'NYS on Pause'

Signs Executive Order Mandating Hospitals Increase Capacity by at Least 50 Percent - Goal of 100 Percent Increase in Capacity

Announces DFS Will Request Health Insurers Disclose Number of Registered Nurses, Doctors Who Work for Them So State Can Ask to Temporarily Serve

FDA Has Approved Use of New Experimental Drug in New York on a Compassionate Care Basis

State Opens Drive-Thru Test Facility in the Bronx — State has Opened 6 Mobile Facilities to Date

Launches 'New York Stronger Together' Campaign — Celebrities Sending Videos of Themselves at Home to Reinforce Governor's Message That Young People Need to Stay Home to Help Stop the Spread — Watch Videos from Robert De NiroDanny DeVitoBen Stiller and LaLa Anthony

Confirms 5,707 Additional Coronavirus Cases in New York State - Bringing Statewide Total to 20,875; New Cases in 36 Counties

Governor Cuomo: "We implemented New York PAUSE, which stopped all the nonessential workers, et cetera. We have to start to think about New York Forward. Steve Cohen and Bill Mulrow, who I worked with for 30 years, they're now in the private sector, they're going to start to think about this. How do you restart or transition to a restart of the economy? How do you dovetail that with a public health strategy? As you're identifying people who have had the virus and have resolved, can they start to go back to work? Can younger people start to go back to work because they're more much tolerant to the effect of the virus? So, how do you - you turned off the engine quickly, how do you now start or begin to restart or plan the restart of that economic engine? Separate task, but something that we have to focus on."

Cuomo: "Many people will get the virus, but few will be truly endangered. Hold both of those facts in your hands: Many will get it, up to 80 percent may get it, but few are truly endangered and we know who they are. Realize the timeframe we're expecting, make peace with it and find a way to help each other through this situation because it's hard for everyone. And the goal for me: Socially distanced but spiritually connected.

The increase in the number of cases continues and that is what we are watching every day. They see it as an upward trajectory. I see it as a wave that will break at one point and the question is what is the point of the break, and if when the wave breaks does it crash over the healthcare system? That is what we have been talking about.

So, two track simultaneously, you have to reduce the spread, the rate of spread of the virus. You are not going to control the spread, but you can reduce the rate of the spread so you can handle it in you hospital system. That is what every state is doing. That is what this is all about. How do you reduce the rate of spread? Reduce the density, do more testing, isolate the people who test positive. Second track, increase hospital capacity as quickly as you can so that at the apex of the wave you have the hospital capacity for the people who will need the hospital capacity, which are the vulnerable people that we have been talking about.
Reducing the spread, density control, we have taken every action that government can take: closed the gyms, theaters, other high density businesses, non-essential employees, social distancing, Matilda's law. Remember, this is about protecting vulnerable people: older people, compromised immune systems, underlying illness. Those are the people that are vulnerable here. That is the focus of all of this.

The greatest density control issue right now is in New York City. I saw the issue myself. I told New York City I want a plan. Yesterday, I said I want a plan on how they are going to control and reduce the density. I want the plan today. I want the State to be able to approve the plan. It has to focus on young people and the gathering of young people. I have said it before, you can get it. The numbers show you can get it if you're a young person and you can transmit it and it's reckless and it's violative of your civic spirit and duty as a citizen as far as I'm concerned. If New York City needs legislation to enact their plan once we approve it I would ask New York City to pass that legislation quickly. If they have a problem passing legislation they should let me know.

Also on reducing the spread, increase the testing capacity. When you identify somebody positive isolate that person. What we've done on testing is important. March 13 is when the State got the authority to start testing. Up until then the federal government was controlling all the testing and it was going through that bottleneck of a federal government. I don't mean that in a pejorative way but it had to go through the FDA, the CDC. I said decentralize that task. Let the states do it.

March 13 the FDA allowed the State to start testing. In 10 days, we've gone from testing 1,000 people per day to 16,000 people per day. How much is that? That's more than any other state in the United States is testing. That's more per capita than South Korea which was the gold standard of testing. They were doing 20,000 per day. On a much larger population, about double the population of New York, so we're doing 16,000 which compared to China, South Korea per capita is even higher. So in short we're doing more testing than anyone.

Two points off that: kudos to the team that put that testing in place and the nurses and the doctors, God bless them for being out there every day and doing it, but also our numbers will be higher on positives because we're doing more tests. We have multiple locations that are working now and we'll be increasing those locations.

Second track, increase hospital capacity, increase the number of beds, we have 53,000, we may need 110, we have 3,000 ICU beds, we may need between 18,000 to 37,000. That's my greatest concern because that's where we need ventilators to turn those ICU beds into beds for people suffering from the virus.
We are today issuing an emergency order that says to all hospitals you must increase your capacity by 50 percent. You must. Mandatory directive from the State - find more beds, use more rooms, you must increase your capacity 50 percent.

We would ask you to try to increase your capacity 100 percent. Okay? So we now have 53,000 beds. We need 110,000 beds. If they increased the capacity 100 percent that solves the mathematical projection. Right? I think it's unreasonable to say to every hospital basically double your capacity. I don't think it's unreasonable to say try to reach 100 percent increase but you must reach a 50 percent increase. Fifty percent increase, we're only at 75,000 beds. We still have a problem between 75,000 and 110,000.

Once you secure the bed you have to secure the staff. You are going to have staff that are getting sick and need to be replaced. You create these new beds, you don't have the staff for those new beds now. They just don't exist. Your staffing is to your number of beds. You increase the number of beds you need more staff.

We are going to the entire retired community, health care professionals who are licensed, registered and we're saying we want you to enlist to help. It's not a mandatory directive. I can't legally - well I probably could legally - ask them to come into State service. But this is just a request. We put it out. We've gotten very good response. There are hundreds of thousands of health care professionals who are licensed and registered in this state but we have 30,000 responses to date and I'm doing an emergency Executive Order for all nurses who are registered to enlist and the Department of Financial Services is sending a directive to insurance companies. Health insurance companies employ many nurses, doctors, et cetera in the insurance business. We're saying, we don't need them in the insurance business now, we would like them to help in hospitals because this is not about assessing insurance claims at this point. This is about saving lives. When we get to assessing insurance claims, we can handle it then.

Supplies are the ongoing challenge nationwide. Masks, PPE, ventilators are the number one precious commodity. This is happening on an ad hoc basis We are competing with other states as I have said. We have made certain strides. We have a full team working on it, we're very aggressive. We're talking to other countries around the world. We're talking to companies. We have New York manufacturers who are really stepping up to the plate and converting factories, et cetera. But this is not the way to do it. This is ad hoc. I'm competing with other states. I'm bidding up other states on the prices. Because you have manufacturers who sit there and California offers them $4, and they say well California offered $4, I offer $5 and another state calls in and offers $6. It's not the way to do it.

I was speaking to Governor J.B. Pritzker about this yesterday. Why are we competing? Let the federal government put in place the Federal Defense Production Act. It does not nationalize any industry. All it does is say to a factory, "you must produce this quantity." That's all it does. I understand the voluntary public-private sector partnership, and there are a lot of good companies who are coming forward and saying let us help. But it can't just be who wants to help let me know. We need to know what the numbers of what we need produced and who is going to produce and when. I get that a lot of companies are stepping up and doing good things, and that's a beautiful thing. They're doing it here in New York too, but you can't run this operation that way. It can't just be based on we're waiting for people to come forward with offers and if you happen to get a lot of offers on gloves, then you have a lot of gloves. But if you get no offers on masks, then you don't have masks. 

The Defense Production Act just says you can tell a company manufacture this many by this date. Yes, it is an assertion of government power on private sector companies, yes. But so what. This is a national emergency, and you're paying the private sector company They're going to produce a good and they're going to get paid, and by the way, they're going to get paid handsomely. You cannot continue to do these supplies on an ad hoc basis. We have had success securing supplies. We're going to be dispatching them across the state today. These are the number of goods that are going out. You heard on the news that, especially in New York City, they're worried about running out of supplies. Again, this won't get us through the entire situation, but this is a significant amount of supplies that will be going out. New York City, for example, 430,000 surgical masks, 176,000 pairs of gloves, 72,000 gowns, 98,000 face shields, 169,000 N95 masks, which are very precious now. They're about $7 a mask.

So, these are significant supplies. We have been having some success in gathering them and we're distributing them, and this should make a difference. Well, it will make a difference. Again, not until the end of the crisis, but short term. Hospital capacity: I'm on my way down to the Javits Center today. I want to make sure those hospitals are getting up right away, then we're going to use Stony Brook, we're going to use Westchester, we're going to use Old Westbury. President Trump did deliver yesterday. I put forward a series of requests in the morning. He did the briefing in the afternoon, and he responded to those requests. That's government working, that's government working quickly and I thank him for it. It makes a big difference to New York. We're getting those emergency hospitals. The Javits hospitals for example, those are 1,000 beds right there with the equipment, with the ventilators, and with the staffing. So, that's a big deal.

The president declared what's called a major disaster declaration. That allows FEMA, Federal Emergency management agency, to help us. There's normally a 75-25 split between the costs of those services. Federal government pays 75. The state pays 25. I said to the president I can't pay the 25. We just don't have those kinds of resources. The federal government has the authority to waive that 25 so the federal government pays the whole 100 percent. And that's what the president is doing [for the National Guard] and I appreciate that. I also asked for the FDA to expedite the approval of an experimental drug that we are working on here in the state of New York, which I'll tell you more about in a moment, and the president also did that the FDA gave the New York State Department of Health approval to use on a compassionate care basis a drug that we think has real possibility.

On the drug therapy, Tuesday we're going to start the hydroxychloroquine with the zithromax, that's the drug combination that eth president has been talking about. the FDA approved New York State Department of Health to proceed with an experimental drug, again on a compassionate care basis. But what it does is it takes the plasma from a person who has been infected with the virus. Processes the plasma and injects the antibodies into a person who is sick. And there have been tests that show when a person is injected with theantibodies, that then stimulates and promotes their immune system against that disease. It's only a trial. It's a trail for people who are in serious condition. But the New York State Department of Health has been working on this with some of New York's best healthcare agencies, and we think it shows promise. And we're going to be starting that this week. There's also work on a serological drug where you test the antibodies of a person and see if they had the virus already. We all believe, thousands and thousands of people have had the virus and self-resolved. If you knew that, you would know who is now immune to the virus and who you could send back to work, et cetera. So we're also working on that.

The numbers today, total tested up to 78,000, tested overnight, 24 hour period, 16,000. As of yesterday about 25 percent of all the testing nationwide is being produced right here. Number of positive cases, we are up to 20,000 statewide. 5,000 new cases, which is obviously a significant increase. And as I say that trajectory is going up, the wave is still going up, and we have a lot of work to do to get that rate down and get the hospital capacity up. You see it spreading across the state, the way it spread across the nation, and that will continue, my guess is every day. We have, right now on hospitalizations, 13 percent are being hospitalized. None of these numbers are good, but relatively that is a good number. Remember it's the rate of hospitalizations and the rate of people needing ICU beds. 13 percent is down, it has gone as high as 20 percent, 21 percent, hovered around 18 percent, 17 percent, 13 percent is a good number. Of that number, 24 percent require the ICU beds. The ICU beds are very important because those are the ventilators.

Most impacted states, you can see that New York far and away has the bulk of the problem. And that's relevant for the federal government, that's relevant for the Congressional delegation that is arguing for federal funds. Fund the need. Fund the need. New York, we have 20,000 cases, New Jersey, 1,900. California, 1,800. So, proportionately, in absolute terms, New York has by far the greatest need in the nation.

Again, to keep this all in perspective, Johns Hopkins has studied every case from the beginning. 349,000 cases. Death toll worldwide is 15,000, right? Many will get infected, but few will actually pass away from this disease. Also, this is all evolving and this is all evolution and we are still figuring it out. There has to be a balance or parallel tracks that we're going down. We're talking about public health, we're talking about isolation, we're talking about protecting lives.

There also has to be a parallel track that talks about economic viability. I take total responsibility for shutting off the economy in terms of essential workers. But, we also have to start to plan the pivot back to economic functionality, right? You can't stop the economy forever. So we have to start to think about does everyone stay out of work? Should young people go back to work sooner? Can we test for those who had the virus, resolved, and are now immune and can they start to go back to work? There's a theory of risk stratification that Dr. Katz who's at Yale University is working on, which is actually very interesting to me. Which says isolate people but really isolate the vulnerable people. Don't isolate everyone because some people, most people, are not vulnerable to it. And if you isolate all people you may be actually exposing the more vulnerable people by bringing in a person who is healthier and stronger and who may have been exposed to the virus, right? Can you get to a point where the healthy, the people who are most likely not going to be effected can go to work? Remember, you study the numbers across the countries that have been infected. The survival rate for those who have been infected is like 98%, right? A lot of people get it, very few people die from it.

So, how do we start to calculate that in? We implemented New York PAUSE, which stopped all the nonessential workers, et cetera. We have to start to think about New York Forward. Steve Cohen and Bill Mulrow, who I worked with for 30 years, they're now in the private sector, they're going to start to think about this. How do you restart or transition to a restart of the economy? How do you dovetail that with a public health strategy? As you're identifying people who have had the virus and have resolved, can they start to go back to work? Can younger people start to go back to work because they're more much tolerant to the effect of the virus? So, how do you - you turned off the engine quickly, how do you now start or begin to restart or plan the restart of that economic engine? Separate task, but something that we have to focus on.

I offered my personal opinion yesterday - I separate my personal opinion from the facts. You can disregard my personal opinion. You can disregard the facts, but they are still facts. I said don't be reactive, be productive, be proactive. Somebody, a few people have said to me afterwards, well what did that mean? That happens to me often. Look, this can go on for several months, okay? Nobody can tell you is it four months, six months, eight months, nine months - but it is several months.

We all have to now confront that that is a new reality. That is not going to change. You are not going to turn on the news tomorrow morning and they are going to say surprise, surprise this is all now resolved in two weeks. That is not going to happen. So, deal with this reality. Understand the negative effect of this, which I have spoken to personally because these are personally negative effect. You do not feel them governmentally, you feel them personally. You fee then in your own life.

And don't underestimate the emotional trauma and don't underestimate the pain of isolation. It is real. This is not the human condition - not to be comforted, not to be close, to be afraid and you can't hug someone. Billy and Steve walked in today. I had not seen them in months. I can't shake their hands. I can't hug them. You know this is all unnatural. My daughter came up. I can't give her the embrace and the kiss that I want to give her. This is all unnatural and disorienting. And it is not you, it is everyone. It's the condition,

And we are going to have time. And the question is how do we use this time positively? Also, at the same time we have to learn from this experience because we were not ready to deal with this and other situations will happen. Other situations will happen and let's at least learn from this to be prepared for the next situation as dramatic as this one has been.

Also finding the silver lining, the positive. Life is going to be quieter for a matter of months. Everything will function. Life will function. Everything will normal operations, there won't be chaos. The stores will have groceries. Gas stations will have gasoline. There's no reason for extraordinary anxiety. But it is going to change. You won't be at work, you can't be sitting at restaurants, you're not going to be going to birthday parties, you don't have to go to business conferences on the weekends. There's less noise. You know what, that can be a good thing in some ways: You have more time. You have more flexibility. You can do some of those things that you haven't done, that you kept saying, "Well I'd love to be able to, I'd love to be able to." Well now you can. You have more time with family.

And yes, I get family in cramped quarters can be difficult, but it's also the most precious commodity. For myself, this young lady, Cara, is with me. She would never be here otherwise. You know, I'm dad, right? The last thing you want to be when you're in Cara's position is hang out with the old man and hang out with dad and hear bad dad jokes, you know - they'll come with the holidays, they'll come when I give them heavy guilt, but I'm now going to be with Cara literally for a few months. What a beautiful gift that is, right? I would have never had that chance. And that is precious, and then after this is over she's gone, she's flown the nest. She's going to go do her thing, but this crazy situation is crazy as it is, came with this beautiful gift. So one door closes, another door opens. Think about that.

And as I said, normal operations will continue. As I said from day one, the level of anxiety is not connected to facts, there is no chaos the net effect - many people will get the virus, but few will be truly endangered. Hold both of those facts in your hands: Many will get it, up to 80 percent may get it, but few are truly endangered and we know who they are. Realize the timeframe we're expecting, make peace with it and find a way to help each other through this situation because it's hard for everyone. And the goal for me: Socially distanced but spiritually connected. How do you achieve socially distanced but spiritually connected? I don't have the answer but I know the question.

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