State Will Monitor Four Core Factors to Determine if a Region Can Re-Open: Number of New Infections, Health Care Capacity, Diagnostic Testing Capacity and Contact Tracing Capacity
Outlines New Safety Precautions Each Business Must Put in Place Upon Re-Opening
More Than One Million New Yorkers Have Been Tested for COVID-19 to Date
New York's National Guard Has Made Nearly 300,000 Testing Kits to Collect Samples
Announces Special Enrollment through the Marketplace will Remain Open Through June 15, 2020
Confirms 2,538 Additional Coronavirus Cases in New York State - Bringing Statewide Total to 318,953; New Cases in 45 Counties
Governor Cuomo: "Reopening is more difficult than the closedown. The closedown was relatively simple, right? You go into the basement, you throw the big power switch, and everything just goes down. Close the businesses. Stay at home. It was a blunt operation and when that was done all across the country, just stop everything now. When you go to restart, the reopening, now knowing what we know, it's more nuanced. You have to be more careful. And again, no one has done this before, and no one has been here before. So, first, start by learning the lessons that we did learn through this experience."
Cuomo: "Government is fundamentally in a different position than it was just a couple of months ago. This is for real now, right? Government politics - it's not about optics, it's not about celebrity, it's not about press releases, it's not about what I put on Instagram yesterday. This is about government leaders performance, their expertise. This is a situation where their competence and their ability can be the difference between life and death, literally. What the governments have done - federal, state, local - what we've done in this state has literally saved lives."
Earlier today, Governor Andrew M. Cuomo outlined additional guidelines for when regions can re-open. The state will monitor four core factors to determine if a region can re-open:
- New Infections: Based on guidelines from the CDC, regions must have at least 14 days of decline in total net hospitalizations and deaths on a 3-day rolling average. In regions with few COVID cases, the region cannot exceed 15 net new total hospitalizations or 5 new deaths on a 3-day rolling average. In order to monitor the potential spread of infection in a region, a region must have fewer than two new COVID patients admitted per 100,000 residents per day.
- Health Care Capacity: Every region must have the health care capacity to handle a potential surge in cases. Regions must have at least 30 percent total hospital and ICU beds available. This is coupled with the new requirement that hospitals have at least 90 days of personal protective equipment stockpiled.
- Diagnostic Testing Capacity: Each region must have the capacity to conduct 30 diagnostic tests for every 1,000 residents per month. The state is rapidly expanding capacity statewide to help all regions meet this threshold.
- Contact Tracing Capacity: Regions must have a baseline of 30 contact tracers for every 100,000 residents, and additional tracers based on the projected number of cases in the region. The state is currently building an army of contact tracers with Mayor Bloomberg to meet the needs of each region statewide.
Governor Cuomo also outlined which industries and businesses can open in each phase of the state's re-opening plan. Businesses considered "more essential" with inherent low risks of infection in the workplace and to customers will be prioritized, followed by other businesses considered "less essential" or those that present a higher risk of infection spread. Regions must not open attractions or businesses that would draw a large number of visitors from outside the local area.
The Governor also outlined new safety precautions that each business must put in place upon re-opening to help lower the risk of spreading the virus. Businesses will be required to:
- Adjust workplace hours and shift design as necessary to reduce density in the workplace;
- Enact social distancing protocols;
- Restrict non-essential travel for employees;
- Require all employees and customers to wear masks if in frequent contact with others;
- Implement strict cleaning and sanitation standards;
- Enact a continuous health screening process for individuals to enter the workplace;
- Continue tracing, tracking and reporting of cases; and
- Develop liability processes.
The Governor also announced that more than one million New Yorkers have already been tested for COVID-19 to date.
The Governor also announced New York's National Guard has made nearly 300,000 testing kits to collect samples, 60,000 of which are being sent to labs and hospitals across New York State.
The Governor also announced the special enrollment period through the NY State of Health Health Plan Marketplace will remain open through June 15, 2020.
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. Thank you all for being here. From my right, let me introduce who I have with me and acknowledge some special friends. To my right is Gareth Rhodes, who has been,, works with the Department of Financial Services but he's been working with us in Albany during this coronavirus pandemic. To my left, Melissa DeRosa, who's secretary to the governor. To her left, Robert Mujica, who's the state budget directly. He doesn't smile much nowadays because the state budget is not in great shape, but when the federal government does the right thing and gives us funding, we expect he's going to smile, that big smile again. It's a pleasure to be in Rochester with so many of my friends who've done such great work for the state. Former lieutenant governor Bob Duffy, who worked with me when we first got started and has done great work for the entire State of New York. Danny Wegman, pleasure to be with you. Wegmans is a great New York corporation, and Danny's a great civic leader, and they've been very helpful through this situation. Also, thank you for allowing us to do the antibody testing at Wegmans, that's been very, very helpful. And we thank you for everything you've done. And Nicole Wegman, thank you, pleasure, thank you for being on our New York Forward advisory board to help us going forward and find our way through this.
Let's give you an update on where we are today. The total number of hospitalizations is down. You see that curve coming down. You see that mountain that we went up. Now we're on the other side of the mountain. You start to see the shape of the mountain. Unfortunately the decline from the mountain is not as steep as the incline, right? And the big question for us in New York and every state across the nation has been how fast and how low does that decline go, right? How fast does the decline actually happen? And what is the lowest level that the decline will reach? Unfortunately you see that we were hoping for a quick up, plateau, at the top, which is what they talked about, but a fast decline. You see the decline is, again, not as steep as the incline. But it is a decline, and that's good news.
The net change in total hospitalizations is down, net change in intubations is down, and that's always good news. When a person is intubated, roughly 80 percent of the time, there's not a good outcome. So the fact that intubations is down is good news. And then the other end is how many new cases are coming in the door every day? How many new diagnoses in COVID cases? And that number is also declining. So not only are the number of people in hospitals coming down, but the number of new cases coming in the door is down. And that's good news because it had plateaued at about 900 statewide for a few days. But this number is down at 700, and that's a good number. I would take this with a grain of salt, as they say, because this is reporting from yesterday, which was a Sunday, and sometimes we get different results on the weekend. Remember, this whole reporting system has just been put in place. This never happened before. This is now every hospital in the state reporting, every day, for the first time. So, it's a plus or minus across the board.
This is the number that haunts me every day, and this number is not declining anywhere nearly as fast as we would like to see it decline. Still 226 New Yorkers who passed away. And so we don't become immune, we talk about these numbers. 226 families, right, that's 226 wives or brothers or sisters or children that are now suffering the loss of a loved one. So we remember them in our thoughts and our prayers. People are all talking about reopening, which we should be talking about. This is not a sustainable situation. Close down everything, close down the economy, lock yourself in the home.
You can do it for a short period of time but you can't do it forever. But, reopening is more difficult than the closedown. The closedown was relatively simple, right? You go into the basement, you throw the big power switch, and everything just goes down. Close the businesses. Stay at home. It was a blunt operation and when that was done all across the country, just stop everything now. When you go to restart, the reopening, now knowing what we know, it's more nuanced. You have to be more careful. And again, no one has done this before, and no one has been here before. So, first, start by learning the lessons that we did learn through this experience.
And second, let's be smart about what we do. And I get the emotion, and I get the impatience, and I get the anxiety. We all feel it. When I say the situation was unsustainable, it's unsustainable on many levels. It's unsustainable economically, it's unsustainable personally. A lot of anxiety is now all through our community. We see it in increased alcoholism, increased substance abuse, increased domestic violence. So this is a very, very difficult period, and people want to move on. Yes, but let's be smart about what we do and let's learn the lessons.
One of the lessons is, we have never been here before, and we didn't really know what was going on. CDC releases a report, end of last week, that says the virus was actually coming to the east coast from Europe. Everybody was looking at China for all those months. China was last November, December, the virus migrated from China while we were all staring at China, and went to Europe. And the strain that came to the United States came from Europe. We had people in the airports stopping people from China, testing people from China, the federal government did a lot of testing, a lot of screening, people getting off planes, from China. Yes, but meanwhile the people from Europe were walking right past them. And that's where the strain came from that was infecting this area. And that's what the CDC just learned last week, and this is going back to February, right? On one of the most studied topics ever.
Again, just learn the lessons of what happened. You now add that piece of information on the Europe trips, and then you see the number of flights that came from Europe during that time, where they landed, and now you - It explains why you've seen the outbreak in Chicago that you've seen, why you've seen the number of cases in New York because, yes, the flights were landing here, people were coming from Italy, and the UK, and from European countries, and nobody thought to screen them. Nobody was on guard. And you add that to the density of New York, especially in New York City and that virus just took off, okay. We didn't know. We didn't know. Now we do. We also can look back in history and look at that 1918 flu pandemic they talk about. The places that opened too soon saw that flu come right back. And by the way, that flu was not one wave. That was three waves: first wave, second wave, third wave. The second wave was worse than the first wave.
And you see, watch the other countries that went through this before us, right? We're not the first one down the chute. There were other countries that went down before us. You see they wanted to reopen also. They were feeling the pressure on reopening. And you study those cases and you see that you reopen too soon or you reopen unintelligently and you can then have an immediate backlash. And that's not speculation. That is looking at other countries, and look at what has happened around the world. And then you talk to the experts who know, listen to what they're saying. Dr. Fauci, who I think is one of the best voices and minds on this, Dr. Fauci's been through this in different iterations. He was one of the pioneers on the HIV virus and AIDS. And he says we could be in for a bad fall and a bad winter. Could be. Why? Because he doesn't know. He's not sure but could be for a bad fall or bad winter.
Okay, so put all of this in the equation and then also acknowledge and actualize that the truth is that nobody knows what happens next, and when it happens. Well, how can that be that nobody knows? We're so sophisticated. We have so much intelligence. We have so many experts. This is the United States of America. How can it be that no one knows? Because no one knows. I speak to the best experts globally, globally, and nobody can tell you for sure. Now, experts, we look to experts, and we expect them to know, so we push them to know. "Answer the question. Tell me when. What's going to happen in September? What's going to happen in December?" Sometimes the answer is, "I don't know." Sometimes that's the honest answer.
I was talking to my daughters last night, and they said, "You know, you say at your briefings, I don't know. How can you say that?" First, I'm not really sure they watch my briefings. But they're right. Sometimes I say I don't know. Why? Because I don't know. And if you don't know, say you don't know. And I speak, again, to the best minds in this country, the best minds around the globe, and they don't know. So, if you don't know, say you don't know. It doesn't mean you're not smart, no reason to get defensive. I don't know. When you know what you don't know, and admit it, it will actually keep you safe. My daughters don't quite agree with this yet, but I haven't given up on the concept. Know what you don't know. Know when you don't know what the future holds, you can be safe because then you can prepare for different possibilities. And that's where we are. We don't know. But we will be prepared for all possibilities.
So, reopening. Chart a course. With the best information you have, learning from the lessons you have, but be able to correct that course depending on what happens, which means, don't act emotionally. Don't act because "I feel this, I feel that." Because someone said, "Well other states are opening, so you must be able to open, if other states are opening." Forget the anecdotal, forget the atmospheric, forget the environmental, forget the emotional. Look at the data. Look at the measurements. Look at the science. Follow the facts. And that's what we've done here from day one. This is no gut instinct. This is look at the data, look at the science, look at the metrics. Move forward, measuring what you can and what you know, and then be prepared to adjust. "Well, I want specificity, I want to know for sure." You don't. But there's liberation in knowing that. So, let's do this intelligently, based on metrics, and we'll see what happens and we'll adjust to whatever happens. "Well, what does that mean on metrics?" You can measure this. And we have to measure this. You look at that percentage and the rate of hospitalizations, which we have, right? That's the chart that goes up and down. You watch that hospitalization rate, do your diagnostic testing so you know how many people are testing positive, and you can watch that rate going up or down or flat. Do the contact tracing, so after the testing, you follow up and you do that contact tracing. And you are then reducing the infection spread by isolating the positives. If you do those things, you will control the rate of transmission of the virus, which is everything.
Nobody says you're going to eliminate the virus in the short-term. Nobody. But you can control the rate of transmission, and if you can control the rate of transmission, you can control the rate of transmission from becoming an outbreak or an epidemic or overwhelming your public health system. That is the best you can do. So, control the rate of transmission to what they call 1.1 or less. 1.1 is every person infects 1.1 other people, more than one other person. If you're doing that, that is an outbreak. That means it's going to increase exponentially and it's going to be out of control. As long as your rate of transmission is manageable and low, then reopen your businesses and reopen the businesses in phases, so you're increasing that activity level while you're watching the rate of transmission. The rate of transmission goes up, stop the reopening, close the valve, close the valve right away. So, reopen businesses, do it in phases and watch that rate of transmission. It gets over 1.1, stop everything immediately. That's where the other countries wound up.
They started to reopen, they exceeded the 1.1. It became an outbreak again. They had to slow down. Rather than starting and stopping, you'd rather have a controlled start, so you don't have to stop, right? And that's what you learn from the other countries. You reopen too fast, then you have to stop, and nobody wants to have gone through all of this and then start just to stop again. Well, how does that happen?
First of all, it's not going to happen statewide. This state has different regions which are in much different situations than other regions in this state. And rather than wait for the whole state to be ready, reopen on a regional basis. If upstate has to wait for downstate to be ready, they're going to be waiting a long time. So, analyze the situation on a regional basis, okay? And you look at a region on four measures -- the number of new infections, your health care capacity. If the infections go too high you overwhelm your health system, now you're Italy with people on gurneys in a hallway because your hospital system can't handle it. Do your diagnostic testing so you're seeing how the infection is increasing or decreasing. And do the contact tracing, have that system in place so when you're testing, you find a positive, you trace the contacts from that positive person and you're isolating them to bring down the rate. And you do that on a regional basis. That system has to be in place for a regional basis.
How do you start? When can I start reopening? We look at guidelines from the CDC, which say a region has to have at least 14 days of decline in total hospitalizations and death on a three-day rolling average. So, you take a three-day average, you have to have 14 days of decline. You can't have more than 15 new total cases or five new deaths on a three-day rolling average. This is telling you that you're basically at a plateau level that you can actually start to reopen. Then you're watching the rate of infection and the spread of the infection, and the benchmark there is fewer than two new covid patients per 100,000 residents, right? It's based on your population to account for the variance in the different sizes of regions across the state. Then, anticipate, protect yourself from all possibilities. Well, what if we have a surge again? Never fill your hospitals to more than 70 percent capacity. Leave 30 percent in case you have a surge. Remember, this virus is tricky. The rate of infection -- a person who gets infected today shows up in the hospital ten days from today or two weeks from today. So, that infection rate goes up, you don't feel it for two weeks. There's a lag to it. You want to make sure you have 30 percent of the hospital beds available in case you have that surge. Also, learn the lessons from before. Every hospital has to have 90 days of PPE for that hospital, at the rate that they have been using it during COVID. We cannot have another mad scramble where nurses and doctors don't have gowns and masks, etcetera, because the hospitals don't have the necessary stockpile. So make sure every hospital has the stockpile.
On the testing, we have done really remarkable work on testing. One million New Yorkers have now been tested believe it or not and the CDC Coronavirus Task Force for the White House recommends that for a region to reopen, you have 30 tests for every 1,000 residents ready to go.
So what testing capacity do we need for a region to reopen? You have to be prepared to do 30 tests for every 1,000 residents. New York is doing more tests than any country in the state by far. New York is doing more tests than any country on the globe per capita. So we're way ahead in testing but it doesn't matter what we're doing statewide. To open a region, that region has to have a testing capacity of 30 per 1,000.
The National Guard has been doing a great job for us in putting together testing kits and distributing testing kits and we want to thank them very much but we have to have those tests and we have to have what they call tracers, contact tracers, in place and Mayor Bloomberg has been very helpful, former mayor of New York City, in putting together this tracing system.
This has never existed before on this scale. A group of people who literally trace contacts from a person who's positive. Who did you have dinner with last night? Who did you have dinner with two nights ago? Who might you have been in contact with? And then contacting those people to say, do you have any symptoms? If you do, you should know you were with John Smith. John Smith tested positive. He said he went to dinner with you. You should be on alert. That whole tracing system has never been done, not only in this state, but in this country. So that all has to be set up and it has to be done.
Once that is all done then you can talk about reopening businesses. Well, which businesses do we open first? You open businesses first that are most essential and pose the lowest risk, okay? Most essential and the lowest risk. Phase one, we're talking about construction, manufacturing, and select retail with curbside pickup. They are the most essential with the lowest risk. Second phase, professional services, retail, administrative support, real estate. Third phase, restaurant, food services, accommodation. Fourth, arts, entertainment, recreation, education.
Remember, density is not your friend here. Large gatherings are not your friend. That's where the virus tends to spread. That's why those situations would be down at the end.
Then we need businesses to also reimagine how they're going to do business and get ready to protect their workforce, to change their physical environment to the extent they need to and to change their processes to make sure people can socially distance, people remain in a safe environment. And that's going to be up to businesses to come up with ways to reconfigure their workplace and their processes to make this work and that's business by business. Government can say these are the standards but a business is going to figure out how to do that.
When you look at this state, there are some regions that right now by the numbers pose a lower risk, some that pose a higher risk. We can tell you by region right now, of those criteria that we went through, which ones are in place for which region, so which ones have the right hospitalization, the right testing regimen, the right contact tracing regimen, and which ones still have work to do in those areas. And this is going to be region by region and each region has to put together the leaders in those respective areas who put together this system and monitored this system literally on a daily basis. So, they're getting all that input, all those specifics, all that data, and then day by day they're making a decision as to how to proceed with reopening based on the data. Based on the facts. That'll be a little different for every region in this state.
May 15th is when the statewide PAUSE order - P-A-U-S-E not P-A-W-S - the PAUSE order. The PAUSE order was stop all businesses, stay at home. That expires on May 15th. May 15th, regions can start to reopen and do their own analysis. But, these are the facts that they have to have in place to do it. Start now, don't wait until May 15th. Don't call me up on May 15th and say, "Well, the PAUSE order expired, I want to open." Because I'm going to ask you the questions I just presented. Do you have a healthcare system in place? Is your health system ready? Can your hospitals handle it? Do you have testing in place? Do you have tracing in place? Have you talked to the businesses about how they're going to reopen?
So, we have a couple of weeks, but this is what local leaders - this is what a community has to deal with to reopen safely and intelligently, in my opinion. This can't just be we want to get out of the house, we're going. No. Let's be smart, let's be intelligent, let's learn from the past, let's do it based on facts.
You know, we are at a different time and place. Government is fundamentally in a different position than it was just a couple of months ago. This is for real now, right? Government politics - it's not about optics, it's not about celebrity, it's not about press releases, it's not about what I put on Instagram yesterday. This is about government leaders performance, their expertise. This is a situation where their competence and their ability can be the difference between life and death, literally. What the governments have done - federal, state, local - what we've done in this state has literally saved lives. We've reduced all the projected hospitalization rates dramatically. By about 100,000 New Yorkers.
100,000 fewer New Yorkers were hospitalized than they predicted. 100,000. Thank about that - if we had 100,000 people in our hospital system. First of all, our hospital system would've collapsed if the projections were true. If we didn't change those projections. We literally saved lives. How many of those 100,000 would've been hospitalized and would've died?
So, we've done great work at a tremendous cost and tremendous hardship, but we've done great work. We just have to remain vigilant and smart and competent going forward. And that's what New York tough means. New York tough means we're tough, but we're smart, we're disciplined, we're unified, and we are loving. It's the love of community and love of each other and respect for each other which is what has gotten us through this and will continue to.