April 21, 2020
Albany, NY

Video, Audio, Photos & Rush Transcript: Amid Ongoing COVID-19 Pandemic, Governor Cuomo Announces Elective Outpatient Treatment Can Resume in Counties and Hospitals Without Significant Risk of COVID-19 Surge Starting next Week

Announces State Will Take a Regional Approach to Reopening

Governor Will Meet With President Trump at the White House Today to Discuss Testing

Confirms 4,178 Additional Coronavirus Cases in New York State - Bringing Statewide Total to 251,690; New Cases in 41 Counties

Governor Cuomo: "When I say we have to move to help Western New York, yeah, there will be some places in the state where you hear a voice that says, 'No, no, no, we have to worry about ourselves. We have to take care of us and they're on their own the way we're on our own.' Not in New York. That's not how we operate. Nobody is on their own. We are one state, we are one family, we are one community, and we're there to help one another. So whatever Erie County needs, whatever Western New York needs, you have my word that the rest of the state will be responsive."

Cuomo: "New York, we make ourselves. This nation, we make ourselves -- World War I, World War II, the Great Depression -- some of the most tragic situations actually forged the character and the resolve of this nation. New York State is the same thing and we have to be smart enough to do the same thing here. And we will because we're New York tough."

Earlier today, Governor Andrew M. Cuomo announced elective outpatient treatments can resume in counties and hospitals without significant risk of COVID-19 surge in the near term. Hospitals will be able to resume performing elective outpatient treatments on April 28, 2020 if the hospital capacity is over 25 percent for the county and if there have been fewer than 10 new hospitalizations of COVID-19 patients in the county over the past 10 days. If a hospital is located in a county eligible to resume elective outpatient treatments, but that hospital has a capacity under 25 percent or has had more than 10 new hospitalizations in the past 10 days, that hospital is not eligible to resume elective surgeries. If a county or hospital that has resumed elective surgery experiences a decrease in hospital capacity below the 25 percent threshold or an increase of 10 or more new hospitalizations of COVID-19 patients, elective surgeries must cease. Further, patients must test negative for COVID-19 prior to any elective outpatient treatment. The State Department of Health will issue guidance on resuming elective surgeries.

Restrictions on elective surgery will remain in place in Bronx, Queens, Rockland, Nassau, Clinton, Yates, Westchester, Albany, Richmond, Schuyler, Kings, Suffolk, New York, Dutchess, Sullivan, Ulster, Erie, Orange and Rensselaer Counties as the state continues to monitor the rate of new COVID-19 infections in the region.

Governor Cuomo also announced the state will take a regional approach to reopening and will make decisions on which counties and regions to open and when to open them based on the facts and data specific to that area. Lieutenant Governor Kathy Hochul will coordinate Western New York's public health and reopening strategy, and former Lieutenant Governor Robert Duffy will volunteer as a special advisor to coordinate the Finger Lakes' public health and reopening strategy.

The Governor also announced he will be meeting with President Trump at the White House today to discuss testing.

VIDEO of the Governor's remarks is available on YouTube here and in TV quality (h.264, mp4) format here, with ASL interpretation available on YouTube here and in TV quality format here.

AUDIO of today's remarks is available here.

PHOTOS are available on the Governor's Flickr page.

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

Good morning everyone. Good to see you, good to be with you. Let me introduce the people who are with us today. From my right, Gareth Rhodes, who works with me in state government and who has been involved in this special effort from day one. From my immediate right, Dr. Jim Malatras, technically a doctor, not like a medical doctor, but still a doctor. To my left, Lieutenant Governor Kathy Hochul, my partner in state government, who has been a true treasure to the people of the State of New York. And to Kathy Hochul's left, Dr. Candace Johnson from Roswell Park Cancer Institute, which is where we are today in Buffalo. Roswell Park is one of the leading cancer institutes in the United States and a real jewel for the State of New York, and I thank her very much for their hospitality today.

Let me give you some of the facts today. One of the points we want to make today is, we're in Western New York, Buffalo. We've been talking a lot about New York City and the situation in New York City and Long Island and Westchester, and Rockland, the suburbs of New York City. But, just as we're seeing across the country, this virus presents a slightly different problem in different parts of the country. It also presents a different problem in different parts of the state. Overall, the total hospitalizations are basically flat from where they were yesterday. And as you see, the overall curve is on the way down, and that is good news certainly. The net change in hospitalizations is down. Not down as much as we would like. Change in intubations is down, and that's always good news because intubations means a person is on a ventilator. 80 percent of the time when people are on a ventilator, they don't come off the ventilator in a successful way.

The number of new people in the state who walked in the door yesterday or were diagnosed with COVID is 1,300. That is down and that's good news, relative to really bad news which is what was happening up until then, right. We have to remember our calculus of good, our definition of good has changed here. Good is now not terrible. But on an absolute scale, 1,300 people walk in the door with COVID on a single day in the State of New York, that would not be good news in any other context besides the context we're living in.

This is Erie County. Buffalo is in Erie County, New York. And you see the numbers, we had a dramatic increase in Erie County. And then basically a leveling, flat little uptick yesterday. Number of total hospitalizations in Erie, three-day average, again, basically flat. These numbers, we're not taking any of these one-day numbers, even three-day numbers, as absolute. This is a new reporting mechanism that just was put in place. So from a statistical point of view, I don't know exactly what the margin of error is, with all due respect to the great statisticians doing this. We've been watching the spread all across the state because this is like stamping out a brush fire. You need to run to where the fire is and put it out there. So we were watching for a spread of the fire from downstate New York towards upstate. Whenever we see a small fire starting, we jump on it right away. Testing, isolation, et cetera. But that's remained fairly constant, and that's also good news.

But the point that different regions of the country have different, quote unquote curves, the virus does not hit at the same time at the same rate. So you hear about different states in the country. And when they're going to hit their apex, when they're going to hit their top and when they're going to come down, it's different all across the country. It's also different across the state. We've been talking about states like they're uniform homogenous entities. Some are more homogenous than others. When I was in the federal government, I worked in every state. So you have a whole different variety of states. This state, we have very different regions within New York. When you say New York, people think New York City. Yeah, one of the densest places on the globe. You also have upstate New York where, in some counties, you have more cows than people. People don't think of New York that way. So, as you see variety across the country, we have variety across the state of New York. You have to watch each one of those individual curves and when does that region hit a high point and where is that? Because depending on that region's curve, is how you've got to calculate your strategy. You're looking at those curves - how long is the ascent up the mountain and then how long are we on that plateau and then how long is the descent from the plateau? Western New York, I believe we're on the plateau. Now the question is how long are we on that plateau and is it a plateau or might it still ascend? Downstate New York, it appears that we're on the descent. The question then becomes in downstate New York, how quickly do we descend?

The worst news and the ugliest part of my job these days is telling New Yorkers this news. In Erie County we lost 7 hospitals deaths yesterday for a total of 125. In the state, we lost 481 people. 452 in hospitals, 29 in nursing homes. Again, nursing homes are a central focus and priority for all of us going through that.

Where are we today? We're operating with two rules. First rule is do no harm. Second rule is start to plan the reopening. Planning the reopening is just that - plan the reopening. Understand it, calculate, calibrate it. Nobody's ever done it before. How do you do it? When do you do it? But first rule, do no harm. We paid a tremendous price to get where we are today and make the progress that we have made today. We've paid a tremendous price to control this beast. We closed down everything. People have worked tirelessly in the healthcare system and the first responders and the essential workers. You showed you can control the beast. Do no harm. Don't go backwards. That's the first point and then plan the reopening.

On the do no harm, you take a place like Erie County, any region in the country or in the state that is still on the ascent or on the plateau, beware of a hot spot. Beware of an increased need. In this state, what we've said is any need, anywhere in the state, the rest of the state will surge capacity and equipment and energy to help that part of the state. So, when downstate New York needed help, Upstate New York was there. If Upstate New York needs help or Western New York or Central New York or the North Country needs help, the rest of the state will be there. You have my word on that.

These crises, pressure brings out the best and the worst in people. I believe that, individually. You get to really see how a person responds at a time of crisis. You get a little snapshot of their character and of their foundation. It's also true of the collective, also true of society. And when I say we have to move to help Western New York, yeah, there will be some places in the state where you hear a voice that says, "No, no, no, we have to worry about ourselves. We have to take care of us and they're on their own the way we're on our own." Not in New York. That's not how we operate. Nobody is on their own. We are one state, we are one family, we are one community, and we're there to help one another. So whatever Erie County needs, whatever Western New York needs, you have my word that the rest of the state will be responsive.

Hopefully we're on this plateau, and on the other side of the plateau is a descent. So, we can manage it. But if it's not a descent and it's an ascent anywhere in the state, the rest of the state will be there, and part of it is, testing, testing, testing. I know it's a granular topic, but it's important. We're also going to have a regional calibration that we're going to make on hospitals. You have many hospitals that are very quiet. Some hospitals are actually laying off people, believe it or not, in the middle of this because they have no patients. We artificially stopped the number of patients going into a hospital because we ended what's called elective surgery, elective treatment. And therefore, people can't go into the hospital for an elective procedure. In those parts of the state and in those hospitals where the hospitals are laying off people because they're so quiet and they have that capacity and capacity for the virus is not an issue, we're going to allow elective outpatient treatment, which means the number of beds remain available because the number of people using those beds is still relatively minimal. And we're going to allow it in those hospitals and counties in the state that do not have a COVID issue or we couldn't need their beds in case of a surge. This will not include Westchester, Rockland, New York City hospitals, et cetera, because we have a real COVID problem there. It won't include Erie County, Albany County, or Dutchess and several other counties where we still need to protect those hospital beds in case we need them for COVID.

On testing, people need to understand this issue because it's going to be determinative and it's complicated and it's been somewhat politicized, and now you hear different arguments about testing. Here are the simple facts on testing. And again, testing is something that no one would have expected as an issue. Testing we do in this country and nobody really noticed, we have an old system. It's a private sector system. When you went to the hospital and the doctor said, "You have to have your child checked for this or you have to be checked for this." You go to a lab, you have your blood tested, that was the testing system. No one ever imagined that this testing system was going to become hyper relevant to survival and would need a capacity of 20, 30, 40, 50 times what the system was doing. So, this came out of the blue in many ways. It's one of the lessons we will learn, but for us it came out of the blue.

How does it work? You have national companies that are private manufacturers of laboratory equipment and their piece of equipment can operate their test kits, okay. There are a number of these private sector companies. They make a machine, they sell that machine to labs, a network of labs all across the nation. We have about 211 labs in New York State. They buy these machines from these national companies and they then have that machine. Sometimes they buy a number of machines from different manufacturers, and now they have a number of different machines. Some have higher output, some have lower output, but each one requires that you go back to that manufacturer to get a test kit and reagent that works for that manufacturer's machine, okay?

So, it gets very complicated quickly. There are different, what they call reagents, chemicals that you need for each manufacturer's test kit and each manufacturer's machine. The big labs will have bought a number of different machines from a number of different manufacturers, okay? So, these are some of the big manufacturers, not all of them. You hear about Abbott who has a new fast test. These companies are all working to come up with these tests now, who is faster, who is quicker, one-hour test, 20-minute test, 15-minute test, five-minute test. Every one of those manufacturers, you need to have their test kit and their reagents to operate on their machine. You have some labs that have five or six different manufacturers' machines. When you go to the manufacturers and you say, "I need you to increase capacity," many of the manufacturers are saying "I can't. I can't get enough reagents. I can't get enough swabs, these cotton swabs. I can't get enough vials. I just don't have enough material for my own test kits." That's the determiner of testing capacity, okay? And you're asking a system that -- let's say normally did 1,000 tests. You're asking a system that did 1,000 tests, by the way, I need 50,000 tests. So, they didn't anticipate this volume. Some of these manufacturers will say, "Look, I have a supply chain that is an international supply chain. I get my chemicals from china, I get my chemicals from here." So, that ability to ramp up is what we're all struggling with and every state is in charge of administering testing because the 200 labs in New York State are regulated by New York State.

I regulate the 200 labs. It's only appropriate that the state should be in charge of actual testing in the state. I agree with the federal government's position on that. I have 200 labs, I should come up with a system that says how many tests in Buffalo? How many tests in Albany? How many tests in Manhattan? How many tests in Long Island? That's my business. I should be held responsible. I should be held responsible for making sure those 200 labs actually deploy across the state in a smart way. Hold me responsible. Where it gets hard is when the labs that I regulate say the manufacturers are the problem. And then I call the manufacturers and the manufacturers say 'I can't do it because it's an international problem.' That's where we are now.

Last night I get home, I have my three daughters with me now, which is a joy 99.9 percent of the time. We're sitting there, we're watching the news. Governor Larry Hogan comes on the news. Great guy, Governor of Maryland, Republican Chairman of the NGA—National Governor's Association—I'm vice chairman, so I work with the governor. And Governor Hogan says 'I bought 500 test kits from South Korea.' And there's a picture of Governor Hogan at the airport, South Korea airliner, and Governor Hogan says 'I got 500 test kits from South Korea.' And my daughter turns to me and looks at me and says 'wow that was really smart.' And she just looks at me—doesn't say anything else, she didn't have to. Felt that immediate wave of guilt descend upon me. One of my other daughters, who's a little more pointed in life—a little more literal, said why didn't you think of that, Dad?

Why didn't you think of buying test kits from South Korea? So now I was really just feeling de minimis as a governor. Larry Hogan is a better governor. Why didn't I think of buying test kits from South Korea? Why didn't I think of buying test kits from Korea? From China? It's not what states normally are responsible for. God bless Larry Hogan. He, he really thought outside the box and was very creative, but that piece is where the federal government can help us. Take that national manufacturer and that supply chain for the national manufacturers and let the federal government figure out South Korea and China and international supply issues. Rather than have 50 states now figure out how to go be like Governor Hogan and figure out how to buy tests in South Korea. That's where the federal government should help, and that's the, that's the intelligent distribution of responsibility on testing. So the federal government's right: the states should take the lead. Yes. Partnership. Federal government you have to help us with this national manufacturer and the supply list. After you do the testing, states have a second big task, put together an army of tracers who then trace each person who tested positive. Who did they contact? And then isolate those people who you contact.

Also, talking about reopening—we're going to make reopening decisions on a regional basis. Based on that region's facts and circumstances about the COVID virus. In other words, just like some states will reopen before other states because they have a different circumstance when it comes to COVID and their status with COVID, it's also true across the state. North Country has a totally different situation than New York City. Central New York has a different situation. We operate as one state but we also have to understand variations and you do want to get this economy open as soon as possible and if a situation is radically different in one part of the state than another part of the state take that into consideration. That's what we're going to be doing. So the same logic that applies to the country applies to some states, this state, where you have those varieties across the state and we need to take that into consideration.

So the way we've been working on the economy in general across the state, where we recognized there's one state, yes, but there are regional economies within the state, and we've been working with each individual regional economy, we'll do the same thing on this phase. Let's talk about reopening economies in that regional context and coordinate it regionally. That's what we're going to be doing.

And again, I've said this statewide but I want all our regional partners to hear us. Let's not talk about just reopening. Let's not have gone all through this and all we're going to do is go back to where we were. How do you use this as an opportunity to learn the lessons and to build back better? That's what we have to do.

For Western New York we have my partner, Lieutenant Governor Kathy Hochul who as everybody knows is from Buffalo. We'll ask her to take charge of Western New York, monitor the public health issues, make sure if there's a problem in terms of public health, we're marshalling all the resources from across the state to help Western New York and also to start to work on the reimagining and reopening plan for Western New York.

We're also going to ask Bob Duffy who worked with me in the State to volunteer, to be a special adviser to coordinate public health and reopening in the Finger Lakes, the Rochester area.

Last point, we've gotten through difficult situations before. Western New York, we went through seven feet of snow a couple years ago. That was fun. We learned from that. The state, we went through 9/11 which was a crushing experience but we learned from that and we're different and we're better. We went through Superstorm Sandy and we're the better for that. We've going to be the better for this. I believe that.

It's the hard times in life that actually make you better and make you who you are if you're intelligent enough to learn from them and to get the message from them. That's what we have to do here. We have to do it individually. We have to do it collectively. What did we learn about ourselves, about the world, about the country from this period that we're in? You get knocked on your rear end in life. It happens. You knocked on your rear end. It's going to happen. The question is, do you get up and if you get up, what type of person are you and did you learn from getting knocked on your rear end? Sometimes you get knocked on your rear end and you have nothing to blame.

Things happen in life. Health issues happen. Bankruptcies happen. Things happen. You get knocked on your rear end. Okay, get up. Get up. Have the strength to get up. Have the wisdom to learn from the experience and be a better person for it. Michael Jordan documentary is on TV, I am a big Michael Jordan fan. He doesn't make the Varsity team, Michael Jordan. Bad coach, maybe. But he got knocked on his rear end. He was disappointed. What did he do? He worked, worked harder, practiced more - Michael Jordan. Michael Jordan wasn't just born. God didn't say here he is. He made himself the great player that he is. And New York, we make ourselves. This nation, we make ourselves, World War I, World War II, the Great Depression, some of the most tragic situations actually forged the character and the resolve of this nation. New York State is the same thing and we have to be smart enough to do the same thing here. And we will because we're New York tough. But not just tough. It's easy to be tough. It's hard to be smart and disciplined and unified and loving. That's what's harder than being tough. But we're all of the above. That's why we're special.

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