Showing posts with label Mayor de Blasio on COVID-19 At Bellevue Hospital March 10. Show all posts
Showing posts with label Mayor de Blasio on COVID-19 At Bellevue Hospital March 10. Show all posts

Wednesday, March 11, 2020

Mayor de Blasio on COVID-19 At Bellevue Hospital March 10, 2020


 Mayor Bill de Blasio: Well, first thing I want to say is – I want to thank these extraordinary people who work here at Bellevue.

This is a world-renowned institution that does so much good every single day. This is a place where – I say this with tremendous respect to all of you – you, day-in, day-out, year-in, year-out, you handle whatever's thrown at you and you're doing an amazing job. I remember vividly the days I got to spend with some of you during the Ebola crisis, there was no place better in America to handle that challenge. And you did it beautifully and you're playing a crucial role right now helping us address coronavirus. One of the very first people came to be tested in all of New York City, came right here and, thank God, that was a negative back when – seems like a long time ago – it was only weeks ago. But we are depending on all of you and all your colleagues in Health and Hospitals, and I can safely say we are in very good hands with all of you. Let's thank them again.

Also, this group is exceptionally good at the elbow bump. I think you guys can go out and teach all of New York City how to do that. I want to start up on our update today. We've got some new information, but I wanted to say something really clear to all New Yorkers. Every single day, we're going to give you new information. Every single day, we're going to give you what we have that we can tell you that's clear and helpful. But every single day we're to tell you we're also receiving a lot of new information from our own experiences here in the city, from national sources, international sources, and everyday we're trying to understand the exact right approach to take the information changes day to day. We get new interpretations all the time. We get new strategies all the time. We're going to constantly update people, but you should assume a changing dynamic. This a – you know, we've dealt with a lot of things but I think we can all say with coronavirus we have rarely seen a situation that started with people not even understanding the disease to begin with because it was brand new – that's been the whole international community, medical community. And then, we've all had to learn by doing and our understanding of the best approaches keeps evolving. So, you will hear change because the information is changing. But we are still in the middle of a fight right now. We have to, every single day, do the best we can with the information we have and the resources we have. So, we'll tell you what we're doing, why we're doing it, and then as information changes we'll provide those updates. The fact is, everything is inherently preliminary at this point because, again, the information about the disease continues to evolve. It helps us to have our own experience here in New York City, our own work from our Department of Health and Health and Hospitals, our disease detectives giving us new information all the time. But there's a lot more out there that we are trying to glean and work with.
The crucial point I made yesterday, and I'll keep saying it, New Yorkers are going to be able to have a really big impact on this crisis by your own actions. So, the government is here to protect you, protect your health. We're going to do everything we know how to do. We're going to throw in every resource we got, but this one is participatory. This one is for everybody to be a part of the solution. The government cannot solve this alone. It has to be in every family, on every block, in every workplace. Everyone has to participate from those basic things, washing your hands, hand sanitizer, covering your mouth when you cough or sneeze onto the kinds of decisions we make in our life, starting with being very sensitive to the vulnerable people. We have seen this over and over again. It's very consistent all over the world. People over 50 with the preexisting conditions, that's the number-one problem. Either people like that in your life, support them, be really careful, watch out for them. We need New Yorkers to watch out for their fellow New Yorkers, which New Yorkers are very, very good about. But if someone in your life is vulnerable, be careful – another great example I'm giving, and I think it's a real life example – grandparents who want to visit their grandchildren, we all understand that that's normally fantastic, but if a grandchild is sick, the grandparents should not be visiting with them now. If the grandparent wants to visit their son or daughter, but the son or daughter is sick, this is not the right time for that. So, we really want to be clear about those common sense measures. The folks who are vulnerable need to take precautions. We need to support them as they take those precautions. We've talked about employers being as flexible as possible where you can have some telecommuting. We like that. We need that. Where you can't, we understand. Where you can stagger work hours – that helps. Everybody can participate. Literally every single person that'd be part of ending this crisis. So, we'll keep giving information and we'll keep updating people every step of the way.
Now, folks want information, they want accurate information. Want to remind you, you can go on our website, nyc.gov/coronavirus – nyc.gov/coronavirus – and you can text COVID to 692-692 – that's COVID to 692-692. I think it was yesterday we said 20,000 people have done that. Now, 60,000 people have done that. It's a really good way to keep informed. We're going to give a quick presentation, then you'll hear from – I'll give a presentation – you'll hear from the CEO of our Health and Hospitals, Dr. Mitch Katz, you'll hear from the Speaker of City Council Corey Johnson. I want to thank for their partnership and the good work they're doing Borough President Manhattan, Gale Brewer, thank you very much; Council Member Steve Levin of Brooklyn, thank you very much for all you're doing working with us.
Okay, so as we said, we're now in what we are simply calling phase two, and that means more and more guidance to New Yorkers of things that we want you to adjust in your life. I gave the example of employers staggering work hours and allowing telecommuting where they can. Again, those who are self-employed, those who have the ability to make those decisions yourself, we want you trying to – if you're going to have to use subways, use it on off hours. To the maximum extent possible, avoid the rush hour. If you can telecommute yourself, we prefer that right now. We need people to be mindful. We have a real concerned about the super packed subway cars, particularly in rush hour. If you don't need to be on one of those, please avoid them. Even means letting a few trains pass until one's less crowded. And then there's the really basic, but very, very important things – you know, a lot of people get sick and they power through it. A show of hands – even these health care providers – you ever been sick and powered through? Raise your hand. Raise your hand. Okay, stop doing that.
So, what we need to do, all of us, is if we're sick, we need to take it seriously. We need to talk to our doctor. We need to stay home if we're sick. Health care workers, obviously we depend on you, so the best way is for the health care – and Mitch will speak to this – health care worker's sick, they get to be evaluated by health care professionals, and if they shouldn't be at work, they shouldn't be at work. If they can be, that's great or with whatever precautions, and I want you to go in detail about that. But for the rest of everybody else, if you've got those cold and flu symptoms, don't go to work, consult with your doctor, make sure you're well before you get in the presence of lots of other people and, God forbid, do not go near someone in that vulnerable group over 50 with the preexisting conditions.
Okay, I'm going to state it just so we're consistent – over 50 preexisting conditions, that means heart disease, lung disease, cancer, diabetes, and a weakened immune system. Those five areas – we've also said not a condition, but a factor – smoking and vaping. Smoking and vaping do not help, in fact, they make it harder for someone to handle coronavirus for folks who have the preexisting conditions and are over 50 be very, very mindful of who you're coming in contact with. We want you to adjust your routines mindfully and if you do have symptoms, that group of people needs to get to care immediately.
Okay. Now, update on numbers. We have a very rapidly evolving situation on the numbers of cases and we're obviously concerned when we see more cases, but there's a piece of this that actually is in its own way good news, which is the testing capacity is coming online more and more. We still are waiting for that formal confirmation from the FDA that we've been talking about. We're hopeful but we still want it to be 110 percent formal. We haven't gotten that yet, but the private labs that started up on Friday are now really ramping up. So, we are starting to get more and more test results back. They are coming in so intensely now that being able to give you the detailed case breakdown, we're not in that position to do that at this moment, because so many new cases are coming forward. We will of course when we can give you updates on particularly pertinent cases and again, what we have been doing historically – there was a good question yesterday – I want to just clear this up for all the cases we've given you up to date –the ones with detailed profiles were all New York City residents, but one exception, the original lawyer from Westchester County, and the reason he was counted among the city cases was he was diagnosed hospitalized in New York City and remains in New York City. That was the one aberration. But now, with the private lab results coming in very, very rapidly, we're adjusting our approach, because we don't get the profiles on each case as quickly as we were because of the sheer numbers. So, again, we won't be giving across the board individual profiles. We will be giving them in particular cases. And we are happy to be getting more and more test results because it allows us again to ensure that people are getting the care they need, people are isolated that need to be isolated, and folks who are negative can go on with their life.
As of 12 noon – so, I gave a report yesterday and then this morning we had a different report. Now, we have another update as of 12 noon, working with the State of New York, the number now for confirmed cases in New York City is now 36 – 36, that is 16 new since yesterday and 11 new even since this morning at 7:00 AM when I last spoke about this. I said yesterday, we're going to start to talk to you about people who have their cases resolved. The first two that we will get information on, but they are not yet fully through the process, are the two health care workers who had been in Iran. They are now asymptomatic. They're going through a first of two tests that will lead to them coming out of quarantine. We're waiting for the results soon on the first test and it will take a second in short order thereafter, if both those come back negative, they will be out of quarantine hopefully as early as the end of this week. So, those are the first two that we will report on. As other people come out, we're going to give you those updates.
Now, as of – this is – I want everyone to hear a carefully, this is a different time frame because this is the last information we have. As of 10:00 am, before some of the newer information came in on cases, so this is probably dated by now – actually, is dated by now, but at least it's somewhat helpful information. As of 10:00 am, the number of negative cases for New York City was 258 – that was 57 new since yesterday. The number of pending tests, 195. So now, what you're seeing is we're talking about – and this is what we've been projecting – we'll be doing hundreds of tests a day and that's where the numbers are getting – moving so rapidly that we won't be able to do the individual cases the same way, again, with some exceptions.
In mandatory quarantine, 30 people right now. In voluntary isolation, 1,980. So, this is the context of community spread, which has only been with us since the latter part of last week and intensive testing, which has really only been with us the last few days. Now, we're going to see a very different trajectory in terms of the information flow and the numbers and we're going to keep giving updates every day.
Okay. A few quick updates in terms of the city. An issue that has been getting a lot of attention, rightfully so, around the country, around the world is cruise ships. So, the cruise ship terminals in Red Hook and the West Side of Manhattan, those are licensed via the Economic Development Corporation. They are run by a private entity called NY Cruise. We are following the guidance of the CDC and saying to all New Yorkers, this is not the time to take a cruise. I just want to start with that. Obviously, the cruise ships have been a real focal point for problems while our nation gets ahead of this crisis. This is not a great time to take a cruise, but if people do choose to take a cruise specific actions are being taken. The two terminals are being thoroughly cleaned throughout and health care workers will be on site if anyone is leaving on a cruise for additional screening during boarding. Anyone who attempts to get on a cruise and it has a temperature of over one 100.4 – 100.4 will not be allowed on a cruise ship. So, that's outgoing and that's trying to guide our fellow New Yorkers on how to handle this situation and protecting all the fellow passengers. The obvious other question is the incoming, and on the outgoing, I don't have in front of me, but I'm going to turn to my team and say we should check with EDC on the outgoing cruises – we have the incoming, let's get the outgoing dates. For incoming cruises, the next incoming cruise to the Manhattan terminal on the West Side will be Sunday, March 15th that cruise will be met by Department of Health Officials. And the same standard of 100.4 degrees will be implemented in this case, meaning folks who are coming off that cruise with that temperature will either, if they're from New York City, depending on their overall health, they will either will be allowed to go home into self-isolation or will be taken to a hospital depending on their health. If they are not from New York City, they'll be taken to a hospital or other health care facility right away. That Sunday, March 15th – this coming Sunday. The next incoming cruise to the Red Hook terminal in Brooklyn is April 9th, so we won't be seeing much there anytime soon.
On the issues related to the federal government, I mentioned that we still are waiting for the formal approval on the automated testing. Again, we keep seeing promising signs and some movement, but we do not have the fully confirmed formal approval. We need that right away. We've also talked about the N95 masks, which are particularly important for keeping our health care workers and our first responders safe. We definitely need more of these masks. The State, to their great credit, has kept their reserve. They gave us 120,000 new N95 masks. That's crucial. I want to thank the State for doing that, but we will certainly need more and we'll need them soon. We're sending a specific request today to the U.S. Department of Health and Human Services for 300,000 more N95 masks, specifically for our Health and Hospitals personnel who need them and for our first responders. That supply, in addition to the 120,000 from the State, the 300,000 more we're requesting from the federal government, we could get that soon, that will take us through the coming months. Related to our disease detectives, we are working right now to double the number of disease detectives. One element of that will be training all school nurses to do this work, to do the initial screening. We'll have an update shortly on the exact timeline on the doubling and the protocols we'll use, going forward. But the – one of the most immediate things we'll do is get all of these very effective school nurses into this work immediately. That's going to help us speed up the process.
An important note for all New Yorkers – obviously, there's information out there about coronavirus and there's misinformation and there's confusion. One area that should be crystal clear is that it is absolutely crucial for everyone to keep giving blood. There is no danger in giving blood, but we must maintain our supply. At this moment, our supply is okay, but we're concerned. We have seen some workplace blood drives canceled. That is a worrisome sign. So, we will be working to make sure that as many as possible blood drives continue. We're encouraging all New Yorkers who can to give blood. I'll be doing that myself in the coming days. And a thank you to all New Yorkers who have been giving blood and everyone who works to keep our supply strong. But there is no health risk related to coronavirus in the process of giving blood.
One more update. Yesterday, we talked about later in the day an emergency medical technician who works for the Fire Department tested positive for coronavirus. The information we have at this moment is that that was passed along by a flight attendant who is this individual's girlfriend who had been traveling to an affected area. As a result of this diagnosis, five fellow EMT are in self-quarantine. They are all asymptomatic. The EMT in the timespan that's pertinent here treated 11 patients, but as – when treating these patients wore protective gear. The Department of Health and the FDNY will be reaching these patients today to follow up and do the normal diagnostic work. But the good news is they are identified and the other good news is that the EMT wore protective gear, but we're still going to treat each case obviously very seriously.
And that is a thank you to all New Yorkers who really have been following the guidance in so many ways and helping us to address the situation here in New York City. Now, to talk about the capacity of our Health and Hospitals facilities and all the personnel, like these good people here, who will be part of fighting off this virus here in this city. We want to turn to CEO of Health and Hospitals, Dr. Mitch Katz.
President and CEO Mitchell Katz, Health and Hospitals: Thank you, Mr. Mayor. And thank you for having this at Bellevue. Bellevue is the longest running public hospital in the United States. Established prior to the signing of the Declaration of Independence, Bellevue was a leader in the HIV/AIDS epidemic. Bellevue was there to provide care with compassion without fear, to provide the very best of care. Also, in the Ebola outbreak, this hospital was the only hospital in New York State to successfully take care of somebody with Ebola who fully recovered and to do that without any other infections occurring to health care personnel. This is a hospital that knows how and knows how to do it with compassion, with love, with competence. It's also a public hospital, which means that people who are undocumented, people without insurance, they know that they can come here, they can come to Bellevue, they don't have to worry that they're going to get a bill that they can't pay, that they're going to be treated as unwelcome. With all of the negative anti-immigrant spirit coming out of Washington, how great that that's not true in New York City, it's not true at Bellevue, and I'm so grateful to you, Mr. Mayor to the City Council for always maintaining that.
We are prepared at Bellevue. We are prepared at the other 10 acute care hospitals of Health and Hospitals. We are prepared at our other 60 outpatient sites. We have known for several weeks that it is likely that we would reach a point where there would be many people seeking our services because of respiratory disease. As the Mayor has explained, 80 percent of people who contract this virus will have little or minimal symptoms, but 20 percent will need healthcare services, and probably about 5 percent of those people will need intensive services such as a breathing tube and a ventilator machine. We are prepared for that. We have been practicing – Bellevue in all our acute care hospitals have plans. Now, those of you in the press may say, well, wait a minute, we've been hearing that hospitals are crowded.
We've been hearing that ICU's, are crowded already – how could you possibly be prepared to take on additional people? And the answer is that in an emergency you change how you operate. You don't continue to operate in the same standard. So, we are prepared at Bellevue and all of our hospitals that were we to have many patients with respiratory distress, we would rapidly discharge those patients who are in the hospital now and do not need to be in the hospital, because they can be safely cared for at home. We would cancel all elective surgeries, so there is a lot of incredibly valuable work that a hospital like this does – we remove gallbladders, we fix hernias, we fix bones, we do arthroscopy, we do bariatric surgery – all very worthwhile. All that stops in an emergency. We have outpatient clinics, Health and Hospitals does 1.1 million outpatient visits a year. In an emergency, we will be canceling our outpatient surgeries. We will be canceling our outpatient visits and we will be directing all our great physicians and nurses and technicians and physician assistants and nurse practitioners and pharmacists to our inpatient areas. We know we're in every hospital. If we needed to set up intensive care beds, someone thoughtfully asked the other day, well, but do you have enough intensive care bed? An intensive care bed is defined by the great nurse who is caring for the patient is not a physical space. If you give me a great nurse as I have in Bellevue, I can turn any space into an intensive care space. What matters is the staffing. What matters is having the appropriate equipment. We have at Health and Hospitals 376 negative pressure rooms. If we needed to double up negative pressure rooms, not something we would ever do in regular practice, where the overwhelming likelihood is you'd have two patients with different diseases – of course they would not go in the negative pressure room together. In the case where we suddenly have many people who've tested positive of COVID-19, we would be able to double up existing spaces. We have practiced on our masks. We have practice on our gowns. We know the different levels of protective equipment that are necessary. We have implemented that in all of our settings. We very much appreciate the efforts on having more testing. That would make a huge difference for us and we greatly appreciate the efforts that you, Mr. Mayor, and the City Council have made to make that happen so that we know who is sick, who is not sick, and that will allow us to take care of people. We are 30,000 employees strong. We will all be taking care of those patients. If we have a large number, Mr. Mayor, Mr. President of the City Council – we are ready. We are prepared.