Transcript: Mayor de Blasio Holds Media Availability at Bellevue Hospital to Thank the Doctors and Nurses Caring for Dr. Spencer

October 26, 2014

Mayor Bill de Blasio: Good afternoon, everyone. My wife Chirlane and I just spent time with the extraordinary healthcare professionals here at Bellevue Hospital. We met with doctors, nurses and other employees who are doing an absolutely amazing job in this moment of crisis.

As I've said before, this is a hospital to no stranger to the very toughest situations, whether it was 9/11, Hurricane Sandy, the AIDS crisis of 20 years ago – this hospital has been the go-to medical facility in New York City for decades, and the people here handle themselves with that battle-tested spirit, that professionalism, that strength that you would expect of people who have been part of the toughest situations. If there was a military analogy to be made, the people who work at Bellevue are the Marines of our healthcare system. They are extraordinarily tough and capable, and only the finest get to be a part of this operation at Bellevue Hospital.

We – Chirlane and I – went to the isolation floor, the floor where Dr. Spencer is now. We met with the medical team, we met with the nurses, each and every one of them – not just volunteering to do this crucial work, volunteering with a sense of mission, believing it is their duty to take on the toughest assignment.

And I want to talk about some of the discussion that's happening around this country related to our healthcare professionals, particularly our nurses. I also want to talk about some of what some individual nurses have experienced even here in this city the last few days, of people misunderstanding what's going on right now.

Let me just dwell for a moment on the fact that we went to the floor that is now the center of this moment. The eyes of the world are on the isolation floor at Bellevue Hospital. And the people who work there were calm and cool and collected. They were purposeful. I met people who have been providing care to Dr. Spencer over the last few days. They had a purposeful attitude, sober, straightforward. They understand what their duty is and they're only too proud to perform it. And we all need to honor them. We all need to respect them, the same way we respect soldiers who go into battle to protect us, the same way we respect first responders, firefighters, EMTs, police officers – we need to respect our nurses, our doctors, our lab technicians. They are the first responders in this crisis and they're doing an absolutely extraordinary job.

I remind you – from the moment on Thursday when Dr. Spencer called and said he for the first time had a fever – from that moment on, everybody – everybody in our healthcare system in New York City, the folks who work in our emergency medical service, our Office of Emergency Management, all the different pieces have coordinated in incredibly effective fashion and the care for Dr. Spencer continues to be the finest in the world. You'll hear an update from the president of the Health & Hospitals Corporation in a moment on Dr. Spencer.

Again, the medical personnel fighting this fight, particularly our nurses, deserve our respect. We heard reports in the last few days of nurses being mistreated in our city – when it became clear that they worked at Bellevue – being treated differently. We heard reports of people being unwilling to serve them food or treating their children differently. That is absolutely unacceptable.

That is absolutely unacceptable. We are in a crisis where we all have to hang together and we have to first respect our first responders. I did not see people disrespecting soldiers in wartime or police or fire in the middle of a crisis that they respond to. I will not accept anyone disrespecting our nurses or our other medical personnel. And anyone who stands in the way of their work stands in the way of everything we have to do in New York City to protect our people and there will be consequences for those individuals. I want to make that very plain.

Secondly, we've watched – so many of us – the events unfold in New Jersey. Anyone who has heard Nurse Hickox's explain her situation in her proud, passionate, intelligent voice knows that what happened to her was inappropriate. Each government has to make decisions. We understand that. Federal government has made a series of decisions, the state governments have a right to make decisions. But the problem here is this hero, coming back from the front having done the right thing, was treated with disrespect, was treated with a sense that she had done something wrong when she hadn't, was not given a clear direction. We respect the right of each government to make decisions that they think are right for their people but we have to think how we treat the people who are doing this noble work and we must show them respect and consideration at all times, and we owe her better than that, and all the people that do this work better than that.

Here in New York City we have faith in our public health system. We believe – and we think we have a lot of fact to back this up – we believe it is the finest health care system in the world. We've seen that on display here at Bellevue in these last days. And I want to emphasize that here in New York City our medical system is fully prepared to handle the Ebola crisis. Our medical experts have been studying the disease intensively. In fact, when we were in the isolation floor, Chirlane and I watched as a group of them in a conference room were having a conference call with medical experts from around the country, continuing to perfect their approach to treatment.

And we are working every day with our state and federal partners, and we believe that that is the right word to use in a moment of crisis. We are all partners. Our state government, our federal government are necessary partners in this fight, and we will treat them as such. We've been working in close, close coordination which is why everything has been done so smoothly. The information and support we've received from the CDC and other federal agencies, the support we received from the state health department. We're not going to engage any sense of division. It is absolutely a time when unity is necessary to fight this disease, so we will continue constantly to communicate with our state and federal partners. Protocols have been set in place and they are being scrupulously followed.

I want to say what I've said the last few days because I have to say it every day. There is no reason for New Yorkers to be alarmed. This is a very difficult disease to contract – very difficult. It is not airborne. It cannot be contracted through casual contact, only through direct contact with bodily fluids. As Dr. Bassett said a few days ago, reflecting on the situation in Dallas, all of the individual quarantined in Mr. Duncan's house, who had close contact with Mr. Duncan – every single one of them left quarantine a few days ago healthy. So, it takes an extraordinary amount of direct and physical and intimate contact to contract this disease. Any New Yorker who has not been exposed to the bodily fluids of someone who has the disease cannot get sick. There is no reason for New Yorkers to change their habits in any way.

And if you look around the city the last few days – in our subways, on our streets, in our restaurants – no one is changing their habits. New Yorkers are strong, resilient, focused, and they understand there is no cause for alarm and they should go about their business and they are. I think one of the reasons that has happened is because of the strong and clear voice of our health commissioner, and I want to thank Dr. Mary Bassett for being a voice of calm, sanity – a voice of factuality throughout this crisis. I think all New Yorkers deserve her – she deserves from all New Yorkers a deep thank you on behalf of what she has done for us. Thank you, Dr. Bassett.

We want to answer the question all New Yorkers are asking – what can they do? There are two things and only two things we're advising. If an individual believes they meet the characteristics that could suggest they have been exposed to the disease – they have been in one of the three affected countries in the last 21 days or been in close, intimate contact with someone who was, and additionally they have a fever, those individuals should either call 9-1-1 immediately or go to an emergency room. No other options – do not go to a private doctor, do not see if it passes by, immediately call 9-1-1 or go to an emergency room if you are in that situation.

Second, we've talked about the fact that the symptoms related to Ebola can seem like the symptoms related to the common flu, and that is a challenge for our public health capacity. Because flu symptoms are similar to Ebola, the less flu we have, the easier it will be for the medical system to focus on Ebola. Therefore, every New Yorker who has not yet gotten the flu shot should do it immediately. It is easy. It's available at doctor's offices, clinics, many pharmacies. You can actually help our medical professionals to focus their attentions on the challenge at hand by doing something as simple as getting a flu shot. A few words in Spanish:

[Mayor de Blasio speaks in Spanish]

With that, I'd like to call up the president of our New York City Health & Hospitals Corporation, of which Bellevue Hospital is his flagship institution, Dr. Ram Raju.

Dr. Ram Raju, New York City Health & Hospitals Corporation: Thank you very much, mayor, and first of all I want to thank the mayor, the first lady, Commissioner Bassett, the legislators as well as the Bellevue partners for being here today to talk to us and say some kind words, I really appreciate that. It means a lot to me as well as the employees who work for our system.

I just want to talk a little bit about Dr. Spencer. This morning, a doctor, our patient, and his doctors and nurses at Bellevue Hospital Center. The patient looks better than he looked yesterday, but his condition continues to be serious but stable with the expected symptoms of the virus. He tolerated the plasma treatment which was given to him yesterday well, and he had a good night's sleep. From his first day here, he expressed gratitude with the care he's receiving under the watchful eyes of the dedicated, well-trained and professional team of ICU physicians and nurses we exclusively assigned to his care.

On behalf of the patient, I thank all New Yorkers for the prayers and well wishes. The entire Health & Hospital Corporation family and the expert team at Bellevue are committed to do what we do best, and we do the best for this brave, caring doctor and we wish him all the best and bring him back to good health.

To the members of media I just have a request – we are distributing a flier which basically tells you the photography of the correct personnel PPE, which our doctors and nurses and other healthcare providers are [inaudible] due to the care of the patient, so I would very much like you to take this picture in your news statements.

With that, thank you very much, mayor, for the opportunity, and thanks for the kind words.

Mayor: Thank you Dr. Raju for your leadership of this extraordinary Health & Hospitals Corporation and for all the work that is being done here at Bellevue.

I just want to take note of the fact that late afternoon yesterday I had a tremendous honor. I spent about 10 or 12 minutes on the phone with Dr. Craig Spencer, and I have to tell you, it is always an honor to speak to a hero, but to speak to someone who's literally fighting for his life but is energetic, focused, concerned for others – I should add, has a great sense of humor and it was quite a bit in evidence late afternoon yesterday, this is an incredibly noble human being.

There have been some, again, misunderstandings, misstatements about this individual. This is someone who did what we would only wish any of us would do in a moment of crisis. He ran toward the danger. He went to where the need was greatest, not only to protect people in the nation in which he served, but to protect all of his here at home, to protect the entire world. I expressed my gratitude to him on behalf of the people of New York City. He's truly a hero, he's an incredibly humble human being, and someone that I look forward to spending time with when he has made his recovery.

With that I'd like to turn to the Chief Medical Officer for Bellevue, and again express my great appreciation to him and all of his team for their professionalism and their effectiveness, Dr. Nathan Link.

Dr. Nathan Link: Thank you Mr. Mayor for your kind words of support and for your presence here and support for the last three days.

As most of you know, we have been preparing for this moment for three months. We, Bellevue, we HHC, together with Department of Health and Mental Hygiene and FDNY – we began preparing three months ago because the mayor asked us to be ready for the moment when a patient might possibly appear in the city with Ebola virus disease. We needed every bit of those three months to prepare. It was an enormous challenge to create essentially a hospital within a hospital with all new procedures and policies, to train our staff from head to toe, to procure equipment – and really with a fine tooth comb go over every single aspect of the care so that we would be ready. And we did this together with our colleagues in the Department of Health and Mental Hygiene and our brothers and sisters in FDNY to make those procedures work so when a patient came – arrived, it would go smoothly.

I'm pleased to say that all that preparation paid off. Every step of the way, everybody did exactly as they were supposed to and I haven't really identified a single misstep in any aspect of the care that's taken place. So, I'm immensely proud of our staff, our nurses and doctors, our lab techs, our transporters, the waste handlers, all the people who have a job to play and are playing it exactly as it has been scripted, and based on things that we learned from other experts around the country – in Emory in Nebraska – who I consider the gold standard for how to care for very sick patients safely.

The care of the patient is under the direction of Dr. Laura Evans, director of critical rare at Bellevue Hospital. Dr. Evans is experienced in critical care and has also, as the mayor described, been consulting regularly with colleagues around the country with tremendous experience in the care of Ebola patients, at Emory, the CDC in Nebraska – there's really a daily conference call, and I've just been overwhelmed by the support that has come pouring in from these folks and elsewhere to move heaven and earth to deliver whatever care we need, experimental agents – whatever this patient needs is really available. I think it's fair to say that if any treatment is available in the world, it's available to our patient. And he's had an opportunity, given his experience, to participate in decision–making and choosing the options that are right for him.

So, I'm very proud of our doctors. I'm proud of our nurses and I want to end by saying that we recognize – we see Dr. Spencer as a hero, working overseas, but we also see the staff of a hospital, especially our nurses, who are in the room all the time, as heroes here in New York City. And I echo the mayor's words of wishing that the people of the city appreciate – express their appreciation for the work that the staff of our hospital and the agencies all through this city have been doing in the last three days to keep our city safe, our staff safe, and our patient safe. Thank you very much.

Mayor: Thank you, Doctor. Well said. I have to echo the point about every single individual that works here at Bellevue, regardless of their role, including the folks who provide security, the folks who do the day-to-day maintenance – every individual is a part of this fight. They all deserve our appreciation and respect. Any New Yorker who meets someone who works at Bellevue Hospital should be saying thank you right now, thank you for your service – the same way we do for a man or woman in uniform. Because these individuals are right now fighting to protect all of us and they deserve our thanks.

We've had tremendous support and cooperation from the labor unions that represent the people who do the work here. I want to just acknowledge and thank some of their leaders who are with us – Henry Garrido of DC 37, Jill Furillo of NYSNA, and Frank Proscia of SEIU. Thank you for your leadership and your partnership in this. I want to say, the elected officials of this city have participated with us from day one in the preparation process and the public information process. They've been extremely supportive and proactive.

A number of elected officials all over the city have helped us. I want to acknowledge those who are with us today, including State Senator Brad Hoylman, Assembly Member Brian Kavanagh, and Council Member Corey Johnson, and thank them for their leadership. And on behalf of all the elected officials of the city, I'd like to call upon Brooklyn Borough President Eric Adams and I think it's fitting because he has been one of the strongest voices, reassuring New Yorkers throughout this crisis, especially the people of Brooklyn, but he also spent 20 years of his life as a New York City police officer, rising to the rank of Captain. So, he knows something about dealing with tough situations, and I think he's provided a real perspective to New Yorkers on how to address a challenge like this. Borough President Adams.

Brooklyn Borough President Eric Adams: First of all, thank you, mayor. And I think that we cannot say enough about the steady hand and the clarity of that – his administration and those of HAC have all provided as we're going through this global crisis. The mayor stated that there were two things that everyday New Yorkers could do, I just want to add one more thing.

We have a responsibility to make the de-mystification of this disease part of our everyday conversation. As New Yorkers, we love our drama on Broadway, not in the hallway of our medical facilities. We have professionals who are doing the job on the ground. We need to show the entire globe how to move forward with fighting this crisis. The way goes New York, goes America. The way goes America, goes the globe. And so, the tone we set today is going to cascade throughout the entire planet. Winners want the ball when the game is on the line and Bellevue is the team we want on the field to ensure that we can score success for the entire globe. Thank you.

Mayor: Thank you very much. Thank you, Mr. Borough President. Just one more comment and then we'll take a few questions. The international community has been responding to this crisis, but we need to do more. The United States has been leading the way and obviously the United States military will play a crucial role, turning the tide of this disease. But we need to encourage and support every doctor, every nurse, every medical professional who bravely chooses to go in harm's way and help end this crisis. This disease needs to be stopped dead in its tracks and that will only happen through medical professionals choosing to go there voluntary. We need to support them. We need to appreciate them. We need to lighten their burden. We need to show them tremendous respect and we need more to come forward. I think it's incumbent upon all of us at the federal level, the state level, the local level, to work together to support, in fact, more medical professionals going to the front line so we can end this crisis once and for all. We've got a lot to do here, but let's talk about the root cause. We know exactly where it is. We know it can be stopped. Ebola has been stopped before. We know this. It's time to do it again, and the only way that happens is with the exceptional medical professionals of the type who have already gone, we need to be there for them in every way. With that, we welcome a few questions. Right down the middle there.

Question: Dr. Raju and Dr. Link, if you don't mind, I wonder if you could clarify the protocols for the nurses and other caregivers as they emerge from this and what protocols they have in terms of self-isolating or otherwise, and perhaps contrast that with the other policies we're seeing emerge from the two states, New York and New Jersey, for incoming caregivers.

Dr. Raju: The isolation room is divided into three different zones – the red, yellow, and green zone. The red zone is where the patient is, and the PP is completely [inaudible], which I showed you here. This is the PP. They were to going into the zone. When they come out of the zone, they basically have another person instructing them, commanding them, now you take off your hood, now you take off your gloves.

Question: The 21 days –

Dr. Raju: The 21 days – everybody who goes into the room is being logged on and we see what this chain is in there, and then they're all given a thermometer and they check their temperatures, and we report the temperature every day, making sure that they are taken care of.

Question: They're not quarantined?

Dr. Raju: They're not quarantined but they take temperatures.

Question: Can you contrast that with the policy that the state's now insisting on for incoming caregivers?

Dr. Raju: I'm not going to comment on the policies of the government, but this is what we do here. If somebody wants to comment is fine, but this is abundance of caution. This is the right way to do that.

Mayor: Right, just a different situation you're talking about – patients here who are getting an immense amount of care in a very controlled environment. So, this is a different reality.

Question: Hi mayor, the white house is pressuring the state governments to roll back the mandatory quarantine policy. This affects New York City residents. Have you taken a position on this?

Mayor: Look, I've said before, I'll say again. We have to have unity here in this moment. We've been working very closely with the federal agencies – the CDC and the other federal agencies – working very closely with the governor and the state health department. We'll continue to do that. It's a time for everyone to think together and coordinate and get on the same page. This is a complicated crisis, to say the least. But, the best thing we can do is show a sense of unity and purposefulness. So, we will work with, as we have, the decisions of the federal government and the decisions of the state government. What I think we've seen, is that there is inherently a certain amount of flexibility in each of these decisions because at the local level they have to be implemented in the real conditions, and decisions have to be made in real time. I think everyone understands that. But, the bottom line is, we are seeking unity with both our federal and state partners because it's a moment of crisis.

Question: [inaudible] health commissioner, are healthcare workers a threat to public health if they've dealt with Ebola patients? Should they be quarantined?

Commissioner Bassett: Well, there are two parts to this question. So, you've heard about the healthcare workers who are taking care of Dr. Duncan here. I mean, Dr. Spencer, sorry. Dr. Spencer is being cared for by an around–the–clock team of extremely dedicated nurses and other workers. Anyone who comes into contact with the red zone that Dr. Raju described is being asked to begin immediately monitoring their temperature twice a day, and they will continue monitoring their temperature twice a day to 21 days since their last contact with Dr. Spencer.
This extends also to the emergency care workers who transported Dr. Spencer. Anyone who had contact with him – all of them wearing personal protective gear – are as a matter of caution, monitoring their temperature twice daily.

Question: [inaudible] healthcare workers who are not symptomatic [inaudible]

Commissioner Bassett: So, a healthcare worker who – any individual – who is not symptomatic, does not pose a risk of transmission to others. We've been saying over and over again that people contract Ebola from someone who is sick with Ebola and contact with their body fluids. Thanks.

Mayor: Sir, you got a couple in. Let's get to someone else.

Question: You specifically objected to the treatment of Nurse Hickox, so I'm wondering if you can talk a little bit about what it was you were concerned about, and how that meshes with your feelings on New York's plans to quarantine.

Mayor: I think what we heard very clearly is she was not given a clear explanation of what was going on, why it was going on, how long it would take, what the next steps were, and then we heard even as late as this morning that she had no sense of what the next steps would be. Again, a returning hero should not be treated that way. It's fine for the pertinent level of government to come to a policy decision, that's part of what leaders have to do, particularly in a crisis. But an individual who is a returning hero needs to be treated with deference and respect, even if a new policy is in place. Explain it – as she said, she was subjected to numerous questionings by numerous people which she felt was interrogation-like. That's absolutely inappropriate. If there was a policy in place, one leader in the healthcare apparatus should have explained it to her she should've been accommodated in a comfortable, positive location and been provided with a lot of support. Obviously that did not happen. So, I want to differentiate the ability of a government to make a policy decision, which we inherently respect, particularly in a moment of crisis, from the decision of how you implement that and how you treat people who are heroes. These are the heroes. These are the people who are saving us. They should be treated with utmost respect. Even if there is a quarantine, they should be treated with utmost respect. We've attempted to do that in our situation here, not only of course with Dr. Spencer, but with the three individuals who came in contact with him –a lot of communication, a lot of respect, talking to high-level officials, trying to do the best we can to accommodate their needs.

Question: You talked about Dr. Spencer getting better. Is he still experiencing any –

Mayor: Let me have Ram and Dr. Link speak to his condition.

Question: Can you just elaborate on his condition and I'm asking if he is still experiencing any gastrointestinal symptoms [inaudible].

Dr. Raju: You know for the sake of patient privacy, I'm not really going into details about what his symptoms are. But, as I said before, he is looking little better than he looked yesterday, but I just want to say that he still remains in a serious but stable condition.

Mayor: That's the key point – serious, but stable condition. Yes.

Question: Can you address reports that some hospital staff have been calling out sick so as not to deal with Dr. Spencer?

Mayor: I'll let Dr. Raju and Dr. Link speak to the question but I want to go back to the point we made earlier. The hospital staff here has been doing an absolutely extraordinary job. Remember, everyone on the isolation floor volunteers to be there. They put themselves in harm's way. They also know that what is being done is extraordinarily professional and their colleagues have each other's back and are as well trained as anyone on the planet. And yet, some of them have gotten negative messages out in the communities of our city about their service to our city, so I want to say it very, very clearly. Respect the people who work at Bellevue. Thank them – that is the only way to comport ourselves. As to specifics, go ahead.

Dr. Raju: The rumors floating around saying that people are calling in sick is completely not true.

Mayor: Last one, right here, last one.

Question: What did the communications consist of with your office and the governor's office before his announcement on Friday and what did you guys know going into –

Mayor: Well, I said yesterday very clearly, we were not consulted in that instance. We have had, however, rather frequent consultation. I've spoken to the Governor pretty much every day in the last few days. I've spoken to him a couple times today. Dr. Bassett's been speaking to Dr. Zucker regularly, the state health commissioner. So, I emphasize, and I want people to understand this point, when you enter into a crisis, this could be considered similar to when we're in a national security-type crisis. This is obviously a healthcare crisis. When you enter into a crisis, there is an extremely important value placed on unity, coordination, communication. It's hard to do in a middle of a crisis. Sometimes there will be disconnects, but we value it. I don't think it's a time for partisanship. I don't think it's a time for personalities. I don't think it's a time for bickering. It's a time for everyone to get on the same page and protect our people. So, the fact is that we've had tremendous cooperation coordination with the state, and of course with the CDC and other federal agencies. And part of why that dynamic played out on Thursday so smoothly is that all three levels of government have been preparing together for the execution of a plan, and that's why there was no disconnect then. I really want to focus on that fact. From time to time again, in the midst of ever-changing circumstances, there will be moments where people have to catch up with each other and connect and get to a point of unity. But when the rubber hit the road, on Thursday morning, every agency was on the same page. All the preparation, all the drilling paid off. Everyone spoke with one voice and that's why Dr. Spencer is here. That's why everything is being handled as well as it is. Thank you very much.