New York Gov. Andrew Cuomo COVID-19 Press Conference Transcript December 7

Gov Andrew Cuomo: (00:00)
Good morning, everybody. I hope everyone had a good weekend, or as good a weekend as you can have in these circumstances. Today is only day 282. Think of it that way. “Oh, this has been going on a long time.” It’s only been going on 282, glass half full, glass half empty.

I want to thank New Yorkers and all the people who gave me great birthday wishes. My birthday was yesterday. People were curious. I was 39 years old again, I’m just going to repeat that number 39. I like it. So I’m going to sit on that for a while. But I had as great a birthday as you can have in this new normal. My daughters came up, it was all great. The dog gave me a bone.

We have a special guest with us today, Dr. Anthony Fauci. Dr. Fauci, I like to call American’s doctor. He was probably the singular voice, in my opinion, as a medical professional who offer guidance and facts and clarity to people all through this countrywide, worldwide. He always stuck to the science. He always stuck to the facts. He was clear. When it was difficult news, he offered the facts. He did it in a way that was calming, but was truthful, and that’s a hard balance, but he did that extraordinarily well.

He’s also been very kind to me. I’ve spoken to the doctor many, many times throughout this situation and he’s given me great advice and great guidance. He was also very helpful to New Yorkers on a personal level. He was very helpful to my brother, Chris, when he got COVID early on, gave him good advice, but the doctor has been a great, great friend to New York.

I’m just worried when the doctor sends us the bill for all the consultation that he gave us. But you know what? Dr., maybe you could take the … just to ease bookkeeping. You take the Cuomo consultations, me and my brother, put them together on Chris’s bill, send Chris the bill. He’s a very generous person, my brother, Chris. So I’m sure that’ll be fine with him.

Dr., let me give you a sense of where we are and give you the facts today, and then I’d like to ask you a couple of questions to get your advice on where we go forward as this situation changes. Our positivity rate today, without what we call micro clusters, micro clusters are the high problem areas in our state, which we have localized and we have special strategies in them, and they have a higher percentage rate than rest of the state. They’re small zones, but they’re intense positivities. Statewide, without those zones, we’re at 4.2. If you add those zones in, we’re at 4.7. The positivity in those high intensity zones is 6.5.

We did 152,000 tests yesterday, on a Sunday. It tends to be our lower testing day, but we still did 152,000 tests. 80 New Yorkers passed away. They’re in our thoughts and prayers. 160 additional hospitalizations, 22 ICU and 13 intubations. Our Rt we estimate at about 1.2 now.

When you look across the state, you see a very varied picture. This is number of people who are hospitalized, and we look at the percent of the population that is hospitalized. So for example, the highest percent of hospitalization is actually upstate, Finger Lakes, that’s the Monroe/Rochester area, Buffalo, Western New York, Central New York.

You come down to New York City, Long Island, we actually have a lower rate hospitalized than upstate, which is an exact flip of where we were in the spring. Spring, we had a largely downstate situation and upstate the situation was much better.

New York State, we’ve done a couple of things that are different than other states. In New York, the state sets all the policies on close down, the state keeps numbers that are determinative of the policies. We don’t do it on a county or a city level. This, to me, avoids what I call the hodgepodge effect. Hodgepodge is a technical medical term that we have here in New York, we also apply it to government hodgepodge, just a discoordinated mess.

It also reduces forum shopping. You know, when you see states where one County is open, and one county is closed, and you want to go for dinner, you go to the neighboring county. You want to go get a haircut, you go to the neighboring county, which only increases the number of people traveling, which is exactly what you don’t want to do, and it reduces the confusion.

We’re also then taking it to the next level. We try to coordinate with surrounding states. So if I’m going to close restaurants, I try to coordinate it with New Jersey, Connecticut, et cetera, because if I close a restaurant, but you live in Brooklyn and you can drive to New Jersey, then all I did is increase the traffic in New Jersey. It’s not a perfect coordination, but in lieu of a national set of firm guidelines, which is frankly, what I would have liked to see, we have come up with a regional compact of guidelines.

We have been very transparent and communicative with New Yorkers. We have websites. I give them numbers every day. I wanted them to hear the facts. If anything, I’ve been accused of being overly communicative, especially at home. But the more facts people know, I think, the better.

And we have been religious about following the data and the science. We do more testing than any state in the United States, by far, we have more data points by far, and we rely on the data and it’s not anecdotal, it’s not political, it’s not an opinion.

We also started something called the Surge and Flex public health system management, which is something we’re going to be implementing in an increased way today. Surge and Flex is not the most creative name, but what it says is, we surge and we flex the hospital system in the state. We start with 54,000 hospital beds statewide. We can then mandate, by the Department of Health, with Dr. Howard Zucker to my left, Jim Malatras to his left, Gareth Rhodes to my far right, Melissa DeRosa to my right. You know Dr. Zucker and Melissa, you’ve worked with them.

But Dr. Zucker can order a 50% increase in beds, which we’ve done before. Dr. Zucker can order no elective surgeries, which we have done before. And we can create field hospital beds, which we’ve done before. And we can create several thousand field hospital beds. So when you look at our hospital capacity, we start with 54,000 beds, you can increase it by 50%, that takes you to 75,000 total bed capacity. Roughly 35,000 of those beds are now occupied.

If you cancel elective surgery, we estimate that you reduce the number of occupied beds by about half. That takes us to a total system capacity of about 58,000 beds for COVID patients. Today, we have 4,600 hospitalized. So that gives you a range of the capacity for the system. We can also add 5,000 additional field hospital beds. That would be, from my point of view, the last resource. We did that, the Jacob Javits Center, for example, we did 2000 beds. Dr. Fauci, it looked like a field hospital in an army. You just saw an ocean of cots. I just hope we never have to get to that point.

Today, the Department of Health is going to issue an order saying, hospitals have to increase their bed capacity 25%. We can issue up to 50%, they can do that physically, but we’re only going to go to 25% because we don’t have a capacity criticality at this moment.

We are aware of staff resources. The staff comes into this stressed, right? You want to talk about a long year, nurses, doctors, hospital workers, 1199, they had the longest year of anyone. So they come into this stressed. We’re going to ask retired doctors and nurses to sign up and we will automatically reregister them in the state without cost. We believe we can get about another 20,000 nurses and doctors from this mechanism.

Then the flex, on the Surge and Flex is we have 215 hospitals. What happened in the spring, interestingly, was not that the system was overwhelmed, individual hospitals got overwhelmed, and the individual hospitals did not have the capacity to balance patients. Frankly, this was an education for me. So you have public hospital systems, and let’s say you have a public hospital system that had 10 hospitals. One hospital gets overwhelmed, they did not have the capacity to balance those patients among their other nine hospitals, right?

So even in the public systems, before somebody walked into one hospital that was already overburdened, they didn’t say, “Hold on, I’m going to put you in an ambulance and drive you to my sister hospital that has less volume.” What our flex says is, those hospitals have to flex patient load and share it first within their system.

We also shift patient load among private hospitals, which was frankly, more unorthodox, right? You got to go to NYU Langone. You think you’re going to NYU Langone, what we say on the flex is, if NYU Langone is filled, or at capacity, we’re going to transfer you to Mount Sinai or another hospital.

Then we actually have the capacity to shift between public and private systems. None of this has been done before, it was highly disruptive for the hospital management system. But we started it in the spring. It went fine enough, and we now have had more experience in it.

We’ve started the flex management system where every night we get an inventory from every hospital doctor. How many patients do you have? How many ICU beds do you have? What capacity do you have? And we do that on a daily basis. If our hospital capacity becomes critical, we’re going to close down that region. Period. We call it close down a red zone.

What is critical hospital capacity? Our formula is, if your seven day average shows that within three weeks, you will hit critical hospital capacity, we close you down. So if your seven day average says, if that continues for three weeks, you’re going to hit critical hospital capacity, we close you down. We want that three week buffer. Then we call critical 90% of your hospital capacity. So a little complicated. If your seven day average says, “If it continues for three weeks, you’re going to hit 90% of your hospital capacity,” closed down.

The CDC changed their guidance on Friday. Some have been critical about the changing guidance from CDC. I’m not, I believe as the facts change, your opinion changes, as the facts change, your strategy should change. I don’t have a problem with that, but they offered additional guidance on indoor dining, especially, and we’re going to follow their guidance.

If after five days, we haven’t seen a stabilization in a region’s hospital rate, we’re going to clamp down on indoor dining. Five days, if the hospitalization rate doesn’t stabilize in New York City, we’re going to close indoor dining. We’re now we’re at 25% in New York City. In the rest of the state, any region where the hospitalization rate doesn’t stabilize, they’re now at 50% capacity, indoor dining, we’re going to go to 25%. We have zones that are called orange zones, where it’s already closed. That wouldn’t apply here. Bottom line for us, I see it as hospital capacity versus vaccination critical mass. I think that’s the ultimate bottom line. Can your hospitals handle the increase until you start to see a reduction from the vaccinations? On the hospital capacity, do everything you can do to slow the spread. Then at the same time, accelerate the vaccines.

The frustrations we’re seeing here, we estimate over 70% of the spread is coming from small gatherings, and that’s a problem. We’re going to go through the holiday season. I think there’s going to be more small gatherings. I’ve been talking until I’m blue in the face about the apparent safety of being at home, the apparent safety of being with your family, but that can be misleading. Your brother, your sister, your mother can love you, but they can still infect you.

I know you think you’re sitting in your living room and you’re safe, but your living room is not really a safe zone. This isn’t a political question. Trump’s CDC and the Biden advisers all agree on the small gathering guidance, but it’s about personal responsibility and community concern, and I’m telling you compliance is a major issue for us here. I’m also frustrated that we see polls that suggest a high percent of Americans are not ready to take this vaccine. 49% nationwide, a bigger problem in the black community, 57% say they’re not ready to take the vaccine, but 75% to 80% needs to be vaccinated to hit critical mass on the vaccination, and that’s a problem, if you have 50% saying, “I’m not taking it,” but we have to hit 75 to 80.

The good news is New York still has one of the lowest positivity rates in the nation. Only Maine, Vermont, Hawaii are lower than we are, and Maine, Vermont, Hawaii, beautiful states, but different than New York, they don’t have the cities, they don’t have the density, et cetera. So for us to be down that low is really good news.

As a matter of fact, our worst region, our highest region in terms of positivity is still lower than 41 states. So it’s tricky because relative to everyone else we’re doing well. But the real question is, it’s not a relative contest at the end of the day, it’s how you’re doing in your …

… A relative contest at the end of the day. It’s how you’re doing in your state. So to recap, we’re going to monitor the hospital capacity. If it doesn’t stabilize, we’re going to reduce the indoor dining restrictions. We go to zero New York state, 25% everywhere else. If you hit critical hospital capacity, we’re implementing the surgeon flex. We’re going to add 25% additional hospital beds, renew the registration for nurses and doctors to get us a backup staff pool, continue to caution on the small spread, and at the same time, we are gearing up to have the most efficient, most effective, most fair vaccination program in the country.

Reaching out to the Black community, Latinos, undocumented, to make sure that it’s fair. So a couple of questions for you, Dr. Fauci. That’s what we’re doing in general. Your opinion has always been valuable to us. The holiday spread, I think it continues through Christmas, Hanukkah, et cetera. Trying to guess, and I know it’s a guess, when we could see a peak to this holiday spread. Is it after New Year’s? Is it January, mid January? Do you have any guess, educated point about that? And again, thank you very, very much for being with us.

Anthony Fauci: (19:46)
Well, thank you very much, Governor, for give me the opportunity to listen to what I found to be a very interesting plan that you have for New York. It seems really sound, and you have a lot of backup contingencies, which I like. So you’re not going to get caught shorthanded on this, I’m certain. So thank you for that. With regard to the issue of the holiday spread and the peaks, they’re going to be superimposed upon each other. So you would expect the full blunt of the travel and the family setting gatherings with friends that you alluded to as being a problem, you’d expect that the effect of the Thanksgiving surge would be probably another week and a week and a half from now because it’s usually two and a half weeks from the time of the event. The problem is that’s going to come right up to the beginning of the Christmas, Hanukkah potential surge.

So you have a surge upon a surge, and then before you can handle that, more people are going to travel over Christmas, they’re going to have more of those family and friend gatherings that you accurately said are an issue. So if those two things happen and we don’t mitigate well, we don’t listen to the public health measures that we need to follow, then we could start to see things really get bad in the middle of January. So I think not only for New York state, but for any state or city that is facing similar problems without substantial mitigation, the middle of January could be a really dark time for us. But as you said in your presentation Governor, there were some things that we can do to mitigate against that.

I think particularly the appreciation that it’s such a natural thing to think, “When I have family and friends over for the holidays, Christmas and Hanukkah,” you get indoors, you take your mask off because you’re eating and drinking, and you don’t realize that there may be somebody that you know, that you love, that’s a friend, that’s a family member, who is perfectly well with no symptoms and yet they got infected in the community and brought it into that small gathering that you’re now having in your home. So that’s the reason why I want to underscore what you said, that’s one of the issues. But bottom line for your first question, mid January is probably going to be the bad time.

The small spread, family spread, living room spread, we call it living room spread here, so 16 States have done an order of no more than 10 in a home. The CDC guidance that President Trump’s CDC says no more than 10. Some states have gone to no more than eight people. Compliance is very low on that. Do you think that is a sound rule, that no more than 10 in the home?

Governor, I think that’s a very sound rule, and I feel 10 may even be a bit too much. It’s not only the number, Governor, but it’s the people who might be coming in from out of town. You mentioned in your presentation how you don’t want somebody who’s from New York who wants to go to a restaurant that’s closed in New York, they go to New Jersey and then they come back, they’ve traveled back and forth. In addition to the absolute number of the people in a home for a gathering or a social setting, you want to make sure you don’t get people who just got off an airport or a plane or a train and came in from Florida or came in from wherever. That’s even more risky than the absolute number. So not only the number of 10 seems reasonable, but make sure that when people come in, that they’re not people who you have no idea where they’ve been or who they’ve been exposed to. You want to be friendly, you want to be collegial, but you really got to be careful about that.

Yeah. No, you’re so right, doctor. And the practical implications are so difficult. As I mentioned, I had a birthday yesterday. One of my daughters who wasn’t with me who wanted to come up, she had to quarantine before she could come to my birthday. So you want to go travel and see someone, it’s not just that weekend. It’s the whole quarantining process before. And in this state, we have very strict regulations of when you come in, what you have to do. On the vaccinations, looking ahead, 75%, 80% is going to be very hard to reach. New Yorkers are tuned in and we’re going to be very aggressive on public education outreach, et cetera. But what does your crystal ball say? When is 75, 80 even feasible? I hear anywhere from May, June, July, August, September, what would you guess there? Which is when it’s really over, right? When the vaccination hits critical mass?

Yeah, when you have 75%, 80% of the people vaccinated, you have an umbrella of protection over the community that the level of community spread will be really, really very low. The virus will not have any place to go. It’s almost metaphorically, if you think the virus is looking for some victims, when most of the people are protected, the virus has a hard time latching on to someone. When that happens, Governor, is going to be entirely dependent upon how well we do, how well I do, you do, your health officials, in getting the message out of why it’s so important for people to get vaccinated. Because if 50% of the people get vaccinated, then we don’t have that umbrella of immunity over us. But let’s say it works out well, let me answer your question specifically, and we do a really good job of convincing people.

Between now and the end of December, you would likely get a substantial proportion of health care providers and people in your nursing homes. As you get into January, you’ll get the second level. And then February, third. I would think by the time you get to the beginning of April, you’ll start getting people who have no high priority, just a normal man and woman, New Yorker in the street who’s well, has no underlying conditions. If we get them vaccinated in a full court press, get them really going and you do that through April, May and June, by the time you get to the summer, because you remember it’s a prime boost, which means you get vaccinated today, you get a boost 28 days from now, and then seven to 10 days following that you’re optimally protected.

Even though you could get some protection even after the first shot. But optimally it’s within seven to 10 days following the second shot. If we do that well, by the time we get into the core of the summer and get to the end of the summer and into the start of the third quarter of 2021, we should be in good shape. That’s what I’m hoping for and that’s the reason why it’s so important to extend ourselves out to the community, particularly to the Black, African-American, Latino, the people who are undocumented, the people who we really need to get vaccinated.

Well doctor, I couldn’t agree with you more on that. I’m pushing the Congress right now, New York… Look, I think it would be discriminatory not to understand the situation that exists with the Black and Latino population who by the way, had… Blacks had twice the death rate of whites, Latinos had one and a half times the death rate of whites, higher infection rate, higher percentage of essential workers. We’re going to need a whole effort just to educate and outreach and get into public housing and communicate with their communities because otherwise, they’re not going to flock to the local Walmart or Kmart or Walgreens to take this vaccine. I think we’re going to need an affirmative effort to do that. Let me ask you this. Our school positivity rate is amazingly low. Even in communities that have higher spread, we’re seeing much, much lower infection rates in schools. It’s almost a universal statement that the school is the safest place to be in the community. Does that surprise you?

It originally did surprise me because we were always concerned if you look at the influenza model, the issue is the kids are in school, they get infected, they come home and they infect their parents and their relatives. We’re not finding that with this coronavirus. In fact, to are, I think, real positives of a spinoff of this is the realization that schools appear to be a place where the positivity, just like you all are seeing it in New York, the whole state including New York City, you’re not alone.

We’re seeing that in other parts of the country, that the test positivity in school is actually really low, which is really a good thing, which is one of the reasons why when we were talking about what the best strategy would be, we would say something like, “Close the bars, keep the schools open is the best thing to do so long as you subsidize and help the restauranters and the bar owners so that they don’t go down and essentially crash because of the economic strain.” But if we can keep those things under control, subsidize those people as well as keep the schools open, we’d be in good shape.

Yeah, and I think you’re exactly right. The CDC says more restrictions on indoor dining, which I understand. And again, changing positions when facts change is intelligent, people say, “Well remain consistent.” I’m not going to be consistent if the facts are inconsistent. And if I see a different situation, I’m going to change my opinion. But the Congress, Washington also has to understand those bars, those restaurants, they need financial assistance because this has been a long year and they have bills to pay. So you can’t tell them, “We have to close you down,” without saying, “Here’s the economic reality and we’re going to help.”

Absolutely.

Doctor, on the question of this state’s infection rate versus other states, we’re lower than all states besides Vermont, Maine, Hawaii. Does that surprise you, and how do you explain that?

I have to say being a New Yorker, Governor, it doesn’t surprise me. You guys, as you and I have discussed on many phone calls that we’ve had, you got hit with a sucker punch right from the beginning, when the cases came in from Europe, and the Northeastern corridor, particularly New York State, particularly the metropolitan area, got hit really, really badly. You recovered from that, was after you got hit badly, your baseline level went way, way down and very, very low, and then you did things which were the appropriate way to avoid getting re surging. So the bad news, and it’s painful for me to see it from a distance to my place of birth, but you guys got really slammed.

And then you rebounded and you rebounded in a way that you kept your test positivity low, because you did the prudent things that you need to do. And I was following it from here in Washington and I was seeing that whenever it looked like things were getting a little out of hand, you tightened the rope a little bit. And then when things went back, you eased up a little bit. So I’m not surprised that your infection rate is really low because I think you were doing the right things after you had a really serious hit in the beginning when you were there in the late winter, early spring.

Doctor, on this education of the population of both the small spreads and even more now the vaccine, “Take the vaccine, it’s safe,” I think that’s going to be difficult to do. I think you have tremendous credibility, not just across the country, but across this state. And I think your voice on saying that the vaccines are safe would be important. I said that as soon as the vaccine is deemed ready and safe, I’ll be the first one to take a vaccine. Maybe we enlist you, I’ll do it with you. We’ll do an ad telling New Yorkers it’s safe to take the vaccine, to put us together. We’re like the modern day De Niro and Pacino. You can be whichever you want, you can be the De Niro or Pacino. Fauci and Cuomo, I’ll give you a… Who do you want to be? De Niro or Pacino? Which one do you want to be?

I love them both. I love them both. I don’t want to insult one or the other. If I say one, I don’t want to hurt the feelings of the other. Who is the politician?

All right, last question. I know you’re down in Washington, you’re doing great duty, but I know you miss New York. We want to figure out what to send you for Christmas? What food do you miss the most that you can’t get down there that you could get if you were back here in New York, in Brooklyn?

Governor, whenever I need some comfort food and I dream back of my days in the Bensonhurst section of Brooklyn, the thing that comes to my mind are two things, a nice Nathan hotdog and a really steaming pastrami sandwich. That would be really great.

All right. So no cannolis, no meat balls? Nathans hot dogs?

I don’t want to overdo it. I don’t want to overstay my welcome. I’ll take them all.

All right, done. Doctor, thank you so much for everything you’ve done for this country. God bless you. God bless you.

Thank you so much, Governor.

This was a moment that we really got to see what people were made of. When the pressure’s on, you see the weaknesses and you see the strength. And the pressure was on and it forged you into a rock that really stabilized this nation. So God bless you for what you did, doctor, and I know what to get you for Christmas. Send the bill to Christopher. Thank you very much. God, bless you doctor. Be safe.

You too, Governor. Thanks an awful lot. Appreciate it.

Thank you. Thank you. Okay. Italian guy asked for a Nathan’s hotdog and a pastrami sandwich. You can’t figure out anything anymore. If you had to bet what he was going to ask for, from Bensonhurst. Anyway, questions?

Speaker 1: (35:52)
Governor, for the indoor dining shutdown as soon as this Wednesday, I believe New York City’s tested above 3% for eight days straight.

First, there are different numbers, right?

First, there are different numbers, right? The state sets the policy, the state uses the state numbers. Local governments have different numbers, different configurations. That’s nice. But we use the state numbers. CDC came out with additional guidance on Friday, and we’re going to follow that additional guidance, which is basically more caution for indoor dining. We’re going to watch the hospitalization rate over the next five days. If that hospitalization rate doesn’t stabilize, which frankly, I don’t expect it to. I think Dr. Fauci is right, you’re seeing the Thanksgiving wave is just starting to break. And then the Christmas, Hanukkah, Kwanzaa wave is going to start. So I don’t see it. New Yorkers could change it, right? Because it’s all a function of behavior. But if the hospitalization rate doesn’t stabilize over the next five days, then we’ll go from 25 to zero in New York, 50 to 25 outside of New York City, besides the orange zones, which are already at zero.

Speaker 2: (37:23)
Would that take effect the next day? On Saturday, I guess?

That would take effect within a couple of days. We’d give the restaurants a couple of days to reorient.

Speaker 2: (37:37)
So then should we expect it would take effect the following Monday then if cases or hospitalizations continue-

We’ll say Monday if the rate doesn’t stabilize. And again, look, forget the indoor dining. Let’s look at the big picture. We are looking at hospitalization capacity. And if we don’t get the rate under control and you are going to overwhelm your hospitals, we will have to go back to shutdown. There are certain absolutes, okay? What is the absolute here? You cannot overwhelm your hospitals. You can’t be Italy. You can’t overwhelm your hospitals. If you are at a rate that is going to overwhelm your hospitals, you must shut down. Not just indoor dining, shut down, only essential businesses.

Oh, we don’t want to do that again. Then change your behavior. But if we don’t change our behavior, that is the absolute reality of the situation. How can you talk about close down again? That was terrible. Because it’s the truth. It’s the truth. I started this telling people the truth, I’m going to end it telling people the truth. You cannot overwhelm the hospitals. No state is better than we are at managing the hospital system. By the way, no other state does that surge and flex plan. So we will manage the hospital system as well as it can be managed. But if you’re going to overwhelm the hospital system, then we have no choice but to go to close down.

Now, Dr. Fauci, just to get the full parameter here, right? Because we look at these day to day, but it’s not really day to day. Look between now and vaccination effectiveness. That’s the window we’re looking at. We’re looking at December, January, February, March, April. And then April, as Dr. Fauci said, you start to do the general population. Between now and then, slow the rate of spread, slow the rate of hospitalization. If you overwhelm the hospital capacity, you will have to go back to shutdown. There are no options. That’s not discretionary. That’s not well, then maybe there’s an alternative. You can’t overwhelm the hospital system. Overwhelming the hospital system means people die on a gurney in a hallway. And the life you could have saved you can’t save because you don’t have the staff, you don’t have the doctor, you don’t have the nurse. And people die unnecessarily. Those are the absolutes.

Speaker 3: (40:58)
Governor, how do you address the misconceptions about the vaccine? People have said to me, “I don’t want to get injected and then get sick and get the COVID virus.” Or they feel it’s being rushed and they don’t feel it’s going to be stable or viable. So how do you address people? Some of these things may be inaccurate, but how do you address these misconceptions?

New Yorkers are a skeptical bunch. I don’t blame them. I’m a New Yorker, born and bred. I’m skeptical. I am. Take a vaccine. You take the vaccine first. Okay? And you tell me how it goes. And then you call me and then I’ll take the vaccine. That’s what I say when you say to me I should take the vaccine. All the polls say it. It’s a real problem. A, you have many people who think the vaccine was rushed for political reasons by the Trump administration. And that Trump interfered with the medical approval process. That is a real factor. True, not true, doesn’t matter. That’s a real factor. B, you’re asking people to take a vaccine and older people to take a vaccine. That’s frightening. And the doctors will say, “There could be side effects and we’ll do more testing six months, eight months.” And this whole situation on COVID has been changing all the time. Now there are long-term effects. I thought once COVID was over, it was over. Now, maybe it’s not over.

I get it. It is going to be a public education campaign with people with credibility and people who are willing to lead by example. I would not ask New Yorkers to take any vaccine that I would not take myself.

Speaker 3: (43:04)
Will you take one publicly?

I will publicly take the vaccine. Also, on that Trump skepticism, we added a New York State Review panel headed by a Nobel Laureate. So you’re going to have the Trump approval, the New York State Panel as a second approval in case you were nervous about Trump, second approval. And then Dr. Fauci will say, “Take it.” I will say, “Take it.” Other leading health experts will take it. And answering that New Yorkers’ question, it’s safe. Okay, if it’s so safe, put the needle in your arm and let me know how it feels. And I’m willing to do that. Zack.

Zack: (43:56)
Governor, can you talk about the situation in Staten Island? As you know, there were gathering protests. They’ve arrested the bar owner there a couple of times. Kind of an ugly incident. We heard about where he may have run over a sheriff with his car. What do you make of what’s going on out there? Is there some sort of aversion culturally to mask wearing and social distancing?

I think this, Zack. I think it is a very troubling and disturbing situation. I think people are frustrated, people are anxious, people’s lives have been disrupted because they have been. It’s not just COVID fatigue, it’s COVID exhaustion, it’s COVID anxiety, it’s COVID anger. I understand that. I understand that. But we have to deal with it. But what happened in Staten Island, there were certain, first of all, Staten Island has gone from the lowest death rate in the city to the highest death rate in the city. So all these local officials who are saying, “That’s right. We don’t have to do any of this. Forget this. Don’t comply. Freedom.” Yeah, freedom to die. Congratulations, you went from the lowest death rate in the city of New York to the highest death rate in the city of New York. You gave great advice to your people. More of them died.

A New York value was, there are a couple of primary New York values, one of them was you don’t assault a police officer. You don’t assault a police officer. They are defending a person who drove his car into a law enforcement officer, drove 100 yards with a law enforcement officer clinging to the hood for his life. And that’s who they’re championing? That’s who they’re championing? Someone who attacked a law enforcement officer? You don’t attack the NYPD. You don’t do it. They’re putting their life on the line. You don’t attack them. You don’t attack a law enforcement officer who’s doing his or her job.

And when you have someone who drives their car into someone, could have killed him, hospitalizes him. How dare you? What signal are you sending when you glamorize that type of behavior? “Yeah, that’s right. Run over the police.” What? What? Who says that? Who’s ever said that? “Well, we’re not going to comply.” Congratulations. You represented your people well. More have died. Go back and campaign. We went from the lowest death rate in the city to the highest death rate in the city because of my advice. Congratulations. Congratulations. No. It’s repugnant to the values of any real New Yorker. You never assault a police officer. Tough guy drives his car into a police officer. No. It’s disgusting. And a coward.

Speaker 4: (48:11)
Governor, we currently have a series of orange zones across the state that were set up using positivity rates. Are those now going to be altered or eliminated based on your new model using hospital metrics?

The CDC guidance targets indoor dining, which we’re following. The orange zone, the real difference between a yellow zone and an orange zone is the indoor dining and gyms and salons, gyms and salons, on the numbers, we have so many protocols on the gyms and salons. They’re not major spreaders on the numbers. It is about indoor dining. This is on top of the orange regulation. So this would supersede. So in other words, you’d close indoor dining in New York city in five days, which is what would happen in an orange zone. Marsha.

Marsha: (49:10)
So my question to you is this. You’ve said that you would, if the hospitalization rates don’t stabilize, you would close indoor dining totally in New York City. And the rest of the state would go to 25%.

The 50 to 25. Except in the orange zones, which are already closed. Yes, ma’am.

Marsha: (49:26)
Do you have in your mind a number of hospitalizations that would trigger your decision to do that? And also, and I want to make sure I understand this, are you also saying that this is just indoor dining and bars? You’re not going to go after gyms, hair salons, beauty parlors, nail salons, anything like that?

This is just indoor dining. The CDC has targeted the indoor dining as a spreader. And this is indoor dining. Stabilization is stabilization. Stabilization-

Marsha: (49:58)
[inaudible 00:13:59].

Stable. Where you are now stabilized instead of going up, right? So this is stabilization. This is increasing. If your hospitalization rate now is whatever it is, let’s say it’s 4%, instead of going from four to five, you’d have to stay at four and stabilize. So it’s no longer increasing. Right now, it’s increasing.

Marsha: (50:30)
Okay. What if it’s stable in New York City and it goes up in Buffalo?

It goes region by region. So if it’s stable in New York City, then we’re fine. If it doesn’t stabilize and continues to increase, which it has been doing, which I expect it to continue to do unless people change their behavior, then you would have a close down in New York City.

Marsha: (50:58)
In other words, if it’s stable in New York City, you don’t invoke the indoor dining rule in New York City? Or say it’s stable in Westchester or Long Island, you don’t invoke it there, but you invoke it in places where there is instability in the hospital system?

It’s region by region. That region’s rate would have to be stable. Am I asking-

Speaker 5: (51:20)
No, that’s correct. So Marsha, we’re looking at all of them by regions that we’ve broken the state out into the 10 different regions. And when you’re looking at hospitalizations, it’s important to look at it regionally because, for example, in New York City, if you live in Brooklyn, you could go to a Manhattan hospital, right? So the hospital system acts more together regionally. So what the governor is saying is we’re looking at this region by region. And if the hospitalization rates in each region don’t stabilize, if you’re a region outside of New York City, you’d go from 50 to 25. They have less crowding and density. In New York City, 25 to closure.

Marsha: (51:52)
So how do you get out of the sanctions? So in other words, say it continues to go up in a region, but then it stabilizes. Would you then bring back indoor dining in that region?

I don’t know. I don’t know. When would you undo restrictions? Yeah, you would have to see a stabilization or a reduction. Frankly, we’re looking at the opposite situation. We are looking at continued increases from now through mid-January. Did Dr. Fauci just say mid-January or late January? Mid-January? Because just think about it, right? You’re still dealing with Thanksgiving. Thanksgiving runs right into Christmas, Kwanzaa, Hanukkah. Runs right into New Year’s Eve, New Year’s Day. That’s why I said when we got to Thanksgiving, remember I said, “It’s not Thanksgiving. It’s the beginning of 37 days of a holiday season.” And if you don’t radically change your behavior, which is very hard during the holiday season, I get it, but you will see an increase through that holiday season, through New Year’s Eve, New Year’s Day. Give it another two and a half weeks, and then you’ll feel the full increase.

So I can see an increase right through mid-January. And then, well, what starts to decrease it? Hopefully you stabilize mid-January and then the vaccine starts to kick in. But this is a road nobody’s been down. But if you’re crystal balling it. And that’s what I heard Dr. Fauci to say in a lot of the projections to say … Dr. Zucker, is that …

Dr. Zucker: (53:55)
Yeah, it’s absolutely correct.

You have a crystal ball? Do you want to give us a date in January?

Dr. Zucker: (53:59)
You said mid-January. I made a bet with you [inaudible 00:18:02].

I’m sorry?

Speaker 6: (54:03)
January I made a bet with you. It was brief. I’m sorry.

Moshe: (54:04)
Closing down could happen as early as Monday.

As early as Monday if the hospitalization rate doesn’t stabilize and again Moshe, we are in control of this. This is nothing predestined and we’re talking about life and the COVID increase like it’s a fait accompli. It is not a fait accompli. So just change your behavior, change your behavior and get past this mistaken impression that I am home and my home is safe. I’m with my family and my family is safe. 50% of the spread is asymptomatic spread. So your sister who loves you can infect you and she will say afterwards, “I didn’t even know I had it. I felt fine. I didn’t sneeze. I didn’t cough. I didn’t do anything. I would have never done that on purpose.” And she’ll be telling you the truth. 50% asymptomatic spread. And that’s why the CDC just changed their guidance literally on Friday.

Speaker 7: (55:29)
You said that it’s not a fait accompli yet you also say it’s inevitable and you can tell what people dying on gurneys. If it’s inevitable, why wait?

No, it is not inevitable.

Speaker 7: (55:46)
You said earlier inevitable.

If I use the word inevitable… Let me change that word. I believe that is what is going to happen. I believe you’re going to see Thanksgiving run into Christmas, run into Hanukkah, run into New Year’s and you’re going to see this. I believe that. And that’s what most experts believe. That’s what Dr. Fauci just said, but it doesn’t have to be that. You could see New Yorkers change their behavior and be more careful and flatten and you don’t have the increase. That is a possibility. I don’t think it’s a probability because I’ve been sitting here for the past month saying, please, please, please, but it is a possibility. Worst case scenario, the number keeps going up and it gets so high that you endanger overwhelming the hospitals, then we have to hit pause and go back to closure.

Oh, we don’t want to do that. We don’t want to do that. Then, you have to alter your behavior to reduce the spread. Do I believe between now and five days, we’ll see a stabilization rate in New York City? I would be pleasantly surprised. I don’t think it is probable, but it is possible. Do I think we hit hospitalization criticality and have to close down? I pray no. I hope no. I hope New Yorkers get it before we get there. I’m restarting the briefings Monday, Wednesday, Friday. I’m going to show you the number every day. Say here’s the number. Another two points and we close. Here’s the number. Another one point and we close. Here’s the number, another half point and we close. So it’s up to New Yorkers. Well, why do I have any hope? Look at our infection rate. Vermont, Maine, Hawaii, New York, that’s all New York intelligence and unity and community and toughness and love define the nation. Define the nation. That’s what New York did on the infection rate. So it’s possible.

Speaker 8: (58:48)
So in the spring, the pandemic was pretty much defined by shortages. We’re running out of ventilators. We’re running out of beds. There’s always been some things missing. And what healthcare workers have told me is they worry that they’re the next shortage if there are fewer nurses. I’ve talked to a lot of nurses who said they’re retiring. They have PTSD from what they’ve experienced. And I want to know because we’re going to see the increase in bed capacity, are you concerned about that there’s not going to be enough nurses or other professionals to staff it and is there anything in your power that you can do to kind of assess beyond the medical reserve?

Yeah. Let me give you the ups and the downs. At our surge in the spring, we had 18,000 people with COVID in hospital beds. Let’s say 19 was our high number. Okay. We now have about 4,000 people in hospital beds. 19 was the high number. And then 19 was the high number in a circumstance that was reminiscent of an apocalypse, right? It was 19,000. Dr. Fauci, I forget his word. He didn’t say we’ve got ambushed, sucker punch. Because what happened to us was we had that spread from Europe as the doctor said and nobody told us. I believe it was federal negligence or it was frankly, the federal government lying to us. But the virus spread to Europe. Infected Europeans were coming here. There was no European travel ban until March 16th, so we went from zero to 100 overnight. I don’t believe we ever have that situation of stress again. I don’t believe we get to that number of people in the hospitals again.

Gov Andrew Cuomo: (01:00:52)
And we didn’t have a staff shortage at that time. We had tremendous staff stress, fatigue, et cetera. I believe we’re going to be in a more controlled circumstance this time with less overall stress. I get the PTSD phenomenon. I think about the decisions I make from a PTSD point of view. I think about the advice I get from my staff by the way, who I think have PTSD from the situation. And when you’re looking at the numbers, are you looking at the numbers or are you looking at the numbers with this filter of PTSD from the spring? But we didn’t really have a staff shortage. We just were brutal on the staff if you will. We’re going to bring up the reserves. I think we’re going to have, if I had to estimate, tens of thousands of retirees who will come help the system.

And if we balance it better, remember what happened last time. And I had talked to Dr. Fauci about this before, but you guys have to appreciate this. The system wasn’t overwhelmed, individual hospitals were overwhelmed and the individual hospital was a silo. So they showed up at one hospital that by the way had a sister hospital over here and a sister hospital over here and rather than sending people to the sister hospitals, they just got sat there and got overwhelmed. Why? Well, that’s how we operate. People come from our community to our hospital and we accept them. I know, but this is a different situation. The volume is too high. You have to not accept that person when they come to the door say, “I’m sorry, Zack, but there’s an ambulance outside that’s going to drive you to Melissa. It’s a hospital right down the block. It’s not as good as my hospital.” She thinks it is, but it’s not. Take you to Howard’s hospital. It’s not as good as my hospital, but it’s not bad. We didn’t manage the volume because there was no management system. The state doesn’t manage.

Speaker 8: (01:03:32)
I remember the press conference you had at the Javits Center where Mr. Dowel and Mr. Roski were there and you’re talking about this management system. Was that at the point of like, you set it up, it was kind of too late. The hospitals were starting to come down from that way of… and now that this is in full effect… I know Northwell was talking about how you’re doing early warnings and trying to figure out which hospitals are more likely to go overwhelmed so if Elmhurst is slammed, you send them to a different hospital instead of the situation you’re talking about. So I was just hoping to elaborate more on what the state did earlier on and how that’s going to apply for any other searches moving forward.

It was the first time we had ever seen this situation and in truth, we are better equipped now. It is still not perfect because we don’t run any of these systems. The HNH is a separate system in New York City. It’s run by New York City. They have HNH. What do they have? 11 hospitals? Nine hospitals? 11. They have 11 hospitals. They run 11 hospitals. Did you really need me to tell HNH, “By the way, you have 11 hospitals. Don’t overwhelm one. Distribute it among 11”? The private hospital system, the state really has no management. We regulate, but NYU Langone is NYU Langone and Mount Sinai is Mount Sinai. So this is really a new role for us. That’s why no other state does it. We just step in and say, “There’s a public health emergency. And we are now going to oversee the system like an oversight capacity,” but think about it. It was just extraordinary because this is all a private system, basically 215 hospitals, overwhelming majority private and then you have a couple of public systems. Suffolk has a public system. New York City has a public system. Erie has a public system. Who else has a public system?

Jim’s hospitals, I’m especially watching closely because I don’t believe he is a natural load balancer. Let’s take one more.

Speaker 9: (01:05:59)
The vaccine, the FDA is supposed to offer approval as soon as Thursday. Would the mechanics then be that once it’s approved on Thursday, it gets loaded onto trucks, airplanes. How does it physically get to New York? And where do you first anticipate those vials arriving on Monday or Tuesday?

It gets approved by Washington. The military, General Perna is in charge of transporting it. They use FedEx believe it or not. Another company called McKinnon. Do you remember the name of that other company? McKesson? McKesson, they transport it as soon as the federal panel meets. Our New York panel has already been talking to the FDA. Our New York panel will review the FDA while the vaccines are in transport. The New York panel will act assuming they approve it. The trucks roll. We then have the prioritization of where they go nursing home, nursing home workers. Within the healthcare workers, there are about 700,000 healthcare workers, the high risk health care workers and those are the first three tronches. And frankly, we’re not beyond the first three tronches, which will take weeks and weeks to get beyond those first three tronches. I have to go to work.

Speaker 9: (01:07:32)
Would you bring it into Javits, like is there a center?

The feds distribute wherever we ask them to distribute and we then have regional distribution plans from there. Thank you very much.

New York Gov. Andrew Cuomo COVID-19 Press Conference Transcript December 7

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