Transcript: Mayor de Blasio Provides Updates on New York City's COVID-19 Response

March 5, 2020

Mayor Bill de Blasio: …a number of different areas. What I’m going to try to do in each briefing is create as much continuity with the previous briefing as possible. And as I said, I think we are going to be doing a lot of these for the weeks to come. So, let me start with, yesterday we talked in detail about the family from Westchester and the law firm, Lewis and Garbuz, where both the mother and father of that family worked. In addition to the mother and father, eight other individuals at the law firm – seven employees want to intern – four residents of New York City, four residents of areas outside New York City all have been tested. Here is what we know so far – for the four New York City residents, the tests have all come back negative. For the one resident beyond the couple of themselves from Westchester County, the test has come back negative. We have three more tests pending. We will have those results today and we'll publish them as soon as we have them.

And everything's very dynamic, as everyone is seeing, so these numbers can move at any given moment. But as of this moment, I've got – obviously, we'll talk about the four confirmed cases, the four cases that tested positive, but now the number of negative cases is 26. We have 26 tests completed, have come back negative. We have two new cases confirmed this morning in New York City, a man in his forties, a woman in her eighties. Both are critically ill at this moment. Both did have substantial preexisting conditions. In the case of the man, respiratory issues related to smoking and vaping; in the case of the woman specific illnesses related to her advanced age. One is at a hospital in Brooklyn, one is at a hospital in Manhattan. Again, we're going to try always to define what we are able to tell you, what we're not yet able to tell you. Obviously, there's a confidentiality issue here that we have to be sensitive to. These are voluntary hospitals, not public hospitals.

Okay. Now this gets into the issue of community spread, which we're very, very concerned about obviously. And this is kind of defining a changing reality. So, today, we're going to be talking about some strategic differences even compared to yesterday now that we have more evidence of community spread. So, in the case of these two individuals, neither one had a connection to the areas affected in other parts of the world. So, there no travel nexus. Neither one connected to any of the other cases we've seen. Our disease detectives are working with their families right away on mapping their contacts. And we'll have more to say on that shortly and we'll obviously be following up with any close contacts. The community spread issue – we are seeking a guidance from the World Health Organization and from the CDC now that it's clearly established as a phenomenon here. We are trying every day to get a better understanding of this still new disease. We are not getting all the answers we would like, but, to be fair, the entire medical community around the world is trying to get clear answers and clear facts. What we do know is when you have a community spread dynamic, you have to assume it could be anywhere in the city. So, we are going to work on an assumption of the intense vigilance. We're going to update our approaches as we get more information. A phrase I've just learned – transmissibility is sort of the amount or the ease with which this is transmitted. World Health Organization continues to say this disease is less transmittable than the flu. But again, we are watching carefully. A community-spread dynamic suggests it will be more pervasive and that worries us obviously in terms of how easy it might be for someone to come in contact. Again, goes back to what people can do. And this is the consistent part, because it is affirming as we use the example yesterday of the measles – it is not a disease that the substances hang in the air and if you come into a room where they've been present that it's easy to contract. We know that is not the case. What we're concerned about is direct contact with fluids. And so, that's the area where people can do all the smart basics, the hand washing, the alcohol-based hand sanitizer – thank you, Commissioner, you've gotten that in my brain. Obviously, covering your mouth when you cough and sneeze – all those basics really matter.

Notwithstanding our real concern about the situation, the overall numbers still remain, in a sense, very favorable. We have only four confirmed cases. Obviously, out of 8.6 million people, we have 26 tests that have come back negative. I want to note, I should've said this up front for continuity – the two Yeshiva students who the disease detectives identified from the first Yeshiva – so, that is the roommate and the best friend of the student from Westchester – both have been tested, both came back negative. So, they're in that negative number of 26. So, again, by the numbers, we remain in a strong situation. The community-spread dynamic is unpredictable and worrisome, so we're watching carefully. And I want to alert everyone, each day we may tell you we're finding something new about how this disease is acting in general, how it's acting here in New York City, so our level of concern is rising for sure. That said, the big picture point, I'll keep saying it, we do know this for a fact, over 80 percent of the folks who get it have very mild symptoms, very mild experience, and the vast majority of folks even who have more serious outcomes still end up seeing it through. So, it comes back to – I'm making really clear, we believe in a containment strategy. We understand there are limits to that at a certain point, but that is the strategy we're using. We believe in a strategy that focuses on identification and testing. We believe deeply in the work of the disease detectives and we will be introducing you to some of them soon so you can get to see the real human beings who do this important work. But finding everyone who needs a test and getting them a test as quickly as possible and isolating them when they need to be isolated is the smart strategy.

We have a directive for all New Yorkers, and I'm first going to talk about all New Yorkers and then let's specifically talk about City workers. For all New Yorkers, if you had returned from one of the five countries I'll indicate, we're asking you to isolate yourself for 14 days as a precaution. Any New Yorker coming back from any of these countries – China, Iran, Italy, South Korea, all on the current CDC list. Japan should be on that list we believe. So, from the point of view of New York City, if you're coming back from Japan, you should isolate for 14 days. And obviously if you have symptoms, then you need to get to care and testing. Now, this is a brand-new thing I'm going to introduce to you today. Thanks to our Health Commissioner, this order is being issued as we speak – the Commissioner's Order. And this refers to City workers, specifically first responders, health care workers and educators. So, this'll be up online momentarily. Under this order, the Commissioner has the ability to determine case by case specific actions. And if the Commissioner determines that anyone fits the criteria and is a risk, they can be required to get a coronavirus test. Right now, I can tell you, anyone who has traveled to one of the affected countries and has symptoms will be required and the broad assumption has to be that those who have symptoms alone, except for a particular extenuating circumstances, anyone who has symptoms will be required to get tested and we will act in accordance to that test in terms of if and when they can return to work. Anyone who refuses testing must comply with a quarantine and there will be specific employment consequences if they refuse testing. We'll get you the details on that.

I want to also emphasize – again, I think we're in a very dynamic crisis, which I have said to you guys I believe will be months if we're lucky. This is the first Commissioner's Order, I doubt it will be the last. You will see evolving actions. This one refers only to city workers – obviously, the Commissioner has a power and I have the power to do things related to the general public as well. So this is – we're going to take each step as needed. We'd love it if we don't have to take a lot more steps, but we are prepared to do a lot more the moment we need to.

Consistent with the topic of City workers, an update related to schools. So, we have three teachers who have recently come back from Italy. I'm going to give you a lot of detail on one and then there's two more where I can give you a little detail, but we will have more specific as soon as certain notifications have been made. First teacher, it was part of a high school trip at James Madison High School in Brooklyn, 3787 Bedford Avenue – 44 students and this teacher plus six other staff members went to Italy. My understanding is to one of the affected areas of Italy and that's important here. Obviously, countries are experiencing this crisis but there are areas of particular concern. Came back on February 23rd. The teacher was symptomatic, the teacher has been tested, the teacher tests negative. We are assessing all the other staff and students on the trip. At this moment, we have none with symptoms and we believe we have a low-risk situation, especially given that we're getting close to the 14-day mark, but they are being carefully assessed. If anyone needs testing, they will get it.

This is a good example of a situation I want to clarify about. We've been talking a lot about how to talk to parents. And I'll say this – and at any point now or in the back and forth my health colleagues will jump in – but the basic guidance to parents who are very, very concerned right now is, if your children are healthy, at this moment, there's very, very little to be concerned about. If your children have serious respiratory diseases or a compromised immune system, we want you to be extra vigilant and we want, in that case, we obviously want to make sure our schools are aware of those particular students. So, looking to the Chancellor and the Health Commissioner and the Deputy Commissioner that we obviously have the ability with school records and school health facilities, something you used to do, to understand school-by-school who those students are. We're going to have particular sensitivity around those students, but, at this moment, because there's not a single symptomatic student anywhere in New York City public schools that we know of, we're not taking an additional action. But that, just the human guidance to parents – and I'm saying this as a parent – based on what our public health officials are saying is only if your student has a serious respiratory problem or have compromised immune system is there an immediate threat. Otherwise, as everyone is seeing, this disease disproportionately affects older folks and folks with a serious preexisting conditions, but, obviously, overwhelmingly it's been adults.

Two other teachers – in this case, they both returned from a vacation in Italy over the winter break. So again, we're getting close to the 14-day point. We will have more information shortly. Both are being tested today. We'll have the results on that shortly and then we'll talk about pending notification, the specific schools and any other follow up. But again, those teachers just went themselves personally on vacation, not with students or other staff.

I want to give you a couple of agency updates. Department of Correction – all housing units, day rooms and common spaces are now being cleaned once per day. Shower areas are being cleaned three times per day. Transport buses are being cleaned and sanitized daily. Staten Island ferry – every ferry, each boat will get a deep clean every 72 hours minimum, often more than that, more frequently than that. Terminals will be consistently clean, constantly clean. DOT crews are also handing out material on the ferry to educate customers as to the facts on the virus. Those – I obviously gave you some other agency updates yesterday. Those are some of the things that are happening in our government, but I want to emphasize we need from another government, the federal government. This is a still the case. Even though there was a little progress last few days, it's still not what we need. We need the ability to test as many people as possible, as quickly as possible. We cannot do that without help from the federal government, period. The CDC has finally broadened the criteria, which is good, but we do not have the physical capacity. We need the FDA to speed up approval of the test developed by private companies. We just need this to be a consistent effort by the federal government. It has not been. The goal has to be the decentralized testing as quickly as possible and maximize our ability to do what we need to do.

One other piece of news, literally coming in just before I came out here from New Jersey, but related to us. We have one new case in New Jersey that has a significant nexus to New York City. We don't have the details yet. Our health authorities are speaking to the New Jersey health authorities. I will be speaking to the Lieutenant Governor who's in the role of Acting Governor, because Governor Murphy has been in surgery. So, Acting Governor Sheila Oliver, I'll be speaking to her later on today. We will get you an update as soon as we have more of the details. We're going to have our disease detectives engaged with the health authorities in New Jersey to track what that nexus is. So, we know there's a case and we know there's a nexus, but we don't have the details on that. Hopefully we'll have that in a matter of hours.

A few quick words in Spanish and then I'd like to have the Speakers of the City Council, Corey Johnson, say a few words before we open up to questions.

[Mayor de Blasio speaks in Spanish]

With that, I’d like to turn to Speaker Johnson.

[…]

Mayor: Thank you, Speaker. I couldn't agree with you more and thank you for that rightfully passionate statement. Yeah, we're just not – I want to amplify, we're not going to accept any discrimination. There are real consequences. Some forms of discrimination are illegal and you will feel the consequences of it. But also, if anyone's paying attention, this disease is now in, I think, 79 countries of the world, so it is unfortunately affecting people of all backgrounds, all nations. We have no time for discrimination. I also want to thank the Speaker, I appreciate the hearing he's having. I also want to thank them for riding the subway and want to inform you all that I'll be going from City Hall to OEM by subway, and you will all be welcome to join, anyone who wants to come along a little bit later on this afternoon.

Go ahead, Katie.

Question: So, the CDC added Italy to a level three non-essential travel warning a week ago. I want to know why [inaudible] and if they did, I’d be happy to be wrong – why didn't DOE proactively go and see what schools had trips to Italy, and the other countries, South Korea, Japan. We're just now finding out that 50 people from a school traveled to Italy for February break, one had symptoms, and I just want to know if that was done, let me know, and if it wasn't, why not?

Schools Chancellor Richard Carranza: So, again, you said it was added a week ago. These trips were in February. So, as the information was coming to us where we're going back and finding out where are students going, where were these trips planned for? A large agency, lots of groups moving. The good news is, going forward, we have very, very clear protocols. We now have an inventory of all of these trips, even trips to non-designated countries. We're sharing those trips with our partners in the Department of Health to make sure that there's nothing brewing that they know of that we don't know of. So, going forward, we have tight controls.

Question: Did you not have inventory before and could you let me know if there were other trips made during February break?

Chancellor Carranza: We can get that information to you. But again, we are going back and there are some trips, quite frankly, that – even our unofficial trips, they’re paid for by parent organizations, they’re paid for by a church-related organization. So, we're trying to get an inventory of everything and everywhere and we're in the active process of that. We've been doing that for about a week as well.

Question: With all due respect, I know teachers who probably can't go to like the Hall of Science without notifying their district. I'm just trying to clarify, you mean the Department of Education wouldn't know if a school sanctioned DOE trip with 50 people –

Chancellor Carranza: That’s not what I’m saying. What I'm saying is that there were a lot of trips, there was a lot of information. CDC was changing and giving different guidance. We were working through the Department of Health as well – a lot of moving parts.

Mayor: Right. Richard, let me just, for everyone's sake. I use to know when I was a parent, I don't know what this year the exact dates of winter break were. If we could give that, I don't know if you have at your fingertips, but we can get the exact dates of winter break, I think it will help to answer the point that's being raised here. But the bottom line is, we're going to inventory everything now and go back and look if there's anything we need to follow up on specifically.

Question: [Inaudible] point was that they shouldn’t have traveled –

Mayor: Again, I would just – I’ve been very clear, we’re going to inventory everything and we're going to be very transparent about it.

Question: I just want to clarify two points. The first, the two new cases in New York City, the man and his [inaudible] is there any connection between the two of them?

Mayor: No.

Question: No. And can you clarify –

Mayor: I’m double-checking – no. No.

Question: And are there three confirmed cases in New York City, or four –

Mayor: Four if you include the guy from Westchester who worked in New York City, lived in Westchester but isn't in New York City hospitals. So, we're calling that in New York City for the sake of abundance of inclusion.

Question: [Inaudible] he’s in Westchester.

Mayor: Correct.

Question: About the lawyer, his wife, do we know if his wife had traveled to Israel?

Mayor: We know he traveled to Israel. I don't know if we know his wife's traveled to Israel.

Deputy Commissioner Demetre Daskalakis, Department of Health and Mental Hygiene: I'm not aware of her travel itinerary. We do know that he traveled to Israel, but way before he got –

Mayor: But she is – again, I'm trying to – there's so many cases I'm trying to make sense – she's asymptomatic?

Deputy Commissioner Daskalakis: Correct.

Question: I have two questions. One is – yesterday, you said there'd be an update to the protocol regarding staff who show symptoms of school.

Mayor: When you say staff – I’m sorry –

Questions: Teachers –

Mayor: Teachers. Yeah, that’s the Commissioner’s Order.

Question: Okay. So that is how you're dealing with [inaudible]. Also, the teacher who you said today had been tested, it was negative. Is that the same one that we talked about at yesterdays –

Mayor: Yes, I believe it's the same. Let me think – I'm trying to keep my continuity tight. I'll say it again just to make sure we're all over-communicating. James Madison High – there’s a teacher who went on an official school trip with students over there – again, tested negative. We'll have the other two teachers results today.

Chancellor Carranza: Mr. Mayor, can I amplify?

Mayor: Please.

Chancellor Carranza: There was additional guidance and protocols that were sent to all 152,000 employees in the DOE today with very specific instructions. We've also updated our guidance to all principals about how to work with students, how to work with other staff members if they are presenting. So, there's been updated guidance as well.

Question: [Inaudible] ask the DOE press office to share that? [Inaudible]

Chancellor Carranza: Yeah, absolutely. Absolutely – just went out.

Question: [Inaudible]

Chancellor Carranza: Sure, say that again?

Question: [Inaudible]

[Chancellor Carranza speaks in Spanish]

Question: Just a few questions wrapped up under the quarantine headline. There are 1,000 people quarantined in New York State. I wondered how many in New York City? Are any of those involuntary? And do we – how many mental health – I'm sorry, how many Department of Health staffers do we have to check in on them? And are you worried about a shortage of staffers to check in on the [inaudible]?

Mayor: The last point – the last point I was saying, we're obviously in a crisis. The message to the Department of Health is that whatever staffing they need, if they need to hire new, if they need to gently borrow from a Health and Hospitals, which has been wonderful about offering personnel, or from any other agency, there's not going to be a staffing shortage. That will be whatever they need, whenever they need it. As to the quarantine numbers and whether there's any involuntary –

Commissioner Oxiris Barbot, Department of Health and Mental Hygiene: I'll start and then Dr. Daskalakis can add anything that I’ve missed. With regards to individuals that are returning from the involved countries. The guidance from CDC and we, along with our state partners and various jurisdictions across the country, are taking the approach of providing them information when they get off the planes, giving them our phone number, what symptoms to look out for, and then we reach out to them on a daily basis to make sure that they are not developing symptoms. It's what we call voluntary home isolation. And so, they have a phone number to call us if and when they develop symptoms. There haven't been any individuals in that group that have reached out to us thus far. And then, we have individuals who are in mandatory quarantine and I'll let Dr. Daskalakis speak to that.

Deputy Commissioner Daskalakis: Currently, individuals who are under mandatory quarantine really fall into two categories – individuals who are – actually, three – individuals who have active COVID-19 disease. So, they're in isolation. There are also individuals who are close contacts of a COVID-19 case. Those are also individuals who are on quarantine. Then additionally, it is a dwindling population of individuals returning from Wuhan, China. So, currently, there is no one who meets that criteria.

Question: And what’s the universe? How many people are in quarantine, mandatory versus voluntary?

Mayor: If there’s any – let me pause you guys. It’s a very, very fair question. If you are 100 percent sure you have all the up-to-date facts, give them. If not, we should get back shortly.

Commissioner Barbot: So, we have the two individual – sorry, we have the two individuals that we have identified earlier as having a travel nexus to Iran.

Mayor: If there's any – let me pause you guys. It's a very, very fair question. If you are 100 percent sure you have all the up to date facts, give them, if not, we should get back shortly.

Commissioner Barbot: So we have the two individual – sorry – we have the two individuals that we have identified earlier as having a travel nexus to Iran. And in addition to that we have a number that changes on a daily basis in terms of returning passengers from the five affected countries, China, Italy, Iran, South Korea, and now Japan. And so that's a fluid number that we can get back to you on. I think - yeah, we'll get back to you on that correct number.

Question: I’m just sorry, one last follow up. How often are those unannounced spot checks that you mentioned yesterday?

Deputy Commissioner Daskalakis: During the period of quarantine? They're done a couple of times a week.

Question: Is there a nexus with the 42-year-old man in Nassau County who was diagnosed with COVID in New York City? [Inaudible].

Mayor: I have not heard – haven't heard on that one. If there is a nexus, do we know anything yet?

Deputy Commissioner Daskalakis: Which person in in Westchester?

Question: [Inaudible], in Long Island, in Nassau County. The Governor today said that there was a 42-year-old man who tested positive and you're looking to see if there's a nexus or you know that there is [inaudible]?

Deputy Commissioner Daskalakis: We’ll have to follow up. Usually what will happen is they will reach out to our disease detectives to have a conversation. So I'm sure that those are happening. But we'll follow up,

Question: Can someone on the panel clarify how many tests New York City has, if you're running low and also the type of test if it's the one developed in Albany or if it’s a CDC test?

Deputy Commissioner Daskalakis: So currently we have enough tests to test around a thousand people. The test that we're currently using is the kit that was shipped by the Centers for Disease Control. We have not brought the New York State - New York City Cooperative Test onboard yet.

Question: What is the nexus between the New Jersey case and New York City –

Mayor: That’s what we’re waiting to find out. So we do believe from the initial information, there will be, for example, someone who works here, you know, that's kind of thing. But it's really, literally was breaking before I came in here. So we know enough to say, we assume it's someone who's been in New York City a lot and there may be that kind of contact. We've got to get our disease detectives connecting with the New Jersey health officials and map that quickly.

Question: Do we know anything about their travel [inaudible]?

Mayor: We don't know anything yet, but we'll know more in the next few hours. Go ahead, Rich.

Question: So I may have missed this but the two teachers who came back from vacation, were they in a school when the decision was made to test them or have they not been back into the school building or did they voluntarily say, you know, we ought to be tested? What happened?

Mayor: Richard, correct me. I think both have been home for a period of time –

Chancellor Carranza: They have been at home. Yes, correct.

Mayor: So the whole time since they got back? So just let me do this fact point is we're going to really always try and shower you guys with facts. Winter break, Saturday, February 15th to Sunday, February 23rd, I did math, 11 full days, including today, since then, not including February 23rd, which would be the day they either were traveling back or they were already back. But if you want, the cleanest interpretation has been at least 11 days for anyone who was overseas on winter break. Maybe more in some cases. So in this case or these two cases, Richard, did they go, did they stay home since to the best your understanding or do we need to confirm that?

Chancellor Carranza: So the best of my recollection, they were in school for one day, did not feel well, went home and have not been back in school since.

Mayor: Okay. We're going to confirm that. We'll get you the exact details on that and we'll get you the results on their tests. Erin?

Question: Can we get some more clarity on the Commissioner's orders? So this is – you can order testing under what circumstances?

Mayor: Can I just confirm too colleagues? Is it online yet? When we'll be online momentarily? Okay. Go ahead. I'm sorry, Erin.

Question: What are the circumstances under which you can order a city employee to take a test?

Mayor: I’ll start and the Commissioner will get into more it. It begins with if they have been to one of the countries, they're experiencing the crisis within the timeframe, and especially if they are symptomatic. But again, it gives the Commissioner the right to make that determination. Simply being symptomatic is sufficient. You and this – I’m just going to leave it on.

Commissioner Barbot: That's absolutely right, Mr. Mayor.

Question: Okay. If they refuse to do that, you said they will be quarantined. Is that a mandatory quarantine?

Commissioner Barbot: Mandatory quarantine.

Question: Okay. And you said they would face discipline. Is that termination or at the type of discipline specified?

Mayor: It depends on the employee. But the point is there – we want to be very clear, look, I come at this with a positive spirit. I think everyone would want to follow the Commissioner's orders in the name of their own health, their family's health, and the people they serve and come contact with. But I'm just trying to be very straightforward from the beginning. This is not optional. This is required.

Question: Is there a response to [inaudible]. Have there been city workers who have not wanted to take the test?

Mayor: This is - given the severity of what we're talking about here, the situation we're facing, we want to be very clear from the beginning that it's not optional. So we're just, I'm a believer that if you make clear as consequences, it helps to people to understand.

Question: And then finally, is there a reason to city workers specifically as opposed to this applying to anyone? Especially with the authority you have.

Mayor: The city workers in this case, the healthcare workers, obviously I think that says it speaks for itself. These are folks who we need and we need them to be healthy – and if they are in contact with other people, we cannot take a risk if they might spread disease. First responders, exactly the same point. Educators, additional sensitivity cause they come in contact with children even though again this is not a disease that seems to focus if you will on children. Those three areas to us just made total sense to delineate. We have the option of going further into the general public in different ways, if we need to. It’s something we're going to assess day to day, hour to hour. Go ahead. Ashley, did you have? No? Yes.

Question: I wanted to ask. We have a lot of larger events coming up. It's getting warmer. What's the threshold for deciding whether or not to cancel those events? And a follow up question, there are in the city like the South Bronx where their high rates of childhood asthma and do you have specific plans for areas like that?

Mayor: The first point this is something we're asking ourselves regularly. We're watching and again I think to be very clear, the last 24 hours have changed the dynamic with the first community spread. So previously we went quite a while where the only the only impact we were feeling was directly related to travel or even for quite a while we weren't feeling any impact. Right? So now with communities spread being established, it will be a constant discussion of whether we need to start canceling events. We are not there yet today just based on what we're seeing, the limits we're seeing, the numbers on the testing and the high rate of negatives. We're not there. It is a constant conversation and this is the group right here that will be making that decision together.

Question: [Inaudible]?

Mayor: There’s not a formal rubric that – I mean we're talking about a lot of factors but I will ask the question, is there a, a model rubric from either CDC or World Health Organization?

Commissioner Barbot: There isn't. Generally we take into consideration the severity of the illness along with how far wide it has spread.

Question: So would there be like parameters, let's say indoor events as opposed to outdoors activities –

Mayor: Again, I want to clarify in theory, yes. But I want us to – I don't want a respectfully – I don't want to see reporting that says we're planning on closing events when we're not. We're not planning that yet. If we get to that point, we're going to specify to the maximum extent possible what sorts of things we're concerned about and what we are not, but we're certainly not there yet. Your other question was about asthma. I mentioned that we are concerned for sure. I'm someone who has mild asthma but for folks who have severe asthma, especially in particularly kids with severe asthma, we have a real concern there. Again, we do not have a single a nexus to the schools vis-a-vis kids at this point. We don't have a single symptomatic kid we know of, but we are watching very carefully. If we saw something else in schools, the ability to identify any kid with severe asthma and I think that's a case where we would say if we see a school situation, we're concerned about, we want to get those kids isolated from that situation very quickly. That's just my common sense answer. But would you guys like to add?

Commissioner Barbot: What I would add is that this is, as we have said in a previous press conference, a good time for individuals who have chronic underlying diseases to make sure that they're up to date on their refills and not to take for granted that, you know, they can go to the pharmacy next week or the week after. Want to make sure that in the event that someone is symptomatic and they haven't gotten their flu shot or I want to – I need to get my daily plugin, it's still not too late - that they have the medication that they need at their disposal. And one of the things that we've also been talking about is not only individuals, let's say that child with asthma, but especially older individuals who have chronic underlying diseases. We want to make sure that they are up to date with, you know, their doctor's phone numbers so that they have the easiest possible access to care.

Mayor: Can I do two things on that? One, would you remind people that that a site, you can go to the find out where you can get a flu shot?

Commissioner Barbot: Yes, you can go to our website nyc.gov/health and there is a flu tracker on there and it'll tell you, or you can go – call 3-1-1 to get the pharmacy nearest you or the nearest H + H facility to you that where you can get immunization.

Mayor: I want to come back on the prescription point too. I want to make this a little vivid for everyone. So I think everyone understands here we are encouraging calm and we're encouraging people to do the things they can do. But here's something where I want people to feel a little more urgency, which is on the prescriptions. A very, very different reality but I remember vividly in the days after Hurricane Sandy because of the disruption that occurred, pharmacies were closed. People could not get meds they needed. We're not in that kind of situation, but we all can imagine a crisis in which there's basic disruption of supply chain. That's not hard to imagine in this case at some point. So please all New Yorkers get your prescriptions filled now. Protect yourself, protect your family, do not hesitate. Get them while you can get them. That's just smart for everyone. I hope we never get to a point where it's a consideration, but everything that people lay in now is in their interests. Go ahead.

Question: So how are you addressing a small business concerns? You know, we talked about Chinatown, but I'm hearing that restaurants were let's say, groups or organizations that have been scheduling events, you know, large dinners that they're canceling on the restaurants. And so this has been happening –

Mayor: Yeah, Juliet. I mean, I want to be clear about the sort of the serenity prayer here. What we can control and what we can't. And when what we're doing that I think is helping is telling people the facts very transparently and reminding people that, you know, life is going on in New York City. And I've been plenty of places in the city in the last few days where life looks pretty normal, actually. School attendance, we just, Richard and I just discussed this today in New York City school attendance is higher than it was the same day a year ago. So New Yorkers, all of you have to obviously report a lot of information, including information that causes people some concern. New Yorkers are pretty tough, pretty resilient. They're generally going about their business. Some organizations, you're absolutely right, are making choices, some travel related changes, et cetera. But I think the best thing we can all do is remind people, keep going about your lives, you know, keep going out and patronizing those businesses. We'll tell you the second we think you should change your behavior. You're - and again, we're constantly communicating here, but right now go about your business, Erin.

Question: For Chancellor Carranza, there's been some requests to provide on private schools with sanitation materials so they can do the deep cleaning or disinfectants is, is that anything you planned to do?

Mayor: So our approach to this is we are here to serve the children in New York City. All children. So we are working with our nonpublic schools. Our charter schools, our early community-based, early education centers. They're getting all of the guidance that we're providing to the Department of Education. They're getting the same guidance. We have liaison is working with them. We are also providing cleaning supplies to all of those organizations and networks as well. And we are just considering them all part of the children of New York City. So we are working very closely with them.

Question: Yes. Two questions. First is do the two cases today, are those New York City residents or are they being treated in New York City?

Mayor: Residents.

Commissioner Barbot: Residents.

Mayor: Residents, and being treated in New York City. Oh, I’m sorry, go ahead.

Question: What is being done to address the homeless population who may not have as much access –

Mayor: [Inaudible] different times, so a lot of your colleagues have heard this. I'll reiterate again. We have an extensive outreach initiative, which has nothing to do with coronavirus. It's been going on for three years. But the positive outcome of that is that the vast majority of our street homeless folks, we have very specific information on our outreach workers, know them pretty personally know if there's particular challenges that might be pertinent here, are talking to them as the maximum stand possible regularly. If anyone has symptoms, we're going to make healthcare available. If they have symptoms that indicate an immediate danger and they're not acting on it themselves, we have the power to have them come involuntarily and get treatment.

Question: Thanks. Will the police be bringing in the homeless population –

Mayor: If necessary, yes, but what I don't think we have a single instance of that yet, but we have that power and ready to use it.

Question: As far as the Madison students or any others who have been on school trips, have they been asked to quarantine? Are they doing that?

Mayor: The Madison students right now are asymptomatic. The staff is asymptomatic and they're almost at the end of the 14 days as well. So I think we have a little unusual situation there where the information flowed when it did. But I'll check with our doctors here. I think at this point it wouldn't be a time to start a quarantine unless we saw something problematic.

Commissioner Barbot: That’s correct.

Deputy Commissioner Daskalakis: Correct.

Commissioner Barbot: No need for it.

Mayor: Yes.

Question: In terms of the city's messaging for people who do develop symptoms, I know you've been saying people should go to their doctors, but a lot of doctor's offices are saying that they don't – they're not equipped to handle coronavirus and they should go to the ER, but then ERs are saying that people should not go unless they need urgent care, so what can you clarify –

Mayor: So, I think we have a little unusual situation there where the information flowed when it did. But I'll check with our doctors here, I think at this point it wouldn't be a time to start a quarantine unless we saw something problematic.

Deputy Commissioner Daskalakis: Correct.

Commissioner Barbot: That’s correct. No need for it.

Question: In terms of the City's messaging for people who do develop symptoms, I know you've been saying people should go to their doctors, but a lot of doctor's offices are saying that they don't – they're not equipped to handle coronavirus and they should go to the ER, but then ERs are saying that people should not go unless they need urgent care. So, what –

Mayor: I want to pause you for a moment, respectfully. I don't know who these people are who are saying what and I don't know how widespread it is. Our message is abundantly clear – get to health care. If you call your doctor and your doctor says, I can't see you, which I would question that doctor's approach to begin with, but then, yeah, you go to Urgent Care, you go to go to a Health and Hospitals clinic or hospital. Go to health care wherever it is readily available. If you can't find it, call 3-1-1, which we've said incessantly, we'll tell you where to go. So, your default is, come to one of our facilities immediately.

Question: Regarding – I just want to clarify, you were saying that you can test 1,000 people. Does this mean, heaven forbid, we get to a point where there are a 1,000 [inaudible] who need testing, at that point there's no longer the availability to do testing. And related to that, federal funding – Mr. Mayor, you were talking about the need for the federal government and step in to ensure we've got enough funding for tests. Can you maybe tie –

Mayor: Funding – I actually feel better about the funding than I do about the testing. The, you know, Congress is acting, which is great and I really want to commend Senator Schumer who immediately noted how extensive this crisis was and raised the bar on the federal funding request. The President said days ago in his remarks that there would be reimbursement to localities. So, that part actually has been much more coherent than in some other situations. The test capacity, right now, we need to get to the point where we can do hundreds a day, every day, maybe even more at some point, and we're not there yet. We are not – now, you've seen the numbers develop. I mean, right now, you know, with four positive and 26 negative from the beginning of this crisis, we're still in a – we want to stay there – we're in a very, very minimal dynamic at this moment, but we know it could move very quickly. We've seen that – not anywhere, we've seen that in advanced industrialized nations like Italy and South Korea where the numbers jumped in a matter of days. So, we've got to get to more testing capacity. We can't do that alone. We need the federal government.

Commissioner Barbot: What I would add is that we're also partnering with our academic and commercial labs and our understanding is that we will have some commercial lab capacity starting next week. And so that'll help a lot.

Question: [Inaudible] about mandatory isolation. I assume this is just – maybe, I shouldn't assume, but I assume it's just a term. It's not like you're – has anyone refuse to be isolated?

Commissioner Barbot: So, it depends on the individuals that we're talking about. You know, Dr. Daskalakis referred to how we monitor individuals that are on mandatory home isolation where we do random checks to make sure that they're being compliant and that the level of monitoring that we do really has to do with level of risk. And so, there are, for example, individuals who may be returning from one of the affected countries where they are perfectly asymptomatic. We are asking them to be on home isolation. That doesn't mean they can't go out if they are asymptomatic. It does mean that we want them to minimize outdoor exposure. And the minute they have any kind of symptoms, cough, no matter how mild it is, a temperature, or feeling unwell, we want them to call us or their provider to get them to treatment as early as possible and get them tested. I mean, one of the things that Mayor has been really clear about is we want to make sure that New Yorkers who need a task get tested as soon as possible.

Mayor: But I think, just following through the question, I don't think we have an instance of someone refusing mandatory or voluntary. I think that – because remember, before it ever became an issue for New York City, there have been weeks of people being pretty damn scared by what they were seeing, particularly in China. My sense here is we have a high level of adherence, a high level of interest in following the rules right now.

Go ahead.

Question: Is the city helping out folks financially who are on this mandatory 14 day – or, recommended 14-day isolation?

Mayor: That's not part of what we do to the best of my knowledge.

Commissioner Barbot: So, we are working with our sister agencies to make sure that we put in place what we call wraparound services, which include, you know, if someone is having mental health issues, if someone is have having housing issues, we have measures in place in case someone does end up needing financial support. Honestly, we haven't come to that situation yet.

Question: What kind of financial support do you think agencies might be able to provide?

Commissioner Barbot: So we are working for example, with our Department of Social Services to determine like for example, we've already helped people enroll in insurance, right? So that's one way to help them financially. And our DSS partners are also working with us to figure out all the different ways that New Yorkers might need help.

Mayor: Right, but not income replacement if that's an issue. I just want to be really clear because I think sometimes I understand the questions, but there's the assumption that the City government does what the State government does, federal government does, charitable organizations, et cetera, et cetera, all wrapped in one. There are limits.

Question: [Inaudible].

Mayor: No, I know. What I'm saying – I think a lot of times just over many, many situations, there's sometimes a little bit of drift of what the City can and should do. Absolutely we are going to help people. Absolutely we're going to look for every service that we can provide, some of which has financial ramification. Income is their own reality. Hopefully employers are going to be sensitive.

Question: It’s been said that dogs and cats, your pets cannot catch this virus. Can they carry and other animals like mice, rats and pigeons, can they carry this and give it to humans?

Commissioner Barbot: I'm going to defer to Dr. Daskalakis on that one.

Deputy Commissioner Daskalakis: We think that – we know that pets are fine. There are mixed data.

Mayor: Did you say fine? I couldn’t hear you.

Deputy Commissioner Daskalakis: They're fine. They are safe. So I think there's always data about shedding and identifying viruses. But so far nothing convincing that would make us concerned about our furry friends, so I think our cats and dogs are fine.

Mayor: Finish up on this side and I'll go back over to that side. Go ahead.

Question: Sorry, just to be clear about the students who traveled to Italy, not just the Madison students, but any students who've come back in the last 14 days. No one is showing symptoms –

Mayor: There’s 1.1 million public school students. We don't have a single one we know of anywhere. Any kind of student who is showing a symptom.

Question: [Inaudible]

Mayor: No, I just want to make sure you're hearing this first point. Anybody, if we get any more information about nexus, we want to know it and act on it immediately. But just wanted you to hear the overall point. Did you get – what was, did you have another question?

Question: I just want to make sure no students have been asked to quarantine.

Mayor: No, go ahead.

Question: Okay. So I just talked to many small business owners in Chinatown [inaudible]. They are very thankful for the Mayor and Corey Johnson comimg to Chinatown to have dinner to promote business. But what else? The City or the City Council can do, like financial aid or you know, give them some – the sales, to reduce the sales credit or something sales taxes reduced maybe? Any possible way to help?

Mayor: I think there's clearly we're very concerned about these small businesses and we're concerned about small businesses beyond that are starting to feel the effect around the city. We don't have an easy answer right now. I want to keep encouraging people to go out and live their lives and patronize those businesses. But we're certainly going to look at anything that we can do that would be helpful.

Question: [Inaudible] I am sorry if I'm making you repeat yourself. I know at the beginning you said that the numbers looked really good. I mean, pretty good.

Mayor: Wait, because I want to make sure we are speaking the same language? Do you mean the overall testing numbers?

Question: Correct.

Mayor: Yes.

Question: Can you just, I just wanted you to put those in a little more context of how slowly this is spreading or if we should still expect to see some, some exponential –

Mayor: I think until 48 hours ago, if you just were gone by the numbers you would feel very, very good. I think the last 48 hours are sobering. You know, community spread is an entirely different ballgame and I don't want people to assume, I don't want people to overreact because this is going to be a day to day, hour to hour thing, which is why we're trying to constantly update you when we have information. Community spread is different. It makes it a lot harder for us to control the situation. That said, even though we now know it exists in New York City as a phenomenon, it is still striking that, you know, of a city of 8.6 million people in a crisis that’s been going on for six weeks or more. You know, four people who are positive and 26 who are negative. And we do have a handful of pending tests as well. But you know, that's striking in comparison to what you've seen some other places and I do think it is because people are heading the guidance, they're getting to care. We have obviously the most extensive health care apparatus anywhere on Earth. That's all helping us. But we're all very sober right now about what tomorrow could bring or the day after that.

Commissioner Barbot: I don't think any of us would be surprised to have more individuals identified who show no nexus to travel to the affected areas. And that's why it's really important for New Yorkers to take measures now that we hope they've been taking to heart. And those are very simple. It's washing your hands frequently, covering your mouth and your nose when you cough or you sneeze. And you know, I don't think I've made, I've sort of gone deep enough into why that's so important. Right? And the reason why we want people to wash their hands frequently because that's the way in which the virus can be introduced into your mouth, to your eyes. And those are the areas that are the easiest entry points for the virus. And so to the degree that New Yorkers, as I've said earlier, make alcohol based hand sanitizers. They're best friends if they don't have easy access to, you know, water sources. That's how they're going to keep themselves, their kids, their families and their communities, the safest. But again, we are in a situation where we are doing everything we can as the Mayor said to contain. However, we would not be surprised to see other cases of community transmission.

Mayor: Just to note what, we'll take some more, but I know the Speaker has a hearing starting at 3:30 and everyone here has to be a part of it, myself excluded. So, or almost everyone I think. So we're going to take some more but we need to wrap relatively soon. So it will be the last one on this side. Then we're going over all the way to the left and we'll take questions over there.

Question: I just want to clarify, the folks who are urging to self-isolate who had been to those five countries, is that you're asking, or you're telling them?

Mayor: Which category are you talking about here?

Question: Folks who have been to those five countries?

Mayor:  Not the city employees? Overall?

Question: Overall, you're saying you're urging them or you're saying half to self-isolate and we're going to track if you do.

Commissioner Barbot: We are urging them to self-isolate.

Question: I know you said for now Mr. Mayor, people are doing the strict adherence to the rules, but I think we all know that there are folks who don't follow the rules. So what are the consequences if you're supposed to quarantine and you don't, are there fines? Will the police get involved? What are the consequences here?

Mayor: So let's just go over the basic protocols that exist in a case like this. And obviously again, I think a good way to think of this is we are climbing a ladder right now where we do see very good results on a voluntary level and we do see good overall dynamics in the city. But we, you know, this is indicative, so you saw communities spread in the last 24 hours or so. You now see a Commissioner's order. I'm indicating there could be a lot more coming behind this. We're going to get more and more mandatory as needed. But today, let's clarify where we are. And then clarify the kind of history that is existed around previous quarantines.

Commissioner Barbot: So as we've said earlier, there hasn't been anyone on mandatory quarantine that has tried to, the term of art is elope. And you know, I think it's important to note. I think it's important to note that as the Department of Health, we have taken every measure possible to make it as easy as possible for these individuals to remain in quarantine. Above and beyond that, because we communicate with them on a regular basis, on a daily basis for those that are in mandatory quarantine, we develop a relationship with these individuals. And so it hasn't come to that, but if we were in a different scenario, you know, the powers that we have could include you know, the police powers that we have. No one wants it to come to that. And so that's why we take the investment and the time to put in those supportive services.

Mayor: Yes, Ashley?

Question: Two questions, first with the two people who – two current patients, most recent patients, a 40-something-year-old man and 80-something-year-old woman, I think to some people it might be pretty worrisome that you all haven't identified the source of their infection. I'm wondering if you all have any hypotheses that you are evaluating or any kind of reasonable suspects and that I'd like to ask the question after that.

Mayor: So I'm going to start as the layman here. I want to caution, your question's fair, but I think it's and I don't say this disrespectfully, I think it's two days late. I think community spread, if I'm understanding the doctors, you can't any longer find the specific origin. This is the whole reality. We started with a crisis where presumably the only way you could get this disease is someone came specifically from China. Then it turned into someone came from China, South Korea, Italy, et cetera. Now it's past all that. It's just out in our communities to some extent and we are not in the practice of being able to say, here's where you go back to the origin point. What we would do at a case like that with those two individuals we're doing right now is say, okay, who are the people that you had enough direct contact with? And that's the disease detective work, which we talked about a lot yesterday. You know, to reasonably have a possibility of having spread this. The object lesson is the Westchester family where the father manifested and therefore there was the mother and the two kids. That was a very, very obvious universe. The other obvious universe was the law firm. So what I think will happen from now on is not a search for the origin but a search person by person for their network that we then need to follow up on to make sure if they need testing they get testing.

Question: [Inaudible] you had to kind of look at that for the two of those individuals?

Mayor: No we said it’s, literally breaking them. It's, you know, this is only in the last hours. And so the disease detectives are working with them and their families right now or their families really because both of them are intensive care to map those contacts. And then just so I want to go back to the Yeshiva example cause it's the live other good example. The student from the Westchester family, undergrad at Yeshiva. The disease detectives identified who are those people we need to follow up on. Two people, in fact, roommate, best friend got to them. They've gotten tested, they came back negative, repeat, repeat, repeat with every new case, that's what we're doing now.

Question: On to that second question. What's your advice to people who can't afford to take the time off? Either their employees won't allow them, they can't afford to lose the days at work. What's your advice to them?

Mayor: Look, if anyone is sensitive to how much people struggle to make a living and how even a loss of a day's pay can be very, very problematic. But this is beyond anything we normally deal with. The last time, remember there was a pandemic of this nature it was 11 years ago. This one is still, you know, this disease is still not fully understood. That is a fact. No cure, no vaccine. We cannot play around. So even if it means economic suffering, people cannot take a chance with this disease. If you're told to stay home you just have to stay home for yourself and for your family. For the good of everybody.

Question: I just wanted to confirm that the total universe of staffers at the school who have self-isolated or self-quarantined is the three teachers of whom traveled to Italy?

Mayor: Yes.

Question: I have two questions. This first one is in terms of the lawyer, I know it was said to you that he had gone to Israel a few days prior. Does that mean there’s a nexus there? Is there a search for a nexus there?

Mayor: We don’t think so. I'll start and you guys will jump in. We don't think it’s based on Israel. We think it's based on community, which is the first instance of community spread.

Commissioner Barbot: Right. His travel to Israel was in January, which is way beyond the incubation period.

Question: And the other question I had was about the disease detectives. You guys could go into a little bit of detail as to what that doorknob looks like? You know, are they checking temperature for instance. How long is their interaction with them? Whether it's –

Mayor: I'm sorry to interrupt. This is someone, they're talking to someone who we already have a concern about and they're talking about them to figure out who are the other people in their world that we next need to get to?

Deputy Commissioner Daskalakis: So they are called disease detectives because it's what, it's exactly what they do. It's they investigate, they will interview either the primary individual who has a disease to identify what their, what their motion is. They will also talk if they cannot speak to that primary person, to family and friends who are identified. They look at institutions where the individual has been and don't just say where have they been, but track them. So for instance, for school, they'll look at what a class schedules are and also see if we can identify seating scenarios depending on who was around, if they were on a and others sort of meetings again, they do the same things. So it's really, it's very intensive. And also always evolving. So, you know, we'll, I think the Mayor described it exactly, that you identify one person, you tell their friends, their friends tell their friends and you get more and more sort of information about the circle of folks that you need to be concerned about or potentially not concerned about depending on exposure.

Question: And how about the folks that have already had a positive coronavirus [inaudible] the days when a detective goes to their house. What's the protocol there?

Deputy Commissioner Daskalakis: It's actually more than just spot visits. So for the individuals who are admitted to the hospital, the answer is very straight forward. They're continuously monitored. So that's very straightforward. It's the individuals who are on home isolation. We do spot checks to make sure they're complying to their mandatory quarantine. But additionally we reach out to them daily to make sure that they're feeling well and that their needs are addressed. And so we really are in effect case managing them from a distance and then also spot checking them to make sure that they're compliant.

Question: And how have they progressed to today? Like has – I know you said that they're checking in daily, so are they better or from the first case – are they better today as –

Mayor: So again, reminding you – and again, I'll make sure I'm articulating a lot, but I want everyone also listen carefully because the lawyer we said yesterday, the lawyer is already getting better. Thank God. Not entirely out of the woods, but getting better. The Yeshiva student better.

Deputy Commissioner Daskalakis: Correct.

Mayor: Right. The health worker who was in Iran better.

Deputy Commissioner Daskalakis: Correct.

Mayor: So, you know, again, this is this, as we're learning this disease that there is, you know, some, it's not just a one way street, right? We are seeing people come through it and get better and we're done with and we're moving on to other people now. We've got two folks in particular now though, we're worried about. The two new ones today, but the previous two actually are doing very well right now.

Question: [Inaudible]

Mayor: I’ll just let that one in because I think it’s important. Doctors, what does better mean?

Deputy Commissioner Daskalakis: So, for the two individuals in home isolation, there’s not a lot of difference between sick and better at the moment –

Mayor: Just clarify – you mean husband and wife who came back from Iran.

Deputy Commissioner Daskalakis: Husband and wife – correct.

Mayor: One is, again – careful, one is a positive, one is a negative we’re treating as a positive.

Deputy Commissioner Daskalakis: That is correct.

Mayor: So their status right now – their health?

Deputy Commissioner Daskalakis: For a lack of a better word, they’re doing fabulously well.

Mayor: Okay. The lawyer, what exactly can you tell us?

Deputy Commissioner Daskalakis: We can tell you that he is still in the intensive care unit, but that he’s stable, doing better.

Mayor: Let me go to the last two. Rich and then Erin – go ahead.

Question: So, the two teachers that came back from vacation from Italy are now being tested, they went into school one day, they didn’t feel well –

Mayor: We’re going to confirm if it was one day or more, but it was a limited period of time for sure. They had been out of school for a period of time and we’re going to get you – so, I want to do – on them – is wrap it all in a bow, get the test results, get the school, all the facts, but I’m going to give you that. We also, as I said, we have some notifications to do. We’ll get that to you either later on today or tomorrow.

Go ahead –

Question: [Inaudible] can you clarify, does the paid sick law apply if you are recommended isolation, if you’re not just sick?

Mayor: Certainly, it would count under the five days, for sure. Right? I mean, that’s a no-brainer.

Question: And as far as the guidance to travelers, that’s a new guidance today that everyone coming from those countries [inaudible] and could you just list the countries again [inaudible] –

Mayor: Sure, absolutely. We track the CDC on China, Iran, Italy, South Korea. We disagree with the CDC on Japan. It is on our list, we think Japan should be treated the same as the other four. We think they should put it on their list too.

Okay. And we will see you again soon.

Question: [Inaudible]

Mayor: Again, nexus to New York, but we are waiting to get more details on what that means. We will have that to you as soon as we have it.

Thank you. Thanks, everyone.