Andrew Cuomo New York Coronavirus Briefing Transcript: March 17

Andrew Cuomo: (00:00) ... great Health Commissioner, Dr. Zucker, Melissa DeRosa, Secretary to the Governor, Robert Mujica, Budget Director. Let me go through an update. Andrew Cuomo: (00:11) As you know, the situation changes daily now which is expected. This is an evolving situation. Numbers ramp up. That's been the experience in every country that this has visited. So, we want to make sure that you understand that as the facts change, our strategy changes. We have a plan. We're sticking with the plan. The plan adjusts or moves as the facts move. Andrew Cuomo: (00:44) The first stage was always testing. The first step was testing, and the second step was containment, and they work together. The testing has ramped up. It's continuing to ramp up. It will be in the thousands per day. That is going very, very well. The state is managing its testing capacity. We're working with the federal government on bringing on automated testing. That is all going very, very well, and the numbers are going up. Andrew Cuomo: (01:16) Containment, we've taken a number of measures, significant measures to do containment and that is working very well. On the containment side, we had a tri-state strategy, which is highly unusual but highly effective. We worked with Connecticut and New Jersey, and we announced the same rules in Connecticut, New Jersey, and New York. Why? Andrew Cuomo: (01:43) You don't want people shopping different states, because different states have different rules. You don't want people driving to Connecticut or New York or New Jersey, because there's a different set of rules, so uniformity works. It's hard to do, but when you can do it, uniformity works, and we did that yesterday with restaurants, bars, gyms, all closing 8:00 last night, and staying closed today with the caveat that they could sell off-premises by delivery, and the State Liquor Authority changed their rules to make that possible. Andrew Cuomo: (02:27) We closed all schools. All schools are closed for a period of two weeks. And the 180-day SED requirement is waived for two weeks. At the end of two weeks, we may renew that period of time, but all schools have the same period. Why? Because once again, you need uniformity. You don't want a business having some employees in one school district that is open, and one school district is closed. So, in all of this disruption and all this change, try to keep it as uniform as possible and the rules as uniform as possible, so to the extent the businesses can operate, people can live their lives, keep it uniform. My phone has been ringing off the hook with a number of local officials saying people are very, very upset. Who's upset about the gym being closed? Who's upset about their restaurant is closed? Who's upset about the bar is closed? Actually, I've had the highest number of calls being complained about bars being closed. I don't know if that is that distinctly representative of anything, but that's just anecdotal. Andrew Cuomo: (03:50) Some people are upset about schools being closed. I said to the local officials, and I want to say to the people of the state of New York, if you are upset by what we have done, be upset at me. County executive did not do this. The village mayor did not do this. The city mayor did not make these decisions. I made these decisions. These were all state ordered rules. It's not your local elected official. I made them because I believe they are in the best interest of the state. I know they cause disruption. I know people are upset. I know businesses will be hurt by this. I don't feel good about that. I feel very bad about that because I know we're going to have to then deal with that issue as soon as this immediate public health issue is over, but my judgment is do whatever is necessary to contain this virus and then we will manage the consequences afterwards. Andrew Cuomo: (04:59) The old expression, the buck stops on my desk, the buck stops on my desk. Your local mayor did not close your restaurants, your bars, your gyms or your schools. I did. I did. I assume full responsibility. Andrew Cuomo: (05:15) Again, these are all statewide rules because we don't want people shopping among different jurisdictions. You close the bars in New York city, but you keep them open in Nassau, Andrew Cuomo: (05:31) all you'd see is a flood of cars going to the bars in Nassau, so the uniformity is important. It's also important that no local government puts any rules in place without first checking with the Department of Health, so the Department of Health can make sure that they are consistent with all other rules that we are about to put in place. Mitigation is continuing and is ramping up. There are many rumors out there. Part of the fear, the anxiety, people spread rumors. Well, maybe you're going to quarantine New York city. We hear New York city is going to quarantine itself. That is not true. That cannot happen. It cannot happen legally. No city in the state can quarantine itself without state approval, and I have no interest whatsoever and no plan whatsoever to quarantine any city. Andrew Cuomo: (06:45) Will you contain the New Rochelle? We did a containment zone on New Rochelle, which was actually misunderstood. Nobody was contained in New Rochelle. There was no cordon around New Rochelle. You could come and go in New Rochelle as you wanted. The containment referred to the virus. All we did in New Rochelle was close the schools and close places of large gatherings, so nobody was contained within New Rochelle and nobody's going to be contained in any city in this state. So, that's a deep breath moment. Andrew Cuomo: (07:32) And the last part of the strategy is dealing with the healthcare care system and this is where we are now going to shift our emphasis, and I want people to understand what we're going to have to do with the healthcare system because that is now our top priority. And remember what we've been saying all along. There is a curve, everyone's talking about the curve, everyone's talked about the height and the speed of the curve and flattening the curve. I've said that curve is going to turn into a wave and the wave is going to crash on the hospital system. I've said that from day one because that's what the numbers would dictate, and this is about numbers, and this is about facts. This is not about prophecies or science fiction movies. We have months and months of data as to how this virus operates. You can go back to China. That's now five, six months of experience. Andrew Cuomo: (08:42) So just project from what you know. You don't have to guess. We have 53,000 hospital beds in the state of New York. We have 3000 ICU beds. Right now, the hospitalization rate is running between 15 and 19% from our sample of the tests we take. We have 19.5 million people in the state of New York. We have spent much time with many experts projecting what the virus could actually do, going back, getting the China numbers, the South Korean numbers, the Italy numbers, looking at our rate of spread because we're trying to determine what is the apex of that curve, what is the consequence, so we can match it to the capacity of the healthcare system, match it to the capacity of the healthcare system. That is the entire exercise. Andrew Cuomo: (09:44) The "experts," and by the way, there are no phenomenal experts in this area, they're all using the same data that the virus has shown over the past few months in other countries, but they're extrapolating from that data. The expected peak is around 45 days. That can be plus or minus depending on what we do. They are expecting as many as 55,000 to 110,000 hospital beds will be needed at that point. That, my friends, is the problem that we have been talking about since we began this exercise. You take the 55,000 to 110,000 hospital beds, you compare it to a capacity of 53,000 beds and you understand the challenge. As many as 18,000 to 37,000 ICU beds, okay? An ICU bed is different than a hospital bed. An ICU bed has additional equipment, most notably ventilators, and that's why you hear on the news, ventilators are very hard to get globally. Why ventilators? Because we're all talking about acutely ill, mainly senior citizens who have an underlying illness. They have emphysema. They're battling cancer. They have heart disease, and then they get pneumonia on top of that. That's the coronavirus. They need to be intubated, they need an ICU bed, and that's the challenge and that remains the challenge, and the numbers are daunting. Andrew Cuomo: (11:45) What are we doing? Everything we can. First, flatten the curve, continue to flatten the curve so you reduce that peak demand. We announced dramatic closings yesterday to reduce the density. It's possible we will be doing more dramatic closings, not today, but I'm talking to the other governors in the other states. Showing that expected flow into the hospitals, it's clear we can't manage that flow. How can you reduce the flow? You reduce the spread. How do you reduce the spread? You close down more interaction among people. How do you close down more interaction? Well, yesterday we closed the bars, the gyms, etc. You would continue to close down things such as businesses. Italy got to the point where the only things they left open were grocery stores and pharmacies. Those were essential services, but they closed down everything else. We're not there yet, but I am telling you we have to get down that rate of spread because whatever we do on the hospital side, we cannot accommodate the numbers that demand on the hospital system. Andrew Cuomo: (13:16) So again, we just enacted rules yesterday. We're not enacting any other rules today, but it is very possible because the numbers, as you'll see in a moment, are still going up. Whatever rules we come up with will be statewide rules. Hopefully it could be done with our surrounding states because the best way to do this is uniformity. No shopping among states, among cities, among counties, everybody lives with the same rules, so we don't have people on the road going back and forth trying to game the system. At the same time that you're trying to reduce the numbers coming into the hospitals, you're trying to increase the capacity of the hospitals. How do you do that? The hospital surge capacity. What is the surge capacity? Getting the existing hospitals to hold more people. Right now there are rules and regulations about how many people can be in a hospital, how many people per room, how many square feet per bed, etc. Andrew Cuomo: (14:33) That's for normal operating conditions. These are not normal operating conditions. We're examining the entire hospital system. What is the maximum capacity per hospital? If Department of Health waves their spatial rules, how many people can you get into hospitals? There is a meeting today with all the hospital administrators that I've asked Michael Dowling and Ken Rasky to run. Michael Dowling is a former Deputy Secretary of Health and Human Services, former Health Commissioner, Michael Dowling worked for my father's Health Commissioner. I've known him 30 years. He's extraordinary. Ken Rasky, the same, represents all the hospitals sitting down with the hospitals saying, change your headset. This is not about how you normally do business. Frankly, forget the economics. What's the maximum number of people we can get into your hospital and what do you need to do that, and what equipment do you need to do that, and what staff do you need to do that? Andrew Cuomo: (15:45) We're going back to retired staff and we're asking them to contact us at this website, health.ny.gov/assistance, to get former nurses, former doctors, to sign up to be on call. We're also going to medical schools and nursing schools to try to get additional medical personneL, And then we're talking about temporary construction of medical facilities. Obviously when you're talking about 45 days, you have a limited capacity of what you can actually get done, but I'm working with governments and organizations all across the state right now. How do we set up temporary hospital facilities? even if they're not intensive care units? You can take people who are in the hospital beds, move them into a temporary medical care facility, and then backfill the bed. We're also working with FEMA, the Army Corps of Engineers, and the National Guard, and the Building Trades Unions to help us on this issue. The numbers: total people tested to date, we're up to 10,000 people, which is obviously exponentially higher than it was and it's continuing to grow, positive cases up to 1300, new positive 432, number of counties with cases continues to grow, Clinton County, Rensselaer County have been added to that. Our cases are, again, number one in the nation. Our number of deaths now up to 12, 264 out of the cases are hospitalized. That's a hospitalization rate of 19%. That's higher than the normative hospitalization rate, which is at about 15%, but the 19% is higher. Again, keep this all in focus with what we know, the facts we know of what this disease does and what the impact is, which is the Johns Hopkins study, which has tracked every case since China. Andrew Cuomo: (18:22) A couple of other points and then we'll take your questions. We'll open today, in Nassau County, a drive through testing office. We opened one in New Rochelle. It worked very well. We'll open Nassau today. We're going to open a Suffolk drive through testing office, and we're going to open a Staten Island drive through testing office. We're going to send up the Paid Family Leave Bill to the legislature today. I believe we have a three way agreement on that. It will also have a provision to cover all people who were quarantined and we will be doing that also. We'll also be opening a Rockland drive through testing facility. Andrew Cuomo: (19:08) Two other points: one, this is an extraordinary time in this nation's history. It will go down in the history books as one of those moments of true crisis and confusion and chaos. I lived through 9/ 11. I remember the fear and the panic that existed in 9/11 where a single moment, your whole concept of life and society can be shaken, where you need to see government perform at its best, you need to see people at their best. Everybody's afraid. Everybody's nervous. How you respond, how you act, this is a character test for all of us individually. Andrew Cuomo: (20:03) ... Test for all of us individually. It's a character test for us collectively as a society. What did you do at that moment when all around you lost their head, right? Rudyard Kipling. That is this moment. What does government do in this moment? It steps up, it performs. It does what it's supposed to do. It does it better than it's ever done it before. What does government not do? It does not engage in politics or partisanship. Even if you are in the midst of an election season, even if you are at a moment in time in history where you have hyper partisanship, which we now have. The president of the United States, Donald Trump, it is essential that the federal government works with this state, and that this state works with the federal government. We cannot do this on our own. I built the airports, I built the bridges. Andrew Cuomo: (21:17) We have made this government do things that it's never done before. This government has done somersaults. It's performed better than ever before. I am telling you, this government cannot meet this crisis without the resources and capacity of the federal government. I spoke to the president this morning again. He is ready, willing, and able to help. I've been speaking with members of his staff late last night, early this morning. We need their help, especially on the hospital capacity issue. We need FEMA. FEMA has tremendous resources. When I was at HUD, I worked with FEMA. I know what they can do. I know what the Army Corps of engineers can do. They have a capacity that we simply do not have. I said to the president, who is a New Yorker, who I've known for many, many years, I put my hand out in partnership. I want to work together 100%. I need your help. Andrew Cuomo: (22:35) I want your help. And New Yorkers will do everything they can to be good partners with the federal government. I think the president was 100% sincere in saying that he wanted to work together in partnership, in a spirit of cooperation. I can tell you the actions he has taken, evidence that his team has been on it. I know a team when they're on it, and I know a team when they're not on it, his team is on it. They've been responsive late at night, early in the morning, and they've thus far been doing everything that they can do, and I want to say thank you and I want to say that I appreciate it and they will have nothing but cooperation and partnership from the state of New York. And we're not Democrats and we're not Republicans, we are Americans, at the end of the day. That's who we are and that's who we are when we are at our best. Andrew Cuomo: (23:40) So this hyper sensitivity about politics and reading every comment and wanting to pit one against the other. There's no time for this. The president is doing the right thing in offering to step up with New York, and I appreciate it, and New York will do the right thing in return. Also on a personal level, this is ... We use the word disruption, such a clinical antiseptic word. It's a period of disruption. Life is turned upside down. It's just turned upside down room. Remember those snow globes when you were a kid and you shook the globe and this snow went all over and the whole picture changed as soon as you picked up and shook that snow globe? Somebody picked up our country and just shook it and turned it upside down and it's all chaotic, and things are flying all over, and there's new information and there's mixed information and people don't know what to do and businesses are closing and the rules change every minute. Andrew Cuomo: (24:59) Can I go out? Can I not go out? How do I get the virus? How do I not get the virus? And now I'm at home and I'm stuck at home and the kids are at home and then there's a whole component to this. Don't touch anyone, don't hug, don't kiss. We're human beings. That interaction is so important to us. That emotional affirmation is so important to us and now you have all these weighty decisions. Should I go out? Should I not go out? Is this safe for my kids? Is this not safe for my kids? I'm stuck in my house. I've used my experience just as a metaphor to communicate and relate. Having the kids in the house sounds great. Having the kids in the house, yay, the kids are in the house. I remember when my kids were young. I was divorced. Andrew Cuomo: (26:02) My kids were three girls. They were six and seven and eight years old. Six and seven and eight years old in a small apartment in Manhattan. That's a lot of fun and then that gets old very fast. Right? The claustrophobia just sets in. Sets in for the kids, would set in for me. What I would do then is I would go to my mother and father's apartment, which was also in Manhattan, because it was to get out of my apartment and I would go to my mother and father's apartment. They had a little apartment in Manhattan and my mother was magic with the girls and she would play with them, and she could play with them all day, my mother. My mother is pure sugar. She's just pure love, my mother, but I'd be there for a couple of hours and I'd be sitting there with my father. We'd sit on the couch and we'd watch a ball game and after a couple of hours ... Andrew Cuomo: (27:02) Now the kids are running around and the kids are picking up this, and they're picking up this, and they're picking up his picture frame and [inaudible 00:27:10] put that down, put that down, don't touch that, don't touch this. After a couple of hours my father would say, "I think you have to go to work now pal." I would say, "No, dad. I don't have to go to work." No, no. I think you have to go to work now pal. Having all the kids in that tight environment, that's very stressful. That's why yesterday we said all the fees on all the parks are waived. Get out of the house, go to a state park. We have beautiful state parks. By the way, traffic is down, put the kids in the car, go to a state park, go to a county park, go to city park. Shirley Chisholm park in Brooklyn is beautiful. It's open, it's air. The weather's getting better. Andrew Cuomo: (27:56) Spend the time with the kids. There's also tension among families. I mentioned my mother who is a numerically a senior citizen, although not in her reality, I want her to stay home. I want her to be isolated. She's my mom. I want her protected. One of my siblings said, "I want to take mom to my house and we're going to have a party at my house and I want her to see the kids, et cetera." I said, "That's a mistake. You shouldn't do that. You should let mom stay home." I'm more protective. The sibling was saying, "I want to take mom. She goes to get out of the apartment, [inaudible 00:28:42] to the kids." I said, "You don't know. All you need is one kid." All day long, all I hear about is somebody coming up to me saying, "I didn't know, but my daughter was with this person, blah, blah, blah." Andrew Cuomo: (28:55) So I can even see the tensions in the families and that's real too and people should expect that. And lastly, there is something to this lack of ability to connect. Don't hug, don't kiss, stay six feet away. We are emotional beings and it is important for us, especially at times of fear, times of stress, to feel connected to someone, to feel comforted by someone. I mentioned my daughter, I haven't seen my daughter in over two weeks. It breaks my heart, breaks my heart, and then this concept of maybe I can't get next to her because of this virus. There's a distance between me and my daughter because of this virus. It saddens me to the core, and it frightens me to the core and I had around the phone this morning and I said it to her. I just said it to her. I said, "I can't tell you how hard this is for me not to be able to be with you, not to be able to hold you in my arms, not to be able to kiss you all over your face, which she hates anyway." Andrew Cuomo: (30:34) That plays out 1,000 different ways. You put all this together. It's a hard time. It is a hard time on every level. It is a frightening time on every level. At the same time, it is this much time. It is this much time. Is it three months? Is it six months? Is it nine months? I don't know, but it's this much time. We will get through this much time. Understand what we're dealing with, understand the pressures that we're feeling, but we will get through this much time. Be a little bit more sensitive, understand the stress, understand the fear, be a little bit more loving, a little bit more compassionate, little bit more comforting, a little bit more cooperative and we will get through this time. Andrew Cuomo: (31:42) We will lose people. Yes, like we lose people every year with the flu. We're going to be challenged and tested. There's going to be periods of chaos, yes. We've been through that before also, but this is all we're talking about and we will learn from it and we will be better prepared the next time, because this is not the last time my friends. This has been a growing rate of these emergencies and health situations and storms, but we're going to get through it and we're going to get through it together, but understand the pressures that everyone is feeling, and let's be considerate of those feelings that are now collective and societal. That's my two cents. Any questions? Speaker 1: (32:47) Just a question of ... Speaking of 45 days. I was looking at my calendar, that's right around the presidential primary, April 28th. Are there thoughts to postponing your primary at this point? Andrew Cuomo: (32:59) I have virtually no political thoughts at this time, and no thought about postponing an election. Speaker 1: (33:07) [inaudible 00:13:07]. Andrew Cuomo: (33:09) Yeah, I don't have ... I've not considered it. I haven't thought about it. I haven't had a discussion with anyone about it. Jesse: (33:15) On the issue of mandatory quarantine, San Francisco Bay Area, six counties there have basically shut down. Some city officials in New York City have called for a similar action of sheltering in place in the city. Explain to us what your thinking on that is, why you're resistant to that and whether that could change. Andrew Cuomo: (33:33) I am resistant to nothing. Whatever we do, we will do statewide. Ideally, whatever we do, we will do regionally with the other states. You take an action in one place, Jesse, that you don't take in another place. You say to me in a Nassau County, you have to shelter in place. I say, "Fine, I'm going to go stay with my brother in Westchester." That's what I say. You say, "All of New York, you must shelter in place." I say, "Fine, I'll go stay with my cousin in New Jersey." That makes the situation worse, not better. So to the extent you can come up with a policy, enforce it uniformly. What is the policy? Just yesterday we took very, very dramatic steps. The bar, restaurant, schools, the curve is not flattening to a level that we can sustain, which would suggest that you're going to need to take more efforts to slow the curve. Andrew Cuomo: (34:46) That's what we're exploring now. It is likely that we will take more efforts to reduce the spread by reducing the density. What are they? That's what we're considering, but there's a number of ways to do it. The quarantine suggests you are limiting somebody's movement to a geographic area. Unless you were to quarantine, all you would do is move people out of one place to another, right? Because there are people who just will panic at the thought of being quarantined. We're going to impose a quarantine in Albany city starting tomorrow at 6:00 PM. You know what that means? Everybody gets out of Albany city and gets to another location. And there's ways ... There are many, many steps before that, before you go to limiting an individual's mobility. It's places of density and places that create density, like businesses, right? That's where you would go. You would reduce businesses, business operations, beyond essential business operations. That would be the initial calibration. But we're not there yet either, but these are all the things we're talking about. Speaker 2: (36:24) You've spoken many times about the importance of childcare, particularly particularly for essential workers. There are a lot of parents out there who are concerned about their daycare centers and wondering if those will close at some point. What would you say to them and is that something that's [inaudible 00:00:36:38]? Andrew Cuomo: (36:39) I would ask Mr. Malatris because that is a technical smart, hard question. Mr. Malatris: (36:44) Right now, most daycare centers remain open, they are to help limit density in specific rooms as required, and the governor, knowing especially first responders and our healthcare workers remain essential. We have the four downstate plans for school closures that take care of many of the daycare issues which we will be approving on a rolling basis, they came in last night. And then the governor recently directed the healthcare associations, greater New York and HANYS to develop a plan for drop in daycare at some of the hospital locations to address some of these emerging issues. OCFS we'll be waving many of the requirements and/or vastly expediting those issues that stand up a lot of these immediately, so limit density in many of those areas, in daycare facilities to smaller groups, 10 or fewer. Mr. Malatris: (37:34) So they're bringing in more staff, and in other cases we're standing up daycare or expanding daycare in areas where we have less need. For instance, many of the SUNY and CUNY campuses have not for profit daycare centers given many students are not coming and those faculty members are not essential employees, basically working from home and doing distance. We are working with those daycare providers to provide daycare services for our first responders, healthcare workers and others that meet some of those needs as well with less density so we're limiting to density across the board. Speaker 3: (38:07) Do you anticipate that some of these private daycare operators will shut down at some point? Mr. Malatris: (38:13) We're working right now on the educational side with the department of health, office of children and family services to do it on a case by case basis. It depends on the size of the daycare, depends on if there's any positive cases. All of those things come into play. So when we've been working on the school closure plan, we've been working hand in glove to make sure we have more availability across the state, open up more opportunities by limiting the number of children in specific rooms, specific locations to meet those needs for parents all across the state. Andrew Cuomo: (38:43) Also John, you have to remember when you're setting these policies, these things are all interconnected, right? Close the schools. Okay. How do the essential workers go to work the next day? Who's going to watch the kids? Oops, I didn't think about that. Close the daycare centers. Okay. Then how do the people go to work who were leaving their children in daycare? Leave the businesses open, but close the daycare. Well, how do you leave the business open if you close the daycare? So it all goes like this, right? That's why there is no such thing as a piece meal isolated strategy that works. It has to be comprehensive and it has to be statewide. And the rumors of these things are not productive either. That's why I said to Jesse, quarantine in place. No, no place ... First of all, no state, no locality in this state can take an action without state approval. Right? If Albany city said, "Quarantine in place." Andrew Cuomo: (40:02) If Albany city said quarantine in place, I wouldn't allow it. So whatever we do is going to be statewide, thought through, comprehensive, nobody's going to be quarantined. If there are any additional actions, the likely additional actions would be on the business side first, right? Because before you do anything with daycare or anything else, you have to be home, right? So what businesses need to be operational now, that are putting people in an office setting. If the first step would be reduction on the number of businesses that then leaves parents home, that then allows children to be home. But that would be the normal calibration. Speaker 4: (41:02) Should public libraries close? I know that [inaudible 00:41:05] local citizens at this point but that's also a place where- Andrew Cuomo: (41:07) That's also one of the things we're thinking about and we'll have a decision on that. Speaker 5: (41:10) Dr. Zucker, has there been an estimate of how many ventilators the state currently has, how many of those are available and what the projection is for intubation use [inaudible 00:01:22]? Howard Zucker: (41:22) We do know we have around 4,000 ventilators, but part of the team that the governor put forth with Michael Dowling, Ken Raske, we're going to sit down and discuss that are going forward today. Speaker 5: (41:33) 4,000 ventilators that are available- Howard Zucker: (41:35) Across the state. Well, there are more available than that, but that's the numbers that we have right now. We have a stockpile, there are ventilators there, but we're looking at getting more ventilators. Speaker 5: (41:45) How many do we have in that stockpile? Howard Zucker: (41:48) We have hundreds and hundreds in the stockpile as well. Andrew Cuomo: (41:50) Yeah, but Josefa, your question is right. You are in the thousands. You're under 10,000 and you're right, the need could be much, much higher. And the complicating factor is you can't find a ventilator for sale. We're looking desperately, but China just bought all the ventilators and then South Korea bought all the ventilators, then Italy bought all the ventilators and now Germany is buying all the ventilators and now California is buying all the ventilators. So the main repository for ventilators is federal government. Speaker 5: (42:28) So can the state, given your executive oversight, ask a company like [inaudible 00:42:33] or any other medical supply company in New York to cease production on other things? Andrew Cuomo: (42:39) No, I can't say to a private company, you can only sell us your goods. I cannot say that legally. I can ask them gratuitously and graciously, but they're business people and this is now one of the hot products, right? We saw the price gouging on hand sanitizer and those things. A ventilator can be $20-$30,000 without the premium. Speaker 6: (43:12) Governor and Dr. Zucker, can you talk a little bit more about how you came up with the 45 day estimate, what experts you've talked to, how you got to those numbers? Andrew Cuomo: (43:22) You want to try that. Howard Zucker: (43:22) Sure, sure. So there are individuals who actually do modeling to look at this. There are public health experts, scientists, epidemiologists who studied this and we had two groups look at this and they came up with a similar answer on that. And we're going to sit down and look at that a little bit closer because this was in the course of the past week that we've asked them to give us some of those numbers. We also looked at what has happened as the governor mentioned, over in China and Italy, in South Korea, and that helps us guide the assessment that they make as well. Andrew Cuomo: (43:54) It is always a function of the growth curve, right? When you go sit with these statisticians, they put up China, South Korea, Italy, European countries. You look at the growth curve and it's a curve and the curve hits an apex and the question is when and how high is the apex? And that depends on what you did. How many tests did you take? How many people did you get in isolation? How much did you reduce density? Right now, the curve and the apex is at a point that is unsustainable for our healthcare system. Hence, more efforts to reduce the curve, reduce the spread, more efforts to dramatically increase the capacity of the healthcare system. Speaker 7: (44:48) [crosstalk 00:44:48] Westchester County continues to be the hotspot for the state, is there any ability to send more ventilators to Westchester, is there going to be enough there and if there's not enough [inaudible 00:45:00]? Andrew Cuomo: (45:00) We will distribute the equipment according to the need. So if the need is in Westchester County, that's where we'll move. If the need is in New York City, that's what we'll move. The problem is on the numbers right now. You don't have enough equipment or forget equipment, you don't have enough hospital beds to meet the need statewide. Speaker 8: (45:26) So on the number of hospital beds said, 53,000 but you're going to need 55,000 to 110,000? Why is such a large range and how are you going to come up with all those beds? [inaudible 00:45:38] at capacity right now, is 53- Andrew Cuomo: (45:41) That's what we have been talking about for three... That's been the issue for three weeks. Here are the numbers. We have 53,000 beds, 3,000 ICU beds. Right now we're at a hospitalization rate of 15 to 19%. Today we're at a hospitalization of 20%, so you take our 10,000 cases ... how many cases today? Howard Zucker: (46:08) 1,700 positive. Andrew Cuomo: (46:11) 1,700 positive. You take our 1,700 positive, they're running at a rate of 20% hospitalization, today. We have 19 million people. Howard Zucker: (46:21) Sorry, that's not today that's overall. Andrew Cuomo: (46:23) Overall, the expected peak is somewhere between 55 and 110. The low range, 55 is a problem because we have people now in all those 53,000 or 80% of the 53,000 hospital beds. It's not like they're vacant. 110,000 is a problem because it's double your capacity if every bed was empty. And the real problem is the ICU beds because that's what people are going to need because they're going to come in acutely ill and they're going to need to be intubated and you can't do that without an ICU bed and you can't do that without a ventilator. And that gets back to Josefa's questions because the ventilators are scarce already. Speaker 8: (47:11) Floors in hospitals that could handle ICU patients that you guys could be looking at. And are you doing that? Andrew Cuomo: (47:16) Yes. The meeting today that I mentioned that Mike Dowling and Ken Raske are doing, Dr. Zucker and I are going to appear by video, is saying to the hospital administrators, forget the Department of Health regulations, what's the maximum number of people you can get in your facility? Speaker 8: (47:36) What about nurses and doctors, will they have to be specifically trained to handle those patients? Can they handle that- Andrew Cuomo: (47:41) Well first, we need more nurses and doctors and as I said, we're going back to the retired nurses and doctors. We're going to medical schools, we're going to nursing schools to increase that supply. DOH has waived certain certifications for nurses and doctors, so we have available personnel. Jesse: (48:01) Considering you're saying this is going to peak in 45 days, should parents, businesses, et cetera, expect that a school closures, et cetera continue beyond this two to five week period. Should businesses start to anticipate that they will be closed for 45 days? Andrew Cuomo: (48:16) Jesse, these are projections, I deal with projections because that's where the science and the data says, but there's always a little grain of salt in there that anything could happen. But these are the projections. Now, we're doing schools two weeks at a time and that was some school districts wanted to do one week, some school districts wanted to do four weeks. I spoke with them. I said, look, we need a uniform period of time because the New York Times is operating a business. It can't be that some employees have a child in this school and they can't come to work, but in another school district they can. So uniformity is important. We're doing it in two week intervals, 45 days if you want to say well, is it a safe assumption to say we're going to have a number of two week intervals. That's probably a safe assumption unless it changes. Speaker 9: (49:12) [crosstalk 00:49:12] ... to your request for the Army Corps of Engineers when you talk to him today? Andrew Cuomo: (49:17) We spoke about the entirety of the federal response. I told him what I was looking for. He said that he wanted to be as cooperative as possible. I have been speaking with members of his team again late last night, early this morning. I believe him when he said he will be as cooperative as possible. I believe him when he said he's aware of our situation and the numbers. You know he's President of the United States, you have some states that are in a much different situation than we are, right? I'm Governor of New York, I have some counties that have like one case, where they think this is all much ado about nothing. And then I have Westchester and New York City. He's in the same situation. I know he knows our situation in New York and I believe him when he says he is fully committed to doing everything he can. Speaker 9: (50:24) He's not committal on this specific request. Andrew Cuomo: (50:27) He said, "I'll work with you, what do you need?" I said, "I need the Army Corps of Engineers and I need a FEMA." And he said, "Okay." Speaker 10: (50:40) [crosstalk 00:50:40] ... hiatus or perhaps longer on sales tax for businesses? Andrew Cuomo: (50:47) Right now our revenue projection is so bad. I haven't gotten the controller's report yet, but I believe the controller's report, the budget director was briefed, and I believe he said our revenue estimate was already four to seven billion dollars higher than what he would estimate. Remember, we did our revenue estimate before any of this. So he's saying we're four to seven billion dollars high on the revenue estimate, which means our budget as we prepared it, is possibly overly optimistic. I'd love to say to everybody in this state, I know you're having a tough time, nobody pay any tax. I would love to do that. I've cut taxes. I cut taxes every year, but we're not in a fiscal position to do that. Rob, if you might comment on what you think. Rob Mujica: (51:57) Yeah. I mean our revenue offsets were based on economics that were in late February, so all of those projections are now off. We've asked the controller, those numbers are ... His estimates were actually based on his forecast prior to yesterday's sell off. So we have to look at just liquidity, how much money we're getting in, right? We were also tied to the federal PIT date, so there's talk about that April 15th date meeting move. You're talking about state sales tax. Our dates travel with them, so it really goes back to essentially the federal government will have to step in here to deal with this because we will have our own liquidity issues if we don't get some relief. Speaker 11: (52:47) So based on that, how can you do a budget anytime soon when there's so many unanswered questions? Rob Mujica: (52:51) You'll have to do a budget that has flexibility in the budget to be able to make changes as you go right? As we don't know how long this is going to last as the governor has stated, well, so we need a budget that's in place that gives us the flexibility to hold payments back, modulate things, move payments ahead of time for healthcare. So that's really the budget that you're going to need. One that has flexibility for us to be able to make changes and calibrate as we go throughout the year. Andrew Cuomo: (53:20) Karen, just to stay with that for a second. Karen, how do you do a budget? As Rob said, you pick a point where you believe the rest of the revenues will be. How do you pick that point? Well, we picked the point a few months ago. The assembly picked the point, the Senate picked a point. The controller now says that point is too high, but you pick a point, that's a big decision. You do a budget based on that point and then you say, caveat, if the revenues are below that, we have to have a built in mechanism to adjust the expenditures, right? Do you know what I'm saying? So you pick a point and then you have a built in adjustment mechanism that if the revenues continue to slow, which I believe they will, that you have a self adjustment mechanism in the budget. So you don't have to come back every 24 hours to readjust the budget when the revenues shift. I'll take one more. Speaker 12: (54:30) Governor, can you please comment on if the curve does not flatten and if these cases continue to arise, would you consider domestic travel bans between states? Is that something that you would put on the table if the curve does not flatten? Andrew Cuomo: (54:46) Look, we have the highest number of cases in the country. I don't think a lot of people would be coming this way, so I don't think that's going to be relevant. Look, it's a difficult situation, but we're going to get through it. And again, the people who we are worried about, it's my mother, senior citizens, compromised immune system, underlying illness and making sure we have the hospital beds for them. That's what this is all about and we have to keep that in focus. The reason it's so important is, it's my mother. It's your mother, it's your sister, it's your cousin, it's your father. These are the people who raised us. These are the people who built the society. Andrew Cuomo: (55:36) And we honor them with every cell in our body and we're going to do everything we can do to make sure they're here with us this Christmas and this Hanukkah and this Kwanzaa and next Christmas and next Hanukkah and next Kwanzaa. So we're going to break our rear-end to make sure our healthcare system is there for them, whatever we have to do. Last point is this, keep it all in focus. Keep it all in focus. There was a gentleman who used to be here, he used to come through that back door. Wheeled himself through this room, get behind the desk, dealt with every hardship, raised himself up from a wheelchair every time he had to speak. Franklin Delano Roosevelt, he said most things better than anyone has said them since. Andrew Cuomo: (56:35) And he said, paraphrased, things are going to get worse and worse before they get better and better. And the American people deserve to hear it straight from the shoulder. Tell the people the truth, tell them the facts. And the facts are comforting. And that's my job and what I've been trying to do. These are the facts. This is the truth. I tell you the truth, when it's pretty and when it's not pretty. But knowing the truth, I think is reassuring. And as I know the truth, I tell the people of the state the truth, and that's the first step. And then we do what we have to do and we will. Thank you and God bless you.