Transcript: Mayor de Blasio Announces Dr. Dave A. Chokshi as Commissioner of the Department of Health and Mental Hygiene

August 4, 2020

Mayor Bill de Blasio: Everybody, earlier today, I went over our daily health care indicators and talked about the extraordinary progress this city has made. And again, I always want to thank all New Yorkers because you've all been part of that. We also know there's a lot of challenges up ahead. We still have a long way to go to fight back this disease and we have to make sure at all times we are continuing to refine our strategies and approaches, and that means we always need to be ready to make changes and adjustments, to prepare ourselves for everything up ahead. And any time there's change, there's an opportunity to rejuvenate, there's an opportunity to rethink and go forward with better approaches and that's what we intend to do. We have over these last months realized all the things that we need to learn from the coronavirus crisis, all of the big changes we need to make in our city going forward, all the ways we need to prepare ourselves for the future. We've looked at hard, difficult inequities and disparities, and we realize we have so much to do to address them, but we've also seen things that make us so hopeful as New Yorkers, the extraordinary strength of our health care system, the resiliency of our people, the way we fought back. Remember we were the national epicenter of this crisis and now all over the nation, people are looking to New York City to understand how to fight back against this disease. And the credit goes to every one of you and the credit goes to our health care heroes, our doctors, our nurses, or hospital staff, and, of course, all our colleagues in government at the Health Department and Health + Hospitals, all the agencies who have worked together to address this challenge.

Earlier today, just in the last hour or so, I received a letter from the heads of one of our agencies, Dr. Oxiris Barbot of the Health Department, informing me of her resignation. I want to thank her for her service to the city. I want to thank her for the important work she did during this crisis. And everyone had to give their all, and I know she did, to help us work our way through. So, I want to thank the Commissioner because it was a tough, tough moment for the city. Everyone had to do their best to come up with new approaches in the most difficult of times. I want to thank her for her good work in addressing the crisis. Now, obviously to move forward, to continue to be the city that rebounds from this crisis, to continue to be the city that can deal with whatever new challenges ahead and we know there are many on the horizon, the deep concern that we all feel about the potential of a second wave, the challenge of the flu season coming so many things ahead, we knew, I knew it was important to have a new leader for our Department of Health who could bring together the skills we need at this moment. Someone who could be a manager for that great department, a leader, a visionary in terms of the things that we would have to do in a brand new equation ahead, someone who could communicate that vision, someone would great health care credentials, who also knows our city and our people, and someone ready to fight this fight because he's been involved from day one in addressing the coronavirus challenge and understands what it takes for us to overcome it, and crucially someone who understands that we cannot allow the disparities of the past to continue.

So, remember, we're fighting an immediate challenge with the coronavirus. We have some very big challenges in the months ahead specifically, but then the even greater point, bringing this city back and addressing the underlying disparities, particularly in health care. I know we need a leader who can do that. The person I'm about to announce to you has an extraordinary history. Child of immigrants, grew up with tremendous potential, and worked so hard every step of the way to realize that potential. A Rhodes Scholar, a White House fellow, someone trained at some of the best institutions in our nation, someone who has worked all over the world providing health care to people in need, but most, especially right here in New York City for years serving at the frontline and who played a crucial role in those worst days in March and April helping us to fight through the crisis. Someone who feels a lot of compassion for the people he serves and still sees patients every week as part of that commitment. I can certainly say this is not the first crisis he has been through. The coronavirus was not his first big challenge. He worked in Louisiana after Hurricane Katrina. He was here in New York City as part of the response to Sandy. Again, played a pivotal role at Health + Hospitals addressing the coronavirus crisis and did it by creating a team approach, an approach that focused on compassion for all the people we serve, but really brought together the very best of the efforts of different agencies and different people to achieve what we needed to in a moment of profound challenge.

When Health + Hospitals, the biggest public hospital system in America, had to prepare to add not just thousands, but tens of thousands of beds to accommodate people because of the coronavirus, this is the person who was charged with the task of building out that plan. When it became clear we'd have to depend on telemedicine more than ever because people couldn't get to health care appointments, this is the person who in the space of just a few months, ensured that Health + Hospitals operations were maximizing their telemedicine capacity, reaching tens of thousands of patients in a new way. So, this is someone who knows how to take on any challenge and do it with fairness and compassion and tremendous effectiveness. I've seen it with my own eyes. My team here at City Hall watched his work with tremendous admiration. And so, it's my pleasure to introduce to you the next Health Commissioner for the City of New York, Dave Chokshi.

Commissioner Dave Chokshi, Department of Health and Mental Hygiene: Thank you, Mr. Mayor for that warm introduction. Colleagues, I'm so honored to be here before you today and ready to get started with the important work of safeguarding the health of New Yorkers. I'm a primary care doctor with a public health heart. As the first doctor in my family, I didn't have direct role models showing me what it meant to practice medicine, but I had plenty of experience from getting hospitalized with asthma attacks when I was a child to my father's decades long challenges with diabetes that showed me how health was linked to opportunity. Opportunity is what propelled my grandfathers to take up and move from small villages in Gujarat, India to Mumbai, the New York City of India, two generations ago. My father was the first in his family to immigrate to the United States, settling in Baton Rouge, Louisiana, where I was born and raised because it was where he could find a job.

My wife, Melissa Aguirre, who is here today, comes from a family with one of those only-in-New-York stories. Her Dominican mother and Argentinian father met through a family matchmaker at JFK and raised their two daughters in Queens where they still live and where my wife and I are now raising our baby daughter. Through our family’s stories I can tell you that my work is personal. The patients I take care of every week at Bellevue Hospital, often immigrants working as taxi drivers or housekeepers, remind me of the journeys of so many of my and my wife’s family members. Each of them, each of them, deserves excellent high quality care, but all of them would derive even more benefit if their diabetes or their opioid addiction could have been prevented in the first place. That is the promise of public health.

Public health is also a calling I've answered in crisis after crisis. I worked for the Louisiana Department of Health before and after Hurricane Katrina witnessing with my own eyes the devastation it brought on families I knew and the communities I had grown up in. I saw in a visceral way that those who are already living on the margins are the most likely to become further marginalized in a time of crisis. Here in New York, I was part of a FEMA delegation deployed to Superstorm Sandy in 2012, primarily working with amazing colleagues from the Department of Health and Mental Hygiene. One night visiting one of the emergency medical shelters that had been set up in the Bronx, I struck up conversations with the nursing home residents who had been shifted there. Although they were safe with food medicine and shelter, almost all of them described their sleepless nights, their anxiety due to the storm itself, and because they were cut off from their loved ones. Health crises often cast these long shadows, particularly when it comes to mental health.

Most recently I served as Chief Population Health Officer at our city's public hospitals, which were the first line of defense for so many fellow New Yorkers during the coronavirus pandemic. Our family lives in Jackson Heights, just steps from Elmhurst Hospital. I saw what this virus did to my community, to my neighbors, and to my fellow health care workers. But this epidemic is only the most recent example of the vicious cycles of illness and inequity that I've seen over my career. Each of those experiences further forged my conviction that we must build toward better health systems with prevention at the center and a more proactive approach to avoidable human suffering. I feel fortunate to have been able to do that over the last six years at New York City Health + Hospitals. I built and grew an award-winning team responsible for transforming care for the over one million New Yorkers we served. For instance, our approach to chronic disease achieved the best outcomes for blood pressure, depression, and diabetes in the history of Health + Hospitals, reducing heart attacks and strokes and saving lives and limbs. During COVID response, I helped spearhead our complex system’s surge planning efforts. My team also led our transformation to telephone and video visits, ensuring our patients wouldn't be cut off from care during the crisis. We ramped up from 500 to over 80,000 telephone visits within the span of weeks. These efforts helped ensure our seniors could keep getting their prescriptions as well as the continuity of our mental health treatment.

COVID-19 has unmasked how disease, racism, and economic dislocation intersect with devastating health consequences. I think about one of my patients at Bellevue who asked me in early May, when I thought the lockdown might end. A Colombian father of three, he worked in a restaurant and was growingly worried about money for food and for rent. I remember feeling troubled. Since he had high blood pressure and kidney disease, he was at higher risk for poor outcomes and more likely to get infected because of his job. But the economics of the lockdown brought its own challenges, particularly for his mental health.

We are in a better place with COVID-19 than we were this spring thanks to the efforts of New Yorkers, the administration, the Health Department, and Health + Hospitals. Looking ahead, avoiding situations like the one my patient found himself in will require vigilance and a deep collaboration across sectors, particularly health care and public health. The role of public health is central and clear. Just as with my patients in clinic, our public health approach must begin with listening to patients. For us to succeed, we must use science to diagnose problems and bring together everyone who can stop health threats before they start, whether COVID or otherwise. For us to succeed, I will need to embody my core values of truth, justice, and kindness every day. I'm joining a team that I know already cares deeply about science, equity, and compassion. For us to succeed together, lifting up low income people to their highest state of health, will need to be seen not as charity, but as fundamental to building a better health for all of us.

And finally, for us to succeed, I'll need to listen to and learn from what I know is the finest Health Department in the country, even as I lead them. I'm not daunted by the challenges. I'm motivated by them. And by having borne witness to the frustrations of so many people whose simple wish is to be or to stay healthy. Thank you again, Mr. Mayor, I'm grateful for this opportunity to serve New Yorkers and ready to get to work.

Mayor: Thank you so much, Dave. And I want to tell you – I just want everyone to understand one really crucial, crucial example of the kind of human being who will now be leading our Department of Health and Mental Hygiene, that as I was talking to Dave, and as I mentioned, I have admired Dave's work throughout this crisis as has my team here at City Hall. I talked to him about taking on this role. And he said, there's something that's very important to me, there's one thing I need to know. He said, I need to know that I can keep seeing patients. And I think that speaks volumes that someone who has taken on so much responsibility on behalf of all of us and will be taking on even more, needed to know they could keep that direct connection to the patients he serves and by extension to the people of New York City. I think that's an extraordinary indication of the compassion and the ability of the person who will now be our Health Commissioner. So, Dave, I want to just thank you, that that's the person you are. I look forward greatly to working with you over this next year-and-a-half, as we once and for all beat back this disease and move this city forward. With that, we're going to turn to some questions from the media. We're going to have one more speaker potentially in a few minutes if our video feed works out, but we'll come to that momentarily. So, let's take a few questions from the media now. And let me know, of course, the name and outlet of each journalist.

Moderator: Hi, all we have with us here today, Deputy Mayor Dr. Perea-Henze and Commissioner Chokshi. With that, we will start with Dave Evans from ABC-7.

Question: Hey, Mayor, this is Dave. Can you hear me?

Mayor: Yes, Dave, how you doing?

Question: I'm doing fine. Just a couple of questions. I just wanted to back up a little bit. I don't think any of us are surprised because we haven't seen from Dr. Barbot in quite some time. But was this motivated, did this begin with the whole clash with Monahan early in this crisis or what? Because it does seem a little strange, I think, to the general public, that this has happened. What precipitated her being relegated to basically second fiddle, long ago?

Mayor: I don't – I appreciate the question, Dave, and it's an honest question. No, it's not obviously about one thing. The Commissioner made the decision and I received her letter a little over an hour ago. But it had been clear certainly in recent days that it was time for a change and really about how we move forward. And this is the important thing to think about. I think it's understandable, Dave, everyone wants to know about personnel and personalities and inner workings and that's all understandable. But I think the thing that New Yorkers care about – we've obviously come a long way. How do we sustain that? And then how do we go even farther? We've got to open school safely and keep that going. We've got to bring back our economy. We got to deal with the flu issue up ahead, which is a real one. We got to make sure there is not a second wave. Huge challenges ahead. And we need an atmosphere of unity. We need an atmosphere of common purpose. And people really focusing on all the parts of this government, working together. Whether it's Department of Health and Mental Hygiene, Health + Hospitals, Department of Education is going to play a crucial role, all of it. So, it was just so important to determine a strong path forward. And I really have confidence that Dave is the right person to bring us forward. I think you would agree, right first name for sure. Go ahead.

Question: My second question is related to that and that is, I agree with you, I don't think New Yorkers particularly do care about the personality and who's in and who's out and, you know, the inner workings of all that. But I do think, and I want you to talk to the average New Yorker here for just a second, but I think any New Yorker is going to look at this and say, there's something weird. There is something fundamentally dysfunctional here for the department that's supposed to be head of testing and tracing is not. And B, she resigns in the middle of this pandemic. That's not normal. So, speak to New Yorkers about – do you think that's normal?

Mayor: No, Dave, it's again, a very fair question and I appreciate the invitation to speak to New Yorkers. So, I'm going to do that now. Here's the reality. This city was the epicenter of this crisis. This city has fought back now to be in a position that the rest of the nation is looking to us to understand how to defeat this crisis, this coronavirus. And look, this was a massive team effort. And every day, Dave, I know you watch – every day, I talk about the people in New York City. This was first and foremost about the people, not about any government officials, the people who did this work. And then it was about bringing all of the government together in common cause. And let's be clear. This city went through stage one, two, three, four on time, one percent infection rate now. We've made a lot of progress. So what matters to everyday New Yorkers is did you get the job done? Did we move forward? Unquestionably, everyone deserves credit for that. But we also need to be planning ahead and making sure our team functions as well as it possibly can for the new challenges ahead. And what my job is, Dave, is to make sure we field the best possible team for what we have to deal with going forward. So, I'm convinced this is what allows us to do that. And look, I'd say to everyday New Yorkers, you're in good hands here. You've got a new Health Commissioner with unbelievable experience and ability, a perfect person for the job. You've got strong leadership at Health + Hospitals. You got everyone in the City government ready to move forward and build upon the success of the city. That's what we intend to do.

Moderator: Next we have Rich from WCBS 880.

Question: Hello, Mr. Mayor.

Mayor: How you doing, Rich?

Question: Good. So, I'm looking at some copy from the New York Times here in which they quote a letter from the Doctor saying, “I leave my post today with deep disappointment that during the most critical public health care crisis in our lifetime, that the Health Department’s incomparable disease control expertise was not used to the degree it could have been. Our experts are world renowned for their epidemiology surveillance and response work. The City would be well served by having them at the strategic center of the response, not in the background.” And obviously this has to do with taking a testing and trace away from the Health Department and giving it to the hospital system. So, how do you respond to her words? She's saying she's disappointed in what you did.

Mayor: Look Rich, I think it's pretty straightforward. We've built the largest test and trace structure in the United States of America. And we have the lowest level of coronavirus infection we've had in the city since the very beginning. All of these facts go together. The strategies that have been put together have been highly effective. I want to give credit to everyone who was a part of it. Dr. Perea-Henze is here, our Deputy Mayor for Health and Human Services. I want to thank him for his leadership. All the team here at City Hall. My Chief of Staff, Emma Wolfe, has played a crucial role. Of course, everyone at Health + Hospitals, Dr. Mitch Katz and the whole team there. And in fact, the Health Department’s played a crucial role in test and trace, a number of key figures in the Health Department have played a crucial role in the building and the continuity of that program. So, when you think about it, we had to build, Rich, the biggest apparatus in the country to the tune of thousands of thousands of people. Put it together in a matter of weeks, prevent thousands of infections, which Test and Trace has done, and then keep building from there. It had to be a team effort. And I've said before and I'll say again, Health + Hospitals, which is a huge operational organization, made sense as the home for something this big and unprecedented. But it's never about one agency. It's about everyone being brought into common cause, and that's what we've done. Go ahead, Rich.

Question: So, are you saying that her objections here are illegitimate? I mean, she seems to be saying the expertise really resided in the Health Department. And why was it taken away from the Health Department? Maybe that’s the simple question?

Mayor: I think it's a – Rich again, I know you're asking the question honestly, and it's something I've talked about quite a bit. But I want to just affirm, this was something that had to be created on a vast scale. So, there's no – it's not about something that ever existed before. And there was a model. Health Department has some really good, talented people and they're used to doing this work for sure, but on a much smaller, more precise scale. We're talking not about a hundred people, we're talking about thousands and thousands of people. That kind of operational work, being out in every neighborhood with a huge operational reach, we knew from the beginning that that better fit an organization with 11 hospitals and 70 clinics which is what Health + Hospitals is all about, grassroots health care delivery. That was a much better model if you were talking about setting up testing and tracing in literally every neighborhood of this city. It obviously has worked because the apparatus is up and running on a vast scale, is building and growing all the time, and is helping us stop people from getting infected. And that's the name of the game. So, the expertise of the Health Department has really contributed, but in terms of building an apparatus that could reach every part of the city, it made sense to have it housed in H+H and it's worked.

Moderator: Next, we have Marcia from CBS.

Question: Mr. Mayor, thank you for taking my question. There's been – for months there've been reports of escalating tensions between City Hall and the Health Department. And just a few minutes ago, you said it was time for a change. Maybe you could expand on that and tell us why it was time for a change at this point.

Mayor: Look, I think it's important, Marcia – I appreciate the question, but I also think it's important to focus on the reality of serving New Yorkers and the strategy here. What I'm saying was it became clear that there was a need to move forward. I received the letter from Dr. Barbot earlier today, it was time to create a new approach for where we had to go. And I think this is something that we have to understand, particularly in a crisis environment, you have to keep refining, you have to keep learning from experience, you have to, have to keep thinking about how to put together the best team not just for today but for where we're going, and the crucial reality of teamwork. We need all different parts of the city working together. So, it just became clear that we needed that kind of leader. And I know that Dave Chokshi is that leader. Go ahead.

Question: Mr. Mayor, my second question is this – clearly you didn't seem surprised by her letter because you were ready within an hour or two with a new person to head the department. Had you made it clear to her that you had lost confidence in her or that it was, as you said, time for a change and that you wanted to move the city in a new direction?

Mayor: Again, Marcia, I think I want to respect different conversations and communications that are private and about respecting everyone involved. Sometimes things just happen organically. It was time for a change. It became clear it was time for a change and it was important to have a strong leader ready to step in who had experience. And one thing that distinguishes Dave, is his experience in the Department of Health, experience in Health + Hospitals, the ability to think about how to bring all those pieces together. And, again, I had seen his work firsthand in the immediate response to the coronavirus, my team here at City Hall had seen his work with great admiration. It made sense to bring someone in who was ready to take charge and continue building a strong team approach to everything we have to do going forward

Moderator: Last two for today. Next, we have Shant from the Daily News.

Question: Yeah. Thank you, Mr. Mayor. I know you've already talked about this a little bit, but I'm wondering if you could more directly address the substance of the criticism described in Dr. Barbot’s resignation letter just because she's a major authority, she's not some op-ed writer, and she's saying she's disappointed in your handling of this and that the disease control expertise was not used to the degree it could have been, which is a pretty major criticism. Would you concede anything on that front or are you explicitly disagreeing with that? And then I have a follow up.

Mayor: Shant, again, fair question, but I think I've spoken to this many, many times before. Look in any team there's going to be different viewpoints, but the most important thing is the product. The most important thing is the outcome. Putting together an operation of this size and scale in a matter of weeks is extremely difficult. Making it part of the everyday life of New Yorkers who need help and support, that's what everyone has done here. I want to credit Dr. Ted Long and the whole team at Test and Trace. And, again, with the expertise of the Health Department involved, with the organizational ability and operational ability of Health + Hospitals, we needed all of the above to make this work. And it has been working because it is now a constant presence and a growing presence. So, I believe that expertise at the Department of Health is real and is deeply appreciated and has been part of this and will be part of this. And I'm certainly going to rely on Dr. Dave Chokshi to keep building that, to make sure we're getting the best out of each department, and that it's woven together in a strategy that everyone is contributing to in common. Go ahead, Shant.

Question: Yeah. Thanks for that. I guess I just wanted to say that, you know, this resignation today seems to make it clear that there was real tension between your administration and top health officials, including Dr. Barbot, throughout this deadly pandemic. Do you feel like that tension hampered the City’s response – just like, you know, I mean, if there's major disagreement among top management that are coordinating response, I guess, to put it differently, how can that not have hampered the City's response?

Mayor: Well, it's a very logical question, but I can also tell you that there's a difference between tension and different viewpoints. There's always different viewpoints. We have a variety of health care leaders in addition to other leaders in the administration – everyone was part of this response. When you think about all the factors here, two major health care agencies, Emergency Management, and then all the other, the public safety agencies, everyone was part of the response, especially in the first weeks where we were dealing with the great unknown. And when we didn't have the testing capacity, didn’t even know the extent of what was happening to us. There's going to be differences. There's going to be differences of opinion, differences of perspective. That's normal. What really matters, Shant, I truly believe it, is the outcome. And we fought back. Once the crisis was upon us, the mission was to make sure that people could get health care, that our hospital system held, that we got the PPEs and the equipment. Everyone did an outstanding job in all agencies in making that happen. And then the mission was to beat back the disease and reduce the infection rate and build up the Test and Trace Corps. And, again, today's indicators are amazing, what they say about how far we've come. Everyone contributed to that. But you're going to have disagreements along the way, particularly when you're in a moment of crisis. The question to me is, do you pull together those different viewpoints and different information and move forward? And this City unquestionably moved forward. We're going to take one more question and then we have a special guest who will join us that I want you to hear from. So, let's do one more and we'll turn to our guest.

Moderator: Next, we have Jenn Peltz from AP.

Question: Hi, Mr. Mayor, how are you?

Mayor: Good, Jenn, how are you?

Question: I'm okay, thank you. I actually think that others have asked most of my questions, so I will [inaudible] –

Mayor: Okay. Appreciate it, Jenn. So, everyone I want you to hear from literally one of the leading health care voices in our nation, someone who epitomizes the values of this city in terms of making sure everyone gets the health care they need and in a fair and equal manner, someone I've admired and my wife, Chirlane, has admired for a long time and someone who has worked very closely with Dave Chokshi in his career. So, I wanted you to hear directly from him at this important moment for New York City. My great pleasure to introduce the former Surgeon General of the United States, Dr. Vivek Murthy. Vivek, can you hear us?

Dr. Vivek Murthy: Thank you –

Mayor: There you go.

Dr. Murthy: Thank you so much, Mayor de Blasio, and it's an honor to join all of you today. And on a personal note, it's a particular honor for me to be able to be here at such an important moment for the City of New York and for somebody that I had come to admire greatly over the years, and that's Dr. Dave Chokshi. You know, I have known Dr. Chokshi for over 15 years. I knew him actually, when he was in his training. I was, in fact, one of the physicians at Brigham and Women's Hospital that got to see him develop into an extraordinary physician. And I've also had the chance to work with him and to see him throughout his extraordinary career where he has helped the State of Louisiana and the City of New York as well as the VA, in which he helped the entire nation. And he's done this with humility, with skill, with grace, and with just wonderful communication. He is, as people would – as we say in medicine, Dave is a doctor's doctor. He's the kind of person that you want your family to go to, that you yourself want to go to because of his empathy, his caring, his skill, and his compassion, but he's also an extraordinary public health leader who both sees the forest and the trees.

He was able to function at a 30,000 [inaudible] level, but also be on the ground, understanding what's happening, ensuring that the mechanisms at the institutions in which he works are functioning and functioning well. I know that this is a time of crisis for the country when it comes to COVID-19 and that that crisis is overlaid over many other challenges that we were facing long before this pandemic, especially challenges around depression, substance use disorders, the opioid epidemic, and other chronic disease. And to take on those crises, both the important, as well as the urgent, requires a special type of leader, a leader who can understand that public health is more than just numbers and charts. It's personal, it's about people's lives, it's about their families, it's about their kids, and Dave Chokshi is that kind of leader. So, I'm just thrilled that the Mayor has selected Dave to serve as the next Commissioner of Health for the city. I know that he has the confidence of the First Lady of New York as well, somebody who I also deeply admire and consider a friend, Chirlane McCray. And my hope is that Dr. Chokshi will be able to work closely with the Mayor and with the First Lady and the rest of the team in New York to ensure that New York is healthier, safer, and better off than it ever has been.

Mayor: Thank you so much Dr. Murthy, and thank you for your extraordinary service to this nation. And your clear message today is deeply appreciated because you're someone who truly understands what it takes to deal with this crisis, but even more importantly, to build up a fairer and better health care system for the future. And that's the work we will be doing here, as you continue to do that great work on the national level. So, everyone, I'll conclude with congratulations to Dave as our new Commissioner, ready to take charge immediately, and with an appreciation to all New Yorkers. Again, every time – every time we talk about the coronavirus crisis, I like to remember who fought back, who put New York City into a position today that the entire nation is looking at with admiration, who every day is doing the hard work that will bring us back. Some months from now, when this crisis is over, we're going to look at this whole history and say, how did New York City do this? And the answer is, New York City had a secret ingredient, New Yorkers. So, thank you all for all you've done and together we're going to move forward to make this city healthy and safe. Thank you.