Tuesday, March 17, 2020

MAYOR DE BLASIO HOLDS ON COVID-19 March 17, 2019


  Mayor Bill de Blasio: Welcome everybody again, we'll start with this and we probably are going to go to a calling system soon for obvious reasons. But for now, we are here and I have a number of updates to share. Let me start by saying, of course there was a lot of new information every day that's sobering – thank you – and troubling. But there's also a lot of people stepping up, a lot of people helping out a lot of people really coming to the defense of New York City and the people of New York City. And so, there is some good news and I'm happy to announce one piece of good news as we fight this virus and this challenge. Last night, Health + Hospitals, our public health care system reached an agreement with BioReference Libraries and BioReference Libraries, one of the largest testing companies in America.

This is an example of a real public private partnership at a time of tremendous need. This agreement will allow our public healthcare system to ensure that up to 5,000 coronavirus tests per day can be done. I want to say that again. We will have the capacity in our public health system, just our public hospitals and clinics to perform up to 5,000 coronavirus test per day. That capacity will start to come online on Thursday, it will ramp up in the coming days until we reach that daily total. This is a huge increase in testing capacity for the City of New York as a whole and specifically for Health + Hospitals. You're going to hear a little later on from Dr. John Cohen, who is someone I've known for a very long time and have tremendous admiration for the Executive Chairman of BioReference laboratories. I want to thank you Dr. Cohen and your whole team for working so fast and so effectively with our team to come to an agreement and to put this testing capacity online.

So, I'll give a number of other updates and then you'll hear directly from Dr. Cohen and we will start the Q&A with questions specifically about testing and this agreement before we go to other matters related to coronavirus. Once the testing capacity is up, starting on Thursday, the tests can be processed in one to two days. So that's a strong turnaround time, and the focus will be, and we'll say this throughout on those who are currently hospitalized and who are medically in danger and those who are, in general, the most vulnerable, but we're going to be very careful about the prioritization of these tests. Even with this substantial new capacity, this will be a highly prioritized approach to testing. I want people to be very clear that our healthcare professionals are determining those priorities and we're going to stick to those priorities to ensure we can help those who truly need the testing most and to protect our entire healthcare system.

So, want that to be clear. We'll clarify more as we go through the Q-and-A. We're going to – I'm going to say, and I know my health care colleagues are going to say many reminders throughout this press conference that the guidance remains for those who are sick with the cold and flu type symptoms and only have mild or moderate symptoms. The guidance is to stay home, do not go to the emergency room or a clinic, and remember that there are those who are immediately in real danger, who need those facilities to be available to them. The goal for everyone is wait three or four days, if your symptoms improve, then you're good, if they don't or get worse, that's when you need to contact first by phone your healthcare provider. And this has evolved over the last few weeks as this crisis has deepens. So, this is what we need people to do. If you're sick, stay home, do not go to work, do not go out, do not come in contact with other people and then give it three or four days to see if it develops further. So, that's about the announcement today of the 5,000 test per day capacity going to Health + Hospitals.

I want to go to another update, very different one, but very much about how we have going forward, how we’ll have the capacity, the medical capacity and all the capacity, logistical support that we need to protect New Yorkers in a growing crisis. About an hour ago, I spoke with the Chairman of the Joint Chiefs of Staff of the United States armed forces General Mark Milley. We had a detailed conversation about the capacity that the armed forces could bring to bear to address a crisis like coronavirus and we went over details in terms of different options of what the military might be able to provide. I want to thank General Milley for his willingness to provide assistance and it is quite clear that our military in a high state of readiness and we agreed to continue to communicate and to work closely. So very, very much appreciate the update that I received from General Milley. And even though we are waiting for a lot to happen particularly decision making in Washington to happen it is comforting, it is definitely comforting to hear of the extraordinary capacity of the United States military and that the military isn't a high state of readiness to be able to provide support to not only New York, but other parts of the country as well.

Now, I want to talk about a question that's on everybody's mind, and that is the issue of shelter in place. This is a reality that is being talked about because this crisis continues to grow. We are all deeply concerned about the direction and the trajectory even as we get new information daily and hourly and we're trying to better understand the specific trajectory. It's quite clear this is a fast-growing crisis. In my view, I think the right guidance to give all New Yorkers is, even though a decision has not yet been made by the City or by the State, I think New Yorkers should be prepared right now for the possibility of a shelter in place order. It has not happened yet, but it is definitely a possibility at this point. I believe that decisions should be made in the next 48 hours and it's a very, very difficult decision.

I want to emphasize that it is difficult anywhere in the United States of America. It is particularly difficult in a city with such a large population so densely populated together. But I think the point is come with that decision does have to be made. We will be communicating closely with the State. Obviously, it’s a decision we want to make in common. And I think it's just right to let people know that there is that possibility. To be clear, if that moment came, there are tremendously substantial challenges that would have to be met. And I don't take this lightly at all. Folks have to understand that, right now, with so many New Yorkers losing employment, losing paychecks, dealing with all sorts of stresses and strains, I'm hearing constantly from people who are tremendously worried about how they're going to make ends meet. And that scenario a shelter in place begs a lot of questions. What is going to happen with folks who have no money? How are they going to get food? How are they going to get medicines? How are we going to ensure in a dynamic like that, that supplies are sufficient for our population? What role does the government need to play to ensure that the proper distribution occurs and no one gets left out? There's a lot of unanswered questions and I dare say those are particularly difficult in a City as large as New York City, but I believe we have to quickly come to grips with those questions and determine different contingency plans while deciding if this is the right strategy to move forward with.

And that statement obviously connects with the update on the number of confirmed cases. Now we have information that is updated since the Governors earlier press conference today and you will see you that the numbers continue to grow rapidly. So as of this hour, and this is again our two hour changes now, as of this hour, the number of confirmed cases in New York City is 814, the sad reality, the prediction I made last week that we would hit a thousand cases this week is obviously about to come true and I'm very sorry to say that. Now, the borough breakdown I will give you now I believe, I think we can confirm this is directly connected to that 814 number. So, the borough breakdown as of this point 248 cases in Queens, 277 cases in Manhattan, 157 cases in Brooklyn, 96 cases in the Bronx, and 36 cases in Staten Island. And again, very sorry to say we have lost seven of our fellow New Yorkers to coronavirus.

We will need quickly support from the federal government. Everything I've talked about so far keeps coming back to the federal government. There's more of the federal government can do to help us expand testing. There is obviously much to the federal government could do to ensure that the military is brought to bear to the fullest extent to help New York City and other areas that have been hard hit by the coronavirus. There is so much the federal government can do to ensure that people have income. Right now, although there are some promising elements of the stimulus bill, there is nowhere near the kind of income replacement that people need in this kind of crisis. I mentioned earlier today the parallel to the new deal. We've got a crisis on the scale, obviously, on the trajectory of both the epidemic we saw in 1918, not the exact health trajectory that, as Dr. Cohen and I were discussing earlier, there was a lot less health care available to New York – I mean, to New Yorkers and Americans in general a century ago. But in terms of the sheer reach of this disease, the only parallel will be the 1918 influenza epidemic.

In terms of the economic dislocation, I think it's fair to say we are going to quickly surpass anything we saw in the Great Recession, and the only measure, the only comparison will be the Great Depression. Hopefully not as bad an overall impact, but I think in terms of the sheer reach, again, that will be the only comparison in the Great Depression. The federal government focused on creating jobs to put money in people's pockets. We can't do that now because there won't be scenarios where people can work in congregate settings. There's so many ways we cannot repeat the model of the Great Depression and the New Deal. It's going to take direct income support on a vast scale. And I have said very clearly, the federal government found a way to come up with vast amounts of money to bail out the banking industry a few years ago, to bail out the auto industry, vast amounts of money for a tax cut for the wealthy and corporations, even vaster amounts of money for endless wars that have yielded little for the people of this country. Clearly, the federal government knows how to spend money quickly and on a huge scale. It should be spent on the American people right now, working people who are suffering. They don't have that income replacement. They will not be able to afford food and medicine and the basics. We are sending today additional requests and there's been a nonstop stream of requests to the federal government.

Three letters going out today, one to the veterans administration and to HHS requesting that unused beds in veterans administration hospitals in New York City be freed up for the battle against coronavirus and requesting that medical supplies be expedited and delivered to New York City, including surgical masks of all the different kinds, surgical gowns, all the elements we need to protect our health care workers and allow them to do their work.

Sending out an additional letter to Secretary Azar, HHS, on specific medical supplies that had been provided, but are insufficient uh in previous shipments we've received. And we're sending a letter to the leadership of the United States House of Representative and the United States Senate imploring them to use their power to ensure that the military will be activated in this crisis and that aid will reach New York City and other parts of the country.

Some quick additional updates and announcements. In terms of food provided through our schools this week – this week, as we've said, all schools will be providing breakfast and lunch grab and go options at each school. Next week we will be opening up an enrichment centers, learning centers for uh children of essential workers that'll be providing breakfast, lunch, and dinner. We are also determining a methodology to provide breakfast, lunch, and dinner at additional pickup sites around the five boroughs for young people who need them. This will not, at this moment, be at every school. This will be a more concentrated approach, not exactly what we do during summer, but closer to that then to every school building. But there will be ongoing sources of food for students that who need them in a new form starting next week.

I'm going to go through different items. They don't necessarily all connect, but they're all pertinent. There's been questions previous last few days about our budget process update that we intend to continue the city budget process on schedule, according to the law, and our office of management and budget is continuing to do its work to prepare the budget on time. And you should know that the office of management and budget is working remotely already.

An update related to for-hire vehicles, and for this one I will be signing an executive order right now for for-hire vehicles. We want to protect drivers and we want to protect riders alike. This executive order will ban a ride shares and a pooling of customers. This has been done in agreement with a major for hire vehicle companies such as Uber, Lyft, and Via. And the rule will be a one individual customer per vehicle to of course create social distancing as best possible within the vehicle. This does not disallow a couple that is together already, and actually a real couple. I want to be clear with people, a married couple, for example, or people who live together, or a family that lives under the same roof. Those folks obviously have had deep exposure to each other. It's appropriate for them to share a vehicle but not people who don't know each other. So, we will formalize that now in this executive order.

Related to the health and human services field, we have a huge number of nonprofit workers who play a crucial role in providing health and human services to New Yorkers. They're almost 40,000 nonprofit workers who've been under contract with us. A vast majority right now are in a situation – or, I should not say a vast majority – a very large number of them are in a situation right now where their work places may be closed, but their work is still crucial and we have a variety of things we need them to do. So, for approximately uh 40,000 nonprofit workers already working under contract with New York city, we will designate them as essential workers.

Next topic is, one, there's been a tremendous amount of interest in alternate side parking. Starting tomorrow, Wednesday, March 18th and continuing through Tuesday, March 24th, we will suspend alternate side parking. This is for one week, for seven days. This will give us an opportunity to evaluate the impact and see if it's something we want to do on a longer term basis. I want to just to help all New Yorkers to know, these are discussions we have all day long trying to make the right decisions, doing it for a week to see how it goes, makes all the sense in the world. Doing it throughout a crisis that could easily reach months upon months is a bigger question mark because what our Sanitation Department does related to alternate side parking is actually to keep our streets clean, keep our neighborhoods clean. There is a real connection between clean streets, clean neighborhoods, and overall health care. So, we have to be smart about keeping the city as clean and sanitary as possible. But let's do this first suspension, see how it goes. We'll update you as it gets close to next Tuesday on what we're going to do next. But again, alternate side parking suspended tomorrow through, all day tomorrow, and all the way through Tuesday, March 24th, and then we'll get you an update.

In terms of the criminal justice system, there've been some very fair and important questions about what is going to be done differently. First of all, anyone who is arrested and has flu like symptoms uh will not be taken to a precinct, will not be taken to central booking. There will be a specific methodology limiting their contact with our first responders and using a video conference system uh to immediately provide for the workings of the criminal justice system and our first responders being trained in how to appropriately handle that kind of circumstance. That's if they have those symptoms.

Now, another question has been about the number of people in jail and will there be some alterations. We are evaluating right now working with the Mayor's Office of Criminal Justice and the NYPD, the number of people in our jail system who might be particularly high-risk in terms of vulnerability to the virus and another category of people – those who are incarcerated but are at low-risk of re-offending. We're going to evaluate those numbers and the details and determine if case-by-case any of those individuals should be taken out of our jail system. We don't have a final decision or final numbers, but that evaluation is happening today.

Question came up about business taxes. Here is the instruction – everyone, business owners – everyone should file their taxes on time as normal. We understand some people have obviously a hardship situation. If you have a hardship, you can apply for an extension and if you can prove that your business has been disrupted, we would waive any penalties that you might incur, but the request is that all business owners file taxes as normal to the maximum extent possible and indicate specifically and with a proof if there is a hardship.

It's very important to note that this crisis certainly puts a clear light on the fact that the city of New York does not have unlimited resources. We have a lot we need to cover and we do not have unlimited resources. We need the federal government to play a much bigger role and we don't see enough evidence of that yet. So, our concern is overall when we think about revenue, the impact, all this is happening of course, but we're also concerned we do not see that massive federal stimulus yet. And we do see a lot of volatility in the stock market. So, we are very concerned that we keep our revenue picture as strong as it can be in light of those realities.

Now, very important issue, everyone understands we're going to be massively building out our health care system. We're going to be creating a new health care capacity in our hospitals, but we're also going to be creating health care capacity where there's never been a hospital before because we're going to need this massive mobilization to be able to address this crisis in the weeks ahead. As our health care leaders have said, the physical space in many ways is the easy part. Getting the equipment and supplies, which we do not have enough of for the long haul, we must have federal support for that. But maybe even more challenging – the personnel, the glue of the health care system is the people, the experts, the medical professionals of all types. So, we're launching a citywide campaign and it will look and feel like a war time mobilization message. And the message will be simple; if you are a health care worker, you have any appropriate training, we need you and we need you right away. It's going to be crystal clear. This is so far from business-as-usual, there's no words for it. Anyone who brings health care skills to the equation, your city needs you now.

Now, couple of key categories – there are about 9,000 licensed and retired health care workers who are registered in what is called the Medical Reserve Corps. That corps is managed by our Department of Health. We're going to work to mobilize that corps immediately. It is on a voluntary basis, but we're going to ask all those who are part of our Medical Reserve Corps who can come forward to help, we need you now. Also, licensed workers who aren't in the Medical Reserve Corps can be added to it and that means a number of folks in health care right now could be people in private practice, for example, who are not connected to a larger institution – we are going to need you and we're asking you to sign up for the corps.

The website where you can sign-up is live today. Go to www.nyc.gov/HelpNowNYC. Again, nyc.gov/HelpNowNYC. We need everyone who's able to come forward.

Few more updates. We had enforcement activities this morning by the NYPD, FDNY, Department of Buildings, and the Sheriff's Office out at bars and restaurants to ensure they have closed their in-house dining and have converted to delivery and take- out. We have had a very high level of compliance. There were instances where warnings had to be given and reminders had to be given that initial, and this is initial information, said that was around ten percent of the cases, but overall high compliance and we believe that will only deepen up-ahead and that enforcement will continue so long as we see any lack of adherence.

Few final points, today at 6:00 pm there will be an alert sent to all New Yorkers with an appropriate device. Some of you will remember this has been the same approach that has taken place in the middle of a major weather events, blizzards and hurricanes, or major police activity. You will get a loud audio alert and a vibration. This is happening today at 6:00 pm. We'd like everyone in the media to please let all those who follow what you put out there know. This is to alert everyone to the fact that as we move forward this type of alert will be coming and that we want everyone who can to sign-up for the proactive information; there's still a lot of misinformation out there. So, one, what we're going to say today at 6:00 PM is how important it is to text C-O-V-I-D to 692-692. Or, if you're a Spanish speaker, C-O-V-I-D-E-S-P to 692-692.” The more people who do that – and it's hundreds of thousands already – but the more people who do that, the better off we'll be in terms of ensuring that people are getting real accurate information quickly. But it's also a heads-up. The alert will send at six o'clock, which will be in both English and Spanish, is a heads-up to people that given the severity of crisis, they can expect those more serious alerts from time-to- time and to get ready for them.

Before I turn to Dr. Cohen and Dr. Katz, just a few reminders again, if you are sick - stay home. If anyone in your family is sick, they need to stay home. If you're sick, take those three or four days. If you don't get better, call a doctor. Do not go to the emergency room unless it is truly an urgent and immediate emergency. We have to protect the ability to help those who are in greatest danger and everyone has a role to play in that.

And again, the current rules in effect always potentially subject to change. We want as many people in general to stay home as possible. We want everyone who can telecommute to telecommute and when you're trying to figure out what's an appropriate activity or not, the general rule is stay home - when in doubt stay home. But there are exceptions, Dr. Barbot delineated them yesterday. Obviously, if you need to go out and get groceries, that makes sense. If you need to get to the pharmacy for medicine, that makes sense. If you need to get clean clothes, that makes sense. If you need to get some exercise or take your dog for a walk, that makes sense while you're doing all these things, practice social distancing. Keep three to six feet apart from everyone around you to the maximum extent feasible and when you don't need to be outside, get back home and those are simple rules and we'll keep updating people on them as we go along.

There's a big share of personal responsibility in all of this is not going to be easy. This is going to be a long battle, but New Yorkers are the toughest and the most resilient people in this nation. If any place can handle Corona virus, it's New York City. But I always say behind our tough exterior's beat hearts, gold. New Yorkers are very compassionate people. Look out for those in your life – seniors - look out particularly for those over 70, if they need food, if they need prescriptions, if they need help, let's be there for them. Look out for folks who have those preexisting conditions. If we help each other, we will get through this. I'm absolutely convinced if New Yorkers do what we did after Sandy after 9/11, so many other times, we will get through this, but we all have to do it together.

With that and I just want to thank you, Dr. Cohen and everyone at BioReference laboratories. I am I literally want to thank you on behalf of 8.6 million New Yorkers. You are the cavalry who has rode to the rescue here and we are eternally grateful. And Dr. Cohen, I'd love you had talked to everyone about the new capacity you're bringing online and the work we will all be doing together. Thank you.

Dr. Jon Cohen, BioReference: So, thank you, Mr. Mayor, first off for your leadership and the privilege actually to serve. I can assure you that the folks at BioReference I can tell you have been working 24/7 for literally the last ten days to get up to capacity for what we think is going to be needed and beyond. So first you know, we take this responsibility incredibly seriously and believe that the private sector is here to assist government and government agencies to combat this epidemic. Second, in particular supporting the Health + Hospital Corporation as the largest public health system in the country. And, of course, serving New York City, serving the most vulnerable and at risk populations in this city is something we think is incredibly important for the private sector to step up to and be part of. Third finally as a physician I take this personally. And what I mean by that is I want to make sure that every one of those front line physicians, nurses, health care workers that are actually putting their lives and their risk in the front to get these people done, to get these people healthy, have everything that they need and in our case, the testing ability and to bring that testing ability to them in the most timely fashion so that they can take care of their patients. We will, as we've stated, we have committed to testing 5,000 patients a day and as a result of that, we will ramp up for them as needed in the next couple of weeks.

Mayor: Doctor, thank you again. We really, really appreciate the collaboration and the partnership and we've got a long battle ahead, but it is great to have you and your colleagues on our side. I want to turn to Dr. Mitch Katz, CEO of Health + Hospitals. And obviously he will describe what this new testing will mean for all of the people who work in Health + Hospitals and their ability to serve people in greatest need. 

President and CEO Mitchell Katz, Health + Hospitals: Thank you Mr. Mayor and thanks to you and Dr. Cohen for providing us this capacity for testing. For people who need to better understand why this is so important —remember that not everybody who has respiratory distress has COVID-19. Some people may be suffering from heart disease with it worsening. Some people may have bacterial pneumonia. These are illnesses that typically affect hundreds of people every day at hospitals that we run. What we need to be able to figure out is which seriously ill people have COVID-19 and as quickly as we possibly can. This capacity will assure that we're able to test all seriously ill patients and equally important, it will cut in half the wait time to a final response. So, we will know for sure that the patient is COVID-19 positive or negative and that will greatly improve our clinical care. Let me just say though that while this capacity is wonderful, it is meant for people who are sick and need services at a hospital. The City is working extremely hard and the Mayor's done great efforts on being able shortly to massively expand capacity for testing people who are not symptomatic at other facilities that will be created in non-hospital spaces so that people can be tested in the safest place possible as quickly as possible.

But I'd like to ask all my fellow New Yorkers on behalf of their parents, on behalf of their grandparents, on behalf of people that they know, who have serious health conditions, that right now we need people who are asymptomatic to stay home. We need people with minimal symptoms in the first three days to stay home. We are preparing to take care of anyone who has serious symptoms, people whose symptoms have not gone away after three or four days. And that will all be helped if people who are currently without symptoms or with minimal symptoms will await the greater expansion of testing for them. Thank you.

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