Audio & Rush Transcript: Governor Cuomo is a Guest on MSNBC's The Rachel Maddow Show

Earlier today, Governor Andrew M. Cuomo was a guest on MSNBC's the Rachel Maddow Show to discuss New York's ongoing effort to combat the COVID-19 pandemic.

AUDIO is available here.

A rush transcript of the Governor's interview is available below:

Rachel Maddow: Governor, thank you so much for making time to be here tonight. I really appreciate it.

Governor Cuomo: Thank you. Thank you, Rachel.

Rachel Maddow: First of all, if you don't mind me asking, I do wonder how you are, and how you are holding up, weeks into this crisis now. I have on this show sort of called you the president of the coronavirus response because of the national leadership that you've shown and the national attention to what you are contending with in New York. I just wonder how this is wearing on you after these few weeks.

Governor Cuomo: Well, first, thank you for having me on, and more importantly, on behalf of all Americans, thank you for your coverage. It has really been extraordinary. You know, it's hard. It is really hard. I take my responsibilities seriously. I don't make excuses. When you have 2,300 people who die, and you see it every day and it's only getting worse, that's tough, Rachel, just to deal with, day in and day out. Obviously on an organizational basis, it's hectic. It's 24 hours a day, seven days a week but I've been through that before. It's the death, it's the human suffering, it's the fear, it's the anxiety, that weighs on you. More than the physical fatigue it's the emotional fatigue.

Rachel Maddow: I showed the daily number of how hospitalizations have increased day by day in New York City. We've also seen similar rises in New York State. You've talked very publicly about trying to understand what the models are creating in terms of an imperative for New York, the need to simultaneously hospitalize somewhere on the order of 110,000, 140,000 at the same time in New York at peak. I know you're adding bed capacity everywhere you can, but do you have a clear expectation when every bed will be full and there won't be room to take more patients? Are you sure New York will hit that point and do you know when it might be?

Governor Cuomo: Well, that's the $64,000 question, Rachel. We only know what the projection models say. And by the way, the projection models say different things. For example, when do you hit the top of the curve? Some models say seven days from now. Some models say 21 days from now. So there is a variable about how effective they believe social distancing is. The number of total beds that we would need ranges 60,000 to 110,000, so the range in these models is maddening, frankly, because if you're trying to plan for it it's very hard. But whatever model you pick it eclipses everything we have. We have a 50,000-bed system. We have 36,000 beds in downstate New York where this will hit. It's beds. It's staff. It's equipment. And the easiest thing to do is get the beds frankly. It's going to be about the staff and the equipment and it may even be about the equipment more than the staff, right? You need all three for the system to work and the first one that crumbles, the system crumbles.

Rachel Maddow: Governor, you talk about the anxiety and the fear and the grind of the logistical work that you're doing. I have a base fear when I think about there being severely ill Americans, even by the tens, let alone by the hundreds of the thousands, who need to be hospitalized, who need to be hospital, and need intensive care in order to stay alive, not being able to go anywhere to get that care. I know that we talk about these number and these models and I know lots of states right now are looking at those curves and looking at those projections and seeing how many more beds they are going to need, and how many more ICU beds they are going to need, but I don't know how to prepare people for what it might mean when the hospitals are full and what that is going to do in terms of us as a culture and a society, seeing that kind of level of human suffering.

Governor Cuomo: Rachel, God forbid we get there. God forbid this country gets to a point where you see people literally on gurneys in hallways. For this state I am not going to accept that. We are doing everything we can to mobilize. We're trying everything. For us it is going to come down to not the beds; it is going to be staff fatigue and it is ventilators. You know, most of, almost all of these people now at this point are almost all ICU cases. They all need ventilators and the ventilator becomes a question of life and death and we've been talking about these ventilators for a long period of time. And they're impossible to get, any ventilators. So we've come up with an elaborate plan on how to move around ventilators and splitting ventilators and using anesthesia machines and BiPAP machines. We stopped all elective surgery to free up ventilators. First we have to avoid it. Second we have to be smarter. The one silver lining here is not every place in this country gets hit at the same time. There's going to be a different curve for the disease in different areas depending on when it started. Those curves will have a lag. The problem for every area is the apex of the curve where it just overwhelms the health care system.

New York is going to have one apex. Detroit will have another. New Orleans will have another. Texas will have another. Los Angeles will have another. Why don't we devise a national strategy that moves with that rolling apex, if youwill. I need roughly 30,000 ventilators, which I can't get, but I only need 30,000 ventilators for two or three weeks at the top of my curve. I need backup public health professionals. But I only need them for two or three weeks at the top of my curve. I need backup public health professionals, but I only need them for 2 or 3 weeks at the top of my curve. Why don't we use our national unity and our commonality and say, let's be smart, let's go help this place, when that town goes over its curve, then we'll go to the next, and then we will go to the next, and then we'll go to the next. I think Americans have a lot more commonality and volunteerism than we're using. I asked for national public health people to come into New York. We had over 20,000 volunteers in three days. Twenty thousand. I have 60,000 volunteers in the state. There is more goodwill and American spirit than we are using and I think there's a smarter deployment.

Rachel Maddow: You have been making that case for the federal deployment of resources for the sort of mutually-supportive deployment of resources to the places that most need them, understanding that not everybody is going to hit their apex at the same time. Has that resonated at all with the federal government? I know that you've got a mixed relationship with the Trump administration right now, and they have been able to talk to you about some things and you have been critical of them on others. Has that point that you've been making come home to them at all? I don't see any way that other states or any other cities, that are approaching what New York is in right now, I don't see any other way that they are going to be able to deal with the rolling apexes that you're describing.

Governor Cuomo: You're right. First, to say that I have a mixed relationship with the President is very kind. There is probably no Governor in the country that has been more critical, and probably no Governor in the country that he has been more aggressive towards with his tweets. But on this one, the President and I have said look, this is not about politics. If you help New York State, I will be gracious and say thank you and be in partnership. And if you don't help New York State, I will say that the states can't organize this rolling deployment on their own. It would have to be federally organized. I don't see how you do it otherwise.

Otherwise you're saying to every state, every locality, you must be prepared on your own to handle this. The federal government will give you some back support, but it's up to you. It's not going to work that way, or it could work better the other way. Let's say it that way, Rachel. Which is let the federal government say, look, this is like a slow-moving hurricane across the country, and we know the track that it's going to take. Let's go to New York, board it up, do what we have to do. We all go to New York, and then we all go to Detroit, and then we all go to the next place. I think that's the only way you do it.

Where we are now, 50 states all trying to buy the same equipment, from China, and then the federal government comes in with FEMA, which is trying to purchase the same equipment. This is not the way to do it. I mean obviously, if you could design a system, nobody would design a system where you say to the states, "Okay, you're on your own. You go buy equipment, all shopping the same manufacturers in China." Emergency management rule 101 is leave it to the local governments, right? Local government knows best. That is emergency management rule 101. I was in the Clinton administration, as the HUD Secretary, as you know, and I did emergency management work for eight years. Rule one is leave it to the localities. Rule two is, if the localities can't handle it, then the federal government steps in. Remember what happened with President Bush with Hurricane Katrina. He blamed the Mayor. Why? Because that was rule one. The Mayor didn't know how to handle it and it's the Mayor's fault. Yeah, but it was rule two, which is if it's beyond the capacity of the local government, then the federal government should step in. No state is equipped to handle this situation. State emergency management does hurricanes, floods of moderate dimension, if they are really big, the federal government comes in; that's what FEMA is all about. States don't do public health emergencies. There is no capacity in my state health system that runs 50,000 beds to create and maintain an additional 50,000 beds, just in case once every 20 years, there is a pandemic. You know, it doesn't work that way. But that's where we are now. Hindsight is 20/20. But the states are responsible for their own purchasing, and frankly, there's nothing left to buy anymore anyway. I bought 17,000 ventilators, ordered 17,000 ventilators from China, but I think what's happening is when somebody else outbids you, your order just is gone. I haven't even received 1,000. So that horse is out of the barn. The deployment we could still do, and I think Americans would support that.

Rachel Maddow: In terms of the way it has worked thus far with the federal government, one of the things that we've covered here on the show is the federal government, the Army Corps coming in and helping build out, for example, the Javits Center in New York. Lots of cities are setting up their convention centers as hospitals to house coronavirus patients and you were the first out of the gate with that with this Javits Center buildout in Manhattan. We also saw the navy hospital ship, the Comfort arrive in New York harbor, but there has been some intriguing twists around both of them. The New York Times reporting tonight that the Comfort has a grand total of three patients on board. The Comfort of course has been set up to not take coronavirus patients, until today, the Javits Center was not planning on taking any coronavirus patients either but your office released a statement tonight saying that now that has changed. It seems odd for those things to be changing course now. It seems weird for the hospital ship to essentially be disused in the harbor when New York hospitals are full up. What can you tell us about those federally supported facilities right now?

Governor Cuomo: In fairness, Rachel, the plan was both the U.S. Navy ship Comfort, and the Javits Center emergency medical facility were supposed to be for non-COVID-19 people. The plan was they would be a relief valve for the local hospitals to take the non-COVID patients, and then more COVIDpatients could go into the hospitals. What has happened is the COVIDpatients have overwhelmed the hospitals. Hospitals have now just basically turned into ICU units with COVID patients and because everything is closed down, there are fewer normal trauma cases, and since I stopped all of the elective surgery, you don't have those patients. So the offloading of non-COVID patients really doesn't exist. The Javits Center is at 2,500 beds. We are at desperate search for beds with staff. Javits has beds but more importantly federal staff, and federal equipment. And I called the President this morning, and I explained the situation to him, and to his credit, to his credit, Rachel, in one day he turned around, and he called me this afternoon and said we're going to use Javits for COVID patients, which is a big deal. It's25 additional, 2,500 additional beds. The military apparently doesn't want to use the ship for non-COVID-19, because of a protocol on how they would then disinfect the ship which I don't really understand, frankly. But the ship was never supposed to be for COVID patients. The original understanding was non-COVID-patients.

Rachel Maddow: There is this alarming report today from the entity that manages New York City hospitals, that, if you're in cardiac arrest somewhere in New York City, and EMTs show up and they can't revive you on-site, there is now a change in protocol, where they are not taking you to a hospital to try to revive you there because the hospitals are so overwhelmed. It does seem like having that hospital ship in New York harbor with no coronavirus patients on it, with, as far as we can tell, hundreds of empty beds, and staff there, to deal with it, they could be taking the few trauma patients, the few heart attack patients, the other people who now can't get into the New York city hospitals.

Governor Cuomo: Well, theoretically, they can. This is all new. You have protocols that aren't really established, that have to be set up. Theoretically, the U.S. Navy ship comfort could take a non-COVID trauma case. So I don't know how that protocol works on that. But look, this is, we're all doing the best we can, trying to put together a system, that can handle over 150, 200% of what the system is designed to do. And the federal facilities are an advantage. For us, what it is going to come down to is the staff burnout, staff getting sick, we have 80,000 volunteers, can we get them oriented to the right hospitals and in the right places. And then the equipment, and these ventilators that I never heard of before, now become the most precious piece of equipment, and the difference between life and death. You literally can't acquire them. And we're looking at right now, we have about enough ventilators for six days at our current burn rate, right, of how many we use, how many additional ventilators we use every day. We get past that point, if we're not yet at the apex, we're going to be in a bad place. We have a backup plan to come up, and with additional ventilators, by basically McGyvering the ventilators, but this is truly frightening. I've handled a lot of emergencies, a lot of disasters, as Governor and in the federal government, but this by far and away, nothing comes close to this, in terms of the need for intelligent, rigorous, muscled government to respond quickly and smartly. It all comes down to whether your health care system can handle it. There is no concept here. There is no philosophy. It's can you handle the number of people walking in the door. That's all this is. And if you can't, people die. That's what this is.

And the simplicity is what makes it so tragic, frankly. Because we don't have a piece of equipment, someone is going to die? Because we don't have staff, someone is going to die? How did we get to this place? In this country? That we have to buy all of our supplies from China? I can't get protective equipment because China is making it? China is making the ventilators? We couldn't figure out how to make protective equipment quickly enough? We couldn't figure out how to make ventilators? We can't figure out this rolling deployment? Which makes all the sense in the world and it frankly is simpler for every locality. I said we have all of 20,000 volunteers coming across the country, I said we will return the favor. When we get past our apex, I will pack up every ventilator, I will bring our entire health team and I will go to any community across the country. I will drive personally, and provide them the assistance and thank for them for what they did for New York. That's what we do. There is something called mutual aid in emergencies, in a flood or in a power utility, where utility companies flex. If you remember, you will see on the road, large utility trucks, whenever there is a national emergency, Arizona trucks driving to New York City, New York City trucks driving to Florida. That's how we react to those emergencies. We, mutual aid, you flex, with the need. That we could be doing here. And the consequences are going to be devastating. And what keeps me up at night, is not just the numbers, but a deep sense that it didn't have to be. It didn't have to be.

Rachel Maddow: Governor Andrew Cuomo of New York. I know you have to go, sir, I will just say one last thing before I go, is please give your brother my love and the love of all of us at the Rachel Maddow show, we are not as much rivals as we think of ourselves as colleagues and we are really all hoping the best for him.

Governor Cuomo: He has tremendous respect for you, as do I.

Rachel Maddow: Thank you.