Transcript: Mayor de Blasio Holds Press Availability at The Meatball Shop

October 25, 2014

Mayor Bill de Blasio: Well good afternoon, everybody. It's a beautiful day here in New York City and it is particularly a joy to be here with Daniel Holzman, the owner of this wonderful restaurant. I just wanted to say that Chirlane and I, and Dr. Bassett tried most of the menu in our effort to know exactly all the great things available here at The Meatball Shop. It's an extraordinary place. Talked to a lot of customers who really appreciate it and have stayed very loyal to this place because they love the food and they love the people who are a part of it. We wanted to be here today to thank this restaurant. They've been great partners in the last few days and it's a real interesting example of how New Yorkers deal with a challenge. You'll hear the story from Daniel in a moment, but he's been here in this location four years, has a huge following here in the neighborhood – a lot of devoted customers – he's got a lot of employees that he provides a great job to, and his customers over the last few days have been here to support him. They want to patronize this place even more. And that says something about New York City. There is a reality about New Yorkers – we're not only resilient, we're not only tough, but we stick by each other. And the people of this neighborhood and the customers of this restaurant have been here in greater numbers than ever to support the restaurant and to show that they know this city is safe and that things are being done in a way that makes them comfortable. So I want to thank all the New Yorkers who have stopped by. I want to encourage anyone who's hungry and around Greenwich Village tonight, come over to The Meatball Shop and you'll have some great food. And with that, I'd like you to hear from Daniel Holzman.

Daniel Holzman, Owner, The Meatball Shop: Thank you so much. Thank you all for being here. The Meatball Shop – it has a very special place in my heart because it's my restaurant, but it's really the city of New York's restaurant and the restaurant for the people of the West Village and the other neighborhoods where we have locations. For me, yesterday was my proudest day as a New Yorker – to feel the support from both, the Mayor and the Mayor's office, the Department of Health, and the Office of Emergency Management. They responded so quickly, and they came to our aid to make sure that our servers and our staff and our customers were safe. It really made me feel confident that everything that could possibly be done was being done, and it was being done as quickly as one could ever hope. I really want to say thank you so much for this support, it means everything to me. And thank you so much to New York. And finally, my prayers go out to anybody that has been affected by this. So, God bless you.

Mayor: Why don't you tell them what happened after you re-opened.

Daniel Holzman: My goodness – I guess, around 6 o’clock last evening we opened up the doors, and I was a little nervous to see what would happen, but we had a line down the block, and we filled up immediately and we were busy all night last night. It made me – I just felt so proud to look out at the restaurant and think, shucks these people are coming in to support the meatballs, because meatballs are delicious. We love them.

[Laughter]

Daniel Holzman: Thank you.

Question: Would you spell your name for us?

Mayor: Would you spell you name for –

Daniel Holzman: Daniel Holzman – H – O – L – Z, as in zebra – M – A – N.

Mayor: Excellent – and I think this is further evidence of the extraordinary efforts made by our city employees. I want to thank Dr. Bassett and everyone at the Health Department. I want to thank Commissioner Joe Esposito and everyone at the Office of Emergency Management. We had three businesses that they made sure to review and to clear. I know each and every one of those businesses appreciated that support and the process has gone very, very smoothly.

And this is the right segue into a reminder about some core truths about Ebola. And I want again ask – at this moment we are facing a challenge as a city, as a state, as a country. I'm going to ask my colleagues in the media to please do all you can to get the facts out because sometimes there are reports that don't suggest the truth about Ebola. It's really important to set the record straight. Ebola is a disease that can only be contracted with direct contact with the bodily fluids of someone who is infected. The bodily fluids – blood, for example. But it cannot be contracted through casual contact. It is not an airborne disease. So it's very clear that it is a rare instance in which Ebola is transmitted. It requires, bluntly, intimate contact. That is why it was so clear when our personnel came to the restaurant and confirmed the details that there had been no intimate contact, there had been nothing that would constitute a possibility of transmission of the disease in this restaurant and the other two restaurants – the other two organizations, I should say, were clear. But we've got to keep making clear to people, this is not the common cold, this is not the flu. This is the disease that is actually fairly difficult to contract in very rare circumstances – when there is direct contact with bodily fluids. So, I think if we keep getting that message out it's going to help people understand the difference between some other every day common diseases, and this very, very rare disease.

And second, I want to remind people that if they do feel that they may have been exposed, there are two and only two things to do. Call 9-1-1, or proceed directly to an emergency room. I've said this a couple times, I'm going to keep saying it. Don't go to a family doctor. Don't wait and see how it goes. If you think you may be affected, which means you've been in one of the three countries in the last 21 days, or been in intimate contact with someone who has, and you have the symptoms, most notably fever, that's the time to call 9-1-1 or go to an emergency room. If you haven't been in the country – the three countries, if you haven't been in contact with anyone who's been in those three countries, if you don't have the symptoms, you are in no danger. And we just want to help give people a clear, factual message about what's going on here so that the public can be reassured. The facts are very, very powerful.

Also want to give an update that the most recent case – suspected case, I should say, of a traveler who came into Newark Airport. We just received news that not only was the test that was done locally one that showed no presence of Ebola, but the CDC has done a test as well showing no presence of Ebola in that individual. There will be additional testing as a precaution over the next days, but we're happy to say that that traveler has shown no evidence of Ebola and that's a good news story for everyone. With that, we'd like to welcome your questions. I'm going to ask Dr. – watch out for these recording devices Dr. Bassett – and ask her to join me for the Q [inaudible].

Question: Two pronged, first [inaudible] that announcement late in the afternoon. Did you have any prior notice to that announcement being made? Were you informed? The second part of the question is, what is your reaction to [inaudible] because what it does is it seems to fly in the face of exactly what you just said. You cannot contract it from casual contact, from buses and subways, which the Governor alluded to –

Mayor: Let’s break this – there's a couple different pieces here. On the question of prior consultation – no. On the question of how you contract this disease, I've just laid out very clearly. I think the governor alluded to the fact that this is a big and complicated city, and that if someone's here they're travelling around, and that means that we have to some extra special work to track down people's movements. But that is a very different idea than how you transmit the disease. Our medical detectives – I want to use the example of Dr. Spencer – our medical detectives got to work right away. And I commend the health department because they have very well trained people. This is – I want to say as a matter of fact – known all over the world as the finest municipal health department anywhere on Earth. They have trained for many, many complicated situations. This was the epicenter of the AIDS crisis 30 years ago. We've been through any number of challenges. This is a health department that is battle tested. And so, the medical detectives instantly went to work and they found four people, and only four people, who were even a question in Dr. Spencer's case. In other words, the jury came back – we knew exactly who the four people were. There was no one else who even possibly could have been exposed. One of them immediately was disqualified because it was a car service driver who had no direct physical contact. There had been literally an internet payment and there was no shaking of hands – no exchange of money. So there went one, and we were down to three. Those three are now in quarantine as a precaution. Let me finish because I think it's very important. The three individuals – the fiancée and two friends of Dr. Spencer are in quarantine as a precaution. None of them are showing any signs of illness but they'll remain in quarantine as a precaution. Those are the facts. The whole notion of the complexity of the city – we live that every day, people travel around – but that's a very different reality than whether in every day travel or every day transactions there would be any possibility of transmission, and that case would be exceedingly rare.

Question: [Inaudible]

Mayor: Whoa, whoa, whoa – guys, one at a time. We're still on the first question.

Question: So do you agree or disagree with that 21 day quarantine that they enacted against yesterday?

Mayor: So let me clarify what it is and what it isn't because I've had extensive conversations with the governor since the announcement and I think a couple things need to be noted. This is an evolving situation. Government agencies will update their standards as we go along – the CDC has certainly done that several times – that's normal. The governor made clear in the pronouncement, and certainly in the conversations we've had since, that there is inherent flexibility built in to the approach. The two health commissioners, Dr. Bassett and Dr. Zucker, will be in constant communication on any of the specifics. But let's be clear – what has been said is, a medical professional who had direct contact with Ebola patients or an individual who had direct contact with Ebola patients – that is the narrow definition that was put forward vis-à-vis the potential quarantine. That still has to be determined by medical personnel if those qualifications are met. So it really will come down to – and I want to emphasize, there's a lot of things that we, as layman, should not assume. The medical professionals, the two health commissioners, will determine how that works in practice in New York State and New York City.

Question: I just want to ask, as far as Dr. Spencer's concerned. Considering that he'd gone to the places that he went to while he found out that he was infected. Shouldn't he get some of the responsibility? People are wondering if he actually was irresponsible about this [inaudible]

Mayor: I think that's a really inappropriate characterization. Here is a doctor who volunteered to go into what is the medical equivalent of a war zone. This is no different than a soldier who goes into battle to protect us. Dr. Spencer went to the front line, putting his own life potentially in danger, to save others. Not only to save others in the nation in which he was serving, but to protect the entire world and to protect his native country. So that needs to be fully respected. He also constantly monitored his own condition and at the moment when he had an indication of fever – remembering it was 100.3 – hardly a high fever compared to the norm of 98.6. But the minute he even got to 100.3 between 10 and 11 am on Thursday, he immediately activated communication and he was brought into Bellevue right away. So I think he's comported himself in a credibly professional and appropriate manner.

Question: Was the city able to get the [inaudible]

Mayor: Dr. Bassett – could you say that again for Dr. Bassett?

Commissioner Mary Bassett, New York City Department of Health and Mental Hygiene (DOHMH): The question is about the management of Dr. Spencer. The answer to that question is yes, he has been treated with antiviral drugs. He also will be – yes, and he will also be receiving plasma. He of course, core to the management of people with Ebola Virus Disease is the management of their body fluids and the supportive management, they often describe it as. But he is also being supported by an incredible team. We've received people from the CDC, including people who've been directly involved with care of other people with Ebola Virus Disease being treated here in the United States. So, there has also been contact with the group in Emory – the group in Nebraska. So we have really been fortunate to draw down on the knowledge base that exists across the country and directed towards his care.

Question: [Inaudible]

Mayor: Hold it guys, this is serious subject matter. You're going to have let us finish each answer. We will call upon a number of you. Let me speak to this. We need to be clear that a number of people who have had Ebola in the United States, and obviously the recent situation in Spain as well, went through very advanced treatment and, thank God, came out okay. Nurse Pham is the most recent example of that, and we just heard very good news about Nurse Vinson as well. That suggests a clear pattern of the success of the medical techniques being used in this country to address this crisis. Now that being said, we have a patient at Bellevue – we're going to respect his privacy in every way we can. We have an obligation to you all to give you as much as we can. We also have an obligation to him to respect his privacy rights. We do need to clarify, because we've seen other patients go through this trajectory, that it's a tough road ahead, by definition. It's a tough disease. It's been overcome. You remember, the first two American doctors who were flown back went through very rigorous treatment, had a tough, tough experience, but you've all seen them interviewed on TV since and explain all the details of what they went through. The phase ahead will be a tough one. By definition, the next few days will be tough for Dr. Spencer. This is a hackneyed phrase but, in this case, it is absolutely the truth medically – it will be worse before it gets better. His situation will be worse before it gets better. But he has, literally, the finest care in the world right now at Bellevue.

Question: Do you support the idea of mandatory quarantine for health care workers returning from West Africa?

Mayor : Again, we have a situation here where we have accepted guidance from the federal government, which is the right thing to do – the Centers for Disease Control – and where our state government also has to make determinations. We respect them both. We have working with both of them. We then, within our rights and purviews as a city, make our own decisions and take our own actions. But we've got to be clear. In an atmosphere of crisis, we respect the chain of command here. We respect what the federal government is saying, we respect what the state government is saying, and we're all going to work together within those parameters. But be very clear about the new parameter. It is narrowly defined, related to individuals who have come in direct contact with an Ebola victim and there is additional specificity in terms of allowing the two health commissioners to determine – in the case in New York State – to determine next steps.

Question: Some people [inaudible] this would discourage volunteers from going at a time when more volunteers are needed in West Africa.

Mayor: Well, let's speak to the larger situation. I think it's a fair concern. We have to be deeply concerned as a nation that we make sure there are sufficient medical personnel in those three countries to help solve the crisis. Let's be clear – and I think this is something that all Americans should reflect upon – this country has played a leading role over the last century in resolving global conflicts and challenges. We have gone into wars to protect freedom of others. We have gone into nations to stop genocide. We are going into – and the President's made this clear – we are going to send the United States military to these three countries to help resolve the crisis. We also need medical personnel – expert medical personnel from the United States, and other countries, to go and help stop this disease dead in its tracks. That has to be a paramount concern and every city and state should help in any way it can in that effort because that is how we protect the homeland – kill the disease dead in its tracks in those three countries. So we're going to do all we can to encourage that reality. I think that's a bigger point, in other words. The question of the quarantine is a fair one, but I think the more important question is, what can we do to support and encourage the maximum number of medical personnel to volunteer for that mission, because it's the only way we ultimately end this crisis.

Question: For Dr. Bassett – you're obviously a preeminent expert on public health. If you were to put yourself in Dr. Spencer's shoes, and you had spent some amount of time treating Ebola patients, hands on in West Africa, and you came home to New York, what would you do? Would you be out and about, would you go bowling when you felt fatigued? What would you personally do as a doctor?

Commissioner Bassett: Thanks for that question, and I have to tell you personally I have thought of how important it is for medical doctors from this country to go to Liberia, even for myself – although my job is here in New York. Dr. Spencer followed all of the advice on active monitoring that his organization requested. He was not sick when he left Guinea, not sick when he got on a plane to the United States, and as you have heard from us repeatedly, the first time that he had an elevated temperature, something associated with potential infectiousness, was on Thursday morning – he had a temperature of 100.3 and he immediately sounded the alarm. So I will repeat again that I think that he followed a responsible protocol. We are confident that we have identified all of the people who were in direct physical contact with him. These are three individuals who remain well, but they are in quarantine. They will remain in quarantine for 21 days.

Mayor: The Doctors Without Borders – also known as MSF for its French acronym – Doctors Without Borders has been leading the international response. They are not a government. They are a non-profit organization that has done an immense amount to protect the people of the United States of America and the entire world by going to the front line in large numbers to address this crisis. They have clear guidance. I think there's been some misunderstanding out there about this. They have clear guidance. Someone comes back – obviously at that moment not ill – they self-monitor, and in the event of any fever, or that type of indication, they report it immediately. Dr. Spencer did everything exactly according to what his organization required.

Question: I wasn't suggesting anything other than that. My question to you, doctor, is more than the potential for infection of those people – and that's obviously very important – but there's also all of this. There's Joe's Meatball Shop, and then he gets sick, and now there's a crisis at the meatball shop – and he went bowling, and it becomes sort of a public –

Commissioner Bassett: It’s not a crisis here – no, I think –

Question: There’s a concern –

Commissioner Bassett: There’s a concern and that’s why we’re here.

Question: It becomes a public concern that all of these locations now are – there's an image issue with all of these locations. So I'll ask again, if you had come back from West Africa would you have –

Commissioner Bassett: This is really a hypothetical question that I'm not sure that I'm in a position to answer. But I will reiterate again that the trigger to concern about contagion to others is the emergence of fever and at the moment when he had even a very low grade fever. When I was an intern, we used 100.4 as the cut point for considering it actually a fever. His temperature was 100.3 and he notified his employers, who notified us at the Health Department, and he has had no further contact. We then unleash our job as being medical detectives and find every single place where he's been and we try and identify every single person with whom he'd been in contact. We have done that. We've identified the three individuals with whom he had contact. They are in quarantine. We have visited all of the places that he visited, which we told you about on the very first day that he was diagnosed. This one is one – we came here to verify the story. Was what he said happened here what actually happened? And the answer was, yes. There was no possibility of body fluids contact here at this restaurant. That's why it's open for business. That's why we're sitting here eating a fabulous lunch today and why people were lined up last night.

Mayor: Let me add on – we face a host of challenges every day in our society. What you're asking is a very important question, but it really does get to the difference between reality and perception, okay? We've had a lot of people come back who've had no problem whatsoever. Brave people who went to the front line to fight on behalf of all of us have come back with no problem whatsoever, and we honor them for that. When we've had a situation like this, our job is to make sure that all the facts about the situation is clarified. By the way, we deal with issues like this every single day. This one may have a certain deep concern it generates because it's new – because people don't understand it yet, that's natural. But we deal every single day with things that might be a concern for the health and safety of New Yorkers or anybody else in this country. Our job is to set clear standards and to be very informative, and we're saying in this case – every action was followed up, each institution was cleared, the situation is normal. Look at the three people he was in close contact with, all of whom are well today. So again, you all have an important job to do, but I only ask of you to present the whole picture so people can be reassured not by someone's way of talking about it, but by actual fact.

Question: Is Dr. Spencer's fiancée about to be released from the hospital?

Mayor: Dr. Spencer's fiancée is in quarantine and is well. We're discussing with her now next steps. She will remain in a quarantine, but how we will arrange it is still being determined.

Question: Would she go back to the apartment that they shared?

Mayor: Again, we're still talking through with her specifics, but she will remain in quarantine.

Question: [Inaudible]

Mayor: You can answer these two – when did he get the drugs and is he still stable?

Commissioner Bassett: I believe that he received antiviral drugs on the second day of his hospitalization and the plan for administering plasma is in place. Whether he's received it or not, I can't say. I want to say again what the Mayor has said already very clearly, that this is a disease where we expect that people may deteriorate. He came in very early because he came in as soon as he noted a temperature, and people tend to get worse before they get better with this disease. So, he remains in stable condition but we are aware that this is the natural course of this disease, so I want all of this to be aware of that as we follow him going forward.

Question: This is for the Mayor. How do you feel about the fact that the Governor of the State of New York did not consult with you before making this very serious –

Mayor: Again, this is not about feelings, this is not about personality, this is a crisis in which we all have to hang together to protect our people. I respect the governor greatly. Let's be clear what we said at Bellevue on Thursday night. There has been non-stop coordination and communication between the State of New York and the City of New York. The two health commissioners have been talking multiple times a day for weeks. I've been speaking to the Governor constantly. We have been prepping and training our personnel together. What we need to keep doing is keep that close coordination going. We understand, in a fast moving situation, sometimes there will be moments where the communication's not everything we want it to be. But we also know, in these dynamics, what ultimately wins the day, what keeps our people safe and what works, is close working cooperation between city and state. That's why you saw the situation unfold on Thursday as clearly and smoothly as it did. A protocol was in place, the training had been done, everyone knew what their job was – everyone did their job. That was based on weeks of coordination that will continue.

Question: Mayor, [inaudible] yesterday how you feel the city has stepped up its monitoring [inaudible].

Mayor: I'll start and pass it to Mary. This is something we're starting today. We – CDC issued a new guideline which we wholly support, which is to monitor anyone who has returned – in the sense of the health department having direct contact with them on a daily basis – to check and see if there is any change in their health that might be pertinent. By the way, if they stub their toe or break their elbow, that is not pertinent. If they have a fever or something that might indicate this disease, that would be pertinent. The Health Department will every day be in direct contact with anyone who we have the name of who has returned from the three affected countries in the last 21 days. That list has been provided to us by the Centers for Disease Control. The monitoring will begin today. We are going to – today and in the next few days – have the names of everyone who has entered in the last 21 days. So it is not just people who arrive today and going forward. It will be everyone who has arrived from the three affected countries in the 21 day prior window, and then we'll maintain that 21 day sequence thereafter.

Commissioner Bassett: Let me correct that a little bit if you don't mind, Mr. Mayor. So as you all know, on October 11, the Centers for Disease Control instituted a new program of checking people who arrive from travel that included the three countries, Sierra Leone, Liberia and Guinea, and on entry at JFK – and in four other big airports around the country that together comprise 90% of returning travelers from these countries – they asked them some questions and checked their temperatures. So that was on October 11. We now are able to identify the people who return, actually going back two weeks – I wish we could go back 21 days but we are actually going to be going back two weeks.

Mayor: That's the first day we have information.

Commissioner Bassett: That's the first day that we have the information because before then there was no ready way to identify people who had returned from these countries. That capacity began when the CDC initiated its fever checks and short questionnaire on entry – on return to the United States at five major airports. We will actively reach out to these individuals, contacting them with information that's been provided by the Centers for Disease Control.

Question: How does the Governors quarantine order affect the Department of Health's monitoring process? What about – is there a site being identified if you do need to quarantine people?

Mayor: Let's separate the two points first. First, the monitoring is done by direct contact – ideally telephone, but it can be a visit – by our Health Department, connecting with the list of people we've given. Dr. Bassett's exactly right and I'm trying to emphasize, we will respect the 21 day time frame and be in touch with someone from day one till day 21. But she's absolutely right. The names only go back two weeks, so that's really our true starting point. That monitoring will happen with anyone who's returned. That is a separate concept from anything that might be undertaken with quarantine. But again, the details of quarantine will be worked out between the state health department and the city health department. We will have available spaces if needed. We've identified housing, if needed, that can provide quarantine capacity.

Question: I have a question for Dr. Basset, if I may. Dr. Spencer is obviously an expert in treating Ebola patients. Is he [inaudible] able to assist in his own medical treatment and diagnosis?

Commissioner Bassett: I'm unable to answer to answer that question. I am not actually directly involved in his care. He's being cared for by a very able team at Bellevue Hospital, backed up by advice and consultation with experts across the country and the CDC team that arrived recently, that also has expertise. So I can imagine in all good patient physician relationships the patient, Dr. Spencer in this case, should have the opportunity to participate in and make decisions about their care, but I can't speculate on what's actually happened. That's part of the confidential doctor-patient relationship.

Mayor: Couple more, then I just want to say one thing at the end. Go ahead.

Question: I was wondering, Dr. Bassett, could you personally tell us what you believe about the 21 day mandatory announcement that the governor made yesterday. Also, his characterization implying that Dr. Spencer was irresponsible [inaudible].

Mayor: I just want to say respectfully, guys, you've asked the same question six different ways.

Question: I don't think you've given a straight answer.

Mayor: Well, we've given a very clear answer – that’s an editorial comment. The clear answer is the state has a right to make its decisions, just like the CDC does, and we're going to work with them. This is not about personalities – it's not about personal opinions. This is a crisis in which everyone works together. So I don't think it's about what we think personally, it's about what is going to keep our people safe.

Question: Just given that collaboration and given what we saw on Thursday, do you think there should have been some sort of heads up yesterday from the administration –

Mayor: That's the same question. I think the broad –

Question: Seems like a different question. Should there have been a heads up?

Mayor: I said, why we are doing as well as we have done is the close working relationship between the city, state, and I would add the federal agencies as well. Everyone has been in constant contact, prepping together, drilling together – communicating constantly. That works – that's what we need to do. Do we expect that to work perfectly at all times? No, we are talking about human beings in the middle of a crisis in a fast moving situation. But we are going to do everything we know how to do to keep that close collaboration, and to make sure that everyone is on the same page.

Question: The three individuals who were in contact with Dr. Spencer, they have not yet been cleared [inaudible]

Mayor: No – they are in quarantine. They are well and they will be in quarantine for a while.

Commissioner Bassett: November 14.

Mayor: November 14, is when they'll come out, right?

Question: She might move [inaudible]

Mayor: She will remain in quarantine. She may move location, but she will remain in quarantine. Let's do it again – again I'm going to ask everyone to ask us get facts out. Three individuals – the fiancée of Dr. Spencer and two good friends are the only people he came in close contact with, all three in quarantine, all three are well, they will remain in quarantine until –

Commissioner Bassett: November 14.

Mayor: November 14.

Commissioner Bassett: In the morning.

Mayor: In the case of the fiancée, the location going forward may change, but it will still be a quarantine situation that is being determined. Last one before I make a final statement.

Question: A medical question – doctor, the two close contacts were they – could you clarify, they were bowling with the patient at the bowling alley? Is that why they're considered close contacts? And I will have a follow up after you answer that.

Commissioner Bassett: Well, close contact really refers to direct physical contact. That's why in the case of the car driver we know that he just looked at his cell phone to confirm that the payment had been made. In the case of the two friends, they spent substantial amounts of time with him and had direct physical contact with Dr. Spencer, and that's the basis.

Mayor: For example, they hugged him.

Commissioner Bassett: They hugged, they shook hands, they shared food.

Question: I guess, so sharing food, saliva, potentially [inaudible]

Commissioner Bassett: No, that's not it. They were just spending time together and having – touching.

Mayor: It's an abundance of caution.

Commissioner Bassett: Abundance of caution.

Question: Abundance of caution in the bowling alley. The next person to use the bowling ball – how do you figure that stuff out? People have actually asked me [inaudible] how do you figure that out?

Commissioner Bassett: This is a scary disease, so we understand that people need to ask these questions and we need to keep answering them, and we depend on you in the media to keep getting the answers out. Dr. Spencer was – I don't bowl – but Dr. Spencer had not had a fever at the time that he was at the bowling alley. His first fever occurred on Thursday, the day in which he notified his employers. The Doctors Without Borders notified the Health Department and went into isolation and began getting care for himself. We were not concerned about the description he made of what happened. Our visit to the bowling alley was just to verify, as part of our medical detective work, that the story that he told us matched the experience of the people there.

Mayor: And let's clarify because it's a good question and we want to get back to what we said Thursday. The only instances of transmission that we know of, involved when someone reaches the point of fever. He was [inaudible] in fact, strikingly, even though he reported some fatigue, he went for a three mile run, he went walking, he went bowling. This is someone who clearly was able to do a lot of things that actually everyday healthy New Yorkers might have trouble doing, like a three mile run. Only when he actually had a fever, and quite a minor fever of 100.3, did he report that he now believed he should come in. And I think that's our point here. Nothing in the visits to the three sites – the bowling alley, the restaurant and the coffee shop – nothing out of the ordinary was reported. Nothing that suggested anything that could have been constituted as direct intimate contact, to begin with, with bodily fluids, but second, he was not at the point in the trajectory where we have any evidence of anyone being infectious to begin with.

Final statement – no, we've covered a lot – let me just get this out – final statement. Both a point about New York and a point about what people can do because people always ask this question and again I would appreciate your help getting it out. You've noticed that since the first reports came in publicly on Thursday afternoon, New Yorkers have done something very normal and something, at the same time, extraordinary. They have gone about their everyday lives. People are, all over the city, doing what they normally do – riding the subways, going to work, going to restaurants – nothing has changed. This is a city that does not fall into the pattern of looking at fears, but continues with their lives, and that is part of what makes this place so strong and so resilient. So I just want to express my admiration and appreciation to my fellow New Yorkers for focusing on the facts and not some of the exaggerated fears. And here is the biggest city in the United States of America, one of the most prominent cities in the world – and literally to a person, every report we've seen – everyone is going about their business as normal and that is a credit to all New Yorkers. In the category of what we can do, people have asked us over and over.

And at this point there's two things that are truly helpful. One again, is the exceptional dynamic. If you have been to one of the three countries, have been in intimate contact with someone who's been in one of the three countries in the last 21 days specifically, and you have a fever or any other indication of those kind of symptoms, call 9-1-1. Out of an abundance of caution, at least call 9-1-1, or go to an emergency room. Those are the only two things someone should do if they've been in one of the countries, had direct and intimate contact with someone who'd been to one of those countries in the last 21 days only, and they have symptoms like a serious fever. That's what people – anyone in that situation should do. What everyday New Yorkers can do – I've said it, it sounds a little counter-intuitive but it's actually quite important – is to help the medical professionals who are working so intensely to protect us all. Help them avoid the misleading dynamic of people having the everyday flu and thinking it may be something much worse. The best way to combat the everyday flu is to get the flu shot. So literally, every New Yorker who has not gotten the flu shot, and goes and gets one right now – which you can do at your doctor's office, or you can do at the pharmacy – everyone who gets the flu shot helps our medical professionals by taking those potentially false indicators off the table. On helping us focus on only the very, very few people who actually might be in any other type of danger. That's incredibly helpful and I think the entire medical community of this city would deeply appreciate it if people literally take that as an instruction. If you haven't done it, go do it today. It will help us as we deal with a much bigger challenge, if we can take care of that smaller challenge. By the way, getting a flu shot is a smart thing to do in and of itself. Thanks, everyone.