Governor Andrew Cuomo COVID-19 Briefing April 5: Hospitalizations Dropping in NY

Andrew Cuomo: (00:10)
Good morning, happy Sunday. For those of you who celebrate happy Palm Sunday, happy Passover week for those who celebrate Passover. Thanks for taking the time to be with us today. We want to give you an update as to where we are. The number of cases increase, which is nothing new that’s happened every day since we’ve started this, been a long month. Something a little bit different than the data today. We’re not really 100% sure yet what the significance is as we’re feeling our way through this. Number of people tested, 18,000. Positive cases are up 8,000 total of 122,000 cases. Number of patients discharged. Total discharged is 12,000 1700 discharged in one day. Number of deaths is up. That’s the bad news. It’s 44,159 and we pray for each and every one of them and their families and that is up and that is the worst news, but the number of deaths over the past few days has been dropping for the first time.

What is the significance of that? It’s too early to tell. This is the impact by state, but as I said, the interesting blip may be in the data or hopeful beginning of a shift in the data and the number of cases. Total number of new hospitalizations is 574 which is obviously much lower than previous numbers. That’s partially a function of more people being discharged, but you see ICU admissions are also down, the daily intubations down slightly from where it was. Again, you can’t do this day to day. You have to look at three or four days to see a pattern. Discharge rate is way up and that’s great news and the statewide balance of cases has been relatively stable for the past few days. There is a shift to Long Island. Upstate New York is basically flat and as Long Island grows, the percentage of cases in New York City has reduced.

This is when for those people who look at the data, you have all these projection models and what’s been infuriating to me is the models are so different that it’s very hard to plan when these models shift all the time. But there’s also a difference of opinion on what happens at the apex, right? Everybody, all the models say you go up until you go down. Thank you very much. Then there’s a difference of is the apex a point or is the apex a plateau? In other words, do you go up, hit the high and then immediately drop or do you go up and then there’s a plateau where the number of cases stays high for a period of time and then drops.

There’s a difference of opinion, so you have to think of that when you think about what you’ve seen in the numbers because you could argue that you’re seeing a slight plateauing in the data, which obviously would be good news because it means you plateau for a period of time and then you start to come down. And we’re all feeling our way through this and we have the best minds in the country, literally on the globe advising us because New York is the first.

I also think it’ll be very helpful for the other states that follow. I was just talking to Dr. Zucker about codifying everything we’re learning because when the next states start to go through this, we hope that they can benefit from what we’re going through. But we’re looking at this seriously now because by the data we could be either very near the apex or the apex could be a plateau and we could beyond that plateau. Right now we won’t know until you see the next few days. Does it go up? Does it go down? But that’s what the statisticians will tell you today.

As we’ve said before, the coronavirus is truly vicious and effective at what the virus does. It’s an effective killer. People who are very vulnerable must stay isolated and protected. I mean, that was the point from day one. That was the point with Matilda’s law, my mother, you have to isolate and protect those people. If a very vulnerable person gets infected with this virus, the probability of a ‘cure’ is very long. And that’s what this has really been about from day one. That small percentage of the population that’s very vulnerable, major effort that is impacted everyone to save the lives of those people who are in the very vulnerable population. If you’re not in a part of that vulnerable population, then you will get sick. 20% require hospitalization, but the hospital system is very effective and it makes a real difference. And that’s why the highest number of people ever now being discharged, right?

So you’re just seeing the evolution of this whole story. You’re seeing the narrative unfold, right? We’re all watching a movie. We’re waiting to see what the next scene is and as the movie unfolds, you start to understand the story better and better. A rush of infection rate, rush of people into the hospital system, hospital system capacity explodes, more people are in but more people are coming out. 75% of those people who have now gone into the hospital system are coming out of the hospital system. It also helps with the capacity of the hospital system because obviously the more people who are coming out, it makes it easier to handle the large influx that’s coming in. Having said all of that, the operational challenge for the healthcare system is impossible because the system is overcapacity all across the board. It’s just overcapacity. So what we’re basically saying to assist them is you have to manage with the same resources that you have, same staff, an overcapacity situation, and that is putting a tremendous amount of stress on the healthcare system.

You’re asking a system to do more than it has ever done before, more than it was designed to do with less. I understand that and I get that and day in and day out, the commissioner and everyone at this table deals with the healthcare system. I understand what they’re dealing with. I understand they’re being asked to do the impossible and they are being asked to do the impossible. But life has options and we don’t have any other options. So you get to a situation and you do what you have to do in that situation and that’s where we are. The only operational plan that can work because you know the system doesn’t have the capacity, doesn’t have the supplies, doesn’t have the staff. So how do you handle this surge overcapacity? We call it, we have to surge and flex, which means you have to deal with if you’re an individual hospital or a hospital network, yes, you’re going to be over capacity.

And the only way we can make this work is if we flex the system so that we take all hospitals, all hospital networks. Some hospitals are in networks and we work together as one system, which has never been done. Right. We have public hospitals, we have private hospitals, we have Long Island hospitals, we have New York City hospitals. In totality, it’s the health care system. The state manages regulates the healthcare system, but they’re all individual hospitals and or individual networks and they are accustomed to just doing business and managing their own affairs. That doesn’t work. We have to balance the patient load among all of these hospitals. So if one hospital starts to get high or has a projected high intake, we have to shift that patient load to other hospitals. That means some patients who show up at their neighborhood hospital may be asked…

… their neighborhood hospital may be asked, “Can we transport you to another hospital, which is not in your neighborhood but actually has more capacity?” So we have to adjust that patient load among all of the hospitals, which is a daily exercise, and it’s very, very difficult.

We’re running short on supplies all across the board. Some hospitals happen to have a greater supply of one thing or another. One hospital has a greater supply of masks. One hospital has a greater supply of gowns. When we’re talking about supply, hospitals are accustomed to dealing with 60-day supply, 90-day supply. We’re talking about two or three or four-day supply, which makes the entire hospital system uncomfortable, which I also understand because we’re literally going day to day with our supplies, with our staff, et cetera, which is counterintuitive and counter-operational for the entire healthcare system. I understand that also.

The big operational shift will be the Javits coming online. If we get that up and running efficiently, that’s 2,500 beds for people who test positive with the COVID virus. That is a major shift for the systems. At a time when we desperately need a relief valve for the system, Javits could do that. So we’re working very hard to get that up and running. But that rolling deployment, that flexibility, there is no other way to do that, to do this on the state level. I can’t say to a hospital, “I will send you all the supplies you need. I will send you all the ventilators you need.” We don’t have them. We don’t have them. It’s not an exercise, it’s not a drill, it’s just a statement of reality. You’re going to have to shift and deploy resources to different locations based on the need of that location.

I think that’s going to be true for the country. The federal government, everyone says, “The federal stockpile, federal stockpile.” There’s not enough in the federal stockpile to take care of New York and Illinois and Texas and Florida and California. It’s not an option. The only option I see is there’s a national deployment. Everybody says this is war time. It is a war, and the virus is the enemy. Where New York, help New York today. Thank you, State of Oregon. We’re dealing with this curve today and this intensity, and then nationally we shift the resources to the next place that is most impacted, right? Just what we’re doing in New York City, in New York State on a microcosm, we shift resources from the Bronx to Brooklyn to Queens to Nassau, shift national resources and state resources from New York to Florida, to Illinois, whatever is next on the curve. We are going to do that in any event.

We get through this. People have been so beautiful to us, and it is the New York way. We’re going to codify everything we’ve learned. We get past this curve, whatever part of the country goes next, we will be there with equipment and personnel and however we can help.

The federal government is also deploying approximately 1000 personnel to New York. That’s doctors, that’s the nurses, it’s respiratory technicians. The immediate priority is to deploy those people to help the New York City public hospitals, the New York City public hospital system, H&H, was a system that was under stress to begin with before any of this. So obviously, you add more stress to institutions that were under stress, it only makes the situation more difficult. So we’re going to deploy all the federal personnel who are coming in today, 325, to the New York City public hospital system.

I talk to the hospital administrators on a daily basis. We get them on a conference call, and we do this shifting of supplies and balancing of patient load. I know that I’m asking them to do really difficult things. I get it. I don’t enjoy being in this situation. I don’t enjoy putting them in this position. I know their staff is all overburdened. But all I can say is, thank you to the administration of this healthcare system, and most importantly, thank you to the frontline workers. I mean, these people, they are true heroes in the true sense of the word, what they do day in and day out under very difficult circumstances. We thank them all.

On a different, somewhat lighter note, there’s an accompanying affliction to the coronavirus that we talked about early on. It is cabin fever. It is a real situation, not medically diagnosed. I asked Dr. Zucker, there’s no medical definition for cabin fever, but I believe it exists. It’s the feeling of isolation. It’s often accompanied by radical mood swings, resentment of people around you, varying degrees, for no reason whatsoever. Just an upwelling of resentment, especially towards people who are in apparent positions of authority in this situation, which I’ve noticed. Irrational outbursts can come at any time without any warning, just a irrational outburst, frustration, anger with no rational basis.

Cabin fever in many ways also threatens the essence of our constitution, which is premised on people ensuring domestic tranquility, and it can be disruptive to tranquility. I can attest to that. It’s a real thing. Think about it. It’s only been one month, but it’s been a long month.

Positive interventions for cabin fever. I’m going to take up running again. I used to run back normal days before this job, but I’m going to start running again. My daughter Cara, we’re going to run as a family. We’re going to go out there. Cara’s got a headstart. She’s out there doing five miles every day. She thinks she can beat me. Give me a couple of weeks. I’m going to be right there, right there, fast like lightning. We’re going to do it. We’re going to make the dog come. The dog is also experiencing cabin fever. [inaudible 00:17:24] little disrupted, the order of the pack has changed, different people. He doesn’t know where he fits. He has anxiety. He’s going to come out. He’s going to run. Think of ways to deal with it. I don’t have any great answer.

But a little perspective on the whole situation is also important. I challenged my daughters. This is terrible. This is terrible. This is terrible. This is terrible. I’ve been saying it’s terrible. It’s been terrible for society, the economy personally. But let’s look back at history, right? Generations have gone through terrible times. So my challenge to them is, you find me a generation that has had a better overall situation than where we are right now. Go back World War I, World War II, Vietnam, 1918 flu pandemic. You find me a generation that hasn’t had a challenge to deal with, and we’re going to have that discussion.

Also, keep in mind on perspective, this is going to be over. You see on this story developing, you can start to see how the story ends. They will have a vaccine. Will it be 12 months or 14 months or 18 months? There are a number of treatments that are being expedited and are being tested right now. Dr. Zucker, New York, is working expeditiously and cooperatively with the FDA to try all new different treatments, the convalescent plasma receptor antibody treatment we’re working on. The hydroxychloroquine, we’re working on aggressively. So we’re trying all these new treatments. Some of them show real promise, but you can see where the story ends.

This is opinion not fact, I think you see the return to normalcy when we have an approved rapid testing program that can be brought to scale. We’re now testing rapid testing programs. But when you get to the point where you can do rapid testing of scale and people can start to go back to work because they know they’re negative, we continue to protect the vulnerable population, which is where this was about, but we liberate … As my daughters would say this, they’re seeking liberation. We liberate people who can go back to work, because we know that they’re not in a vulnerable-

… can go back to work because we know that they’re not in a vulnerable category and they’re negative. And I think that is … It’s under development now, the rapid testing and we’re part of it. But that is going to be the answer, I believe. And we get through it because we are New York State tough. Thank you.

Jesse: (20:21)
Governor, in terms of the data that you’re saying, this 594 which is a slight dip from yesterday, how many straight days would you say or statisticians say you would need to see sort of similar numbers to say that we’ve hit the apex?

Jesse, you guys think I don’t give you straight answers. You have to talk to these statisticians. They will not give you a direct answer on anything. We don’t know. See, when did you start with the first two options, it’s either straight up and straight down, right? Or a total V, or maybe it’s up with a plateau and we’re somewhere on the plateau. They don’t know.

Jesse: (21:01)
And the subsequent [inaudible 00:21:03].

That’s right. They don’t know. So, if you look at the three-day roll as opposed to day-to-day, you could argue that you’re seeing a plateauing, but they want the future data to determine if this was a plateau. So in other words, next week they’ll tell you after they have a few days whether we’re on a plateau or it was just a blip. Is that accurate?

Speaker 3: (21:31)
That’s accurate.

Jesse: (21:32)
Are you still anticipating needing 110,000 beds for coronavirus patients? Considering the number of hospitalizations, that seems like a big number.

When we started planning, we had models that we were planning against and they had a worst case, best case, middle case. The worst case was even higher. Their worst case was like 170 … What was the worst case?

Speaker 3: (22:02)
140,000.

140,000 beds was the worst case. The 110,000 was more of a moderate case. Look, I hope we’re somewhere near the apex or we’re somewhere near the plateau, so I would hope that we don’t need anywhere near that number of beds. That’s the good news. The bad news is the number of beds doesn’t really matter anymore. We have the beds, it’s the ventilators and then it’s the staff. That’s the problem.

Speaker 4: (22:44)
Governor, have you been getting statewide crime stats from DCJS and what’s been the trend over the past month? Has crime declined? Is that the silver lining in all this?

Well, it’s interesting. When you close down society, a lot of bad things happen, economic, et cetera, but a couple of good things happen. Anecdotally, we’re hearing the crime rate is down. The number of people going to hospitals who are not related to the coronavirus is also down. There’s fewer traffic fatalities, less crime, less trauma cases coming into hospitals. But we can get you the actual crime data. Has anybody looked at that?

Speaker 5: (23:37)
I know that the crime rate in New York City is down. We can get you the stats statewide.

Speaker 4: (23:42)
Thank you.

Speaker 6: (23:42)
Is there any plan to give volunteers any sort of additional healthcare insurance coverage? There’s some concern among volunteers that the insurance that they have right now won’t cover if they get sick with coronavirus.

We have Department of Financial Services, which regulates the insurance industry, is looking at that question. We’re not sure that the fears are justified. I understand the fear that they may not be covered, but we’re not sure that that’s correct yet. We will do everything in our power to make sure people are protected and have insurance for this and we’re looking at that right now.

John: (24:23)
Governor, we haven’t seen the executive order yet to redeploy ventilators from upstate to downstate. Why haven’t we seen that, and also what would you say to people in Western New York, in the Southern tier, in the Adirondacks who have concerns that this may leave them vulnerable in the coming days, in the coming months as the apex moves upstate?

I would say this, John, the executive order, I’m adding a couple of other things to the executive order, we’re going to have to extend a few policies that are going to expire. The concept here that people have to get is nobody can handle this alone. Nobody. The people of New York City cannot handle this alone. The people of Nassau can’t handle it alone. People of Suffolk can’t handle it alone. People of Westchester can’t handle it alone. People of Buffalo can’t handle it alone. People of Albany can’t handle it alone. Period. That is just a fact. This virus will overwhelm the resources of any single community. It’s also true nationwide.

Our wisdom here in New York, our mental wisdom and our ethos is we’ll help one another. This surge flex, every day we sit there allocating among hospitals, shifting gowns, shifting masks, shifting patients, Nassau needs, Suffolk needs this, Westchester needs this, and that’s the only way we’re doing it, by shifting of those resources. We will come to a point where that wave will run right through the state and we’re going to have to do that for Albany, and Rochester, and Syracuse, and the North Country, and the Hudson Valley. That is going to happen.

And I guarantee the people of this state, that as long as I’m governor of this state, we won’t lose a life if we can prevent it and we’re not going to lose a life because we didn’t share resources among ourselves. Anything anyone needs in Buffalo to fight this virus when it hits Buffalo, we’ll be there. If it comes from Montauk Point, and I have to get in a truck and drive it from Montauk Point to Buffalo, it will be there. And that’s the way we’ve governed this state and that’s the way we’ve operated. That was our mentality post 9/11. That’s how this state has operated for the past 10 years and that’s how it will be going toward. Whatever any community needs, we will be there.

Now, I understand the fear. Well, if I lend you my ventilator, what happens when I need the ventilator? That was FDR and the garden hose, right? First of all, smart is you don’t want your house to burn down, don’t let the neighbor’s house burned down. When the fire hits the neighbor’s house, it’s in your self-interest to put out the fire in the neighbor’s house. Not only is it the right community moral, ethical thing, it’s the smart practical thing. Why did Oregon send us 140 ventilators? Because they’re very nice people. Yes, Governor Brown is a great leader. Why else? Because they see the fire spreading and they say, “Better we put out the fire before it gets to us.

If I’m sitting in upstate New York right now and I see that fire coming up, I say, “Let’s go put that fire out before it gets to us.” But even if the fire gets to you, every hose in this state that can be sent to you because they don’t need it will be sent to you. And, all we’re asking is for ventilators that you aren’t using now and you don’t foresee using in the foreseeable future. Right. I say to you, John, “Do you have any ventilators that you’re not using and you don’t think you’re going to need in the foreseeable future?” “Yes, I do. I have 10.” “Okay, let me borrow two.” The 20% is what gets you to the 500 ventilators.

John: (29:38)
How many of those 500 has the state taken possession of this week?

None.

John: (29:42)
None, yet.

I just want to know where they are if we need them, right? For planning purposes, we know where every ventilator is in the state of New York now. They’re all little dots, right? We know where every ventilator is. I want to know as we’re going through this day-today-to-day-to-day, and we have, by the way, hospitals, they get down-

Day to day to day. And we have, by the way, hospitals, they get down to two or three ventilators. I mean, that’s how tight a margin we’re operating on. I want to know what’s plan B, what’s plan C, if we get to it? And where are they?

And then look, it’s a ventilator. You know? We had one here. It’s on the stand; it’s on wheels. You can move them on a day to day basis. Nobody’s going to get caught short. It’s not like I can’t move ventilators from one place to the other. And you look at the curve, that’s why I say even nationally: you cannot do this any other way. I don’t see any other operational model: it’s when a place is at the apex, all the firefighters run to the apex with their hoses, and then the next place on the apex, you redeploy to that apex. New York city, the apex is either very, very soon, or we’re on a plateau, do what you can then, and then we redeploy.

You know, we talk about the family of New York. Right? I must have said that one million times: family of New York, family of New York, yes, yes, yes. What does family of New York mean? Mutuality, cooperation, sharing benefits and burdens. Okay, this is the time the family has to come together; this is the time. Not just out of spirit and love, out of necessity. You cannot handle this without your brothers and sisters. You can’t.

Press Corps: (31:51)
Governor, can we get an update on the frontline workers, the hospital employees who have tested positive for COVID-19?

What update would you like?

How many there are? What the plans are?

We can get you numbers for that. I don’t know if the top of my head. Do you know how many healthcare workers have tested positive?

Dr. Zucker: (32:12)
We’ll have to find those numbers. We’ll find out.

Is that concerning for you though [crosstalk 00:32:13]?

Oh yeah. Look, you have a problem across the board on number of essential staff who get sick. You have it in the police department, you have it in the fire department, and the healthcare system as it’s the key cornerstone system right now, it’s especially problematic in the healthcare system. And that’s why the recruitment of the volunteers, 22,000 people nationwide, 60,000 people reserve volunteers, we’re pumping them into the hospitals.

Governor, have you spoken with officials in Rockland County? There was a great deal of concern out of Rockland County yesterday about the growth of the virus there. There was some suggestion that you were not aware of the situation in Rockland County. Can you give us an update on that? And have you spoken to them?

Well I know what’s happening in Rockland County and the numbers in Rockland County. You do too because we see them every day. On that specific situation with the Monsey community, Dr. Zucker spoke with them. You want to tell us?

Dr. Zucker: (33:14)
So I spoke with the community and explain the need to abide by these six-foot distance and also the issues of social distance, and to stay at home and reiterated all the points that the governor has made over the course of all these press conferences with everyone there.

And Governor, on a separate-

Excuse me one second. Let me just fully answer that question. [crosstalk 00:33:32]-

Aide: (33:32)
And also, I’ve spoken to a county executive, Ed Day. I think that there was a little bit of a disconnect between the locals on the ground understanding the authority that Executive Order 202-11 gave them on the ground. They’ve got Public Health Law Section 12 and 12-B, and they’ve got the local building code that they can enforce, and there are civil and criminal penalties that are associated with that. Obviously that’s the last-case scenario; in New York City they have been issuing tickets. So they do have teeth behind these executive orders, and I’m not sure that they understood the full weight of the force that they had behind them.

On a separate suburban question, in New Jersey there’s been some … Governor Murphy has said basically, “Stay in your primary residence, don’t go to second homes.” In some parts of Long Island there’s been concern that people are going from New York city to these communities on Long Island. Have you given any consideration to similar social borders telling people not to go out to Long Island or the Hamptons or places like that?

I have not. I’ll take a look at the New Jersey order, but I have not. But I haven’t heard any local officials raise concerns about that here.

So Governor, when you say you’ve spoken to the Monsey community, could you tell us what that means? Who did you talk to? Have you talked to rabbis? Have you talked to government officials?

Dr. Zucker: (34:49)
I spoke with the rabbis in the community, and there were some officials from the county on that call, and conveyed the importance of what needs to be done to prevent the spread of this virus.

And what was the response from the rabbis?

Dr. Zucker: (35:03)
It was just a conversation with them. They heard what the concerns were.

They listened then?

Dr. Zucker: (35:07)
Sure did.

We work very closely with the community of Monsey, as you know, and the Orthodox community in Rockland. I get the issue. But look, also they understand what happened in New Rochelle, the New Rochelle cluster, which is where we had that explosion. One person in a gathering, whatever the gathering … And look, we’re coming into a Palm Sunday, Easter Week, Passover. I had to cancel the St. Patrick’s Day Parade; a lot of people got offended at that. But you can’t have large gatherings where you could have one or two people infecting people. And just because it’s a religious gathering … You know? The virus is a nonreligious enemy.

Let’s take more.

Governor, the Tesla plant in Buffalo, Elon Musk said 9, 10 days ago at this point that he was going to start producing ventilators there as fast as humanly possible. Have you had any discussions with him, with Tesla, about … and is anything going on at that plant with ventilator production?

Does anybody know? I’ve been a little hyper-focused.

Aide: (36:17)
We have been talking to Tesla. They’re actually not talking about making the entire ventilator; they’re talking about making one part of the ventilator. They’re trying to ramp up to get up and running as soon as possible, but nothing’s materialized yet.

So it hasn’t started at that plant?

Aide: (36:28)
Correct.

The problem with ventilator construction is the supply chain. Nobody can make you a ventilator right now in two weeks. That’s General Motors. That’s Ford. That’s Elon Musk. I don’t care how big and how powerful, you can’t make ventilators that fast because there are parts that have to come from other countries. And their timeframe frankly doesn’t work for our immediate apex because whether we’re talking two days or 10 days, you’re not going to make ventilators at that time.

Governor, the president said yesterday that he wanted professional sports leagues to potentially open by August, September, including the NFL. How do you feel about that? Do you think that’s a realistic expectation?

I would love to see sports back, help with cabin fever. But this is not about hopes, and dreams, and aspirations, and what you would like to see. None of us like being here. Follow the data. Follow the science. Let the professional doctor, healthcare professionals, tell you when it’s safe to reopen. And that’s when you reopen.

[crosstalk 00:37:40].

Have you asked the president to come to New York to see what’s going on here?

No.

Would you consider that?

Look, he’s welcome to come. My guess is they would say they’re trying to keep the president’s health protected. And I’m sure he’s got 900 health professionals, like I have to hear from my health commissioner … in a nice way, I love hearing from you … say: don’t expose yourself, don’t go out, stay in a bubble, wrap you in plastic, valuable asset.

Governor Andrew Cuomo COVID-19 Briefing April 5: Hospitalizations Dropping in NY

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