New York Governor Cuomo April 2, 2020
New York Gov. Andrew Cuomo holds a press briefing.
Opening Graphics:
Westchester and Nassau by % in a troubling number. Those numbers are concerning. We are watching those.
It is now in EVERY county in New York. It is false comfort to say we are a rural community. You have counties in New York state where you have more cows than people.
He believes it will march across the nation like this.
The patients discharged is up 1292 - that's good news. The number of people going into the hospital is going up and people coming out is going up.
The number of deaths = 2373
up from 1941
Looking for a trend line - still basically up:
you can start to see a plateauing in the number of intubations but an optimistic view
Discharged number went way up - people going in and people going out.
The challenge is still the APEX.
Everyone is basically in the same battle - the apex is the highest rate of infection - can you handle that number - can you handle the height of the impact on the hospital system which is at the apex - battle of the mountaintop
When is the apex? Depends on which model you use - 7-30 days depending on the model you look at
depends on how that model rates how effective social distancing is - the models that think social distancing is most helpful have a longer timeframe for the apex
we are planning on a day to day basis - deploying assets on a day by day basis
we believe it is closer to the shorter end of the range with our in house people looking at the modeling
we need 70-110k beds at the apex - broad range
we have 53k statewide only 36k downstate - this is primarily a downstate issue
so we don't have the number of beds - every hospital by mandate has to add a 50% increase and they have all done that - setting up extra facilities - shifting patients to upstate hospitals etc
project to hit apex and come down from it - depends on how quickly you come down from it - all models say it comes down quickly - some models have it flattening out - and continuing through the summer
only 1 model we look at for projected deaths - IHME model funded by the Gates Foundation - approx 93k deaths across the country (I believe Dr. Fauci used this model) - NY would be about 16k deaths by that model
Theory is - chain is only as strong as the weakest link - true for hospital
180 hospitals we are focusing on - the greatest issue will be the ones who are most stressed in normal circumstances -
@8:28
- break---
starting @28 minutes into the video
Pleading with businesses to help - he will pay a premium; not asking for any favors
Ventilators - if the rate continues to increase -they have about 6 days worth in their stock pile (depends on the apex)
"We need what we need."
The state is buying the ventilators -they are expensive and the state is broke, so no desire to buy them if don't need them.
Without ventilators, the person dies.
Taking all sorts of extraordinary measures - have in place that can make a difference if we run into a real shortage.
- We know where all the ventilators are in the State of NY by hospital. If a problem - they will transport them from hospital to hospital. Then return them or figure out the finances of it.
- Also increasing ventilators by ending all elective surgeries.
- Also using anesthesia machine ventilators.
- Also- splitting ventilators. Protocol out - 2 sets of tubes can do 2 patients. Not easy or ideal.
- BiPap machines (?) converting - for emergency need.
- Still looking to buy them (too late to ask companies to make them with our 7-30 day timeframe).
- Nationwide - parts of the company with a later curve - companies can ramp up production (2-3 months)
main place to buy - China (?)
Northwell - Premier Healthcare System - has a protocol for 3000 BiPap machines (750k came in yesterday) ??
Also opening Healthcare Exchange Enrollment Period through May 15th - for those who are NOT covered. NY STATE OF HEALTH website to sign up. GET COVERAGE if you don't have it.
His little brother, Christopher, tested positive for Coronavirus - he checked in with him this morning - and he was up and spry and much his normal self.
"There's no greater measure of what you meant to the world than the kids you brought into it." - Christopher
Christopher giving feedback on having the virus - "it's tough"
You've got to rest - your body has a fever -
didn't feel the symptoms until the night after he was diagnosed positive
"rigors" are real - out of a movie (hallucinations, his brother came to him in a dream with an LA outfit, dancing in the dream waiving a wand wishing he could make it go away)
(comic relief - the two brothers joking with each other)
"I believe fish can stay neat and clean." - Gov Cuomo after Christopher talks about him fishing in white
Christopher is quarantined in his basement.
@45 minutes into the video
Questions:
Q: Mandatory Curviews - is he open to this?
A: Depends on what the theory of their action is - what problem are they trying to solve.
Q: How many in the COMFORT and JAVITS center?
A: don't have the numbers - operated by the Federal Govt - for NON COVID patients - theory is that non-covid patients would come out of the hospitals to free up beds for Covid patients. I would have to get the numbers.
Q:
A: They could. You need the Fed govt to allow you to have Javits - Javits and Comfort can do whatever the military allows them to do. On the COMFORT - no COVID bc a ship - how would you disinfect later? On Javits - you could.... not sure what medical staff Covid vs Non-Covid.
Q: China reports - cases and deaths may not be accurate - if true does that impact on the USA models we are using?
A: interesting question - we review the models, but we don't do them. McKenzie, Cornell, etc... does models. The modelers will tell you they use Wuhan data - to calibrate the rate of spread and the effect of social isolation - but also have a lot of data post-China relying on - South Korea - rate of spread now here. The model isn't soley dependent on that China data (at this point).
Q: Did NY receive faulty ventilators from the fed govt
A: We received 4400 - have distributed many - haven't heard of any faulty
LA TIMES in CA reported some sent to them were faulty - have to run ventilators every so often (like a car battery) - so in NY we haven't seen a problem so far.
Q:
A: Fed govt is very aware of our situation. Spoke to President this morning. Working with VP and White House staff etc. I don't think the Fed Govt is in position to distribute to the nation what will be needed. He doesn't know if they have more in the stock-pile. He knows ventilator availability is competing for everyone. I wouldn't be surprised that they don't have enough to provide for all. Therefore, his attitude is that "you are on your own" - he will plead and ask the fed gov for help if needed. "Just assume you are on your own in life". Having said that - I am assuming the fed gov would do whatever they could do to help. Question is what can they do?
R: (sounds like he hasn't heard the President's Press Briefings where President Trump has said the fed govt has 6000 in stockpile)
Q:
A: You are past that point now, you can't find the product (PPE)
Q: BiPAP vs VENTILATOR
A: I have no idea -besides generic comment the BiPAP does not have the same level of force- pump the same air -
DR. BiPAP does not have ability to push as much air in. Ventilators can do different types of support. But BiPAP will help once converted over.
As people's conditions change (better or worse) - you can move them to different machines - not a stagnant situation. A ventilator has more variability than a bipap machine.
Gov. C - this is not an ideal situation. In a perfect world, everybody would have a ventilator. If we hit that apex and run out of ventilators - then we have all those other series of measures (listed above by numbers he covered earlier)
Q: President Criticism of State and Praise of Gov
A: I don't know how you square those two statements.
Got a late start on supplies - we started purchasing - and probably purchased more than any state in the country - bet you more ventilators than any state in the country - very aggressive from day 1
I thank him for his good words that he thinks I am doing a good job
Q:
A: doing all we can for nursing homes, etc.
Q:
A: Let's see where we are after 90 days - rent, income, infrastructure
So much of this is fluid, changing - no one can tell you the right plan in any of these areas 90 days from now - I just want to get there healthy and handle what we need to handle
Q:
A: We'll have to get back to that - to get the # (something about a shipment they received)
Q:
A: We have about 2200 ventilators in the stockpile.
about 350 people come in every night who need a ventilator.
There is no state or country that has done anything to provide ventilators that we are not doing. We looked at Italy, China, etc... We are doing more in terms of back up contingency plans. Every day we try to find more and be creative.
Q:
A: I defy change. Intellectually I am open to growth and change - just not practicality. I think it will change me. This is incredibly hard and difficult. I take my job and responsibility very seriously - I don't make excuses. If I fail, I fail. If something breaks or doesn't work - that's on me. I see those number of deaths every day and I take that personally - and I feel the paid that families are feeling. I'm doing everything I can but people are still dying and that is very hurtful, humbling, and painful - and this is a long time to be under that level of pain. What do you look like when you come out the other side? I don't know.
Q:
A: I don't know if they looked into it - if not, we will.
Q:
A: no and yes - we have discussed this for 2 years intensively - looking at facts and figures (from the rollout of the lot in January)... everyone has been looking at the facts and figures- there is a range of opinion - the bail reform we did last year I am very proud of - it was discriminatory in effect and impact- I think the improvements we made this year are the right ones also.
Q:
A: Essential projects = projects that are public works by an large the state and city need - after this is over - we will have to get back to work and have an economy that functions - have infrastructure is essential part of that - those airports are still functioning - planes still coming in - La Guardia - project would be difficult to freeze and then unfreeze
Q:
A: decide basically on finances - borrowing to deal with short term - look by Oct next year access to the market -
Q:
A: short term borrowing - will look at what they market will allow us to borrow -
APRIL - July 15th shortfall is 10 billion dollars - we have some access to reserves that we have so we will make that determination then
Getting this budget done with all the initiatives in this budget is an extraordinary accomplishment - praises to the legislature -
-While bail eligible crimes - they moved certain crimes to bail eligible with the bill.
Q: MIT recommendations released?
A: they are in the budget can delay them in the budget
Gov Cuomo sang Happy Birthday to a lady in the audience as he walked off.
R: wondering: What if they could avoid needing the ventilator altogether by targeting other treatments or therapies early on?
example: administratoin of the Vit C IV therapies?
