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'It Will Overwhelm the Healthcare System': Governor Cuomo Asks Federal Government To Step In To Aid COVID-19 Response
By
Gwynne Hogan
Published Mar 15, 2020
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Matteo Biatta/Sintesi/SIPA/Shutterstock
By
Gwynne Hogan
Published Mar 15, 2020
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New York Governor Andrew Cuomo pleaded with the federal government to intervene on behalf of New Yorkers, asking them to rapidly build out hospital facilities, institute federal guidelines on the closure of businesses, and institute mass testing for COVID-19 nationwide.
“I can’t do it. You can’t leave it to the states. I’m an aggressive governor,” he said at a press conference Sunday afternoon. “I push very hard. But there’s no way that we could manage this undertaking.”
Without federal intervention, Cuomo added, “we will be sitting here nine weeks, 14 weeks from today seeing a health care system overrun” because of the anticipated shortage of intensive care beds. There are currently 65 New Yorkers in intensive care settings, of 600 beds statewide that are available, he said.
But when asked if he would call for more sweeping closures of businesses and schools, which is what epidemiologists and infectious disease specialists are urgently calling for, he hedged.
"It's something we’re looking at,” he said.
The governor’s remarks come as city council members, public school teachers, healthcare, and library workers, have been calling for more drastic measures to reduce the spread of the virus. Meanwhile, many bars and venues and restaurants are buzzing with what appear to be usual levels of activity.
While the Governor suggested it might be nine to 14 weeks before New York’s healthcare system becomes overwhelmed, other projections are not so generous.
A model created by Michael Donnelly, a data analyst at Facebook, and published in a Medium post on Saturday, suggested the state has far less than that. His calculations project New York will begin running out of hospital beds by early April.
Donnelly’s projections have been circulating through the offices of New York City Council members and high-level staffers coordinating the response to the outbreak, several sources familiar with the matter confirmed.
“This is not a choice of shut down the city or not shut down the city,” Donnelly, who was also deputy chief of staff of the U.S. treasury office of financial research under President Barack Obama, told WNYC/Gothamist. “We will all know people who die. The city will shut down by itself.”
Based on the conservative end of his estimates, by March 25—nine days from today—enough vulnerable people susceptible to severe illness will have been infected by the virus to overwhelm our healthcare system. They’ll need hospital care several days after that, overwhelming emergency rooms and intensive care units by early April.
Donnelly’s modeling relies on an estimate of 1,200 to 3,000 available hospital beds. Avery Cohen, a spokeswoman for the mayor, questioned that bed range, and pointed to an estimated 1,200 hospital beds on reserve, as well as increased capacity by canceling all elective surgeries, as some private hospitals have begun to do. Across the city there are 20,000 hospital beds in use.
Dr. Irwin Redlener, the director of Columbia University’s Center for Disaster Preparedness, concurred with Donnelly’s projections and said he too was consulting with an array of different mathematical modelers who are attempting to predict the spread of COVID-19 in U.S. cities.
“They’re all in agreement. There’s basically no avoiding the calamity New York City hospitals are facing,” he said. “The question is when is it going to be—early April, maybe it’s mid-April, but it’s coming and we’re not ready for it.”
A spokesman for the city’s hospitals said the city had instituted social distancing measures that would slow the spread of COVID-19 like canceling large gatherings of 500 or more people and reducing capacity at venues, and added the model was incorrect but declined to comment further.
“As a city, all of us—including NYC Health + Hospitals leadership—are urging social distancing measures precisely to preserve capacity for those who need it most,” Mitchell Katz, the President and CEO of the city’s hospitals said in a statement. “Projections vary, but the bottom line is that we are trying to implement the measures that will get vulnerable New Yorkers the help they need.”
Beyond access to hospital beds, the city and state also have a finite amount of ventilators. According to a 2015 New York State report, there are around 6,100 ventilators, 85 percent of which are in use on any given day by other patients, with an additional 1,750 stockpiled for a pandemic flu situation. That’s just under 3,000 ventilators available before doctors would have to make choices about which patient gets a one and who doesn’t.
“These ventilators are expensive to begin with and they are scarce,” Governor Andrew Cuomo said at the Sunday press conference. “You can’t find... ventilators no matter how much you’re willing to pay right now.”
New York finds itself in a similar moment to where Italy was two weeks ago, where government officials banned public gatherings in some municipalities and asked people who’d returned from areas with outbreaks to self-quarantine as a precaution. Now officials have had no choice but to put the whole nation on lockdown with dystopian images and videos emerging from Northern Italy of nurses collapsing from exhaustion and the dead left uncollected by coroners for hours.
“There’s a disconnect. I am concerned with the disconnect between the political statements and the statements of health professionals about the potential collapse of our healthcare system,” Dr. Redlener said. “Especially in big cities, we need to be closing restaurants. The 500 people limit is way too high.”
The mortality rate isn’t a static function of how deadly the virus is, Dr. Redlener added—it’s also a reflection of how smoothly the healthcare system is functioning. People seeking care for traumatic injuries, car crashes and asthma attacks are also less likely to get the care they need when the system becomes overwhelmed, he said.
“We haven’t quite absorbed the fact that this is not just people with COVID-19 but people who come in, in more routine ways,” he said. “We’re going to see fatality rates for hospital patients in general increase.”
A high-level government health official familiar with matter agreed with Donnelly’s projections of a system stretched to capacity by early April. He spoke on the condition of anonymity for fear of retaliation. When asked if the city and state were moving fast enough, he had a one word retort: “No.”
“The maximum social distancing that’s possible, is what we should do right now,” the source said. “We’re at war.”
At a Saturday press conference, Mayor Bill de Blasio said he was reluctant to take more aggressive measures to curb the spread of the virus.
"I am not ready today at this hour to say let's have a city with no bars, no restaurants, no rec centers, no libraries,” he said. “If you want to do Italy -- and I don't—you can shut down everything in sight... I think there is a massive fallacy in this discussion as you keep closing [things], what do 8.6 million people do?”
He added he disagreed with New York Public Library’s decision to close its doors. Meanwhile employees of Brooklyn and Queens are worried and furious about being asked to continue to show up to work.
An internal email sent out to Brooklyn Public Library employees Saturday from Library CEO Linda Johnson, and shared with WNYC/Gothamist, indicated City Hall was pressuring the library to remain open.
“The City, which provides 85% of our operating budget, is intent on ensuring that healthcare workers are able to report to work, children continue to go to school and the essential services provided by the library will continue to be available,” the email reads.
Donnelly, meanwhile, reiterated his fear that one way or another New York City must shut down.
“It’s a choice of shut down the city in an orderly way, save lives, bring in the National Guard. Feed people and deal with the economic hit,” he said. “Or deal with a bigger economic hit, destroy trust in government and tens of thousands more dead...That’s why France shut down its entire country. That’s why Spain shut down its entire country..And it’s shocking to me that our elected officials haven’t realized that yet.”
Tagged
COVID-19
Governor Andrew Cuomo
coronavirus
health care
Gwynne Hogan
Gwynne Hogan is a former Gothamist reporter.
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Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
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