Showing posts with label Governor Cuomo Announces New Hospital Network Central Coordinating Team. Show all posts
Showing posts with label Governor Cuomo Announces New Hospital Network Central Coordinating Team. Show all posts

Tuesday, March 31, 2020

Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces New Hospital Network Central Coordinating Team


  Let me go through where we are today on the numbers. Give these people an update. The number of cases still going up. We're all in search of the apex and the other side of the mountain. But we are still headed up the mountain. Number of people tested last night was a near record amount. We tested over 18,000 people. We're testing more people than any state in the country and I'm very proud of that. More per capita than China and South Korea.

Total number of people tested, 200,000. Population of 19 million, is not going to give you a random sample, but it's been helping us track down on the positive cases. Number of positive cases, 9,298. Total cases 75,000 cases. You see the predominance in New York City, then Westchester, then Nassau, then Suffolk, then Rockland. So you can see it's that area of density. It spreads out from that area of density. The march of coronavirus across the State of New York continues. We're down to just two counties that don't have a case. The overall numbers, 75,000 have tested positive. Ten thousand people in our hospitals, 2,700 ICU patients. Good news, 4,900 - almost 5,000 - discharged. That's up 771. So people come in, they get treated, they go home.

New York is at 75,000 cases. Next state is 16,000. California is at 7,000. So you can see New York, there's a magnitude of difference more than any other state. Fifteen-hundred fifty deaths. That's up from 1,218 yesterday. Again, we're studying the charts. We're trying to study the data, follow the data. The data is uneven. It bounces. Numbers often bounce in any model. There are variables in this model. The hospitals are reporting it, so what every hospital reported, were they busy, are they combining a couple of days in one? It's an imperfect reporting mechanism.

You see the basic line is still up. What the statisticians will tell you is you basically draw the straight line that columns indicate and you see that we're still going up which is what we see on the overall trajectory, that we're still going up. Number of intubations was down, not much, but it was down and that's a good sign. You also see the number of discharges going up and that's consistent. The longer people are in, they either get treated and leave or they get put on a ventilator and the longer you're on a ventilator, the less likelihood you will come off the ventilator. That is the blunt truth of this situation.

We have two missions overall that we are pursuing. One is the front line of this battle is our hospital system. That's where this is going to come down to. The second is social responsibility. Stay at home. Don't get infected in the first place. Don't get infected in the first place because it goes back to you're creating a burden on our health care system that our health care system cannot handle. We're talking about exceeding the capacity of our hospital system by some estimates, 2 times. So what does this come down to besides all the other issues? It comes down to not overwhelming the hospital system because those people who need acute care may not be able to get the acute care. So it's all about the hospital system. That is the front line.

What we're doing is we are following the mathematical projections of the experts. We're speaking to all the health care professionals, all the health care providers. World Health Organization, National Institute of Health, Dr. Fauci, CDC, FDA - the whole alphabet soup of health care experts and the mathematicians who then have different models. We talk about five different models and compared the models and tried to find the median through the models. That's how we plan everything. Follow the data, follow the science. People ask me, "What do you think, what do you think?" I don't think about this. What do I know? I'm not an expert. I'm not opining. I talk to experts and I follow people who know.

But for the hospitals procure equipment, identify the beds, support the staff, that's what it's been all about. Of those priorities number one is support the staff. They are the front line and they need relief. They are physically exhausted even more they are more emotionally exhausted. This is unlike any other disasters. Hurricanes, earthquakes, floods - they happen, they are fast, they're over, you start rebuilding. This is different. This is ongoing and the duration itself is debilitating and exhausting and depressing. I'm speaking to healthcare professionals who say, "Look, more than physically tired I'm emotionally tired seeing the pain and death that they are dealing with every day."

In general, I am tired of being behind this virus. We've been behind this virus from day one. The virus was in China. We knew it was in China. Unless we assume there's some immune system variation with Asian people, it was coming here and we have been behind it from day one since it got here and we've been playing catch-up. You don't win playing catch-up. We have to get ahead of it. The second rule is never underestimate your opponent, and we underestimated this virus. It's more powerful, it's more dangerous than we expected, and the third point is plan forward. Get ahead of it. Get ahead of it, fight the fight today, yes, but anticipate the next battle and plan for the next battle.

And the main battle is at the apex. We're still going up the mountain. The main battle is on the top of the mountain. That's where the main battle is going to be. The apex of the curve and then we come down the other side of the mountain. We are planning now for the battle at the top of the mountain. That's what we are doing. Get a staffing plan ready now for the battle at the top of the mountain. Equipment stockpile now - we're gathering equipment that we don't need today because today is not the day of the battle. The battle is when we hit the apex, depending on who you believe, 14 days to 30 days from today.

And also we need a social acceptance of the time expectation. We're all anxious. We're all tired, we're all fatigued. It's been all bad news for a long time. Our whole lifestyle has been disrupted. Everybody knows wants to know one thing, when is it over, nobody knows. Well, President said by Easter; this one said by this - nobody knows. You can have a hypothesis, you can have a projection, you can have an opinion but nobody knows, but I can say this, it is not going to be soon. If our apex is 14 to 21 days, that's our apex. You then have to come down the other side of the mountain once you hit the apex, so calibrate yourself and your expectations so you're not disappointed every morning you get up.

Yesterday we met with the entire state hospital system, Dr. Zucker and our team - first time they were all in one place. And we said to the hospital system, "Look," what I just said to you, "We are dealing with a war, we are dealing with war we've never dealt with before. We need a totally different mindset. We can't do business the way we have always done business - we need unprecedented sense of cooperation, flexibility, communication and speed." And that's what we talked through yesterday, and we have to do it now. The healthcare system is one of those balkanized systems - it's like our state education system, it's like our criminal justice system. It's in place. It's fragmented. They have their own identities, their own associations, it's regionally organized. That all has to change.
We don't have the ability to meet the capacity of our healthcare system as an entirety. That assumes the healthcare system is working as an entirety. That's not how the healthcare system is organized now. We have New York City hospitals, and then we have Long Island hospitals, and then we have Westchester hospitals, and then we have upstate hospitals -- that has to go. Even in New York City you have two basic hospital systems in New York City: you have the private hospitals, voluntary hospitals, about 160 of them, which are some of the finest healthcare institutions in the United States of America. You know, this is Mount Sinai, Columbia Presbyterian, et cetera. Some of their members are also upstate, but they're the large, private institutions. Greater New York Hospital Association, Ken Raske runs that association of 160. 

You then have in New York City the public hospitals, the New York City Health and Hospital Corporation. They are eleven public hospitals. They are a universe, and then you have the private hospitals as a separate universe. The eleven public hospitals are the hospitals that in many ways have always been under greater stress and greater need. We have to get those two systems, the private system and the public system in New York City, working together in a way they never did before. The distinction of private-public, that has to go out the window. We are one healthcare system. On top of that, it can't be the downstate hospitals, and the upstate hospitals, and the Long Island hospitals. When we talk about capacity of beds, when I say we now have 75,000 beds, that's a statewide number. That means those beds have to be available to the people in New York City or Nassau even if those beds are up in Albany.

So, combining that whole system, and you're no longer just the Western New York hospitals, or the Central New York hospitals; it's one coordinate system. It's much easier said than done, but we have to do it. On top of that, you have to overlay the new federal beds that came in that are an entirely new component. We have Javits Center -- 2,500 beds. We have the USNS Comfort -- 1,000 beds. We're planning other federal facilities. These all have to be coordinated on top of the existing hospital network. So, you see the organizational situation that we're dealing with. And let's be honest and let's learn from the past, we know where we have to focus. We know where we're going to have problems in the next hospitals because the hospitals that have the least capacity that have already been stressed are the hospitals that are not going to be able to handle the additional load. That is a fact. You know which hospitals are struggling. We do reports all the time about the financial capacity of hospitals and what hospital are in stronger versus weaker position.

The hospitals that are in a weaker position are the hospitals that are going to suffer when they then carry an added burden. That was Elmhurst hospital. It happened to be a public hospital. It happened to be a public hospital in a place of density. It happened to get overwhelmed and that's what then you saw the burden on the staff. You saw the emotion. You saw the stress. That can't happen, and that's what we talked about yesterday. And people said, "Well, Elmhurst isn't my responsibility. Elmhurst is a public hospital; the City runs it. I don't run it. It's New York City, its' not a private hospital." I don't care which link breaks in the chain. The chain is still broken. It doesn't matter which hospital, which link. Any link breaks, the chain breaks. The healthcare system is a chain; it breaks anywhere, it breaks everywhere.

That has to be our mentality. We laid out a full plan on how to do facility development, how to move people among hospitals so nobody gets overloaded, shifting patients, shifting staff, shifting supplies. None of us have enough supplies. Okay, then let's pool our supplies and let's put them out for the people who need them. Just because one hospital happened to have found a vendor from China who delivered 5 million masks, let's share those masks. And we talked about that yesterday.

We also talked again at length about ventilators which everybody knows is a key piece of equipment, identifying all the ventilators in the state, who has them, who has them in a stockpile, who ordered them, who expects them to come in and we'll have one stockpile of ventilators that we can distribute for everyone who needs them. We also talked about splitting of ventilators because that's a technology that does exist. It's been used before. It's not ideal. You take one ventilator and it's used for two patients.

The federal government is a partner in this obviously. I spoke to the President again yesterday about this situation. I spoke to the Vice President. I spoke to Jared Kushner. The White House has been very helpful. We have to get the federal agencies on the ground to understand how this operates, especially FEMA, because we have to be coordinated and people have to know what they're doing and this is no time for anyone to be learning on the job. And we're going to be working through that today. PPE, same thing. We want to know what everybody has. One stockpile, we'll distribute it fairly.

Testing, how do we get, when does this end? This ends when we get a fast track test, an at home test, 15-minute test, and people can find out when they can go back to work because they're negative. We're working on additional testing. As I said, the department of health has a new test, but that's when this ends.
We're also working on the new medications. We're leading the country in many of these developments. We have saliva testing. We're working on the antibody testing and plasma testing at the same time.

We put together an essential coordinating team. It's going to be led by the Department of Health. Westchester is on it and Greater New York, New York City is on it, Long Island is on it. If the federal government is going to participate they have to be part of this team because we have to know what we're doing and I don't want FEMA coming in and blowing the coordination of what everyone is trying to do.

The coordinating team is going to organize upstate-downstate transfers, set patient loads for hospitals, so if one hospital gets up near an overload capacity, let's call it, those hospitals start to send patients to other hospitals before they get up to their max. Within the New York City public hospital system, within the Greater New York private system, and then among the different systems. Different mentality. But we have to do it.

We set two missions. One was hospitals. Second was individual responsibility. The individual responsibility is about discipline. It's about selflessness and being informed. The basic point is stay at home. Stay at home. I know it's hard to stay at home and I know everyone thinks, you know, I can go out, I can be smart, and I won't get infected because it's me. I'm a superhero. It's not going to be me. That is not true.

And it's not just about you. It's not just about your health and your life that you're playing with here, my friend. You can infect other people. So I've been trying to communicate this many different ways for many days. We still see people coming out who don't need to be out. Even for essential workers, people have to be careful. And again, I've been trying to communicate that. Everyone, everyone is subject to this virus. It is the great equalizer. I don't care how smart, how rich, how powerful you think you are. I don't care how young, how old. This virus is the great equalizer.

My brother Chris is positive for coronavirus - found out this morning. Now, he is going to be fine. He's young, in good shape, strong, not as strong as he thinks, but he will be fine. But there's a lesson in this. He's an essential worker. Member of the press. So, he has been out there. The chance you get infected is very high. I spoke to him this morning and he's going to be quarantined in his basement at home. He's just worried about his daughter and his kids. He hopes he didn't get them infected.

You don't really know Chris. You see Chris. He has a show at nine o'clock on CNN. But you just see one dimension, right? You see a person in his job and in his job he's combative and argumentative and pushing people - but that's his job. That's really not who he is. He is a really sweet, beautiful guy and he's my best friend. My father was always working, so it was always just me and Chris. He's a lawyer, also, Chris. He is a lawyer because growing up the decision point came to what do you want to do after college? And my father was very strong personality, and my father basically suggested forcefully to Chris that he should be a lawyer. It was a different time and a different place, you know? Now, my daughters, Cara, who's here, they all follow their individual stars. This is their destiny, which is right. If you had said to my father, I want to follow my individual star, he would say, you're going to follow your individual star right out that door, you know? That's what he would have said.

So, Chris went to law school but he never really had a desire to practice law. He calls me when he is about 26, he is at a law firm and he said, you know, I don't want to be a lawyer. I said I know but you are now a lawyer. You are. He said, but I don't want to be a lawyer. He said I want to be a journalist. I said you want to be a journalist? I said, too late. You're a lawyer. You have to pay law school bills. You didn't go to journalism school. It is too late. No, no, I think I can do it. God bless him. He quit the law firm, went to work for Fox TV, which is a whole separate conversation in the house, and then worked his way up. He's at CNN. He does a beautiful job, but a sweet guy and now he is quarantined in the basement but he's funny as heck. He said to me even the dogs won't come down stairs, he says. But he is concerned about his wife and his kids.

But the reason I raise this is he's smart. He's social distancing, yes. But you wind up exposing yourself. People wind up exposing you and then they find out they're positive a couple of days later. And I had a situation with Christopher two weeks ago that I even mentioned my mother was at his house. And I said, that is a mistake. Now, my mother is in a different situation. She is older and she's healthy, but I said you can't have Mom at the house. And he said, no, no, no, Mom is lonely. She wants to be at the house. I feel bad. She is cooped up in the apartment. I said, yeah, I feel bad she is cooped up in the apartment too. But you expose her to a lot of things. You have the kids there, your wife there. You're coming and going. Your wife is coming and going and you could expose mom to the virus. And love is sometimes a little - needs to be a little smarter than just reactive. And we had a whole discussion. And truth, now, he is informed. I'm informed. Was that dangerous? Was that not dangerous? I went back to Dr. Zucker and I said look, we have to tell people, what are the rules? How does this work? That's when I came up with Matilda's Law, and I said I named it for my mother. And it was very clear about people who are older and what they should be exposed to. My brother, it was two weeks ago, if my brother still had my mother at his house, again out of love and comfort, and my mother wanted to be at eth house anyway, by the way, she didn't want to be sitting at home in an apartment. So she would have been doing what she wanted to do, he would have been doing what he wanted to do. It would have seemed great and harmless, but now we'd have a much different situation. Because if he was exposed, chances are, she may very well have been exposed, and then we would be looking at a different situation than just my brother sitting in his basement for two weeks. So think about that, right. My brother's smart. He was acting out of love. Luckily we caught it early enough.

But it's my family, it's your family, it's all of our families. And this virus is that insidious. And we have to keep that in mind. Keep in mind Matilda's Law. Remember who is vulnerable here. And protect them. You want to go out and act stupid for yourself, that's one thing. But your stupid actions don't just affect you. You come home, you can infect someone else, and you can cause a serious illness or even death for them, by your actions. And people have to really get this, and internalize it, because it can happen to anyone. Two weeks with my mother and Christopher, today is a very different situation.

Last point, there is nothing that I have said different since I started these briefings. And there's nothing we have learned that is different since I started these briefings. We know what to do. We just have to do it. It is individual discipline to stay at home. That's what it is, it's discipline. No social distancing. It's discipline. Well, I'm bored. I know. I'm bored. It's discipline. Making this healthcare system work, that's government skill, that's government performance. That's saying to that healthcare system, I don't care how it worked yesterday, I don't care whose turf this is, I don't care whose ego is involved, I'm sorry, we have to find a way to work, a better way. Time to say to that federal government and to FEMA and HHS, you have to learn how to do your job, and you have to learn how to do it quickly. Because time is not our friend. It's about a social stamina. This is not one week, two weeks, three weeks, four weeks, five weeks, six weeks, okay? This is not going to be an Easter surprise. Understand that and have the stamina to deal with it. And it's unity.

Let's help one another. New York needs help now. Yesterday I asked for healthcare workers from across the country to come here because we need help. We will pay you, and more importantly, we will return the favor. This is going to be a rolling wave across the country. New York, then it'll be Detroit, then it'll be New Orleans, then it will be California. If we were smart as a nation, come help us in New York. Get the equipment. Get the training. Get the experience. And then let's all go help the next place, and then the next place, and then the next place. That would be a smart national way of doing this. And showing that unity. And, unity meaning, we're not, I know this is a political year, and everything is a political backdrop, and Democrats want to criticize Republicans, Republicans want to criticize Democrats. Not now. Not now. There are no red states, there are no blue states. The virus doesn't attack and kill red Americans or blue Americans. It attacks all Americans. And keep that in mind, because there is, there is a unifying wisdom in that.