In early March, New York Governor Andrew Cuomo began conducting daily televised press conferences to report on the quickly accelerating Covid health crisis in the state. New York City Mayor Bill de Blasio soon followed Cuomo’s lead, holding his own daily press conferences to report on the city’s efforts to respond to the crisis.
At that time, the news they reported was grim. As the death toll spiraled upward at a frightening rate, panicky government officials struggled to provide enough ventilators and ICU beds to keep the virus from overwhelming New York City area hospitals and ICUs, while urging the public to cooperate with drastic lockdown and social distancing orders issued in a desperate effort to “flatten the curve” of new hospital admissions and death rates due to Covid.
By early April, the Covid death toll in New York hospitals had peaked, and the curve was headed downward, but state and local government officials still urged the public to keep the preventive measures in place to prevent the virus from spiking once again.
The crisis had passed, but the emergency lockdown continued. New York’s schools, places of worship and “non-essential” businesses remained shut while other regions of the country began the process of cautiously re-opening. The Covid curve continued downward in New York, but at a fearful economic, social and educational price.
Meanwhile, Cuomo and de Blasio filled their daily press conferences with self-congratulation as they struggled to shift the blame onto others for their own lack of preparedness, slow responses, fatal mistakes and confusion which resulted in the preventable deaths of thousands of New Yorkers due to Covid. Both men boasted about the wisdom and liberal political correctness of their anti-Covid policies while excoriating the ignorance of anyone who challenged their logic.
To illustrate New York’s progress at suppressing the coronavirus outbreak, Cuomo appeared in front of a sculpture of a mountain that he said represented the curve of hospitalized cases during the Covid outbreak which reached its peak after the first 42 days and has been declining ever since. On Sunday, the state reported 853 Covid patients currently hospitalized, down from the peak of more than 18,800.
JUDGE STRIKES DOWN ANTI-RELIGIOUS COVID ORDER
Their hypocrisy and anti-religious discrimination were exposed last week in a ruling by Judge Gary Sharpe of the federal District Court for Northern New York in Albany. His injunction blocks the state from enforcing Cuomo’s and de Blasio’s coronavirus restrictions limiting indoor religious gatherings to 25% capacity when other types of indoor gatherings are being permitted by state regulations for up to 50% capacity in the Phase Two and Phase Three re-opening stages.
In his 38-page ruling, Judge Sharpe said, that because of the unequal treatment, religious activities in New York State “will be burdened and continue to be treated less favorably than comparable secular activities,” amounting to discrimination that violates the protections in the First Amendment of the Bill of Rights to the U.S. Constitution. The ruling also lifts state restrictions on the number of people who can attend outdoor religious gatherings.
Judge Sharpe noted that both Cuomo and de Blasio have expressed approval for public protests against racism and police brutality that blatantly violate their coronavirus guidelines while continuing to enforce restrictions on religious gatherings.
“Governor Cuomo and Mayor de Blasio could have just as easily discouraged protests, short of condemning their message, in the name of public health and exercised discretion to suspend enforcement for public safety reasons instead of encouraging what they knew was a flagrant disregard of the outdoor limits and social distancing rules,” the judge wrote.
Judge Sharpe’s ruling was also praised in a statement issued by the federal Department of Justice, which called it, “a win for religious freedom and the civil liberties of New Yorkers. . .
“The Department of Justice will continue to support people of faith who seek equal treatment against threats and actions by public officials who discriminate against them because of their religion.”
As New York City belatedly begins to emerge from the lockdown, Cuomo has been boasting about the success of his anti-virus policies, while criticizing states such as Florida, Texas, Arizona and their Republican governors for the sharp rise in new Covid cases they are now reporting after starting to ease their lockdowns at the end of May. Cuomo also announced last week that he was imposing a mandatory 14-day quarantine on visitors to New York from eight states with sharp upticks in Covid cases, to prevent the return of the virus.
QUARANTINE IMPOSED ON U.S. VISITORS TO NEW YORK
Cuomo joined with New Jersey’s Governor Phil Murphy, and Connecticut Governor Ned Lamont in issuing the quarantine orders for travelers from South Carolina, North Carolina, Florida, Texas, Alabama, Arkansas, Arizona, Washington and Utah. Arriving travelers who do not quarantine would be subject to fines between $2,000 to $10,000.
The next day, attorney Jon Corbett, whose office is in California but who maintains property in Brooklyn, filed a federal lawsuit against Cuomo’s quarantine order in the Southern District of New York, claiming that it was an unlawful “abridgment” of his right to travel freely inside the United States.
Cuomo has also been criticized for calling for an investigation of a Westchester County student who attended her June 20th local high school graduation “drive-in” ceremony after visiting Florida, where she apparently was infected by the virus.
The unidentified student began showing symptoms after attending the graduation ceremony which was held at the Chappaqua train station for graduating seniors at Horace Greeley High School. Since then, four other students who were in attendance have tested positive for the virus.
While Cuomo and the mainstream media have been blasting President Trump and Republican governors for endangering public health by re-opening too soon, they have ignored the inconvenient fact that 90% fewer people in those states are now dying from Covid than died in New York during the peak weeks of its outbreak.
Some increase in new cases had always been expected when the lockdowns were eased, but thankfully, a much smaller percentage of the new cases, now appearing at a rate of 40,000 a day nationwide, require hospitalization or treatment in an ICU. The dire media predictions of a second imminent Covid crisis have been vastly exaggerated for partisan purposes in an election year.
“CUOMO’S COVID CHUTZPAH”
Over the weekend, Cuomo complained bitterly in an NBC News interview that he is still getting unfair “political heat” over at least 6,250 nursing home deaths in New York due to an order he issued through his Department of Health on March 25th. In an editorial entitled “Cuomo’s Covid Chutzpah,” the Wall Street Journal reminded its readers that the governor “is responsible for the single worst public-policy mistake of this pandemic: His administration’s order requiring nursing homes to accept Covid patients from hospitals. That bad judgment let the virus rampage through institutions with the most vulnerable populations.”
The editorial also noted that when Covid was peaking in New York, Cuomo had angrily declared, in response to quarantine orders from Florida and Rhode Island, “We will not let New Yorkers be discriminated against.” It also mentioned the “ill-grace” of criticism coming “from the man whose state still has by far the most virus infections and deaths.”
Cuomo’s blunders have continued.
NYC RESTAURANT REOPENINGS IN JEOPARDY
On Monday, Cuomo and de Blasio struck another blow against New York’s already struggling restaurant industry when they announced that they were reconsidering their previous decision to permit restaurants in the city to reopen their dining rooms as part of the city’s move into Phase 3. They justified the move on bases of reports that the recent spike in Covid cases in other states had been traced to their failure to enforce social distancing rules in their recently re-opened restaurants.
In this case, Cuomo and de Blasio were following the lead set by New Jersey governor Phil Murphy who re-imposed an indefinite ban on inside dining rooms throughout New Jersey just two days before he had previously said that they could re-open.
Cuomo said he was worried about people from states with a high number of infections who might travel to New York City for the specific purpose of eating in city restaurants.
“It’s not just indoor dining alone,” the governor said. “Indoor dining in New York City, where you already have issues with high congregations, you already have issues of people clearly violating social distancing, and you now have an added factor of viral spread all across the nation, and a high likelihood that those people will come to New York City. It’s that combination of facts that’s precarious.”
Mayor Bill de Blasio echoed Cuomo’s doubts reopening city restaurant dining rooms, declaring, “The indoor dining element is now in question. “We’re going to work it through with the state, figure out how we want to approach it, if we want to pause that piece for a while or modify it.”
Restaurant owners in both New York and New Jersey were stunned by the sudden reversal. Many said it would mean major additional financial losses because they had already re-hired furloughed staff and ordered perishable fresh food in preparation for the re-opening of their dining rooms.
According to state employment data, because of the shutdowns ordered in March, dine-in restaurants in New York City had eliminated more than 119,000 jobs.
MANY RESTAURANTS MIGHT NOT SURVIVE
The New York City Hospitality Alliance, a business group that represents restaurants and bars, issued a statement noting that, “New York City restaurants and bars have been financially devastated. Our small businesses urgently need certainty and immediate support on rent, expanded outdoor dining and other responsive policies if they are to have any real chance of survival and recovery.”
On Monday, Cuomo announced new requirements for the reopening of indoor shopping malls across New York state. He now insists that they must refit their ventilation and air conditioning systems with high efficiency particle air filters, commonly known as HEPA filters, because they might to help reduce the number of tiny droplets containing the Covid virus in the air, Cuomo also said he was urging other businesses which have already been allowed to re-open to also install the HEPA filters which are designed to remove particles as small as .01 microns from the air, much smaller than the typical .125 diameter of coronavirus particles.
Cuomo added that he’s concerned about New York City’s lax enforcement of social distancing and mask wearing requirements on businesses that have already reopened.
“You can see it in pictures, you can see it if you walk down the street, you can see the crowds in front of bars, you can see the crowds on street corners. It is undeniable,” Cuomo said.
Cuomo also took advantage of the opportunity to repeat his condemnation of the Trump administration which, he said, fail to show leadership in the fight against the virus.
“It is time to wake up America. The White House has been in denial on coronavirus from the get-go and the federal response has just been wrong. That’s not a political statement. If you look at the facts, that’s exactly what it says,” Cuomo said.
CUOMO BOASTS THEN HIDES
Two weeks ago, after weeks of delay, Cuomo ordered the NY State Health Department to issue a ban than has denied the right of Jewish families to send their children to sleep-away camp, an experience that children in the community look forward to all year long, and which has become a widely practiced annual tradition for generations.
Cuomo’s decision to hide behind the state Health Department instead of issuing the sleep-away camp decision himself, was the most recent of many occasions during the course of the outbreak in which he has attempted to shift responsibility to others for his mistakes, while at the same time claiming to be taking bold action in leading the fight against the disease.
In mid-March, at the start of New York’s Covid outbreak, Cuomo claimed that he personally was responsible for ordering the cancellation of the popular annual St. Patrick’s Day parade on Manhattan’s Fifth Avenue, to the disappointment of the city’s Irish community. At that time, Cuomo boasted that he had made the decision over the protests of community leaders in the interests of protecting public health, knowing it would be harshly criticized in some circles. Cuomo identified himself with the famous plaque which used to sit on President Harry Truman’s White House desk, proclaiming, “The buck stops here,” and publicly criticized President Trump for failing to similarly take personal responsibility for the federal government’s lingering problems in ramping up Covid testing capabilities.
But the St. Patrick’s Day Parade decision proved to be the exception rather than the rule, as Cuomo has consistently ducked responsibility for several other virus-related policy decisions and announcements which wound up increasing the chaos and confusion which significantly added to the horrific statewide death toll which has now passed the 30,000 mark.
At the same time, Cuomo’s government partner in incompetence, New York City Mayor Bill de Blasio, has become an object of widespread ridicule in the city, even by many of his former political supporters
JEWISH COMMUNITIES RECEIVE HARSHER TREATMENT
During his early years as mayor, de Blasio enjoyed wide-spread support from New York City’s frum community. Those days are now over. Two weeks ago, de Blasio infuriated the community by ordering the gates on city parks in Jewish neighborhoods to be welded shut to prevent children from playing in them after three months of being locked in their homes. Just a few days later, de Blasio quietly re-opened all of the city’s parks, ahead of schedule, for outdoor play, but without apologizing or admitting that he had wrongfully singled out children in Jewish neighborhoods.
Meanwhile, as Judge Sharpe noted, both de Blasio and Cuomo have turned a blind eye to the Black Lives Matter-sponsored protests, which pose a much greater threat to the public health, according to their logic, than the religiously-motivated violations in the Jewish community which they have actively suppressed.
Since the Covid threat first surfaced in late January, the responses by Cuomo and de Blasio have swung wildly from one extreme to the other. They started by missing the early warning signs which led to an overconfident dismissal of any serious danger. That was followed by a panicked overreaction, based on false assumptions about the virus. Most tragically, that panic led to a disastrous decision by Cuomo which exposed the most vulnerable segment of New York’s population, the sick and the elderly, to the virus in nursing homes that were unprepared to protect them, leading to thousands of avoidable deaths.
In retrospect, we have finally gained a much more accurate and alarming view of how the Covid crisis unfolded in New York. We can now see it through the eyes of the health care workers who were on the frontlines and put their own lives at risk in an effort to save as many lives as possible from the disease.
INADEQUATE PREPARATIONS
A detailed investigative report was published two weeks ago by the Wall Street Journal, based upon interviews with nearly 90 doctors, nurses, hospital staff and administrators and government officials. It revealed serious problems previously overlooked or ignored by the media, as well as failures by city and state governments to prepare for the Covid health emergency whose likelihood had been foreseen, but whose needs were never properly addressed. The result was a period of several weeks when New York’s hospital system was overwhelmed by the outbreak, causing mistakes and delays which resulted in avoidable coronavirus deaths.
In late March, Governor Cuomo issued an urgent call to hospitals in the New York City area to immediately increase their bed capacity by 50% to meet the Covid emergency. But previous warnings about the possibility of a critical shortage in hospital capacity were consistently ignored. Instead of building added capacity, since 2003, government in New York has allowed, and in many cases, forced, 41 hospitals to close statewide, including 18 in New York City alone.
The city-owned hospital system has been chronically underfunded for generations. Private hospitals throughout the state, particularly in poorer sections of New York City’s outer boroughs, have also been under intense pressure from state authorities to downsize or close their doors. In 2005, New York State created the Commission on Health Care Facilities in the 21st Century, also known as the Berger Commission. Its mission has been to force a 20% reduction in the number of hospital beds statewide, in response to intense pressure from state and federal officials to sharply cut New York State’s $60 billion annual Medicaid budget.
HOSPITAL DOWNSIZING ON CUOMO’S AND DE BLASIO’S WATCH
Much of the downsizing of New York’s hospital capacity has taken place since Cuomo became governor in 2011 and de Blasio was elected mayor in 2013. They have never taken responsibility for the lack of preparedness for the foreseeable health crisis that resulted.
One of the heath policy experts who warned of the danger from such cuts was Elisabeth Benjamin, of the Community Service Society. “The patients at these hospitals that are being closed tend to be uninsured, tend to be racial and ethnic minorities, maybe undocumented. How are those patients’ needs going to be met?” she asked while those reductions were being made. In an interview with USA Today during the early days of the Covid outbreak, Benjamin said, “We’re watching a pandemic-induced disaster because we weren’t ready. That is what has created this perfect storm of not enough hospital capacity and really proliferating the misery and death in vulnerable communities.”
The push to reduce New York state’s hospital capacity was further accelerated by new state and federal laws. The Obamacare law in 2010 offered powerful financial incentives for consolidation that fueled the takeovers and mergers of most of the state’s largest hospitals. That has resulted in the creation of a handful of wealthy and powerful health and hospital conglomerates which now dominate the state’s health system.
The same new financial realities have driven many private medical practices out of business, forcing their doctors to retire early or give up their independence by going to work for the conglomerates. Last year, an American Medical Association survey reported that for the first time ever, more physicians nationwide said they were working as employees rather than as partners or owners of their own private practice.
SHREDDING THE MEDICAID SAFETY NET
As a result, many smaller safety-net hospitals which had been serving low-income patients on Medicaid closed or cut services and beds. In New York State, the fallout has hit everywhere from rural communities across upstate to downstate cities, especially in minority-populated neighborhoods.
Despite the consolidation, many of New York State’s community hospitals remain under serious financial stress. Last year, in testimony on the state budget, David Rich, executive vice president of government affairs for the Greater New York Hospital Association, noted that 26 hospitals statewide were on the state health commissioner’s so-called “watchlist” for closure.
“These hospitals have less than 15 days of cash on hand, and require regular, significant infusions of state dollars just to keep the lights on and to meet payroll,” Rich said.
City and state officials had also long ignored alarms raised by the nurses’ union and respiratory therapists about insufficient staffing and equipment levels.
To be fair, the lack of adequate preparedness by the city and state is not a new problem. After 9/11, there were proposals to expand the ICU capacity of New York City hospitals as a preventative measure, but that never happened. A 2006 New York City plan for managing a possible flu pandemic called for a buildup in the stockpile of ventilator machines, but after a series of budget cuts, there was only enough money to buy an additional 500 machines.
A more serious mistake was the failure by New York’s elected leaders and hospital officials to respond properly the early warning signs of the emerging Covid health crisis.
Mayor de Blasio and other officials held New York City’s first news conference on the coronavirus on Jan. 24—more than a month before the city’s first cases were confirmed—where they played down the possible dangers posed by the virus’s spread.
Early signs of the virus’s arrival—including a rise in patients with flulike symptoms visiting hospitals—went largely uninvestigated by hospital, state and city officials. The city health department was limiting testing primarily to travelers from China. Throughout February, in private calls with hospital administrators, city health department officials played down the possibility that the virus could be spread through the air or by asymptomatic people.
MISTAKES DUE TO HASTE AND LACK OF COORDINATION
Only after the disease started to spread through the city’s low-income neighborhoods in early March did Cuomo and de Blasio mobilize public and private hospitals to create more beds and intensive-care units. The hasty expansion that ensued, and squabbling between the Cuomo and de Blasio administrations, contributed to an uncoordinated effort by government leaders and hospital administrators, generating mistakes that worsened the crisis. Many of the coronavirus patients were so sick that they should not have been transferred between hospitals.
PATIENTS TRANSFERRED WITH “ONE FOOT IN THE GRAVE”
More than 1,600 largely coronavirus patients in two of the state’s largest hospital systems were moved from overloaded hospitals to ones that were less crowded. Many patients arrived at their new hospital in critical condition, and to make matters worse, medical and treatment records from their previous hospital were not always transferred with them.
Under normal protocols, only stable patients would be transferred, but these people came in with “one foot in the grave,” said Dr. David Buziashvili, who worked many shifts at Bellevue Hospital. While on one shift there, he was alarmed to see 10 new transfers in beds with little medical information. “That is not how it should be done, and it is not safe for the patient at all.”
Avery Cohen, a City Hall spokeswoman, blamed the state for denying a request from the city to establish a centralized hub—called a Healthcare Evacuation Call Center—that would have helped better coordinate transfers between hospitals, whether private or public. “We were grasping for every tool at our disposal to save as many lives as possible,” Cohen said. “The state was not interested.”
Dani Lever, a spokeswoman for the governor, said that system wasn’t designed for individual patient transfers. She said a new state transfer system was created in late March after hundreds of open beds near harder-hit New York City hospitals had gone unnoticed.
INSUFFICIENT STAFF
Early in the outbreak, hospitals often failed to separate coronavirus-infected patients from the uninfected, enabling the virus spread throughout their facilities.
After mid-March, the hospitals added hundreds of ICU beds, but government officials and hospital administrators failed to provide a sufficient amount of additional trained staff as they expanded beds into operating theaters, old auditoriums and lobbies. That led to many cases of improper treatments and overlooked patients dying alone.
“Creating beds isn’t the most difficult thing,” said Northwell CEO Michael Dowling. “The issues that get complicated with the creation of beds is the staffing. This isn’t like you can put any staff on any bed at any place.” The crisis would eventually peak at nearly 19,000 hospitalizations, but even that number overloaded the system.
As coronavirus patients flooded into NewYork-Presbyterian/Columbia, the private hospital created new pop-up ICUs. The inadequacy of staffing levels quickly became clear in one operating-room-turned-ICU. Garbage in the makeshift 80-bed unit overflowed with contaminated needles, masks and gowns. Urine and blood stains were at times found on the ground and equipment. “The scope of patient needs compared with the training and resources available presented an absolute crisis,” said Julia Symborski, a nurse who worked in the new ICU.
In that new ICU, one respiratory therapist at times cared for over 80 patients a shift, whereas 10 therapists a shift is typical in normal times. Overworked staffers there weren’t able to suction mucus out of patients’ lungs often enough, resulting in patient complications. Intubated patients’ lips were bleeding and many developed sores on their backs—pressure ulcers—from not being turned over enough.
Hospitals sometimes mismanaged the staff they did have and were slow to hire additional critical-care nurses and key respiratory therapists to manage the growing number of patients on ventilators. The problem wasn’t that there not enough trained medical personnel available nationwide: Brian Cleary, CEO of Krucial Staffing, an agency Health + Hospitals tapped to send 4,000 medical staff during the crisis, said it could have sent in 6,000 more “without blinking.”
TOO MUCH RED TAPE AND NOT ENOUGH TRAINING
In some cases, available doctors and trained critical-care nurses said hospitals failed to cut through the red tape that was preventing them from quickly getting to work to start saving lives.
Chelsea Walsh, a traveling nurse from Hawaii, said all the red tape from NewYork-Presbyterian discouraged her from working there, so she took shifts elsewhere in the city. “I couldn’t work for a hospital in the middle of a crisis that wanted me to do paperwork before I help save someone’s life. The paperwork and the administration’s rules delayed a lot of care.”
Making the confusion worse, state and city government and hospital officials kept shifting their guidelines for when exposed and sick frontline workers who had recovered could safely return to work.
The staffing shortages also led to hospitals losing track of their admitted patients. At Brookdale University Hospital Medical Center in Brooklyn, a family called the ER to inquire about their mother in her 80s. An ER doctor said that when he looked up the patient’s records, he realized she had died two days prior, but nobody had notified her family. “This was happening daily,” the doctor said about the peak period of the outbreak.
NewYork-Presbyterian’s hospital system began recruiting additional staff in February and ended up with more than 2,850 volunteers and temporary frontline staff, including 150 additional respiratory therapists.
While nurses arrived at Bellevue and other locations, “a lot of them had no experience whatsoever,” said Laura Jaramillo, a Bellevue ER nurse. She had to spend time training some of them while also juggling a huge patient load.
“We are not running these ICUs safely or appropriately,” a Columbia-Presbyterian hospital resident wrote in an email to the attending physicians. “The emotional burden of working in these sci-fi-movie-gone-wrong ICUs is through the roof.”
UP TO 40% OF DEATHS COULD HAVE BEEN PREVENTED
Joji Thadathil, a Health + Hospitals Elmhurst hospital respiratory therapist, estimated that more staffing and better equipment could have saved 30% to 40% of coronavirus patients who died there.
Elmhurst hospital became the poster child for the city-owned hospital system during the peak of the epidemic. Media reports featured pictures of refrigerated shipping containers filled with the dead bodies of coronavirus victims stacked up and waiting in the hospital’s parking lot, because the city’s funeral homes and morgues couldn’t keep up with the volume.
Rio Flores, a respiratory therapist, said he documented 50 patients who died in part due to improper ventilator settings by untrained staff and state-provided ventilators with limited functionality at the NewYork-Presbyterian system’s Lower Manhattan hospital. Respiratory therapy is a specialized job that requires a license and at least two years of training.
CRITICAL EQUIPMENT FAILURES
As the number of coronavirus patients spiked, hospitals turned to the state and federal government for hundreds of ventilators, but found that many they received were faulty or inadequate. The Cuomo and de Blasio administrations and hospital leaders failed to ensure the quality of the equipment and supplies they obtained. Doctors and nurses were surprised at the shoddy performance of ventilators distributed to hospitals by the state from its own stockpile, as well as those which were provided from the federal government’s reserve. Much of the overpriced PPE equipment they were able to find on the open market failed to meet FDA specifications.
Mr. Thadathil, the Elmhurst hospital respiratory therapist, and Dr. Meyers, an ER physician, said the ventilators were old and after being attached to them, many patients got worse, due to collapsed lungs and other complications. Dr. Meyers also said that because the ventilator alarms would ring so often, it was “impossible to know if one of those events actually is trying to indicate something dangerous is happening.”
A Health + Hospitals spokeswoman said that many state-supplied ventilators “were not ‘ready to go’ when they came,” and needed additional maintenance before they could be used on patients. But a spokeswoman for Governor Cuomo said that the state had tested each of the ventilators before sending them to hospitals and received no complaints about any of them being faulty.
RUNNING OUT OF OXYGEN
While Cuomo and de Blasio often spoke about the urgent need to procure more ventilators, and complained about the slow federal response, there was no media coverage on the fact that at least eight New York City hospitals had experienced problems securing adequate supplies of oxygen needed to keep coronavirus patients breathing and off the dwindling supply of ventilators.
At Health + Hospitals’ Lincoln hospital in the Bronx, Dr. Dasol Kang said some of his patients, including a woman in her 50s and a man in his 40s, languished without portable oxygen tanks, worsening so much they needed intubation and later died. A Health + Hospitals spokeswoman denied that the hospital experienced an oxygen shortage or had to resort to rationing its supplies.
The problem was not a shortage of oxygen supplies on the commercial market, according to a spokeswoman for Pennsylvania-based Airgas. She said that while her company saw increased demand from hospitals, it “has not experienced an inability to supply requested medical oxygen anywhere in the US.”
However, according to Michael Dowling, CEP of the Northwell, the largest private hospital system in the NY metropolitan area, it was using 50 times more oxygen during the pandemic than ever before and did face some problems as a result. “Did we at a few locations have to address an oxygen issue? Yes. Did we run out of oxygen? No,” he said.
NOT ENOUGH MONITORS AND DIALYSIS MACHINES
Doctors and nurses at eight New York hospitals also reported shortages of the vital-signs machines needed to effectively monitor patients’ breathing. As a result, some patients were left gasping for breath even as they lay hooked up to an oxygen line.
Sometimes, they died without the staff in the ICU realizing it. Often this happened when patients, feeling suffocated, pulled off their oxygen masks. Jenna Smarrella, a traveling nurse from Ohio, said she had a patient in his 80s who seemed stable breathing through a mask when she first saw him at Health + Hospitals’ Harlem hospital. When she came back at a later point to check on him, she found he had removed his mask and was dead. “If he was on a monitor,” she said, “I would have known.”
A Health + Hospitals spokeswoman denied the report, and claimed the system had an ample supply of monitors to track its patients continuously. Medtronic PLC and Drager Inc., two medical equipment companies that supply respiratory-monitoring systems for hospitals, said that they were able to meet the increased demand from New York hospitals during the coronavirus surge and did not encounter any shortages.
New York hospitals also failed to procure enough IV pumps that control medicine flow, as well as dialysis machines, even though, by early March, it became evident from the records of Chinese coronavirus patients that kidney failure was a frequent complication of the disease.
At an ICU at Health + Hospitals’ Lincoln hospital, during the first two weeks of April, Dr. Donya Bani Hani said she saw a coronavirus patient die every day or two because of complications that dialysis might have prevented, although many were so sick that they might have died anyway.
A doctor who worked in a Bellevue hospital ICU said that at least 10 patients died because they couldn’t get dialysis in time. Another Bellevue physician, Dr. Buziashvili, said he saw a patient aged in the 50s die while waiting for a dialysis machine. Still, Buziashvili said, “Bellevue did well to adapt and restructure appropriately as we gained more knowledge on the virus.”
A Health + Hospital system spokeswoman denied that any of their patients died due to lack of dialysis treatment.
FAULTY CITY-STATE COOPERATION
When officials in New York City’s Office of Emergency Management realized that hundreds of coronavirus patients would need to be transferred to keep local hospitals from being overwhelmed, they asked NYS Department of Health to activate a centralized evacuation hub that had previously been used for emergencies like Superstorm Sandy in 2012.
The department denied the city’s request twice, and only agreed to activate the system on March 26 to transport city hospital patients to the pop-up hospital set up by the US Army Corps of Engineers in the Javits Center and to the US Navy’s Comfort hospital ship that President Trump dispatched to the New York harbor. Even then, the transfers were of only limited usefulness, because the Javits Center wards and the hospital ship facilities weren’t initially suitable for critical care or infectious coronavirus patients.
A spokeswoman for Governor Cuomo also claimed that throughout March, the city wanted to handle patient transfers between hospitals on its own, or not to move any patients at all.
It was not until March 30 that Cuomo announced that state officials had found hundreds of hospital beds outside the city that were going unused while the city’s hospital capacity was being overwhelmed by the number of coronavirus patients. Cuomo then set up an ad hoc team to monitor the statewide availability beds, equipment and staff, and to help coordinate transfers between hospitals of patients, personnel and equipment.
But according to Jim Malatras, the president of SUNY Empire State College who has been advising Cuomo on the pandemic, there was no system in place to make sure the patients were transferred to their new hospitals with their medical records, or to follow up on their conditions after they were moved. The focus, according to Malatras, was on “trying to manage volume, not necessarily the individual patient’s needs.”
Nevertheless, state officials insisted the transfer system did ultimately help save lives. They cited incidents at Flushing Hospital Medical Center and Jamaica Hospital Medical Center, when oxygen lines began to freeze up because they were overloaded with ventilators, requiring 26 patients to be transferred within an hour to other hospitals in the city and upstate.
FRUSTRATED DOCTORS COULDN’T HELP NEW PATIENTS
However, the state didn’t have authority to coordinate any patient transfers between hospitals inside the same city or privately-run hospital systems. For a few weeks during the height of the coronavirus surge, the Health + Hospitals system sent about 30 patients a day from their Elmhurst, Lincoln and Woodhull hospitals by ambulance to Bellevue’s emergency room, many of them in critical condition, which is unacceptable in normal times. According to several nurses and doctors at Bellevue, some of those transferred died soon after arriving.
ER nurse George Good said that he got used to the sight of newly transferred patients on a breathing tube, “hanging onto life by a thread,” and then watching helplessly as their heart rates would start to plummet and fall to zero. “It was just something we kind of had to deal with,” he said sadly.
According to one Bellevue doctor, three transfer patients were received one night from Woodhull hospital in Brooklyn—and all were “coding” and in need of resuscitation within 30 minutes of arriving there.
Dr. Buziashvili at Bellevue was disturbed that many patients arrived without records of the treatment they had received at the transferring hospital, and three or four “unknown” patients who arrived without a name, including one who had to be identified by a family member.
According to a Health + Hospitals spokeswoman, about 850 patients were transferred between hospitals in the system during the crisis, but she declined to disclose how many of them survived. “Covid patients were generally unstable, and their conditions changed rapidly regardless of area of care or transport,” was all the spokeswoman would say.
SHORTAGES OF PPE
Shortages of personal protective equipment (PPE) and coronavirus testing capacity for hospital personnel added to the staff shortage problem. Hospital officials said that, as early as January, while the coronavirus was spreading rapidly through Wuhan, China, they became aware of a developing worldwide shortage of PPE.
Before the mid-March surge, New York government and hospital officials said they were confident there was enough PPE available to meet local needs. For example, Montefiore CEO Philip Ozuah said in a Feb. 7 memo to hospital employees about coronavirus that “we are well prepared to meet this clinical challenge,” but behind the scenes, a Montefiore spokeswoman now admits, “Montefiore was making all efforts to acquire PPE.”
In his daily news conferences, starting in late March, Governor Cuomo repeatedly declared that New York hospitals had assured him that they had enough PPE. That claim was quickly contradicted by footage showing New York hospital staff wearing homemade aprons created out of cut-up plastic garbage bags.
HOARDING AND RE-USING N95 MASKS
Initially, many hospital administrators advised hospital staffers that a thin surgical mask was good enough to protect them from infection by virus carried in droplets expelled by coughing coronavirus patients. Later, they were told to wear the much more effective N95 masks. When N95 masks quickly became almost impossible to obtain, the CDC advised hospital staff to use makeshifts covers to protect their mouth and nose, such as bandanas, which, although hardly sufficient, were better than nothing.
Hospital staff complained that because of the shortage, they were forced to wash and reuse the few disposable N95 masks that were available, even after they had become soiled, increasing their risk of infection. Mikhail Migirov, a respiratory therapist, said he realized that the seal of his N95 mask was no longer protecting his nose and mouth during an intubation when he was able to smell the patient’s breath. He later tested positive for coronavirus.
Hospital systems scrambled to find new sources of PPE, bidding up the price against each other and state governments for the available supplies. In mid-April, New York officials realized that some hospitals were secretly hoarding N95 masks, extending the shortage even though enough masks were being made to meet the increased demand.
Cuomo’s office ordered hospitals to give each of their workers a new N95 mask daily if the worker if requested, but the nurses’ union claims the hospitals did not comply. It filed a lawsuit against the NYS Department of Health saying it failed to “fulfill its mandate to protect the health of the public” and neglected to enforce hospital worker PPE guidelines. A health department spokesman responded: “Throughout this crisis, we worked with our nurses and other frontline heroes to make sure they had the proper equipment they needed amidst a worldwide shortage, and we were in constant contact with both union and hospitals to accomplish this.”
NURSING HOME TRAGEDY
As bad as the PPE shortage was in the city’s hospitals, it was even worse in New York’s nursing homes.
Nursing homes were turned into a dumping ground by a March 25 order from Cuomo’s Health Department, which required nursing home administrators to accept the transfer of all patients who tested positive for coronavirus in an effort to free up more hospital beds. The nursing homes were woefully understaffed and unprepared to treat coronavirus patients, but did not dare reject the order from the NYS Department of Health, which has jurisdiction over their operations. Petitions and emails from nursing home operators and concerned family members, warning that transferring coronavirus patients to nursing homes put all their residents at risk, were ignored.
The death of at least 6,250 New York nursing home residents, about a quarter of the state’s total coronavirus death toll, was largely due to that March 25th order. Cuomo did not rescind it until May 10, more than a month after the New York’s daily death toll peaked, and most of the damage had been done. Even as he reversed it, Cuomo refused to admit that the directive was disastrous mistake, or to accept responsibility for its tragic outcome. Instead, he blamed nursing home administrators for accepting patients they were unable to properly care for, despite the order he approved that denied them the right to turn away coronavirus patients.
Cuomo also tried to shift blame to President Trump because, the governor claimed, the March 25 order followed guidelines issued by the federal CDC.
Cuomo and his staff were also responsible for a paragraph in the New York State budget law passed by the Albany legislature in April, which grants blanket immunity from lawsuits to nursing home administrators and executives by the families of nursing home residents who died from exposure to Covid. Cuomo had previously granted temporary immunity to all doctors and nurses treating Covid patients under the so-called Good Samaritan Law, which legally protects those responding to emergency situations.
A group of 14 New York State legislators is now trying to pass legislation to overturn the added protection in the budget covering any nursing home “administrator, executive, supervisor, board member, trustee or other person responsible for directing, supervising or managing” the facility, because of the “negligence” which “occurred at an extraordinary degree” in those facilities.
Cuomo’s critics point out that the state’s nursing home industry provided Cuomo’s 2018 gubernatorial re-election campaign and the state Democrat party with $2.3 million in campaign contributions. The Greater New York Hospital Association (GNYHA), which donated $1.25 million of that total, has publicly claimed that it “drafted and aggressively advocated for” the immunity provision to be inserted into the budget bill.
A PROTEST DOUBLE STANDARD FOR CORONAVIRUS
Until the George Floyd protests broke out, New York citizens were frightened enough of the coronavirus to heed orders to stay home in lockdown, wear masks and observe social distancing even if they weren’t totally convinced that all the precautions were really necessary. They heeded stern warnings from Cuomo and de Blasio that anybody who put a makeshift minyan together in their backyard, teach a Torah class in a mostly empty yeshiva or attend the levayah of a beloved rebbe, posed a threat to public health and deserved to be punished for it.
But the same leaders have blatantly ignored these public health concerns for the sake of promoting the agenda of the Black Lives Matter movement, condemning police for “systemic racism.” In doing say, they undermined the credibility of their anti-Covid decrees.
