Rush Transcript: Governor Cuomo Calls on President Trump to Take Comprehensive Federal Action to Combat Novel Coronavirus Now
March 15, 2020
A rush transcript is available below:
Okay, we want to give you an update on what we know as of today and the recent numbers to date. Also, I am going to take a moment to go through the overall context of what we are doing. Every day we go through the daily update, but it is important that people see and understand the overall context of what is going on.
What is all this about? What the United States is doing, what they are talking about in Washington, what we are talking about here - slow the spread of the virus to a rate that the healthcare system can manage. Slow the spread of the virus to a rate that the healthcare system can manage. You are not going to stop people from being infected. There are all sorts of percentages about what percent of the population will be affected: 40%, 50%, 60%. You will not be able to control that. Nobody thinks you can. But you can make efforts to slow the spread because the real question here is can your healthcare system manage the influx of patients? That is all this is about. And China, South Korea, Italy - it is the same lesson over and over again. You get into trouble when the healthcare system can't manage that rate of intake. So, try to slow the spread so it equals your capacity in the healthcare system.
What do you do to slow the spread? Test, test, test. We made great progress on testing. The President's agreement to allow New York State to do its own testing is very important. We need more federal assistance in allowing what is called automated testing which the FDA still controls. Roche is a company that does automated testing. The President made an announcement with them. But it can't just be a couple of companies for the United States of America doing automated testing. We need more automated testing. What does that mean, automated testing? Manual, you put the test tube in the machine. Automated, everything is robotics. It goes from 30 tests per day to 1,000 tests per day from a laboratory that can go from manual to automated. So that is a tremendous difference and we need more help on that.
How else do you slow the spread? Density control. This awkward seating arrangement that we have here today reflects two things. Number one, that the LCA does not work on Sundays. Number two, spacing out the seating, reduce the density. So, reduce the density the best you can.
Those are both slow the spread strategies, okay? What does it mean to slow the spread? This is Dr. Fauci. Great New Yorker by the way. You see everyone in Washington looking at the charts of the curve. Flatten the curve. Flatten the curve. Reduce the rate so the high point of cases is reduced so it can be managed by the healthcare system. That is what they are talking about. Flatten the curve. Flatten the curve. Why do you want to flatten the curve? Because the curve is not a curve. The curve is a wave and the wave could break on the hospital system. That is what they are talking about the curve. If you have too high a number of people sick at the same time, when they descend on the hospital system you will overwhelm the hospital system. That is the issue here. It has always been the issue here - overwhelming the capacity of the hospital system. And that my friends is important.
We listen to the cable news all day. Well, why did we not start testing earlier? Why were we not prepared? That is all about yesterday, right? That is all recrimination. That is blame. We should have done this. We should have done that, should have done this. I am a governor. I am here today. I am focused on what I need today to prepare for tomorrow. And that is what everybody should focus on. You want to do a retrospective on who should have done what when and who is to blame? Put a pin in it and do it afterwards. Let's be constructive by just focusing on today and tomorrow. There is an old military expression that management officials use: don't fight the last war. This is not about what happened yesterday. We are looking at a new war that no one has seen before. This is a case of first impression for this nation. We have never fought a virus like this with this potential consequence. So, plan forward. You see that wave. Try to reduce the size of the wave. Assume you can't reduce the size of the wave and assume the wave breaks at a higher level than the hospital system can accommodate. I believe that's what's going to happen.
So what do you do? New York State hospital capacity: 53,000 beds, 3,000 ICU beds. Is that a lot of beds? Is that little beds? Three thousand ICU beds presently about 80 percent occupied. Okay? So that means you have several hundred ICU beds available. Why are the ICU beds available important? Because the people who come in, vulnerable populations, older people, underlying illnesses, respiratory problems - they need the ICU bed. They need the ventilators. They need the machines that breathe for them. Those are the ventilators. They are in ICU beds. The overwhelming crush is going to be on the ICU beds, not the 53,000 normal hospital beds because those are basically going to be people recovering from the flu. You can recover from the flu at home. If it's really bad you go into the hospital, they make sure that you are not dehydrated, but the critical people are the people who have underlying illnesses and need those ICU beds and those ventilators. Three thousand goes very, very quickly on any projection of these numbers.
What do we do? Maximize existing hospital beds and hospital capacity, potentially build more capacity, again we're only talking about several weeks here before that wave breaks, potentially build more on the existing hospitals, provide more staff, identify backup staff, that's why we're going to medical schools, retired nurses, retired doctors, develop a reserve staff because health care workers will get sick and when they get sick they go home. You want to limit the hospitals? Limit staff. That's the way you limit the hospitals. Find doctors who are on reserve, and purchase the necessary equipment. What makes an ICU bed an ICU bed? Primarily the ventilator. These ventilators are expensive to begin with and they are scarce and you can't find available ventilators no matter how much you're willing to pay right because there is literally a global run on ventilators. And free up beds that are in the hospitals. How do you do that? Two ways: one, we may get to a point where you can't do elective surgery, you can have your hip replaced next month, not now, or develop another facility that you can move people from an existing hospital bed who don't need intensive care into a different facility.
How can you build more hospital capacity now? That's a great question. It has never been done before. It takes years to build a hospital. It takes years to convert an existing facility into a hospital. It's billions of dollars, it's a workforce in the thousands, but on the theory of try everything, an area you have to explore is can you build more hospital capacity now? I'll get back to that in a minute.
On the reducing density, slow the spread by reducing density. I've been talking to private businesses all across the state. I am asking them to aggressively to consider work from home strategies. I'm asking them to aggressively consider voluntary closings to help reduce density as a social responsibility to protect their workforce but I want private businesses to aggressively consider work from home and voluntary closings. Depending on what businesses do on a voluntary basis we could consider mandatory actions later on. We've already taken mandatory actions, no large gatherings over 500, 50 percent of legal occupancy of a facility. That is a mandatory way to reduce density in the workplace. I'm asking them today to voluntarily consider closings and reductions in workforce. If need be, we can calibrate up the mandatory requirements that we have already put in action. How do you calibrate it up? Rather than 50 percent of occupancy it could be 40 percent of occupancy, 30 percent of occupancy, etcetera. I'm not doing that at this point but I am asking businesses to aggressively consider these measures. If the private sector does not respond voluntarily, if the spread does not slow, then I would increase the mandatory guidelines.
For New York State government, lead by example. All non-essential personnel in the state are asked to stay home from Rockland County south. That's about half the workforce of the state in that area. Why Rockland County south? That is the area with the highest density of number of cases. Remember again, the number of cases varies widely across the state. You're calibrating your actions to the data, to the science. You should be doing different things in New York City than you're doing in a county upstate that only has one or two cases, right? This is a calibration by science to the facts.
The New York State court system congregates many people, tens of thousands of people all across the state. I spoke to the chief judge. I asked her to come up with a plan that keeps the essential services operational. Criminal justice services, emergency family services, et cetera, the essential services available. But non-essential services, actions that can be postponed, to postpone them. Again, reduce the density coming into the court system. I'm asking private businesses to stay home. Reduce the density coming into the court system. Don't jeopardize the criminal justice system, don't jeopardize safety, don't jeopardize family integrity, but if it's non-essential then postpone it. Come up with a plan that reduces the courts to follow that concern. The chief judge is a total pro. She's not just a great jurist, she's also a great manager. She's managed large operations before and all of her skill and tenure has been on display here as the chief judge. And she's ideally suited to do this. I asked her to come up with a plan tomorrow that she will announce on the specifics of how she'll implement this.
How else do you reduce density? You come to the issue of schools. To reopen schools, close schools - a number of schools have closed. We've added Jim Malatras - you all remember Jim Malatras. He used to work here then semi-retired, went to academia. He doesn't consider it semi-retirement, but I like to irk him that way. Close the schools - it's not that easy, it's not that simple. Close the schools, for many families the school is childcare. If you close the schools and the children are home, a large percentage of the workforce may say I have to stay home and take care of my children. There are school districts that are in wealthier parts of the stay where the families are in a position where one parent stays home or they can hire a caregiver. But then there's everybody else, right? I'm from Queens, New York, I grew up in a very working class neighborhood. Most families don't have a caregiver at home - if the children stay home, a parent has to stay home. If there's only one parent in the home, that parent has to stay home. Yeah, but we have essential workers that need to go to work - police people, fire officers, healthcare workers, again, because this is all about the capacity of the healthcare system. We can't have 1199 healthcare workers not coming to work because they have to stay home. We can't have nurses staying home because they have to stay home and watch their child. So, it sounds simple, it's not simple. You close the school, how do you feed the children? For many children the breakfast and the lunch are the two main meals they get and they get that at the school.
How do you distribute food to all these children who are now not in school? So, those are very real concerns. If you can address those concerns, address the negatives of closing the schools, then yes, close the schools. Why? Because it's totally in line with our density reduction, et cetera. These concerns can be addressed and it's up to the locality to come up with a plan to do it. We're speaking to Nassau, Suffolk and Westchester - County Executive Lauran Curran, County Executive Steve Bellone in Suffolk, CountyExecutive George Latimer in Westchester. They're interested in closing schools. We said closing schools, if you can reduce the negative, childcare, student meals, et cetera, then I think it's a good strategy. But, we have to address those two negatives. The worst negative is if we lose essential workers. Police officers say I can't come to work. Firefighters say I can't come to work. Public transportation operators say I can't come to work. And most dramatic impact, hospital workers. Because remember the hospital workers, there will be hospital workers who get sick. That's going to happen. That will reduce staffing in hospitals. That has to be factored in because you know that's going to happen. So given that, you want to make sure you're not artificially making that problem worse. Jim Malatras is going to be working with these counties to try to put together these situations that would take care of the negative consequences of closing schools, which would then facilitate the closing of schools. Ongoing operations, just so we sum up. We're doing testing, we've made great progress there. Thank you Vice President Pence. Thank you President Trump. We have more to do. Density reduction, which is what we've been talking about. School closures, and taking care of the negative consequences that might happen is an ongoing function. Hospital capacity, hospital capacity, hospital capacity. And tracking of the cases. Mapping of the cases. Identifying the clusters so we deploy our resources. The numbers today, total tested is up to 5,272. As I've said every day, the more you test, the more positives you will find. New cases 442. I'm sorry, newly tested 442. This is just testing data. 5,200 tested. 442 tested. Since last evening. Is that correct?
Melissa DeRosa: Yeah, so far this morning.
Governor Cuomo: So you see how fast, we were only doing 200 tests per day. We now did 442 since last evening at about 6:00 when we did the last briefing. Positive cases 729, new cases 69. New York is the state that has the most number of cases. Again, you would have to correlate that to how many tests the other states are doing, because the more tests they're doing, the more cases they will find. We've had three deaths. We had an additional death since we spoke last. 79-year-old woman who had multiple major underlying health issues. And had the coronavirus and succumbed to the coronavirus. Current hospitalizations, 137 out of 729, that's 19 percent of the cases. This number relates back to hospital capacity. 65 patients in ICU already. This is against the number of beds available in ICU units. And you can see how quickly these numbers move. 46 patients intubated. Again, perspective, perspective, because we're fighting the virus, we're fighting fear. The fear is winning. And the fear is disconnected from the facts. Fear is an emotion. Emotion can often be disconnected from facts, and that's what happening here. But this tracks all the cases that have happened since China. 156,000 cases, 5,000 deaths. You look at the people who have passed away in the State of New York, the three people. Those are three people who may very well have passed away from contracting the flu, right. Every year, tens of thousands of people die from the flu. We say they die from the flu, but they very often had, they were battling cancer, they had heart disease, they had emphysema. And then the flu on top of that underlying condition was the straw that broke the camel's back. I did an open letter to President Trump today that made three points. It says we know what is going to happen. Because we have the data and the projections. Look at China, look at South Korea, look at Italy and just plot the numbers. You know the term, you know how effective you are at flattening the curve, and we are now looking at a wave. And we know it is a wave. Do everything you can to reduce the wave. We are. It's still a wave. It is going to be a wave. And it is going to be a wave that at any of these projections will overwhelm the healthcare system. I asked three things. One, on the testing, that, and I'm grateful that he approved the New York testing capacity, FDA has to get out of the way on the automated testing capacity. Let us approve automated testing companies. It can't be one or two companies are the only companies in the United States doing this. You need hundreds of thousands. Accelerate the testing. Second, the federal government has to provide help and guidance to states on what to do and when to do it.
This can't be a national policy of every state does its own thing. You can't have a patchwork quilt of policies. New York State closes stores - okay, New Jersey doesn't. What did I do? I just sent thousands of vehicles over to New Jersey. Flooding New Jersey stores. New Jersey closes stores and [inaudible] and what did they do. They just sent thousands of people to shop in New York and then back to New Jersey. You cannot do this ad hoc - one state at a time. Make a decision. Tell the states this is the decision and then let's go.
Closing schools. If you think schools have to be closed, well then help us. Where do we get the child care? Where do we get the meals? Where do we get the money to provide the meals? There are ways to do it, we could just increase what's called the SNAP program. The food assistance program for families. And say, you know what, your food assistance payment is going to go up 50 percent. You buy Johnny breakfast and lunch. But we have the federal government that is intricately involved in that. Help us plan and help us coordinate. And don't pit one state against the other inadvertently by having to come up with different policies.
The third point is this. You're going to need more hospital capacity. You're going to need more facilities. You're going to need ways to free up those 53,000 beds. You're going to need to construct or retrofit physical buildings. Acquire thousands of pieces of equipment like this. A state can't do that. I don't have that workforce. I don't have the resources, but even if I had the resources, I don't have the physical capacity to turn SUNY dorms into hospitals in 3 weeks. I can't. There's only one workforce that can do that. It's the Army Corps of Engineers and the military assets. That's what they do. They build bridges, they build camps, they have tens of thousands of personnel, trucks, equipment, excavators, logistical managers, purchasing power. Use them to come in right now, identify existing facilities that can be retrofitted and use them to do it.
China built dozens of hospitals in literally a month. How? The Chinese government came in and send we're going to do this, we're going to nationalize it. South Korea, the same thing. You can't leave it to the states. I can't do it. I do not have the resources or the capacity. By the way, I'm in an aggressive governor. I push very hard. But there's no way that we could manage this undertaking. The Army Corps of Engineers. I used to be in the federal government, I worked with them, they're amazing. Their capacity is amazing. And what better time to use those resources than saying let's get to work. Let's retrofit buildings, let's purchase the equipment, let's use that massive logistical machine of the military to actually save lives.
It makes all the sense in the world and, by the way, we have no option. We have no options. You what management is? It's the best option. My expression to my colleagues, what are my options? Well you have none. There's only one. Okay. I pick that option. You have no other options. Otherwise we will be sitting here 9 weeks, 10 weeks, 14 weeks from today seeing a health care overrun. We will be saying we knew this was going to happen, why didn't we provide more health care facilities. Why didn't we do everything we could to make that a reality? Doing everything you can to make that a reality means bringing in that Army Corps of Engineers and bringing in that military expertise. And I hope the President takes me up on it.
|Join the GlobalSecurity.org mailing list|