New York Gov. Andrew Cuomo COVID-19 Press Conference Transcript November 30

Governor Andrew Cuomo: (00:00) ... who's here, because some of you are forgetful. On my far right, Robert Mujica, Director of the Budget. Immediate right, Melissa DeRosa, Secretary to the Governor. My immediate left, Dr. Howard Zucker, Commissioner of the Department of Health. To his left, Jim Malatras. If you ask him a question and expect a response, you have to refer to him as Chancellor Malatras, otherwise he does not respond. It's just a transition period. To his left, Gareth Rhodes, who is the Deputy Director of the Department of Financial Services, but has been working with us on COVID. Governor Andrew Cuomo: (00:39) This is a little different today. We will be joined by a number of participants on Zoom, and we'll hear from a couple of them after the presentation. It's a different phase that we're entering now, and we've been working on it over the weekend, and this is not working. There you go. I hope you all had a good Thanksgiving weekend, and a safe one. I hope you were not a turkey. We've been spending a lot of time talking to hospital administrators, local officials, all across the state this weekend to design a strategy going into this new phase, because we're all seeing new facts. Today's day 275, and it's a new phase in the war against COVID. The war against COVID, because I think of this as a war. It's a war of attrition. It's a war in terms of preparation and mobilization. It's a war in terms of mindset. COVID is an enemy that we're dealing with. It's attacking people. It's killing people. So I talk about it and think about it in terms of a war, and the war changed. Governor Andrew Cuomo: (02:18) Sun Tzu: "Just as water retains no constant shape, so in warfare, there are no constant conditions. He who can modify his tactics in relation to his opponent thereby succeeds in winning." When the facts change, when the attack changes, change your situation and your defense or offense. COVID is shifting the battlefield dramatically, and we have entered a new phase. Came with the colder weather. While the experts talked about what was going to happen when we reached the fall, right? Cold weather, more people indoors, more people are now traveling, there has been a change in behavior among people. They've been informed. They've been educated. They've learned. They've changed their behavior. We have government policies on what businesses operate and how they operate, and that has had an effect. So the chess board has really changed. Governor Andrew Cuomo: (03:31) And then we are coming into the holiday season, and the holiday season is going to have a profound effect. It already has. When people started to travel for the holiday season, when they started to travel for Thanksgiving, when students started to go home, when people started to shop, when they started to move around, increased mobility, increased social activity, increased viral infection rate. It is directly proportionate. And we talked about this before Thanksgiving. You are not just going into the Thanksgiving weekend. You're starting a 37-day holiday period. That's why Dr. Fauci, over the weekend, was talking about there's now going to be on a surge on the surge. So we had a full surge. My words. We now have a holiday surge on top of the fall surge. That's Dr. Fauci's surge on top of the surge. Governor Andrew Cuomo: (04:43) And it's not going to be a one or two-day affair. It's going to be the entire holiday season, which is 37 days. Now, the mindset for the holiday season, all right, we're now all happy and cheery, and we're going to come together, and we're doing gift buying, and we're going to do holiday celebrations. We're going to start to have meals together. The families coming back together for the holiday season. Students are all coming home. Religious celebrations during the holiday season. Governor Andrew Cuomo: (05:19) Yeah. COVID is the Grinch. Think of it that way. And the COVID Grinch is an opportunist, and the COVID Grinch sees this as the season of viral transmission. All those things that the holiday season brings, they all increase social activity, they all increase mobility, and they will all increase viral transmission. So this is the season of the COVID Grinch also. When you hear that holiday music, Marsha, ( singing), think- Speaker 1: (06:02) Can you sing it again? Governor Andrew Cuomo: (06:02) Yeah. (Singing). Think COVID Grinch and be on alert, because that is part of this holiday season. We've also seen behavioral shifts by the policies that we put in place, and by the data that we have received. The bars and restaurants protocols, we've seen a reduction in the level of spreads from bars and restaurants. We've seen a reduction in the level of spread from personal services, hair salons, et cetera. Gyms, we have seen somewhat of a reduced spread, not as dramatic as bars and restaurants or personal services. Mask wearing, great. New York, first state in the nation to have a mask mandate. Our mask compliance is up near 98% great. And all social action, the school protocols and the school testing's great. Highly effective. Astonishing how low the levels of infections are in schools, especially K to eight. Governor Andrew Cuomo: (07:21) Really bad news? Family gatherings and smaller social gatherings have exploded as places where the virus is spreading. So we understand the cause, we understand the effect, and we understand the effect is dramatic. And this is the bottom line on all of this. COVID rates go up. When the COVID rates go up, what happens? The hospitalization rate goes up, and the hospitalization rate is increasing dramatically. End of June, we were about 900. We're now at 3,500. Since the end of June. And that is before feeling the effect of the holiday season. Governor Andrew Cuomo: (08:08) So this, my friends, is the problem. And we are seeing the rise in hospitalizations all across the state. And it's not a situation where it's only happening in one part of the state, and then we can shift resources from one part of the state to the other. Remember the first go around, it was primarily New York City downstate. We had upstate resources that we could share with downstate. That is not the case this time. It is statewide. So we will have a limited ability to bring resources from upstate to downstate like we did in the spring, or from downstate to upstate, because literally every region is dealing with a hospital issue now. And you look at those curves, they're all going up at an alarming rate. Governor Andrew Cuomo: (09:16) So in the new battlefield, hospital capacity is the top concern, period. It's about hospital beds, it's about ICU, and it's about having enough staff and enough equipment. That is the effect, and that's what we're going to have to deal with. We have five strategies that we are announcing today, and that we are putting in place. First, we're going to shift the focus to the number of hospitalizations and hospital capacity. We're going to add to our zone designations, the yellow, orange, red, the hospitalization rate. We know by address where people are coming from who are going into the hospital. The death rate, the case rate, the available hospital beds in that community, the available ICU beds, and the available staff. We are now worried about overwhelming the hospital system, and if those numbers continue to increase, which we expect they will, you will see serious stress on the hospital system. So we're adding those factors into the equation. Also the patient load management of that community, how effectively they're dealing with the patient load. Also PPE and equipment availability. Everybody remembers the nightmare of what we went through with PPE and equipment. Governor Andrew Cuomo: (10:54) We are going to set specific metrics for each one of those factors. I want to wait and see what the numbers are post-Thanksgiving. We don't know what the Thanksgiving effect has been yet. You sat at the dinner table with your in-laws. They said, "Don't worry. I've been very careful. I have been in quarantine." Yeah. It doesn't have to be your in-laws. In-laws can be nice people. They're not the only people who can infect you. Thanksgiving, you'll see three, four, five, seven days until you see people who were infected during Thanksgiving or during Thanksgiving travel. So there will be a week to 10-day lag before we see that number come to effect. We're also talking to the hospital administrators across the state. We want to know exactly where they are with their hospital today, with their capacity, with their PPE, et cetera. Governor Andrew Cuomo: (12:02) We learned this lesson the hard way. We have about 54,000 hospital beds in this state. We were told that we would need 120,000. We lived this nightmare, we learned from this nightmare, and we're going to correct for the lessons we learned during this nightmare. It was the first time ever the hospital system, which is essentially a private hospital system, needed to be managed governmentally. And that was a very difficult transition, but we learned from it. We're going to add on top of yellow, orange, red, an emergency stop provision, where if we had a real hospitalization crisis, we could potentially do a New York pause. California just did a California pause, which is basically a stop, or move one zone to another if we have a critical hospital situation. Governor Andrew Cuomo: (13:08) Today, New York City Department of Health is going to initiate emergency hospital measures. Number one, every hospital has to identify retired nurses and doctors now. We're already experiencing staff shortages. Staff just gets exhausted after a while. They've had a horrendous year. To now go through this again with emergency rooms and a high number of COVID patients coming in, they start tired. They start sick. Start identifying retired nurses and doctors now. We did this last time. It worked very well. Governor Andrew Cuomo: (13:51) We're going to stop elective surgery in Erie County as of this Friday. Erie County has the most critical hospital situation in the state, so Erie County must stop elective surgery. Catholic Hospital System in Erie County voluntarily stopped elective surgery just to be responsible. I thank them. It's now mandatory. They must all stop elective surgery as of Friday. Let's start to free up those hospital beds. If this situation continues to get worse, we'll stop elective surgery in other parts of the state also. Elective surgery are those surgeries that don't have to be done at that time, and we want available beds for COVID people, so stopping elective surgery does that. Governor Andrew Cuomo: (14:44) The individual hospital network load balancing is mandated as of today. Let me explain to you what this is. Talk about learning a lesson the hard way. There are hospital systems in the state that have a number of hospitals in their system, and they can be private or they can be public. Northwell has a number of hospitals in their system. Montefiore. ECMC, Erie County. URMC, Rochester. Kaleida. New York City H&H. They are systems unto themselves, and they can have seven, eight, 10, 11, 30 hospitals in their system. It is mandatory as of today that they balanced the load within their system. They balance patient load. So you distribute the patients among your hospitals in your system. Governor Andrew Cuomo: (15:49) The nightmare we went through last time was a hospital that would be overwhelmed, but that system had other hospitals that had capacity. Well, then why didn't you shift patients from the overwhelmed hospital to the hospitals that had capacity in your own system? "Well, that's not how we operate." Yeah, I get it. I learned that lesson. Forget how you operate. This is a mandate from the State Department of Health. You must distribute patients across your system so one hospital does not get overwhelmed. "Well, the patients don't want to go to other hospitals." Then let's just end elective surgeries now, and we'll make it simpler. But no patient wants to be in an overwhelmed hospital because you're getting less care. The staff is stretched thin. It's in the patient's best interest. Distribute the patient load over the system. We're not going to live through the nightmare of overwhelmed hospitals again. So those individual systems, they must do that now. Governor Andrew Cuomo: (17:18) If a hospital gets overwhelmed, there will be a state investigation. And if the result of that investigation is they did not distribute the patients, that will be malpractice on their part. This was a serious issue last time. It was a case of first impression last time. This time, it's not a case of first impression. I don't mean to be difficult, but difficult is when people die because they didn't get the right health care. That's really difficult. So preparing for that is important. That goes into effect immediately. Governor Andrew Cuomo: (17:57) We also have to prepare emergency field hospital plans region-wide. Plan now for adding 50% capacity to your hospital. If you have 100 beds, you go to 150 beds. We did this last time. It was highly effective. We brought a system from 50,000 to a system of 75,000. Prepare to implement statewide surge and flex. Statewide surge and flex moves patients among systems, right? What I was just talking about was movement within the system, moving Kaleida patients within Kaleida facilities. Statewide surge and flex moves patients among different systems. So theoretically, a patient could go from NYU Langone to Mount Sinai. You move them among different systems. That's a different level of coordination with a different level of- Governor Andrew Cuomo: (19:03) ... different systems. That's a different level of coordination with a different level of emergency. And prepare to staff the emergency field hospitals. Also confirm the PPE stockpiles. Department of Health did regulations as to how many PPE you needed, a 90 day stockpile of PPE. Confirm that you have those PPE stockpiles in place, because we don't want to run through that again. We'll be announcing a hospital capacity emergency tracking system that's going to track these metrics statewide. And that's the first initiative. Governor Andrew Cuomo: (19:40) Second is on testing. We do more testing than any state in the nation. We have the highest amount pro rata. I'm very proud of that. You can't do enough testing. The more testing you do, the more you know, and the more you know, the better you do. It is just that simple local governments. Local governments, the state, hospitals have to work to increase the gross amount of testing, and we have to have a balanced distribution. Governor Andrew Cuomo: (20:07) We are trying to serve a lot of needs and a lot of populations. We have to test healthcare workers. We have to test the nursing homes. We have to test schools. We have to test essential workers. We have to test the business professionals where we put in a protocol that they have to be tested. We have to test the personal services protocols. And you have general population of students who come home, they want to make sure they're not infected. People just went to Thanksgiving, they get a cough. They want to know if they're infected. The localities have to distribute the testing equally or fairly among these groups. Essential workers, they're out there every day. The police, the fire, they have to be tested. There's not enough tests to go around. I get it. But we have to be fair in the distribution. And local governments have to work on coordinating that. Governor Andrew Cuomo: (21:07) Third, keep schools open. All the testing says schools are safer than the surrounding community. We focus on special ed, K-8, doing testing in schools on a sustainable basis for long-term operation. If they're in an orange or a red zone, the state mandate is 20% over a month, red zone, 30% over a month on a rolling basis. They're doing weekly testing. They can pool test. Again, we're very aware of the need to balance the tests because a lot of people need tests. The local district can exceed the minimum state testing level, but they have to make sure that they are meeting their other needs also. It's not enough to test all students and not test essential workers, test all students, but not test all nursing homes, test nursing homes, but not test schools. You have to fairly distribute the tests. Governor Andrew Cuomo: (22:20) We've talked to all sorts of experts all across the country. No state has the testing school protocol that we have in place, no state and no city. So we feel good about that. We have a mandatory close level for school districts. School districts can close lower than the state threshold. We've gone through that in various parts of the state. Our advice is, you don't. We believe in keeping, especially K through 8, open. The schools are safer than the surrounding community, and children get an education, and parents can work, et cetera. But we understand local school district prerogative. They can close below our level. Governor Andrew Cuomo: (23:19) The small gathering spread is now the number one spreader, about 65% of all time cases. This is a dramatic shift. Part of it is the holidays. It's what happens during holidays. Part of it is reduced social options. I can't go to the bar and hang out. I can't go to a restaurant and hang out. I can't go to the movie theater and hang out. Come over to my house and we'll hang out. It's just an adaptation of social behavior to the circumstance. We have a rule in effect no more than 10 at an event. These are all the states that have rules of no more than 10. People say, "Oh, I can't believe the New York rule, no more than 10." Many states have a rule of no more than 10. And by the way, Kentucky just announced they're going to a rule of no more than eight. Governor Andrew Cuomo: (24:29) This is a nationwide problem. I understand that people say, "I don't like the restrictions. I have COVID fatigue. How can you say I shouldn't have more than 10 people in your house?" Look, the truth is government doesn't have an ability to monitor it. But you want to know what is smart, what is reasonable, what is protective of other people and yourself? This is where the spread is coming from. It's the small gathering spread. We have to communicate this now to people the way we communicated masks. Governor Andrew Cuomo: (25:07) Seemingly the safest place, my home, my table, my family. Yeah, even that place is not safe. And we're going to have a new public education campaign that speaks just to this. This is not government being overly dramatic. These are just facts. And look, I've heard the political back and forth, "Oh, this is Democrats saying this." First of all, this is probably the only issue President Trump's people and Joe Biden's people have agreed on. Both of their health advisers say small gatherings are the problem. The CDC under Trump, the regulation was no more than your household for Thanksgiving. That's what the CDC said. So all those people who want to say, "Well, this is political. I'm standing up against it," your president, President Trump, his administration said do it. And Joe Biden's administration health advisors said the same thing. So whose politics are you playing? Governor Andrew Cuomo: (26:27) If Donald Trump says, " The CDC mandates it," and Joe Biden's advisers say, "It's smart," whose politics? Your own politics? You're waving the political flag. Whose flag are you waving? It's agreed to by both. It's a fact of being smart. And luckily, most of us are smart. I had a conversation with someone over the weekend. "Well, nobody's going to tell me how many people to have in my house. It's my house. I want to have my family over, I can have my family over." I said, "You're right." I said, "I'll make a deal with you right now. You do whatever you want in your house. Invite whoever you want. But here's the deal. If somebody gets sick from what you did, you handle it." Governor Andrew Cuomo: (27:28) He said, "What do you mean?" I said, "Don't call an ambulance and expose an ambulance driver. Don't go to the hospital and expose a nurse and a doctor and an 1199 worker because you wanted to be reckless. You handle it. Stay at home and take care of yourself. But don't expose people and don't ask people to risk their lives because you undertook risky behavior." "Oh no, no. I won't agree with that." "Oh, I see. So you want to be able to behave in a risky way, and then if you get sick, then other people have to risk their lives because you were risky. Is that fair?" Governor Andrew Cuomo: (28:16) But that's what they're asking. "Well, I'm going to stand up." You want to be a tough guy, guy being gender neutral? I'll tell you what a tough guy does. Go volunteer in a field hospital in Staten Island and help COVID patients if you're a tough guy. You want to celebrate Thanksgiving? Bring your whole family and your extended family and go volunteer in a hospital and help COVID people. That's how you celebrate Thanksgiving. Don't create more COVID-positive people and then expect other people to come to your rescue. That's not the spirit of Thanksgiving. Vaccinations. That is going to be the weapon. That is going to be the weapon that will end the war. The only question is when. We're going to be very robust and aggressive on the vaccination program. We're building it around fairness, equity, and safety. We're going to have a very inclusive process. I'm reaching out with other governors to the federal government, which has not now funded a Black, Brown, poor community outreach program for the vaccine. Blacks died at twice the rate that whites died. Brown died at one and a half times the rate that whites died. They are less served by the health care facilities. We need a special outreach effort. Federal government has provided no funding to do that. Governor Andrew Cuomo: (29:54) There are also concerns with the undocumented community, that they're not exposing themselves to legal action, so we're working through that. But the vaccine critical mass is still months away. And until the vaccine hits critical mass, keep operating at the maximum safe level. We want the economy open. We want people working at the maximum level that is safe. So to recap, it's about hospital capacity, increase and balance testing, keep schools open. Small gatherings are the number one cause, and we have to alert the public. Small gatherings are difficult. It's not about government enforcement. Government is not capable of enforcing what you do in your home. But again, it's people being smart. And we're getting ready for the vaccine distribution. Governor Andrew Cuomo: (30:51) Personal opinion, if have to wager, you'll see these numbers continue to increase all through the holiday season, probably till mid-January. You have not yet seen the effect of Thanksgiving. There will be a lag, and you will see the effect a week out from today. But I expect those numbers will continue to go up. If I'm really going out and on a limb, I would say, guess, you start to see a stabilization mid-January at a higher rate raised by the holiday season. After New Year's, it starts to settle down, you see the rates stabilize. But the rate will be much higher than it is today. That's why it's about the hospitalizations. Governor Andrew Cuomo: (31:46) You won't see a real end until the vaccine hits critical mass. And I would wager today, you won't see that until late spring, early summer at the current rate. Could change. So we have to settle in, but the good news is New York is doing better than almost any other state on the numbers. New York is better prepared than any other state, and it is all in our control. It's not in your control, but it's in our control. This is all a function of human behavior and social action. It's all what we do. If you wanted to get the rate to zero, virtually, you could do it if you all agreed to a certain behavior pattern. We have to work. We have to function, but it's all in our control. Governor Andrew Cuomo: (32:46) Good news. I believe in New Yorkers. They did this before at a much harder level with less notice, and we'll do it again. But we have to do it. We see the goal line. We just have to get there. Today's numbers, micro-cluster areas, 6%; statewide without micro-cluster, 4; with micro-cluster, 4.5. Test results, 148,000. 54 people passed away. They're in our thoughts and prayers. Hospitalizations are up to 3,500. ICU up to 681. Intubations, 325. "Tough times don't last, because tough people outlast them." Who said that, Marcia Kramer? Marcia Kramer: (33:36) What's his name? Your father's favorite person. Governor Andrew Cuomo: (33:37) A.J. Parkinson. Marcia Kramer: (33:38) A.J. Parkinson. Governor Andrew Cuomo: (33:38) You're right. You get the first question Marcia Kramer: (33:43) Because I've heard A.J. Parkinson [inaudible 00:33:45]. Governor Andrew Cuomo: (33:47) At one point? Marcia Kramer: (33:50) At one point. So I actually have- Governor Andrew Cuomo: (33:50) Oh, I'm sorry. I'm sorry. I'm sorry. You still get the first question, but we have a number of guests who are with us on the Zoom call and we're going to hear from a couple of them. We're going to hear from Ken Raske and Mayor Bill de Blasio and County Executive Ryan McMahon from Onondaga County. We also have with us Michael Dowling; Beatrice Grause, who's the head of HANYS, the Health Association of New York State; County Executive Adam Bello from Monroe; Steve Bellone, County Executive, Suffolk County; Laura Curran, County Executive, Nassau County; George Latimer, County Executive Westchester County. Governor Andrew Cuomo: (34:29) I want to thank them all for all their help over the weekend. I would never have thought to call you over a holiday weekend and bother you. But Commissioner Zucker said I had to, otherwise I would never have done it because I don't believe in that. I'm a 9:00 to 5:00 kind of person myself. So thank you all for allowing us to bother you because the Department of Health mandated. You know how that is, Mike Dowling. We'll hear from Ken Raske and then mayor de Blasio and then County Executive McMahon. What do you think Ken Raske? And thank you for all your good work, and Bea Grause, thank you for all your good work. What do you think about the hospital situation and what we are looking at, Ken? Ken Raske: (35:21) Well, good afternoon, Governor. I think you're right on target. The hospital capacity issue has gone to the top of the agenda again. The spring was brutal. You make no bones about it. We were all worried about replicating the situation we saw so vividly in Italy, with people lined up in the hallways. That never came to pass, thank God. We learned a lot, sir. We learned an awful lot. And working hand in glove with the New York State Department of Health, with your office, particularly, we've come to terms with a lot of issues that we were confronting in the spring, such as the PPE, the stockpiling of PPE. You provided enormously great guidance there. Surge expansion and planning, including 50 to 100% expansion. The new balancing within systems is critical on the load side of things. And I think that your plan as outlined, sir, it makes a lot of sense to the hospital community. Ken Raske: (36:29) The new triggering metrics, as it relates to, obviously, hospitalizations is extremely important, and is built on a foundation that we absolutely need as we go forward. I'm confident, sir, based on what I've seen and what our hospitals are experiencing currently, that our ability to cope with this is going to be a total team effort as it has been, and our ability to respond to the needs of the public, including all their healthcare needs, will be assured by the kind of plan that you just outlined. So we look forward, sir, to working hand in glove again with you, as we have. And I think New Yorkers should be reassured that their healthcare system is in good hands. Governor Andrew Cuomo: (37:23) Well, Ken, with your leadership, this healthcare system managed an epidemic that no other state had to deal with. We had the worst problem in the nation by far. And thanks to you and your partnership, we managed it, and we learned a lot along the way. So we're in for round two. With any luck at all, round two is not what round one was, and we're smarter and we're better for it. But thank you. I'm just sorry that we have to go through it again, but the vaccine is coming and it will- Governor Andrew Cuomo: (38:03) We have to go through it again, but the vaccine is coming and it will end. It will end. Thank you. Let's go to Mayor Bill de Blasio. I know he didn't get a chance to enjoy Thanksgiving because I kept interrupting, but he was very good at speaking with a mouth full of turkey. He was very good at doing that, continuing to eat, but do business at the same time. I respect that. Ken Raske: (38:30) You've got to enjoy it when you can, right? But governor, thank you. I thought the conversations this weekend were really helpful, and I appreciate the plan you've laid out. I want to accent the fact that our hospital systems, our healthcare leadership really deserve tremendous praise for how much they have learned and the adjustments they've made. I thank Ken Raske and all the hospitals that he represents in our New York City health and hospital system and Mitch Katz and his whole team and the amount of strategic improvement that has occurred, as you're right, we found ourselves in the middle of hell out of nowhere in the spring, but since then tremendous work has been done and with some very different outcomes. And this is part of the good news, even in the midst of the challenge that you are focusing on today, that hospitals, our healthcare workers are handling cases with really innovative new approaches. Ken Raske: (39:29) Thank God we are not seeing so far the same stress on our ICUs here in New York City. Thank God we are not seeing people pass away as we did in the spring. We've got a long way to go. And I think you're right to focus us on this whole holiday season and the weeks after, but I want to sound a hopeful note that I think our healthcare system here in New York City is holding strong. We're monitoring it obviously daily, hourly, but I like what I see. I also like the fact that New Yorkers are getting tested. Governor, we had record levels in the last couple of weeks, the number of people lining up to get tested. We're trying to make it easier and set up more and more locations all the time. The expansion of testing is crucial, to spread across all over the city, equitably distributed, as you said, and obviously more deeply in our schools as well. Ken Raske: (40:21) But what we're seeing is New Yorkers are responding. They're coming out and they're getting tested and it's helping us to do the work we need to do to keep everyone safe. So that to me is part of the heroic story of the people in New York City and New York State that folks really have gotten engaged. We need them to keep getting engaged. Ken Raske: (40:40) So our reminder, of course, everyone coming off the holidays, that you need to follow those testing protocols if you traveled and you need to observe quarantine if you don't test out. We're going to be out there in force to make sure that people get the support they need if they need to quarantine, but also to do the good enforcement work, to make sure people realize how serious it is. So governor, thank you for the plan you've laid out. We're going to work closely with you. I know that we learned a lot of lessons from the spring. We're applying them successfully here in New York City. And you're right, we've got a couple of tough months ahead, but there's a better day coming. Everyone needs to be part of the solution in the meantime, and that's what we're going to keep doing here in New York City. Thank you. Governor Andrew Cuomo: (41:27) And mayor, I think the opening the schools, I thought was the right idea, and you're testing in the schools is great, so we know that they're safe. You want to talk about good news and silver linings, the fact that the positivity rate is so low in the schools compared to the surrounding community, so children can continue to get educated and their parents can go about as normal a life as you can have, I think that's going to be very helpful and I think it's going to be very helpful as soon as we hit January, we get through this holiday season. Ken Raske: (42:01) Amen. Governor Andrew Cuomo: (42:01) So, that's also good news. Ken Raske: (42:05) Amen. Governor Andrew Cuomo: (42:08) Thank you. Thank you for being with us, mayor. And we have County Executive Ryan McMahon from Onondaga County. How are you, Ryan? Ryan McMahon: (42:16) Governor, how are you? Yeah. Governor, I want to thank you for your collaboration and your team's collaboration. As you know, the data driven approach to making decisions in this pandemic is one that both sides of the political aisle should respect and appreciate. And I want to thank you for that. In addition to that, because of the testing and tracing programs that have been set up throughout New York State in every county, this allows us to have accurate data, so good decisions can be made. And specifically in Onondaga County, we just went from a yellow zone for many of our school districts and some of our school districts went into an orange zone. And what we learned from the data, to your point and to the mayor's point, was that in school testing showed us that we had a positivity rate of under 0.4% in our districts. So keeping kids in school is safe. The regulations and protocols that your team helped put forward are working. Ryan McMahon: (43:16) And as we move forward, I really want to specifically thank your team for working with the county executives and the mayor over the weekend to look at the orange zone protocols, so we can do it in a safe way, a sustainable way where we can still address the testing resources in other parts of the academy as well. But right now, we're very happy governor. We look forward to working with you. As you know, in Onondaga County, Syracuse basketball. We are in basketball season and we're in the second half of this pandemic. We've just got to grind it out together. Governor Andrew Cuomo: (43:49) Thank you, County Executive. And you're exactly right. We've been through the worst. We're not done yet, but we've learned a lot. It is good news on that school testing. And making the testing sustainable and making sure we balance so we can hit all the needs on the testing is going to be very important. But we'll watch the hospitals, we'll get through the hospitalization issue, and then hopefully we start to turn the corner with this new vaccine. And the next conversation we're going to have to have is on the vaccine distribution and making sure that we do it here in New York better than any other state in the nation. I want to have the fastest, fairest and safest vaccine distribution program in the country, and we will. Thank you for all your time over the weekend, all of you. And again, I would never, Bill Steve, George, Mike, you guys know me, Adam, Laura. I would never have interrupted your weekend if it wasn't for Howard Zucker making me with one of those state mandates, and it was an unfunded mandate. Thank you all very much. Thank you. God bless you. Marsha. Marsha: (45:02) Governor, I have a complex question about, a couple of weeks ago, you said that as testing numbers went up, you might have to turn the valve a little bit to reduce some functions like indoor dining, gyms salons, and in New York City especially, the numbers are going up almost every place except Manhattan. So is it time to turn the valve a little bit more in terms of indoor dining, gyms, beauty salons, and are you thinking of any more orange zones in New York City itself? Governor Andrew Cuomo: (45:36) Here's the problem with the new numbers, the valve no longer controls the spread. When we started, the spread was indoor dining, large social gatherings. The spread now, over 65%, small at home gatherings, living room gatherings. And it's an interesting ... It's frightening, but it's interesting. People adapt. Okay, you can't go to a bar, you can't go to a restaurant. What do you do? You start to go to people's homes and watch the football game or come over and we'll play cards or come over and we'll listen to music. We are social beings. And when you close down social venues, it's not that we're going to stop socializing. We'll just find a different place to socialize. So it's coming from these home gatherings. That's why all these states are doing these 10 limits. Kentucky went to an eight limit. The problem with these, are how does government really enforce that? Governor Andrew Cuomo: (46:58) It's like mask wearing. The only thing you can do is educate people and hope that they hear you and they wear a mask. I think we only gave out a handful of tickets on mask wearing. It's not government enforcement, it's public education. Family gatherings, we didn't do any tickets over Thanksgiving for people who had more people in their house than 10 people. This is not going to be a government enforcement thing. You can't control it with a valve. Either people are going to hear it and get it, or they're not. Either they're going to see those numbers going up and they're going to get it, or they're not. I believe they will because I believe in them, but this is not something a government can really address with enforcement. Governor Andrew Cuomo: (47:53) That's why I wanted to take on purposefully the counter argument, which we hear about the gatherings in the 10. Oh, this is just politics. It can't be politics. Democrats and Republicans agree. It's the only thing they agree on, Trump and Biden, is this one piece. And the state rule is more lax than the CDC's rule. Well, I think it's tough to show that you defy government rule and I'm going to post on the website, "I defied government rule." Really? You think that's tough? No, what's tough is working in an emergency room, working in a field hospital, working with people who have COVID. That shows guts and character, in my opinion. And what shows character is not creating a case for a nurse or a doctor or an ambulance driver to have to deal with, but that's what it's going to be now. It's about people accepting it and hearing it. Marsha: (48:59) In your presentation, you reserve the right to do another New York pause, which in a sense is another lock down. So, are you now giving up on closing indoor dining and salons and gyms and saying, "If the numbers go up, the only solution is a lock down"? Governor Andrew Cuomo: (49:18) No, no. Before you get to hitting the pause button and closing everything, you can have additional restrictions, and an orange zone does that, et cetera. But those numbers are relatively small compared to the small gathering spread. That's where it is coming from. Once you get past that, you're talking about a few percentage points here and a few percentage points there. Marsha: (49:49) Have you given up on restaurants and gyms and salons? Governor Andrew Cuomo: (49:52) No, no, no. The orange zone has additional restrictions on restaurants. A red zone has additional restrictions on the restaurants and the gyms, et cetera. We still have the yellow, orange, red. Marsha: (50:06) So, are you going to see some more orange and red zones in New York City because the numbers are so high? Governor Andrew Cuomo: (50:10) Well, as the numbers go up, I want to add to those numbers the hospitalization rate, because the most critical communities are going to be those where the hospital is overwhelmed. And that's what we want to focus on. Ken Raske mentioned Italy. Remember what we went through, like in Elmhurst Hospital, where the hospital was overwhelmed because that community overwhelmed that hospital. That's all that happened there. It gets into my, well, why didn't you distribute patient load across your system? We learned that lesson, but Elmhurst was overwhelmed from that community. The numbers at that time that Elmhurst happened, are not that different than the numbers today. How striking is that? Do you have those numbers? Speaker 2: (51:07) So March 23rd is that week in early March. There was 3,500 people with COVID hospitalized statewide on March 23rd, which was the same number that we have today. Governor Andrew Cuomo: (51:18) Do you get that? The day Elmhurst overflowed, let's call it, collapsed, the same number of COVID people were in the hospital system as today. 3,500 on both days, but Elmhurst collapsed. How did that happen? That community had a rate that was growing that you did not notice, that then went into one hospital. That hospital did not distribute across the system and was overwhelmed. That's what we're adding to the yellow and the orange and the red. Speaker 3: (52:12) But regarding load balancing, I mean, how much do you have a situation where it's happening so quickly, patients are so sick, you can't necessarily move them. I mean, you're talking about an analogy where this is a war. The general will say, "The minute the shots are fired, the plan goes out the window." It gets very hard to transfer patients who might be at a point where they can't be transferred. Governor Andrew Cuomo: (52:31) Exactly. I've had this discussion at length. I hear your point. This is the argument we had every day in the spring with these hospital administrators until two o'clock in the morning. You have 10 hospitals. You knew the rates were going up in certain areas among those 10. Now you want to say you only had one week notice, six days notice, five days notice. You knew the rate was going up. And rather than letting them walk in the door in that hospital, when Zach came to the door, why didn't you say, "Zach, I'm going to put you in a van and take you three blocks away to my other hospital that has capacity"? Well, that's not the way we normally do it. That'd be a bureaucratic mindset, whether it's in government or large hospital systems, that's not how we operate. And that's when we came up with surge and flex, which is throw the book out on how you operate. I don't really care how you operate anymore. Governor Andrew Cuomo: (53:42) So what we're saying today is among those systems, because they understand exactly what I'm talking about because we had this discussion. In the spring everybody said, "Well, nobody told us." Balance among your 10 hospitals today. Today. You have 10 hospitals, they should be at the same capacity. You know what hospital has the highest rate of COVID patients because you went through it in the spring. Make sure that hospital and the ones surrounding it have reduced bed count now so you have capacity. Balance that load among the 10, wherever there's a hospital system. Surge and flex is the next level, where the state comes in and says to you, "You have 10 hospitals. Your 10 hospitals, I need you. You're in the Bronx. I need you to take people from Buffalo because Buffalo is overwhelmed. And I'm going to bring down 100 people from Buffalo." That's statewide surge and flex, where you shift among systems, which was a wholly inconceivable concept. Governor Andrew Cuomo: (55:04) I'm going to take Northwell people and send them to Mount Sinai. That's surge and flex. Northwell, you're going to send nurses to Mount Sinai. Northwell, you have to send PPE masks to Mount Sinai. That's statewide surge and flex, which was just an incredible level that was inconceivable. All we're saying today is we're enacting that within your network, you must balance the load. And you went through the spring, Zach, so you know the numbers. It's going to be the same communities, and you've been watching the numbers go up. Well, we operate each hospital as if it's its own thing. Yeah. Not in a crisis, you don't. Speaker 4: (55:59) When it comes to using the- Governor Andrew Cuomo: (56:00) Hold on one second, Peter. Go ahead. Speaker 4: (56:01) When it comes to using the hospital metrics, what are the specific thresholds and data points that a region now needs to hit to enter one of the colored zones, and how do you reconcile that with positivity rates? Are we totally ignoring positivity rates now? Governor Andrew Cuomo: (56:16) No. It's going to be in addition to the positivity rate. Those numbers we're going to set this week, we're awaiting the Thanksgiving results, and we're doing it with hospital administrators. In other words, I don't believe the Thanksgiving wave has hit yet. You need seven to 10 days. So I don't believe we've seen the hit from Thanksgiving. Now, is that going to be harder in New York City or Long Island or parts of Erie? I don't know. But during this week, we'll see the Thanksgiving impact and we'll be taking an inventory of each hospital to find out exactly where they are in terms of avail- Governor Andrew Cuomo: (57:03) ... inventory of each hospital to find out exactly where they are in terms of availability, because capacity is how many beds do you have available today, how many beds could you make available if you load balance with your other hospitals, how many beds could you have if you canceled elective surgery, how many beds would you have if we mandated you add 50%. Add all that together, and now that's your capacity. And we need to see the results from Thanksgiving, because I think they're going to be dramatic. Speaker 4: (57:40) Do you expect fewer or more orange zones in this state, given this new layer of using hospitalization numbers as part of this strategy? Like if we were depending solely on positivity rates before and the numbers were increasing, there were more shutdowns on the horizon. But now with hospital metrics being involved, do you expect fewer or more colored zones? Governor Andrew Cuomo: (58:04) Well, they'll be different because they'll be also adding the hospitalization capacity. Our positivity rates are going to be surpassed in a matter of time. They were all a best case scenario and artificially low. 3%. Just think of the number 3%. There's no state in the nation that's at 3% anymore. It's only Vermont and Maine. So at one point, you have to understand and recognize the reality that the cases are going to go up. I want to make sure our number one priority is hospital capacity. That has always been my nightmare has been Italy, Elmhurst, hospital capacity. So that is going to be added in, in terms of our prioritization. I'm sorry. Speaker 3: (59:10) Yeah. You talked about hospitals reaching out to retired doctors and nurses, which happened in the spring. In the spring, you had critical personnel from across the country coming in. That seemingly can't happen now. How concerned are you about having enough staffing as we get into post-Christmas, post New Years? Governor Andrew Cuomo: (59:37) That's a great question and you're right. I'm more concerned about the staff shortage than I am the beds. The beds we can build. It's extraordinarily difficult and expensive, but we can build beds. We can't create more staff and the staff is starting tired. And you're right, how many came in nationwide? Volunteers? Zack: (01:00:14) More than 90,000. Governor Andrew Cuomo: (01:00:15) 90,000? We had 90,000, but how many were national versus New York? Zack: (01:00:19) About 60,000 outside of New York. Governor Andrew Cuomo: (01:00:21) 60,000 outside of New York. How beautiful the American spirit, 60,000 outside of New York. They're all busy. In the spring, it was just us, right? Nobody else had the problem. They're now busy in their own community. So that's not going to happen to anywhere near the same extent. So it's going to be more just our retired and nurses. And I am very worried about staff shortage. Speaker 3: (01:00:52) So it sounds like the potential makings of a crisis. How do you manage that? Governor Andrew Cuomo: (01:00:57) You manage it by raising the pool overall of staff as large as you can, balancing the load across the state and then doing everything you can to reduce the spread. The good news is we know what we're dealing with this time in a way we did not know in the spring, and we're better prepared and we're going to be smarter in the management of it. If you can keep the system balanced and you don't overwhelm any one place and you don't have people working around the clock day after day after day, that's one situation. Governor Andrew Cuomo: (01:01:55) But look, crisis, potential crisis. Everything is a potential crisis unless it's managed properly, right? I think we're going to be fine here on all of this, but we have our work cut out for us. I mean, you can't just sit by and let this happen. It is a function of action. And that's been the difference between the New York strategy and the national strategy from day one, right? National strategy was, "Well, let it happen. And whatever it is, it is. And I don't think it's that bad." Denial. We were the exact opposite. We were activists, truth tellers, informers, and managers. Governor Andrew Cuomo: (01:02:48) And that's what we're going to do again. I'm telling people, the way I told them the truth in the spring, I'm telling them the truth now. Those small gatherings at home, dangerous, creating a real problem. God's honest truth. No political hype, no BS. We're going to have a problem in the hospitals. I'm telling you that right now. It's going to be a serious situation. We're going to manage it. We have to work together. Hospitals are going to have to do things that they don't normally do, I'm telling you that right now. But it is a manageable situation. And I'm telling you, the vaccine will end the war, but the vaccine will not be ready for distribution in the timeframe you think it is. So you have to recalibrate your clock if you are thinking, "I can be irresponsible now, because next week I'm going to take a vaccine and everything's going to be fine." It's not going to be next week. Governor Andrew Cuomo: (01:03:55) That is the God's honest truth as I know it. And what worked in the spring and the reason you're wearing a mask today is because we told the truth and New Yorkers responded. There was no government enforcement of anything that made a difference, a little bit bars and restaurants. And I believe the same thing here. I'm going to tell New Yorkers the truth. I'm going to do what I have to do on my end, but I believe they'll respond. Zack: (01:04:32) [crosstalk 01:04:32] Governor, how does contact tracing- Governor Andrew Cuomo: (01:04:35) Chancellor Malatras had his numbers wrong. So let's relish this moment for a second that Chancellor ... So you want to say, Mr. Chancellor, you were wrong? Chancellor Malatras: (01:04:46) I was wrong. Governor Andrew Cuomo: (01:04:47) Who appointed you, Chancellor? Chancellor Malatras: (01:04:51) It's 30,000 were out of the state, 60,000 were within state. We had 90,000 total. It ended up being closer to 100,000. Governor Andrew Cuomo: (01:04:57) I knew he was wrong. Chancellor Malatras: (01:04:58) About 30,000. A little more than- Governor Andrew Cuomo: (01:05:01) I knew he was wrong, but I was going to hold it in my pocket and use it at the right time. Anybody want to add anything thus far? Speaker 5: (01:05:11) No, just echo that he was wrong. Governor Andrew Cuomo: (01:05:13) Yes. Doctor Zucker? Doctor Zucker: (01:05:15) Two things. One is that we understand his disease a lot better than we did the first time around. And also on the balancing of the system, it's not just COVID patients. It's also the non-COVID patients that they can move. So balancing involves all the other medical conditions, surgical conditions as well. Zack: (01:05:33) [crosstalk 01:05:33] Governor, there's been a lot of reporting that contact tracers are struggling to keep up with all the new cases across the state, especially here in New York City. How confident are you that the state really has the data to know where the coronavirus is spreading the most? Governor Andrew Cuomo: (01:05:47) We have more data than any state in the United States of America. That you know. Is that enough? It's more than anybody else has. You have now done tests on ... We've almost done as many tests as we have people in the state of New York. Is that amazing? We've almost done as many tests as we have people in the state of New York. Contact tracing is not perfect. You are right, Zack. They don't get a great response rate. And it depends on whose contact tracers and different systems are better and different systems are worse. But we have more data than anyone else. And at one point it becomes redundant, right? You're only testing data on four sources. So ... Zack: (01:06:40) But if New York City's can identify where four out of five cases are coming from, I mean, that seems like that would have a pretty big impact on knowing where the virus is actually spreading and acting accordingly. No? Governor Andrew Cuomo: (01:06:52) Yeah. But there's also, what a statistician will tell you is you can take a poll of 500 people and extrapolate what people across the state think. New York City only gets the results of one out of five. Yeah. But one out of five turn out to be 100,000 sample. If you know where 100,000 people got the virus, that's a hell of a base. Governor Andrew Cuomo: (01:07:28) Who didn't ask a question? Marsha: (01:07:29) Are you predicting that when you finally get the results in from the post-Thanksgiving period, seven to 10 days from now, that you'll be making more red, orange and yellow zones around the state? Governor Andrew Cuomo: (01:07:42) Yeah. Marsha: (01:07:45) In New York City and in the suburbs? Governor Andrew Cuomo: (01:07:47) I already did my prediction. See, I want to maintain the position on operating on facts. I gave you the predictions. I'll make you a bet on the Buffalo Bills if you want. But beyond that, all I want to say on predictions is- Marsha: (01:08:05) [inaudible 00:11:06]. Governor Andrew Cuomo: (01:08:08) You'll see a continue increase, is my bet, through mid January. I don't even know if the commissioner's with me on that bet. What would you say? Speaker 6: (01:08:17) I'm good with you on that bet. Governor Andrew Cuomo: (01:08:18) Yeah? Would you? Speaker 6: (01:08:20) Yeah. [inaudible 01:08:20] Marsha: (01:08:20) My question is in 10 days, do you expect to name more red, orange and yellow zones? Governor Andrew Cuomo: (01:08:24) My belief on my crystal ball is the Thanksgiving number is going to be big and it hasn't come in yet. If that's the case, yes. But we have to see what the numbers are. [crosstalk 01:08:37] Let's do someone who hasn't asked, please. Speaker 7: (01:08:41) Thank you. About this keeping the schools open, Mayor de Blasio has offered a plan to have weekly testing for students. So if those students are in an area that turns into an orange zone, are they then going to have to close the school for four days the way the state has and then reopen again? Or can they stay open? Governor Andrew Cuomo: (01:08:58) Who wants to answer that? Speaker 5: (01:08:59) They can stay open. That's something that we worked through in this more nuanced approach, recognizing that, as you said, the mayor's doing testing on a rolling basis. So it's not like if there was no testing and you would have to close and assess. So they would be able to stay open uninterrupted. Governor Andrew Cuomo: (01:09:15) Let's take one more. Speaker 8: (01:09:15) Yes, Governor, I had a question for you. [inaudible 01:09:18] from Pics 11. I know we can't see each other because of the mask. I had a question in regards to Queens hospitals. You mentioned Elmhurst. These were the hospitals that were most overwhelmed at the peak of the pandemic. You spoke to a number of them last week and they talked about so many of those hard lessons that were learned. In terms of the keeping up with the supply of PPE and conditional medical equipment and such, where's the oversight to make sure that those hospitals that were really inundated last time will have the proper supply that they do versus all the other ones? Governor Andrew Cuomo: (01:09:49) You want to answer that Doctor Zucker? Doctor Zucker: (01:09:52) Sure. We monitor this on a daily basis, make sure that they have enough PPE. They're supposed to have 90 days worth of PPE. We're tracking that. We are in contact with all the hospital administrators on a regular basis as well, and also in all the numbers about how many patients are in the hospital, how many COVID patients in the hospital, what we've seen in the ER. And on a regular basis, I reach out to the hospital administrations to be sure that we know exactly what their problems are ahead of time. Governor Andrew Cuomo: (01:10:15) But let me give you a for instance what happened, on lessons learned. The PPE, these masks, hospitals, they're actually bulky because they use tens of thousands of these. They were so available, hospitals just didn't really stockpile them because you could get them delivered the next day from any number of vendors. It was inconceivable that these would become on short supply. A mask, by the way, N95 that we were paying 70 cents for pre-pandemic, we were paying $7 for towards the end. Just think about that. We have since mandated that a hospital has to have a 90 day supply of these, and everything else, at the rate of the height of the pandemic. Okay? So take your high caseload during the pandemic, you have to have a 90 day supply of PPE by department regulation. I'll bet you most of them didn't have a week, but there was no reason to. It'd be like saying to you, you have to have at least 10 cartons of eggs in your refrigerator. I don't have 10 cartons. I have one carton at a time. Then I go and I buy another carton. Speaker 8: (01:11:50) Have you found that those supplies have been adequate across the board since you started checking and implementing that mandate? Governor Andrew Cuomo: (01:11:57) The Department of Health, and literally that's what the commissioner said, it's a requirement. They test it, they call, they report it. So yes. But that's something we learned. Now, the problem is you have 10 cartons of eggs in your refrigerator. So now you have no orange juice. But one problem at a time. Last question. Speaker 3: (01:12:19) Clarification on the numbers. 30,000 out of state, and 60,000 in state. Were those people on a list or were people who actually came in and helped? Chancellor Malatras: (01:12:31) We had about 40,000 that were used in some capacity for nursing homes and hospitals of the 90,000 off the list. And we maintained a central database at the state where we helped with the background checks and everything else so they could easily go right into the facility. Governor Andrew Cuomo: (01:12:48) We will confirm the chancellor's numbers. If they are incorrect, we will correct them publicly. Thank you, guys. Good to see you. I'll see you. Zack: (01:12:58) [crosstalk 01:12:58] neighborhood by neighborhood [inaudible 01:12:59] city as a whole in terms of- Governor Andrew Cuomo: (01:13:01) No. Neighborhood by neighborhood. Neighborhood by neighborhood, because even when you deal with hospitals, it goes community by community. Right? Think of Elmhurst. That was community driven. Thank you, guys.