March 2, 2020
Governor Andrew Cuomo: Good morning. Thank you all for being here. Let me first introduce who’s here and then I’ll make some opening comments, and then I’ll turn it over to Mayor de Blasio. To my far right, Dr. Ken Davis from – President and CEO of Mt. Sinai Health Systems. Dr. David Reich from Mount Sinai Hospital Systems; also, Ken Raske who is the President and CEO of the Greater New York Hospital Association, I want to thank him for all his good work; our State Health Commissioner Dr. Zucker, this good gentleman you know; Bea Grause, who is the President of the Health Association of New York State – HANYS; Dr. Steven Corwin, who is the President of NewYork-Presbyterian Hospital, Joe Lhota, Executive Vice President from NYU Langone Medical Center, but at one time he had a really important job –
And we have Dr. Barbot, Commissioner of the New York City Health Department. The – first, we’re going to speak about the situation that was reported last night with a person who tested positive for the coronavirus. That woman is a health care worker, she’s 39 years old, she had been working in Iran and came back on Tuesday to New York. She did not take any public transportation. As she was a health care worker, she was very aware of the situation and the potential for this situation. We don’t believe that she was contagious when she was on the plane, or when she took a private car from the airport to her residence. But out of an abundance of caution we will be contacting the people who were on the flight with her from Iran to New York. And the driver of that car service. We’ll be contacting and following up with them as the facts dictate. The health care worker also was with her spouse. He was also a health care worker. So they were both aware of the situation. Her husband is being tested also, but we are assuming that he would be positive in the circumstances, and he has been following the same protocols that she has been following. The testing was done at Mount Sinai. Again, since they were health care workers, they’ve contacted Mount Sinai before that they were coming in and they took all precautions necessary. They are at home, at their home, she – the health care worker has manifested some respiratory illnesses, but her condition is mild, so she’s at home, and she’s not even hospitalized, even though she has tested positive for the virus, her spouse is with her.
In general, there is no doubt that there will be more cases where we find people who test positive. We said early on, it wasn’t a question of if, but when. This is New York, we’re a gateway to the world. You see all these cases around the world, around the country, of course we’re going to have it here. And that’s why the whole challenge is about containment of the number of people who become exposed and who become infected. Our challenge now is to test as many people as you can. You’re not going to eliminate the spread but you can limit the spread. And testing is very important, and that’s why the CDC, the federal government’s now allowing us to test is a very big deal, and will make – have a dramatic effect on how quickly we can mobilize and respond. We are coordinating with private hospitals, private labs around the state. We want to get our testing capacity as high as possible. I said to the people around this table that I would like to have a goal of one thousand tests per day, capacity, within one week, because again, the more testing the better. Once you can test and find a person who’s positive, than you can isolate that person so they don’t infect additional people.
We’ll be moving a piece of emergency legislation on the stateside that will authorize an additional 40 million for additional staff, additional equipment. I want to make sure that the health care system has everything it needs. We’re going to be instituting new cleaning protocols in our schools, on public transportation, etcetera, where they will use a disinfectant. Many will use bleach, which is a good protocol in the flu season anyway. So, if people smell – if it smells like bleach when you get on a bus or when a child goes to school, it’s not bad cologne or perfume, it is bleach. And again, we’re going to be focusing on our facilities that treat our senior citizens, debilitated people, or immune-compromised people, because those are the people who are most likely most affected by this virus.
My last point is this. Late last night, my daughter called me, and I could hear in her voice that she was anxious. She had seen on the news that a person tested positive. And my daughter said “what’s this” and I could hear in her voice she was nervous, and my daughter said don’t tell me to relax, tell me why I should be relaxed. Which is a very big difference there. So, I want to make sure I tell the people of New York what I told my daughter – in this situation, the facts defeat fear, because the reality is reassuring. It is deep breath time. This – first of all, this is not our first rodeo with this time of situation in New York. In 1968, we had the Honk Kong flu. In 2009, we had the Swine flu, where we actually closed like 100 schools in New York State. Avian flu, Ebola, SARS, MERS, measles, right? So, we have gone through this before. When you look at the reality here, about 80 percent of the people who are infected with the coronavirus self-resolve. They have symptoms, the symptoms are similar to what you would have with the normal flu, and for most people, they treat themselves, over 80 percent, and the virus resolves that way. About 20 percent get ill. The mortality rate is estimated to be about 1.4 percent. 1.4 percent, what does that mean? The normal flu mortality rate is about 0.6 percent, and the CDC says 1.4, but they’re extrapolating from what we know from countries around the world. First, even on the 1.4 percent, again that is – tends to be people who are debilitated, senior-citizens, many of whom have an underlying illness – that tends to be the people who are vulnerable to this. Good news, children do not appear as vulnerable to this virus. Less vulnerable than to the normal flu. So, that is good news, but 1.4 percent, that’s extrapolating from China and other countries. 80 percent, it’ll resolve on their own. The woman who has now tested positive, she’s at home, she’s not even in a hospital, so the perspective here is important. And the facts, once you know the facts, once you know the reality, it is reassuring, and we should relax, because that’s what’s dictated by the reality of the situation. I get the emotion, I understand, I understand the anxiety. I’m a native-born New Yorker, we live with anxiety. But the facts don’t back it up here. Also, we’re extrapolating from what happened in China and other countries – we have the best health care system in the world here. And excuse our arrogance as New Yorkers – I speak for the Mayor also on this one – we think we have the best health care system on the planet right here in New York. So, when you’re saying, what happened in other countries versus what happened here, we don’t even think it’s going to be as bad as it was in other countries. We are fully coordinated, we are fully mobilized. This is all about mobilization of a public health system – getting the testing done, getting the information out, and then having the health care resources to treat people who are going to need help. Again that is going to be primarily senior citizens, people who are debilitated, and we are going to have a special effort for our nursing homes, etcetera – congregate facilities where senior citizens are being treated.
And I can’t thank our partners enough. Everybody is doing exactly what we need to do. We have been ahead of this from day one. It was a big break when the federal government allowed us to do our testing because now we are actually in control of the system ourselves. And as New Yorkers, we like control.
So, with that, let me turn it over to the good Mayor of the City of New York.
Mayor Bill de Blasio: Thank you very much, Governor. And Governor, first of all, a compliment to your daughter. The apple doesn’t fall far from the tree. She is asking the tough isocratic questions that I know you’re known for and I think it’s a really great vignette to use to help everyone understand what’s going on. And particularly – look, as a parent I want to say I know parents all over the city have been deeply concerned. I really want you to heed the points that the Governor just made. This is a disease we’re learning about, the international medical community is learning about. But so far, it does not seem to be a disease that focuses on our kids – in fact, the opposite. But the point – the vignette with your daughter, that in fact the facts are reassuring. All New Yorkers should really pay attention to this.
We have a lot of information now, information that is actually showing us things that should give us more reason to stay calm and go about our lives. Also, if I have one difference with the Governor’s remarks it’s that we don’t think we have the best health care system in the country or in the world, we know we do, and it’s a credit to everyone here and I want to thank each and every one of you and all the professionals who work with you in –
Governor Cuomo: [Inaudible] credit to us, no?
Mayor: [Inaudible] take it. But in the private, in the voluntary hospitals, our nonprofit health care providers, and our public health care system, there is literally no parallel on Earth. So, there’s a lot of places for New Yorkers to turn for help and I want to emphasize today how important it is to turn for that help, to go get that help the second you think you might need it. So, the facts, in fact, show us that this is a situation that can be managed but bluntly what has been the advantage here in New York – we’ve kind of been the anti-China in this sense – has been to say from the beginning, it’s coming here, it’s a real thing, everyone get ready for it, to be transparent, to be open about it from day one.
And the coordination between the City and State, as is always the case on these issues of health care, has been consistent and strong from the beginning. I want to thank you and your team, Governor, for that. So, the fact is we have told New Yorkers from the beginning, get ready, here it comes, we’re going to all be able to deal with it together. By the way, crucially important – the message to New Yorkers from the beginning has been, this is something we all can handle together, go about your lives, go about your business. People are doing that consistently. New Yorkers do not scare easily, do not intimidate easily. Second, we’ve said if you have the symptoms and have any nexus to the nation’s where the issue is profound at this point, go get health care.
Guess what? People have been doing that. The reason it’s taken all this time to get the first case – I fundamentally believe it’s a matter of common sense – is that people have been heeding the warnings, going and getting tested, going and getting checked on, and that’s helped us to stay ahead of it. Now, we need to keep doing that. Obviously, if you have the symptoms and you have a nexus to the nations that are suffering the most, whether it’s you yourself who travelled or a family member or loved one or someone you’re in close, close contact with, go get help. Get to a medical facility, get to a doctor immediately. It’s crucial to understand – and this is again an evolving situation. I’m briefed constantly by our health care professionals. No one is saying they know everything about coronavirus yet, but we do know a lot.
But this is not, so far, something that you get through casual contact. There has to be some prolonged exposure. And I think it’s really important to get that information out to all New Yorkers. People need to be aware of their patterns. If you’ve had contact with someone who may have had a nexus to one of those countries, that’s an important indicator. Act on it. Listen, there was some question earlier about – in the last few days – about whether you go directly to health care or you place a call first. Here’s the bottom line – don’t hesitate to get to a doctor or a health care facility. If you can call first and let them know that you’re coming and let them know your symptoms, that’s ideal and helpful but the most important thing is not to hesitate. We all know a lot of people – and particularly New Yorkers – tend to shrug things off, tend to say, ‘I’ll get to it when I get it or my schedule is so busy, I’ve got something else I have to do.’ That’s not the way to think about this. If you have the symptoms, if there’s any possibility it may be this disease, get to health care right away.
I want to also say that the case here that the Governor described is an example of the work that is done and we all know this, we remember when we all went through Ebola together and other situations. And I appreciate the Governor’s point – we have been down this road as a city, as a state many times before. We have disease detectives at the New York City Department of Health. The New York City Health Department is renowned all over the world, one of the great public health agencies on Earth. Disease detectives who literally track back everyone’s interactions if they contract a disease, do the work to figure out who they’ve come in contact with. As the Governor said, in this case this individual has only one person they’ve been in prolonged contact with, that’s their husband. That capacity has been honed over years. So, if we have other cases, we’re going to be able to do very fine tuned work to know who those individuals come in contact with, and do the kind of follow-up we need.
Finally, the key point about having the ability to do our own testing – the City and State are working together with the Wadsworth Lab, the state lab. They’ve been fantastic, we’ve been able to get a lot done. We’re going to be able to do so much more now starting this week. The city’s capacity will be up and running for the testing as of Friday. That means results will come in hours, not days. This is going to be a much better situation for all of us. In addition, we’re initiating this week an early detection system. We’re working with a number of hospital systems to bring together information gleaned from thousands of health care professionals as they are having appointments with individual patients and there are cases that have relevance here – respiratory diseases. The information coming from those visits is going to be pooled to watch for any trends, to watch for any areas where we need to do additional outreach or work at the neighborhood level.
This is very much a grassroots reality, how you address something like this. It’s making sure the information flows right down into each neighborhood, into each household, it’s making sure that we have people out there giving people accurate information. It’s making sure if someone needs help they can get it. And I want to emphasize to all New Yorkers – there are people in this city who right now feel they need to get to a doctor but don’t know how, they don’t have their own doctor, they don’t know if they can pay for it, they don’t happen to speak English, they don’t have a way to get to the doctor, they may be disabled. Whatever it is, call 3-1-1. Here’s a simple message. If you think you need care, if you are worried you have the symptoms of coronavirus and you don’t know where to turn, pick up the phone, call 3-1-1. We will help you get to the health care you need. If we need to send someone to you, we will send someone to you. But no one should hesitate. The best thing you can do for yourself and your family and all fellow New Yorkers is get to health care immediately if you think you have that need.
So, with that – and I’ll just conclude with the basics. Remember, everyone, as our Health Commissioner Dr. Barbot likes to constantly remind us, cover your mouth when you cough and sneeze. It’s amazing that that may be the single most valuable thing people can do to address this challenge. Just the basics – wash your hands frequently. If you think you may be sick, act like you are sick, and do something about it. These are really basic rules. If people follow those rules – and I think New Yorkers have been up to date – it will make all the difference in the world. So, following those simple precautions will help us a lot.
And again thank you to Dr. Barbot, our Health Commissioner, Deputy Mayor Raul Perea-Henze of Health and Human Services, and our whole team that’s been working with the State to prepare for this day. And now, we will all be working together to address this challenge.
Governor Cuomo: Well said. Questions?
Question: Governor, can you [inaudible] to a patient zero or is it possible multiple [inaudible] were affected and can ever spring up simultaneously perhaps [inaudible] –
Governor Cuomo: Patient zero is called China, right? And beyond that, China does the tracking. Community spread is going to be real, right? Thus far we've had – you can trace it back to an individual or someone who came from overseas, but we're seeing already on the west coast that there's then community spread where you lose the causal connection along the way. And we believe that's going to happen here. So, we will have more cases, we will have community spread – that is inevitable. And we're in this cycle – well, did anyone test positive – did anyone test positive? I've been saying for weeks people are going to test positive – not just one or two or three or five, there will be many who test positive. That's a false bar that we've set. And you will have community spread where people test positive and you can't track it back to any one causal length. The testing and increasing the testing capacity – and that's why we just had a conversation about how aggressive can we be to ramp up the testing because these institutions can also do testing where they get the test – the approved test – but they have the laboratories to do it. We want 1,000 tests per day. Test as many as you can and then isolate those people so you reduce the spread. But that's all this is about, is reducing the spread, not eliminating the spread. And then you say, well, so the virus will spread. Yes, it will spread, like, by the way, the flu spreads every year. And then you get in to talk about the consequences, which is 80 percent of the people who get this virus will just self-resolve – they'll think they have the flu and they have the symptoms and then it self-resolves.
Question: What precautions are being taken where this woman lives, whether it's an apartment building or in her neighborhood, anything like that?
Governor Cuomo: Well, first, this is a trained health care professional. Obviously, in this environment she was very aware of the possibilities so she did, textbook, everything right. Her spouse, also a health care worker was with her – again, textbook, everything, right? They have basically been in a controlled circumstance. We don't believe she was contagious when she was exposed to other people, because remember the contagion comes from the sneezing, the coughing, etcetera, in an isolated setting. We don't believe she was contagious on the airplane or in the car. Out of an abundance of caution, the “disease detectives” that the Mayor referred to – we're going to contact the people on the plane and the private car driver. But those were really, to the best of our knowledge, the only possible exposure.
Commissioner Oxiris Barbot, Department of Health and Mental Hygiene: I’d like to add to that – what the Governor mentioned. Because of the fact that this New Yorker took early action, and we know that there's currently no indication that it's easy to transmit by casual contact, there's no need to do any special anything in the community. We want New Yorkers to go about their daily lives, ride the subway, take the bus, go see your neighbors. The important thing, as both the Mayor and the Governor have said, we want New Yorkers to lean even more into frequent hand washing and covering their mouths and their noses. And if you can't get to a water source, make alcohol-based hand sanitizer your new best friend.
Governor Cuomo: You raise a good issue. And it's something we, when we talk about being prepared, and we knew this was coming four weeks, which was actually an advantage, having the right supplies, the right masks, the right protective gear, the right training is something we've been working on with the entire hospital system. We started weeks ago in terms of having the equipment and having the training. It has worked very, very well. If any doesn't have the right equipment, they should let us know ASAP and we will get it to them because we have it. And I'm going to refer it to Mr. Ken Raske, who represents the hospitals and who has been working with us on this.
President Kenneth Raske, Greater New York Hospital Association: Well, thank you, Governor. It's a great question. Protecting the health care workers is our primary concern, obviously, within the health care community and having the right equipment is essential in that obligation. And I have to tell you, and it's represented here at this table with the Governor, the Mayor, and our respective Commissioners who are outstanding health department officials – we work hand-in-glove with them in terms of getting whatever supplies that are necessary to the places that are needed. In both cases, both the City and the State, there are stockpiles of stuff – medical equipment, medical paraphernalia and stuff like that that we can draw down. The federal government has one too, and all of which are tap-able in terms of this. But the coordination effort is done in our case through our office of institutions that are running into shortages of this, that, or the next thing. And we will do the best that we possibly can to contact Commissioner Zucker, our commissioner of health in the City, and we will get those supplies to them ASAP.
Governor Cuomo: Also, one general point – there is no mystery to how this is – how contagious this is or how it transfers, right? This transfers like the common flu. So, for health care workers, yeah, you take the right precautions, but it's not like we're dealing with something that we haven't dealt with before. Actually, we've dealt with worse, right? The Ebola Virus, that was really a much more difficult, more frightening situation than this.
Question: Governor, now that the CDC has given the go-ahead for this testing to go forward, are you satisfied that you've gotten everything that you need from the federal government to handle the epidemic?
Governor Cuomo: Have we gotten everything we need from the federal government? No. No, no, no, no – on many levels. On this specific level, we have the testing, but the – I spoke to Vice President Pence, he's heading the President's task force. They're going to be doing a supplemental appropriation. This is going to be expensive for the State, for the City, and we are – I understand the relationship to the federal government, I understand our responsibility, but this is a significant financial burden. We have no issue with the administration, the management and doing the job, but the financial consequences are highly relevant. And at a minimum, we would expect the federal government to help with that.
Question: Mr. Mayor, is New York City’s public laboratory currently testing or not –
Mayor: As I said, as of Friday. This coming Friday.
Question: This coming Friday, okay. And so, what is our current [inaudible] what is the current capacity and was there delay testing this woman because of the [inaudible] –
Governor Cuomo: There is no – we can – our current capacity is several hundred, so we have much more capacity than tests that are being requested. The City lab will come online, the Mayor said, on Friday. The people around this table, they also have laboratories and the State is going to give them the approved test and they will then operate that test. So, we've set an initial goal of 1,000 test per day capacity all combined and then we'll see where we go from there.
Question: The Mayor said earlier that it was a matter of hours [inaudible] give us like a tic-toc of – for someone who gets tested, how that test is done, exactly how long that takes. And also, should this, God forbid, get worse, are there hospital beds set aside in the city for people?
Mayor: As I've said publicly days ago, 1,200 beds are right now identified and can be used in the city without interfering with other health care activities. So, we have that in reserve. Now, I want to emphasize the Governor's point earlier. Right now, we are nowhere near that kind of need. Yes, we do expect communities spread and, yes, we have to be ready for anything, but I want to emphasize that, one, you've got a disease that for the vast majority of people manifests as something that they can handle just by, you know, waiting it out and taking some basic steps. It is obviously dangerous to a small percentage of people, we take that very, very seriously. But I want us to put it in perspective, the Governor's point about Ebola is well taken. I remember I was sitting here during the Ebola crisis. That was a disease that, you know, once it hit, if you got it, you were in grievous danger no matter who the hell you were. This is a whole different reality. But I think the other point to recognize here is that we have the ability to address this. If all of these messages get out of the kinds of things people need to do, the basic precautions, getting to a doctor if you have the symptoms, all of us now being able to test quickly, we have the capacity to keep this contained. If God forbid, it spread, spread, spread, the fact that this hour we have 1,200 beds ready right this moment should be very reassuring to New Yorkers.
Governor Cuomo: Several hours – the test itself takes several hours to conduct. But within about 12 hours the results are turned around from start to finish.
Question: [Inaudible] it’s faster than before.
Governor Cuomo: Yes, because we’re doing it ourselves.
Mayor: We’re not sending it to Atlanta.
Question: When does the State testing start?
Governor Cuomo: It has started, it’s ongoing. The State did this test.
Question: [Inaudible] when did she arrive? On what flight did she take?
Governor Cuomo: We can get you the specifics, she arrived on Tuesday. Our best information is she was not contagious on the flight. Out of an abundance of caution, we're going to be contacting the people who are on that flight. And took a private car to her residence, she was with her spouse. We're testing the spouse who's also a health care worker. We assume the spouse will be positive, okay? So, that's our operating assumption. He has been following the same protocols. They were tested at Mount Sinai and we got the results last night.
Let's do one more –
Question: [Inaudible] a hospital?
Governor Cuomo: Because she doesn't need a hospital. Because she doesn't need a hospital, and that is the point here. Somebody used an expression, this is like the flu on steroids, okay? 80 percent of the people if when infected with a coronavirus will self-treat and self-resolve. They'll think they have the flu because it's the same type of symptoms. About 20 percent will get ill, and, again, as the Mayor said, I've said, everyone on this table has said, the people who are in danger – “most danger” immune compromised, debilitated people, senior citizens, like the normal flu. And those are the people who we have to focus on and concentrate. The good news here, the normal flu also does children – this virus does not seem to affect children. So, this is good news. And the case that tested positive should be an affirmation. She's positive and she's home, because she doesn't need to be in a hospital.
Mayor: Alright, thank you.
Governor Cuomo: Okay. Thank you very much, guys. Thank you.