Monday, April 13, 2020

Governor Cuomo Holds a Briefing on New York's COVID-19 Response - 4/13/2020


  Let's give you some facts. Plain truth facts. Here's the good news: The curve continues to flatten. We've talked all along quote, unquote the experts said there were two possibilities. You could have a high point and an immediate drop off or you could have a plateau. It appears that we have a plateau. It's flattening, it's the flattening of the curve. The increase has slowed down. It flattens out for a period of time. Nobody knows how long because no one has been here before. If you look at the number of total admissions, 18,000, 18,000, 18,000 - that's definitely a flattening. That is good news. Still going up a little bit, by the way, but a basic flattening as opposed to increasing gaps.

The total number of hospitalizations net down, a little bit up, a little bit down. Overall, just follow the line, don't get caught up in the day-to-day. As we say, the three-day rolling average, which is more accurate than any one-day is down again. The net change in ICU admissions is down. Again, I discount these ICU admissions because the old demarcation of an ICU bed in the hospital and a regular bed in a hospital is gone. Almost every bed is an ICU bed. Net change in ICU admissions is also down.

Intubations is real. Intubations is the worst signal. People who are intubated wind up on a ventilator, most often do not come off the ventilator. Some are 70 percent, 80 percent depending on who you talk to. This is a scary number. When that's down, it's good and that is down. The three-day rolling average is down. So that's good news. We were worried about the spread from New York City to suburbs upstate and we have been very aggressive when we get a little cluster spot that's acting up. We jump on it. This is like watching a fire going through dry grass with a strong wind and it's blowing the fire and a couple of embers wind up on one side of the field. The embers start to catch fire and that's a cluster and you have to run over to those embers and stamp them out right away before they grow. You see the stabilization there. That has been good too.

This is a new take on it, we talk about net hospitalizations. This is the number of new COVID hospitalizations to-date. This is how many new COVID diagnosis or people walking into the hospital had COVID. So you see still about 2,000 people per day are walking in or being diagnosed with COVID. You're still increasing the hospital population. Initially, by 2,000 people who are testing positive for COVID, but on the other side of the health care system, people are being discharged on the other end.

The net is what we talk about because we've always been worried about lack of capacity in the hospital system where you pour the water into the glass and the glass overfills. Where the hospital system can't handle the number of people coming in. That's why we've been studying the net. This says, take a deep breath. You still have 2,000 people per day who are coming in to the hospital system.
The terrible news is as terrible as it gets and the worst news I've had to deliver to the State as Governor of New York and the worst news I've had to live with on a personal level. Number of deaths is 671. Not as a bad as it has been in the past, but basically flat and basically flat at a horrific level of pain and grief and sorrow. This is 671 people who passed away on Easter Sunday. For me - I'm Catholic - Easter Sunday is the high holy day in many ways, one of the high holy days, and to have this happen over this weekend is really, really especially tragic and they are all in our thoughts and prayers.

That raises the death total to 10,056. Again, for perspective, 10,000, 2,700 lives were lost in 9/11 and 9/11 changed every New Yorker who was in a position to appreciate on that day what happened. The number of lives lost was horrific after 9/11 and the grief was horrific. We are at 10,000 deaths. New York, 10,000 deaths, New Jersey, 2,000 deaths, Massachusetts, 756, and then you have the state of Michigan.

Why New York? Why are we seeing this level of infection? Well, why cities across the country? It's very simple. It's about density. It's about the number of people in a small geographic location allowing that virus to spread and that virus is very good what it does. It is a killer. It is very good at spreading. It is very contagious and the dense environments are its feeding grounds. We learned that lesson very early on. Remember, we had one of the first hot spots in the nation. One of the most intense clusters was New Rochelle, New York. New Rochelle is in Westchester County. It's not in New York City. Why New Rochelle? That's what I was so concerned about early on. We didn't know what we were looking at. Why New Rochelle, because in New Rochelle one person or two people who were infected were in dense gatherings with hundreds of people and it spread like wildfire.

So it's not just a dense city or a dense community. It's any person in a dense environment. You can be in a very rural county. You know, people think New York is all New York City. No, no. We have counties that have more cows than people by population. You can be anywhere. If you have one person who is infected in a room of 200 people, 300 people, 400 people, now you have a problem.
This goes back to the Spanish flu where some cities canceled parades. Other cities didn't cancel parades. We went through these numbers when we had the decision on St. Patrick's Day parade, which Bernadette still will not forgive me for, but you can have a parade in a relatively small city but you bring people together and this virus has a feeding frenzy.

Where do we go from here? Question of reopening which everyone wants to do and everybody wants to do yesterday. I am at the top of that list. We have to understand on the reopening, as much as we have this emotion, we want it to happen and we want it to happen now and we can't take this anymore and everyone feels the same. It is a delicate balance. Remember what we have to do on reopening. And remember, it has never been done before. None of this has been done before. Anyone who says to you, oh, I know what we should do. I know. Yeah, you don't know because nobody knows and that's the one thing that we have learned over and over again. And this place has never done this before. Also, you look around the world, you see warning signs from countries who have opened.

My point is to our team, I want to learn from those other countries frankly and I want to make sure we know from our studying and assessment of what's going on in other countries what worked, what didn't work, and let's learn from those lessons. You can now go back and look at Wuhan province and look at Italy and look at South Korea and see what they did and see what worked and what didn't work so let's learn. So we'll listen to the experts, we'll follow the data. But remember this is a delicate balance. What are we doing on reopening? We are easing isolation. We want to increase economic activity. That will happen essentially through a recalibration of what are essential workers.

Remember, we never turned off the economy. The economy is still functioning. You can get in your car, you can get gasoline, you can go to the grocery store, you can shop, youcan get on a bus. The economy is functioning. We never turned it off. We turned it way, way down, and it's just the essential services that have been operating, but the essential services have all been operating. What you will be doing in essence on the reopening is recalibrating what is essential. You'll start to open that valve on the economic activity. And you'll turn that valve very slowly, reopening the economy, more essential workers, do it carefully, do it slowly, and do it intelligently. More testing and more precautions at the same time that you're opening that valve. More testing so you have more information about who should be coming in, et cetera. More precautions because you know that works. As you're calibrating and opening the valve.

And while you're opening that valve, watch the meter. What's the meter? The meter is the infection rate. The meter is those daily hospitalization rates. And there is a cause and effect. You have density, you have more people infecting other people, you will see it within a matter of days in that hospitalization rate. So yes, open the valve. Slowly, advised by experts. Keep your eye on the meter. The meter is the infection rate. And watch that infection rate. And if you see that infection rate start ticking up, which would be undermining everything we have accomplished thus far, then you know you've opened the valve too fast. That is the delicate balance that we have to work through. And that is what has never been done before. And nobody can tell you today, I know how to do that, because it just hasn't happened.

So what do we do? First, come up with a reopening plan. I'm not interested in political opinions. I'm interested in what the experts say about this. To the best they can tell you, but, you have public health experts. They can study South Korea. They can study China. They can study all the data that we have. You have economic experts that can help you decide what is the next notch of essential workers that can actually start the economy back up and have a consequential change. But that is a real plan, and that has to be developed, and that has to be smart. The why did the geographic area for that plan the better? Because this virus doesn't understand governmental boundaries.

Well, I'm Westchester County, so this virus has to stop before entering here and follow my rules. No. The virus follows its own boundaries and its own guidelines and it doesn't have any. The geographic area that is an economic area, a workforce area, a transportation area, that's the relevant area that we have to be looking at. You have to coordinate all these systems. You can't start one system without starting the other systems. You can't start the economic system without starting the transportation system. And if you can't run the transportation system, then you can't reopen the economy, just doesn't happen. You have to coordinate the schools with the transportation with the economic system. These systems work in coordination. They're big gears and each gear intermeshes with the other gear. And you can't start one gear with the other gear stopped, right? That's the coordination.

You're going to need federal support, and you're going to need smart legislation passed by the federal government that actually attends to the need, as opposed to normal political considerations.

Testing is going to be key. That's a new frontier for us, also. This state is probably the most aggressive state in the nation in actually getting the testing up. We test more than any other state. We test more than other countries. We test more than the other leading states combined in testing. But, that's still not enough. We have to do more.

We know that the precautions work. The masks work, the gloves work, the temperature taking works. It's abnormal, it's different, but it works, and we have to do it. While we're doing this, we have to remember to stay the course and not jeopardize what we have achieved - and we have achieved much.

This afternoon I'll be joined by other governors. We've been talking to other states - Connecticut, New Jersey, Pennsylvania, Delaware, Rhode Island - for the past couple of days about how we come up with a reopening plan and can we work together on a reopening plan. We'll be making an announcement this afternoon with other governors about just that, the reopening plan.

As I said, the optimum is to have as coordinated a regional plan as you can. I understand intergovernmental coordination can be somewhat of an oxymoron, but to the extent we can work with Connecticut and New Jersey and Rhode Island and Delaware and Pennsylvania, I want to. It is smarter for everyone. For people of their state and for the people of my state. This is a time for smart, competent, effective government. Nothing else matters. I want to make sure that I can say to the people of this state, we did everything we could to the best of our ability and the optimum is a geographically coordinated plan. I don't believe we could ever get to totally coordination with the other states because all those states have little different set of circumstances and facts - I don't even believe we should have a uniform plan without recognizing the state by state distinctions. But, to the extent we can coordinate, we should and we will.

Last point, and this is a personal point, when is it over? I have this conversation a hundred times a day. I had it last night with my daughters. When is it over? It's a difficult conversation because people want it to be over so badly, right? I want the fear to stop, I want the anxiety to stop. I don't want to have to worry about my brother anymore. I don't want to have to worry about my daughters. I don't want to have to worry about my mother. I want it over. I want to get out of the house. I want to get back to normalcy. I've been living in this weird, disorienting, frightening place. I'm afraid to touch people. This violates the human behavior and needs. When is it over? It's not going to be over like that. It's not going to be we flick a switch and everybody comes out of their house and gets in their car and waves and hugs each other and the economy all starts up. I would love to say that's going to happen. It's not going to happen that way. It can't happen that way. Can it happen in some communities across the country, where frankly, they have very low infection rates and they could come up with a testing regime where if they find one or two cases they quickly jump on those one or two and they isolate and they track? Yes. But is that going to happen here? No. Is that going to happen in any community that has a significant issue? No. There is going to be no epiphany. There is going to be no morning where the headline says, "Hallelujah, it's over." That's not going to happen.

What will happen, is there'll be points of resolution over time. What does that mean? There'll be points of resolution. There'll be points where we can say we've accomplished something, we should feel better, we should feel more calm, we should feel more relaxed. It will be incremental. We're controlling the spread. We are controlling the spread. You look at those numbers, you know what it says, we're controlling the spread.

I was afraid that it was going to infect my family no matter what I did. We're past that. If you isolate, if you take the precautions, your family won't get infected. We can control the spread. Feel good about that. Because, by the way, we could have gotten to the point where we said, we can't control this damn thing. We can't control it. It's in the air. It gets into your house. It doesn't matter. You close the door, it comes under the door. You could have gotten there. We're not there. Those numbers say we can control the spread. Feel good about that.

The worst is over. Yeah, if we continue to be smart going forward because, remember, we have the hand on that valve. You turn that valve too fast, you'll see that number jump right back. But, yes, I think you can say the worst is over because the worst here are people dying. That's the worst. The worst doesn't get any bad than this worst. And this worst is people dying. That's the worst.

And Winston Churchill, I mentioned the other day, the end of the beginning. Yes, we can control the spread, and we can reduce the number of people who die and our health care system can do phenomenal work and rise to the occasion and deal with this beast. It has not overwhelmed the health care system, we have controlled the spread and there's confidence to be taken in that. And that's an accomplishment. And it was a heck of an accomplishment. Those health care workers for the rest of my life I will say nothing but thank you to them. And I was not sure we could keep the tide from overwhelming our hospital capacity and they did. Feel good about that.

I believe the worst is over if we continue to be smart. And I believe we can now start on the path to normalcy, and we can have a plan where you start to see some businesses reopening, understanding the delicate balance. I think there will become a point where there's an announcement that we have a medical treatment that you can get sick, but they found an anti-viral medication that can help you treat the disease. So, take another deep breath when we get to that point because, okay, you get infected but there is a drug regimen that can help you. And then you'll get to a point where they announce we have a proven vaccine. That's when it's over. That's really when it's over. They have a vaccine, it's been tested, it's been proven, they can produce it, you're going to get a vaccine, this is the thing of the past, don't worry about it, close the chapter, move on.

Okay, when do we get there? Twelve months to 18 months. I can't believe you said 12 months to 18 months, as Cara said to me. Its 12 months to 18 months. When Dr. Faucisaid how long until a vaccine, he says 12 months to 18 months. When the FDA is asked, how long until you get a vaccine? They say 12 months to 18 months. That's the point - - when you ask me when can I do a deep breath for the first time in five weeks? When they say we have a vaccine. That's when it is over. But, there will be points between now and then when we should feel more confident and we should feel better.

"Well, I want it to be over tomorrow." I get it. I want it to be over tomorrow. I want it to be over tomorrow more than you want it over tomorrow. But that's not reality, so let's calibrate our expectations. In the meantime, stay the course because we have accomplished a lot through heroic efforts of health care workers, police officers, transportation workers who showed up to drive those trains and buses every day. I mean, people just doing extraordinary, brave, generous, courageous things every day. Literally putting their lives at risk for the public. And we have flattened that curve by people's actions, which remember is why those projection models were all wrong. The projection models were high, they weren't wrong. That's a bad word. What they were saying, this is where the infection will go if unabated. What's the question mark on whether or not you can abate it?  Can you put forth a government policy, but more, will people listen to the government policy?

You have 19 million people in New York. I can stand up here all day long and say you must social distance, you must stay home. If New Yorkers don't believe it, if Americans don't believe it, if they question their government, if I don't have credibility, why do I stand here and go through all the facts? I am not asking any New Yorker to take my word for anything. I'm not asking any American, take my word for it. Here are the facts. I'll give you the facts. The good facts, the bad facts, the ugly facts, you get all the facts. You tell me, you decide. They decided on the facts they would comply and they've done things I would have never dreamed that they would do. And they've actually made significant progress. Do not reverse the progress that we have made in our zeal to reopen and get back to normal. That's going to be the challenge going forward. But we'll do it because we are New York tough and tough is not just tough. We know what tough is. But tough is also smart and tough is also united and smart -- tough is also disciplined and tough, most importantly, is loving. While that sounds counterintuitive. They sound repugnant. No, no, no, no. Toughest people are strong enough to say love, the toughest people and that's New Yorkers.

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