Saturday, April 4, 2020

Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces 1,000 Ventilators Donated to New York State


  Let's go through some numbers. The increase continues. We're up to 10,482 cases. 23,000 people were tested yesterday, that's the highest number of testing we've ever done. That's good news. 283,000 total tested. Number of new cases, 10,841. New high. Total hospitalizations, 15,000 people currently hospitalized, 4,000 ICU patients. 10,000 patients discharged, right. That's the good news. Number of deaths, all-time increase up to 3,500, 6,500. Most impacted states, you see New York at the top again. New Jersey has a serious problem in New Jersey and a growing problem. Then Michigan, then California, then Massachusetts. Total number of hospitalized is down a blip, but we believe that's not statistically meaningful. You have the number of ICU cases are up. The number of intubations are up.

The number of discharges are also up. And this is interesting, two thirds of the people who have been hospitalized have been discharged. Okay? Two thirds of the people who have been hospitalized have been discharged. That's what we've been saying all along. Most people won't be hospitalized. People who are hospitalized will come in, be treated, and leave. That's two thirds. One third of that number has a serious condition which will require continued hospitalization. We're tracking the growth of the number of infections by hospital, and we can see just where the numbers are increasing.

We've been talking about hitting the apex. The apex is the point where the number of infections on a daily basis is at the high point, and that is the ultimate challenge for the healthcare system. Can we handle that number of cases at the high point of the curve? I call it the battle of the mountaintop because that's what it's going to be. That's going to be the number one point of engagement of the enemy. By the numbers we're not at the apex. We're getting closer, depending on whose model you'll look at. They'll say four, five, six, seven days. Some people go out 14 days. But our reading of the projections is we're somewhere in the seven-day range, four, five, six seven, eight day range. Nobody can give you a specific number, which makes it very frustrating to plan when they can't give you a specific number or a specific date, but we're in that range. So we're not yet at the apex. Part of me would like to be at the apex and just let's do it, but there's part of me says it's good that we're not at the apex, because we're not yet ready for the apex, either. We're not yet ready for the high point. We're still working on the capacity of the system. The more time we have to improve the capacity of the system is better, and the capacity of the health care system, beds, staff, equipment. We'll be doing a conference call with all the hospitals today to coordinate deployment of the equipment.

Watching the spread of the rate of infections is interesting. This chart is what we've been talking about, but you can see it here. The upstate number is the top bar. The rest of New York has been fairly constant, 4%, 5%, 4%, 5%, Westchester, Rockland 8%, 6%, 6%, 7%, 7, 7. Long Island is the area that is growing. You see Long Island goes from 16% to 17% to 18%, to 19 to 20 to 22%. New York City is actually dropping as the number of cases in Long Island increases, as a percentage of cases within the state. For us, this is about tracking the virus, tracking the spread of the virus, and then deploying as the numbers suggest.

In terms of beds, the 2,500-ed facility at Javits is going to make a major difference. That has to work. The White House agreed to make that a COVID-positive facility. Remember, originally the Javits Center, which is a state convention center, we worked with the federal government, they constructed a 2500-bed facility, it was supposed to be non-COVID. I spoke to the president, transferred that with his intervention to a COVID facility. The federal government will staff that and the federal government with equip that. That is a big deal because that 2,500-bed facility will relieve a lot of pressure on the downstate system as a significant number of beds and that facility has to make that transition quickly and that's what we're focused on. It's going to be very staff intensive, very equipment intensive but the theory there is the best we can to relieve the entire hospital system downstate by bringing those COVID patients to Javits and from the intake to the treatment and it's going to be very difficult to run that large a facility. But if that works and that works well that changes the numbers dramatically so that's a top focus for us. I spoke to the White House today on planning the logistical operation to get that up and get that running asap, and that's the top operational priority.

In terms of staffing, we have 85,000 volunteers, 22,000 out-of-state volunteers. How amazing is that? 85,000 volunteers. I'm also signing an executive order to allow medical students who are slated to graduate to begin practicing. We need doctors, we need nurses, so we're going to expedite that.

On ventilators, remember, we ordered 17,000 ventilators. To give you an idea of how many 17,000 is, the federal stockpile was about 10,000 ventilators for the nation. We ordered 17,000 just for the state of New York. When we ordered the ventilators we were paying for the ventilators. So, trust me, you know the financial situation of the state. We were not looking to spend a penny that we didn't have to spend. We placed that order for the ventilators and we were paying for that order. That order never came through. This goes back to the China situation. We had signed documents, we placed the order,Governor Baker talks about this in Massachusetts. But then you get a call that says we can't fill that order because you had all that demand going in. So, what do we do? We find what equipment we have, we use it the best we can. If you ask hospitals today what ventilators do you have that are unused and available that they don't need in the short term and take 20% of that number of available ventilators, that's 500 ventilators. 500 ventilators is a significant number now. China is remarkably the repository for all of these orders. Ventilators, PPE, it all goes back to China. Long term, we have to figure out why we wound up in this situation where we don't have the manufacturing capacity in this country. I understand supply chain issues, I understand the cost of manufacturing, but there's a public health reason, as we've all learned the hard way, why we need the capacity in this country to do this.

Anyway, it all comes back to China. New York has been shopping in China. We're not really China experts, here. International relations is not what we do on a daily basis. I've been to China before when I was HUD secretary, I did a trade mission with China. So, I have a basic understanding, but we went to the Asia Society to help us navigate China. I asked the White House to help us navigate China. I spoke to the ambassador and we got really good news today. That the Chinese government is going to facilitate a donation of 1,000 ventilators that will come in to JFK today. I want to thank Joe Tsai and Clara Tsai and Jack Ma from Alibaba, and the Nets, but I'm not stating a preference, for their donation. That's going to be very helpful and I want to thank Ambassador Huang very much for his help in making all of this happen because this is a big deal. It's going to make a significant difference for us.

Also, the state of Oregon contacted us and is going to send 140 ventilators, which is, I tell you, just astonishing and unexpected. I want to thank Governor Brown, I want to thank all of the people in the state of Oregon for their thoughtfulness. Again, this was unsolicited. But the 140 ventilators will make a difference. I was thinking about it, on behalf of New York and what it means for our - first it was a kind gesture. I know Governor Brown and she is a kind person, but it's also smart from the point of view of Oregon. Why? Because we're all in the same battle and the battle is stopping the spread of the virus, right? Look at what they did in China. It was in the Wuhan province. First order of business was contain the virus in Wuhan. Why? Because you want to contain the enemy. That's always the first step. Oregon, we're dealing with it now, we don't stop the spread in New York, it continues. And if you look at the projections, Oregon could have a significant problem towards May. Our problem is now. So it's also smart from Oregon's self-interest. They see the fire spreading. Stop the fire where it is before it gets to my home. That was the Wuhan province.

Somebody sent me a great quote from FDR, who had such a beautiful way of taking complicated issues and communicating it in common-sense language. FDR was dealing with trying to get the lend-lease program approved and accepted by the public. Why would this country help another country fight its war? That was the lend-lease program. His point was it's a common enemy. We want to contain the enemy. That other country's fight is actually our fight. If we don't stop the spread then it's going to burn down our own country. But this is how he does it, right? The concept is right, but how does he explain that? Suppose my neighbor's home catches fired and I have a length of fire hose 400, 500 feet away. If he can take my garden hose and connect it with his hydrant, I may help him put out his fire. Now what do I do? I don't say before that operation, neighbor, my garden hose cost me $15, you have to pay me $15 for it. What is the transaction that goes on? I don't want the $15. I want my garden hose back after the fire is over. All right, if it goes through the fire all right, intact without any damage to it, he gives it back to me, and thanks me very much for the use of it. But suppose it gets smashed up? Holes in it during the fire. We don't have to do too much formality about it. But I say to him, I was glad to lend you that hose. I see I can't use it anymore. It's all smashed up. He says how many feet of it were there? I tell him 150 feet of it. He says, alright, I will replace. Now, if I get a nice garden hose back I am in pretty good shape.

The State of Oregon has lent us 140 ventilators. It was kind, it was smart, stop the virus here. It's better for the state of Oregon, it's better for the nation. Their curve comes after ours. We'll return their 140 ventilators, and there's never been a discussion, but frankly I know New Yorkers and I know New Yorkers' generosity. We will turn it double fold, because that's who we are and that's what we believe. So, stop the fire in New York, kind, generous, also smart.

Personal opinion, look I want this to be all over. It's only gone on for 30 days since our first case. It feels like an entire lifetime. I think we all feel the same. This stresses this country, this state, in a way that nothing else has frankly, in my lifetime. It stresses us on every level. The economy is stressed, the social fabric is stressed, the social systems are stressed, transportation is stressed. It's right across the board, but the most difficult level is the human level. It is for me, anyway. It's every day, and it's everywhere. My brother catches the virus. That's stressful. My mother is worried about my brother, and she's concerned. We have a birthday party yesterday for Stephanie, was standing around a cake. 

Everybody's six feet from each other in this bizarre supposed to be just a fun usual celebration of a birthday. My daughter's cousin has a tragedy and that's just emotionally very painful. They can't hug each other and hold each other. They can't even grieve together. The cyberchats, I mean, this is so emotionally taxing that you can't even begin to -- you can't quantify the effect on society and the effect on individuals. And the burden that we're dealing with.

So, yes, I want it over. If there was anything I could do to accelerate getting it over, I would. In some ways I want to get to that apex, I want to get on the other side of the apex and let's just slide down that mountain. On the other hand, we have to be ready for the fight and we have to handle that fight. That's where we are. So, what do we do? You have to get through it. You have to get through it. There is no simple answer here. You're not going to wish this away. You have to get through it. You have to get through it intelligently, saving as many lives as you can. That's hard work, and that's perseverance, and that's mutuality and that's community, and that's finding your better self, and that's finding inner strength and dealing with a situation that is almost unmanageable on every level. Because you are out of control. This is a painful, disorienting experience, but we find our best self, our strongest self. This day will end and we will get through it and we will get to the other side of the mountain. And we will be the better for it. But we have to do what we have to do between now and then. That's just what we're doing here.

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