346,000 Doses of Moderna Vaccine Expected in New York State Next Week
DOH Approves Use & Issues Guidance for Extra COVID-19 Vaccine Doses in Pfizer Vials
6,081 Patient Hospitalizations Statewide - Decrease of 66 from Day Prior
1,068 Patients in the ICU; 592 Intubated - Both Decrease from Day Prior
Statewide Positivity Rate is 5.09%
120 COVID-19 Deaths in New York State Yesterday
New Record 249,385 Test Results Reported to New York State Yesterday
Governor Cuomo: "I believe hospitals are going to be able to manage this. We learned a lot in the spring. They worked together for the first time ever, with that collegiality in the spring and that operational facilitation in the spring, and frankly we've had more time to get ready and they've done more preparation now."
Cuomo: "I believe we can avoid a shutdown...we can slow the spread, and the hospitals can manage it, and this is in our control, and shutdowns are very, very harmful...Shutdowns have many negative consequences and this has been a long year, and the last thing anybody wants is a shutdown."
Cuomo: "The vaccines are going to be distributed medically, not politically. ... This is not going to be done by the political system. ... It's all being done by medical facilities so there will be no politics in the distribution. We have distributed the Pfizer and Moderna vaccine to 292 sites across the state. We have what we call regional hubs that are the medical facility that is working on the distribution plan for phase two."
Earlier today, Governor Andrew M. Cuomo announced that the New York State Clinical Advisory Task Force, following the FDA's advisory committee's recommendation for emergency use authorization of Moderna's COVID-19 vaccine, has reviewed and approved use of the vaccine in New York State. New York expects to receive approximately 346,000 doses of the Moderna vaccine next week, pending final FDA authorization.
The Governor also announced that the State Department of Health has approved and issued guidance regarding the use of an extra one to two doses that have been discovered in Pfizer vaccine shipments. Pfizer vaccine vials were previously believed to contain five doses each, but may possibly contain six or seven doses. Medical professionals administering doses can use any extra vaccine that can be easily pulled into a syringe to meet the dose requirement. Extra vaccine from one vial cannot be combined with extra vaccine from another vial to make an additional dose. The New York State Department of Health is issuing guidance today to guide healthcare professionals regarding these extra doses. A letter from DOH Commissioner Howard Zucker is available here.
AUDIO of today's remarks is available here.
PHOTOS are available on the Governor's Flickr page.
Top of the morning to you. From my far right, Mr. Gareth Rhodes, Chancellor Jim Malatras, Director of Operations Kelly Cummings, Dr. Zucker, Melissa DeRosa, Robert Mujica. Today is day 293. It's incredible, isn't it? 293 days.
Numbers for today, statewide positivity without the microclusters, microclusters are the tense zones, 4.6. Positivity with the microclusters, 5. Positivity in the microclusters, 6.
249,000 tests - highest number ever for us and we test more than any state in the nation so we have more facts. 120 deaths. Hospitalizations down 66. Those negative signs are actually good news. 120 deaths are in our thoughts and prayers and that is terrible news. Reduction in ICU, reduction in intubations. Those are good signs. What does it mean? We find out if it continues tomorrow, but it's good news.
COVID patients hospitalized by percentage of population. Western New York, down, Southern Tier, 0.3; Central New York, 0.5; Mid-Hudson, 0.3; City, 0.2; New York City, Long Island, 0.4; Capital Region, 0.3; Mohawk Valley, 0.4; Finger Lakes, Finger Lakes, Finger Lakes, Finger Lakes in red, which has been consistent over the past several days, growing for a couple of weeks.
Positivity, Western New York, down from where they were and now the picture has changed. It's Finger Lakes and Central New York believe it or not so this is not different than we've really seen. We've seen areas where the infection goes up. We then place a lot of attention, a lot of focus, we get the word out, people react, the number comes down, but Finger Lakes is really much higher and Finger Lakes has a problem, significant problem. New York City, 4.4, so Finger Lakes double the positivity of New York City just for a sense of a balance, double the North Country, six times the Southern Tier. So Finger Lakes, it's not just a situation of the times. It is particular to the Finger Lakes and that's how you should understand it and react. Positivity in New York City - Manhattan 2.75, Staten Island, 5.11, and this is again, it's why is Staten Island higher than anywhere else? There is no explanation. If anything Staten Island should be lower. There's less mass transit, there's less density, so it's not a statement of times. It's a statement of the particular circumstances in that area and that's just a matter of fact from the data. There are still facts.
New York is still at the bottom of the national curve and that's good news. Big question, will we have shutdowns? It's a question everybody asks me. Nobody can answer that question today. People can have opinions but it is purely up to us because it is a question of future actions. It will be determined by us by what we do over the coming weeks. I do not believe that we are destined to have a shutdown. There is no destiny here. Destiny is what we make it. The future is what we make it. It is totally in our control and the shutdown is totally avoidable. Totally.
I believe New Yorkers can slow the spread and that hospitals can manage the increase. Those are the two variables. Can you slow the spread and can the hospitals manage the increase? On the hospitals, we've spent a lot of time working with the hospitals, their capacity, their communication, their ability to deal with the surge, and we've spoken with many of them. They have now shifted to crisis management. We have added capacity, especially in downstate New York, and we have about 31,000 available hospital beds now in downstate New York which is after our Department of Health mandate saying add an additional 25 percent capacity.
Northwell which is the largest hospital system and Greater New York will back up, quote-unquote, the independent systems plus New York City Health + Hospitals Corporation. We went through this in the spring, right. So look at the game tape, and be honest about what you saw in the game tape. And what you see in this game tape from the Spring is you see the same breaks in the wall in the same places. So fortify the wall where it broke before.
You have two types of hospitals. You have hospital systems. You okay? You have hospital systems where you have 10, 11, 30 hospitals in a system. And they have to work better amongst themselves. But they have other facilities in their system. Their question is challenges coordination, making sure they're coordinated amongst each other and they're not operating as separate, independent countries. But they have backup inherent in that they're a system. You have some systems that do not coordinate as well. That's H+H in my opinion. That's where Elmhurst Hospital happened. That was the most dramatic problem we had in the Spring. The other hospitals are coordinating with Health + Hospitals to back them up if there's a problem. What does that mean, back them up? It means before a person walks into a hospital, we have an ambulance out front, and the ambulance takes the person to the neighboring hospital that has more availability. This is a phenomenal management coordination issue because the world doesn't work that way for hospitals. But it has to work that way. And Greater New York Hospital Association, which is the representative of all of the hospitals, is going to work to back up H+H and the independent hospitals that don't have a system to rely on. So Jamaica Hospital, Flushing Hospital, One Brooklyn that has fewer facilities. They will be backed up by the larger systems. So if they have a problem, the larger systems will help them with capacity. H+H has an issue, like last time, the other systems will step in. The hospital systems are the predominance of the hospital beds in New York City. And they're the predominance of the hospital capacity in New York City. So that's all been in the works.
We spoke to Erie County hospitals, Monroe, Haynes, which is the organization that represents the upstate hospitals. They are doing a very good job for the increased capacity and they're coordinating and they feel good. The Department of Health regulation added 25 percent additional capacity and said if they had a capacity issue they would have to cancel elective surgeries. Now, remember, the Department of Health law says, Executive Order is a law, says if a hospital believes, given the numbers, the rate of increase, they could hit 85 percent of their maximum capacity in three weeks, they must notify the state. It's a little confusing. They're looking at a rate of increase. Hospitalization is going up X percent a day. They're predicting post-Christmas X may go to X plus one per day. Factor that out for three weeks. If you think in three weeks, hospital, you may be at 85 percent of maximum capacity, you have to tell us today. Why? Three weeks, so you have a three-week buffer, three weeks they think they're at 85, you have an additional 15 percent buffer, so basically it gives the state one month notice at least. And at that point we would shut down the economy. If that regional hospital system says, we're going to hit 85 percent in three weeks, we'll have a 15 percent buffer, that's when we would shut down the economy. Now, no hospital in the state has given that three-week notice. No hospital in the state. Which means what? Three weeks from today is roughly January 8th. No hospital in the state believes they're going to hit 85 percent by January 8th. No hospital in the state. That's good news because you have no hospital in the state saying they think they're going to hit 85 percent of their maximum by January 8th. So that is very good news. Ken Raske, who is the president of the Greater New York Hospital Association, who was tremendous in the Spring getting us through the Spring crisis, and is really one of the best hospital executives in the country in my opinion and I worked with a lot of them. He issued this statement. Ken is also a somewhat verbose person, uses a lot of words, but he said he's spoken to all the hospitals. They understand the consequences. They're comfortable about handling the capacity and if they're not comfortable about the capacity or they're concerned about the rise in hospitalizations they would be the first one to call for an economic shutdown. I'm kidding about him being verbose, just looks like he's verbose on the slide.
I believe hospitals are going to be able to manage this. We learned a lot in the spring. They worked together for the first time ever, with that collegiality in the spring and that operational facilitation in the spring, and frankly we've had more time to get ready and they've done more preparation now.
And also, we've gone through this before right? We did this before and I believe we can do it again. I also believe, so that's the first factor, hospital capacity, I believe we can manage it. I also believe New Yorkers can slow the spread. I believe New Yorkers can flatten the curve, because I saw them do it. We went through the spring where I had every global expert telling me there is no way that we could flatten the curve that fast.
No way, no government rules, no social action could reduce curve that quickly. New Yorkers defied all the odds, and New Yorkers did it. So I believe New Yorkers are totally capable of celebrating the holidays, celebrate Christmas, open the gifts. I actually think I'm going to get good gifts this year. I think I deserve good gifts this year. So open the gifts, enjoy, celebrate, but be smart be smart. It's a virus. We know how to deal with it. Just be smart, take precautions.
You know how they say, "Happy and Healthy Holidays." You know how they say, "I wish you a Happy and Healthy Holiday?" Yeah, focus on the healthy this year, right. Focus on the healthy.
I believe New Yorkers are capable of doing that. I believe New Yorkers are seeing the numbers and the increase from Thanksgiving, and I think they're going to learn from it. What happened after Thanksgiving? I sat right here and said, "Thanksgiving, you're going to see the numbers go up. People are getting on planes, resort in the airports, more airport traffic, more car traffic. We'll get together. We'll have a great turkey dinner. If we're not smart, you're going to see an increase."
You know what happened? Bloop, we saw an increase. New Yorkers get it. They see the numbers. New Yorkers are smart, I think they're going to learn from Thanksgiving, and I think you'll see a smarter response through the holidays.
So I believe we can avoid a shutdown, and I believe we will avoid a shutdown, I'll go that far. I understand local officials are warning of a shutdown if the growth increases. I understand why the public needs to know this status and the consequences. I have said if we don't slow the spread we could be headed for a shutdown. But we can slow the spread, and the hospitals can manage it, and this is in our control, and shutdowns are very, very harmful.
They hurt a lot of people. They hurt businesses. They have mental health consequences. They hurt children. Shutdowns have many negative consequences and this has been a long year, and the last thing anybody wants is a shutdown.
So I'm working as hard as I can, and hoping, and I believe that we can stay open. And we will stay open. We need a new mantra. Our mantra has to be, "Slow the Spread, Stop the Shutdown." Slow the Spread. Stop the Shutdown. Slow the Spread, Stop the Shutdown. It's that simple. Focus on that. Focus on that. Holiday season. Sitting at the table. Slow the spread, stop the shutdown. That's the consequence and the connection.
At the same time we have to accelerate the vaccine. This is now a foot race between the vaccine and COVID. The faster we vaccinate people, the quicker COVID comes down. They're talking about a six to nine-month timeline. That is all in our control. It's how fast we do it, how many people do it.
We had the first vaccination in the country, I believe, because New York is mobilizing faster, I believe, and more organized than any other state. We had the first superhero, nurse Sandra Lindsay. She is my role model. She took that shot and her face did not flinch. I respect that. And she's my role model, and at one point I'm going to get the shot right here, and I want to keep my face as still as Sandra Lindsay kept her face. No movement in the eyes, no flinch. God bless her. I respect that.
Good news: FDA advisory committee has recommended Moderna so now you have a Pfizer vaccine and a Moderna vaccine. Our clinical advisory taskforce approved Moderna this morning. So we talked about the skepticism about the federal approval process which is nationwide. We said we were going to set up a New York panel to affirm the federal approval. Some people said, "oh, that's going to slow it down. You're suggesting that the federal approval isn't trusted." I'm not suggesting. Fifty percent of the American people said they don't trust the federal approval process. They did that to themselves when they all decided that hydroxychloroquine was going to cure COVID and cure male pattern baldness. That's when they lost their credibility. The New York panel was going to fortify that. Critics then said, "Well, you'll delay New York getting a vaccine and maybe New York won't get the vaccine because of the New York panel." The New York panel acted faster than the federal government.
So there was no delay whatsoever and now the people of this state know, it's not just trusting the federal government, the state government also affirmed it, and I will take the vaccine based on that affirmation.
Next week we receive 346,000 Moderna doses. Remember how this works - the state controls the dispersal and guidelines on the vaccine. They are allocated regionally. The vaccines are going to be distributed medically, not politically. What does that mean? When we went to the COVID test, there was a whole question of who gets the test first. Do the rich and famous get to the front of the line. I anticipate that with the vaccines also. Who gets it first? Was their favoritism, et cetera. Did the politicians have their buddies get to the front of the line? This is not going to be done by the political system. It's not going to be done by the County Executive; it's not going to be done by the Town Supervisor. It's all being done by medical facilities so there will be no politics in the distribution. We have distributed the Pfizer and Moderna vaccine to 292 sites across the state. We have what we call regional hubs that are the medical facility that is working on the distribution plan for phase two. These are those hub facilities, and this is how many vaccines they will distribute in that region. This combines the 170,000 from Pfizer and the 376,000 from Moderna.
Even better news, surprising news, a little bit of a mistake but a mistake that turned good: the supply of vaccines is bigger than we thought the initial shipment of Pfizer vials were supposed to have five doses in them. If you remember when I showed you the Pfizer package, here, I held up the vial and I said there were five doses in this vile. It turns out that there is 40 percent more doses in the vial. When they're measured in the syringe, there was more than five doses. The FDA has authorized using those doses. DOH is authorizing them today. So there's more than five doses. There can be six doses or seven doses and that is actually increasing the number of doses that we have.
We're still on phase one which are health care workers, nursing homes, congregate. Late January, we go to phase two, essential workers, priority, general. 19,000 New Yorkers vaccinated so far. You want to know how to get a vaccine, you can go to that very attractive website, Vaccinate New York. Arm, bicep, harkens back to New York tough, but doesn't say it.
New York State vaccinations are no cost to the public. That is not true in other parts of the country. In this state you do not pay for a vaccination. So, there's one less obstacle.
New York has been through hell, but the finish line is in sight and we just have to get there. A bump along the road: Washington is going to pass a bill with no state and local funding, but it could have education funding and it could have healthcare funding. That would be good. Short term options on the state's fiscal issues: Option A. is to do the budget now. Do a tax increase and do the budget. Some legislative sources are talking about a tax increase of about $1.5 billion to 2 billion. Is that the right amount? Is that too low? And who would you tax and who would you give the money to? We have overall a
$15 billion deficit. You raise $1.5. Alright, where do you put that $1.5 in the scope of that $15 billion deficit? That is a budget decision. That's why you have to do a tax increase as part of the budget, and where do you make up the 13.5 billion? If you only do a $1.5 billion tax increase — even if you did a $2 billion tax increase, a $3 billion tax increase — you still have to make up $12 billion in cuts. I would be open to doing the budget now with the legislature, but it's going to be ugly.
Option B: wait until we know what the federal aid is and do a budget in April. The state can advance $1.5 billion either from reserves or from borrowing to make up for whatever you would get with a tax increase to allocate that funding on an essential basis and then let's find out what Washington will give us to find out where we really are. We can't do $13 billion in cuts — and if we cut $13 billion now in December, and then we get money restored in April, it would be totally disruptive. To do $13 billion in cuts, you have to lay off public employees. You have to lay off teachers. Why would you lay off teachers just before Christmas and then possibly rehire them in April? It doesn't make sense to me.
Again, I would do either, but I prefer Option B, but I'm not going to do a tax increase without doing a budget because that's just a political statement and we have to know how much and it has to be enough to be meaningful. Option B would avoid any disruption.
The AFL-CIO supports waiting until April and they were part of a coalition that called for the tax increase. Again, $1.5, $2 billion, that is a drop of water in the ocean so that's where we are on that. But I spoke to the Labor Leaders who are most directly involved and they support waiting until April and doing it right.
We are also — we understand 100 percent the situation that the restaurants are in. We're extending the sales tax deadlines for the New York City restaurants by waving interest and penalties on sales tax due on Monday, December 21. Sales tax were due on the 21st. We're going to waive that. I understand the fiscal pressures they're under. I hope Washington actually provides relief to restaurants and we're doing everything that we can.
The light at the end of the tunnel is in sight. It's a long tunnel, but there's a light there. There's a light there — and that's a lot better than where we were. So, just stay doing what we are doing and we're going to be OK and we're going to be the better for it.
You know, generations have gone through tough times. Generations have gone through wars. They've gone through depressions. They've gone through terrible disease outbreaks. They've gone through Cholera. They've gone through Typhoid. They've gone through TB. World War II. I missed by just a little bit age-wise, going to Vietnam. I mean, every generation gets its test and it forges that generation and I think we're going to be the better for it.