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At a press conference Monday morning, Gov. Andrew Cuomo and National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci updated New Yorkers on the coronavirus spread. (Images courtesy of the Office of Gov. Andrew M. Cuomo)
At a press conference Monday morning, Gov. Andrew Cuomo and National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci updated New Yorkers on the coronavirus spread. (Images courtesy of the Office of Gov. Andrew M. Cuomo)

Cuomo: Regions will shut down again if they can't control hospitalizations

Mon, Dec 7th 2020 08:25 pm

Gov. Andrew Cuomo said New York restaurants will face harsher restrictions, and regions will go back on “PAUSE,” if the coronavirus-related hospitalizations continue to rise.

“We are looking at hospitalization capacity. And if we don't get the rate under control, then you are going to overwhelm your hospitals. We will have to go back to shutdown,” he said during a press conference Monday morning. “There are certain absolutes. What is the absolute here: You cannot overwhelm your hospitals. We can't be Italy. You can't overwhelm your hospitals. If you are at a rate that is going to overwhelm your hospitals, you must shut down – not just indoor dining shut down. Only essential businesses (will remain open).

“ ‘Oh, we don't want to do that again.’ Then change your behavior. But if we don't change our behavior, that is the absolute reality of the situation.

“ ‘How can you talk about close down again? That was terrible.’ Because it's the truth. …You cannot overwhelm the hospitals.

“No state is better than we are at managing the hospital system. … We will manage the hospital system as well as it can be managed. But, if you're going to overwhelm the hospital system, then we have no choice but to go to close down.”

What It All Means

Cuomo directed the New York State Department of Health to begin implementing the state's "surge and flex" protocol and mandate all hospitals begin expanding their bed capacity by 25% to further prepare hospitals for a future COVID-19 surge. Hospitals had previously been preparing plans for this action as part of New York's winter coronavirus plan. Additionally, the governor issued a call to all retired doctors and nurses urging them to return to service if they are able to do so.

“We are aware of staff resources. The staff comes into this stressed, right. They had – you want to talk about a long year – nurses, doctors, hospital workers, 1199 – they had the longest year of anyone. So they come into this stressed,” Cuomo said. “We're going to ask retired doctors and nurses to sign up and we will automatically reregister them in the state without cost. We believe we can get about another 20,000 nurses and doctors from this mechanism.”

Registration will be renewed at no cost for an individual who completes the questionnaire through the volunteer portal, set up by the New York State Department of Health.

Cuomo also announced regions that reach critical hospital capacity will be designated as a “red zone” under New York's micro-cluster strategy. Specifically, following the implementation of the state's "surge and flex" program, if a region's seven-day average hospitalization growth rate shows the region will reach 90% within the next three weeks, the region will become a “red zone.”

Following updated guidance from the CDC, the governor announced that, if a region's hospitalization rate does not stabilize in the next five days, additional restrictions will be applied to indoor dining. If the hospitalization rate does not stabilize in New York City in the next five days, indoor dining will be suspended; if the rate does not stabilize in regions outside New York City, capacity restrictions will be reduced to 25%.

Fauci Weighs In

Cuomo was joined by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. The governor asked when it would be likely the country would fully reap the benefits of a coronavirus vaccine. Fauci said his best-case scenario – assuming the general public is educated on the vaccine and buys into its effectiveness – would be summer 2021. With upward of 75% to 80% of the general public vaccinated, the country has “umbrella” protection, making it more difficult for the coronavirus to spread.

“Between now and then, slow the rate of spread, slow the rate of hospitalization,” Cuomo said. “If you overwhelm the hospital capacity, you will have to go back to shutdown. There are no options. That’s not discretionary. That's not, ‘Well, maybe there's an alternative.’ You can't overwhelm the hospital system.

“Overwhelming the hospital system means people die on a gurney in a hallway. And the life you could have saved you can't save, because you don't have the staff; you don't have the doctor; you don't have the nurse; and people die unnecessarily. Those are the absolutes.”

Western New York Responds

In response to Cuomo’s instructing hospitals across New York to increase their capacity by 25%, Kaleida Health Chief Operating Officer Don Boyd said, “Similar to what we were facing in the spring, our plan to help fight the ongoing COVID crisis right now relies on four issues: personnel, equipment and supplies, testing capacity and space planning.”

For Kaleida Health, increasing bed capacity by 25% could include any or all of the following:

√ Reopening beds at DeGraff Medical Park (formerly DeGraff Memorial Hospital).

√ Additional intensive care beds at all sites (Bradford Regional Medical Center, Buffalo General Medical Center, DeGraff Medical Park, Millard Fillmore Suburban Hospital, Oishei Children’s Hospital and Olean General Hospital).

√ Doubling up private rooms and conversion of old hospital rooms/space.

√ Utilization of ambulatory surgery space and ambulatory surgery centers.

√ Redeployment of required medical equipment (ventilators, patient beds, etc.).

Boyd said increasing bed capacity will only increase the need for additional personnel.

He added, “We are and will continue to be creative in all areas so we can maximize ancillary staff, nursing and physicians.”

During the initial COVID-19 spike in March of this year, the New York State Department of Health instructed hospitals across the state to update their surge plans to increase hospital inpatient bed capacity by 50%.

COVID-19 Statistics

Erie County

As of Sunday, Erie County had 383 new positive coronavirus cases, for a yearly total of 29,331 (including 594 on Grand Island and 11,453 in the City of Buffalo). Sunday’s positivity rate was 5.8%, with 6,581 individuals tested.

To date, 800,308 people have been tested (3.7% positive), with 902 deaths attributed to the coronavirus. Also, 92,988 people have taken an antibody test (7.4% positive).

Image courtesy of the Erie County “heat map”

Niagara County

The Niagara County Department of Health issued the following update on positive COVID-19 cases:

Source: Niagara County active case map

Source: Niagara County “heat map”

Each region's seven-day average percentage of positive test results reported over the past three days is as follows:

REGION

FRIDAY

SATURDAY

SUNDAY

Capital Region

4.32%

4.50%

4.60%

Central New York

5.48%

5.19%

5.55%

Finger Lakes

6.56%

6.80%

7.01%

Long Island

5.20%

5.38%

5.50%

Mid-Hudson

5.77%

5.97%

6.03%

Mohawk Valley

6.09%

6.35%

6.53%

New York City

3.99%

4.01%

4.04%

North Country

4.12%

4.39%

4.50%

Southern Tier

2.63%

2.33%

2.09%

Western New York

7.44%

7.40%

7.34%

In an afternoon press conference, Erie County Executive Mark Poloncarz pointed out areas with the highest number of cases, per 100,000 residents, for the week ending Dec. 5. West Seneca was tops, with 248.

More than a half-dozen locations reported numbers exceeding 75 per 100,000 (including Buffalo – 14203 ZIP code – at 106, Lancaster at 100.5, Grand Island at 96.1 and West Seneca at 88.8).

“The numbers aren't good,” Poloncarz said. “They are still increasing with regards to new cases in these areas of concern that we've talked about for the last few weeks.”

He explained, “You don't want to be over 50. You really don't want to be over 25, because that means you pretty much can kill the virus. Between 25 and 50 means it's replicating; infections are continuing, increasing; anything above 50 is really bad. And as we talked about before, anything 70-75 and above is exceptionally bad – and unfortunately we have too many communities in Erie County that are above 70 in the new daily cases per 100,000 population category.”

As a region, Western New York was at 64.21 as of Saturday, with 7.3% of new tests identified as positive for the coronavirus.

Erie County also reported a new high for COVID-19-related hospitalizations, with 410 on Dec. 3.

Images courtesy of Erie County

•••••••

Commissioner of Health Dr. Gale Burstein said, “The week ending Dec. 5, which was last week, we had the most number of cases reported than we've ever had – 4,305 cases – which gives us 7.6% of all the tests done were positive.

“I can tell you that, in our experience and at Erie County Health Department with testing, as you know we're running BinaxNOW tests on people that are symptomatic. Last week, of just testing people who were symptomatic at our rapid testing clinic, 25% of those symptomatic people were positive.

“So, if you have symptoms that could be consistent with COVID-19 – it could be a fever, could not include a fever – we see people who are infected who don't have a fever – respiratory symptoms, any type of illness, please stay home. Don't go to work; don't go outside your room and infect the rest of your family; don't send your kids to school. Just please stay at home, and get a test – if you can.”

Additional Look at Numbers

The regional hospital bed capacity and occupancy numbers, including the number of hospitalizations as a percent of the region's population, is as follows:

 

Region

COVID Patients Currently in Hospital in Region

COVID Hospitalizations as Percent of Region Population

Percent of Hospital Beds Available in Region

Capital Region

220

0.02%

26%

Central New York

296

0.04%

26%

Finger Lakes

545

0.05%

30%

Long Island

702

0.03%

18%

Mid-Hudson

618

0.03%

25%

Mohawk Valley

146

0.03%

26%

New York City

1416

0.02%

19%

North Country

38

0.01%

46%

Southern Tier

134

0.02%

39%

Western New York

487

0.04%

28%

NYS TOTAL

4,602

0.02%

23%

 

The regional ICU bed capacity and occupancy numbers are as follows:

 

Region

Total ICU Beds in Region

Total Occupied ICU Beds in Region

Percent of ICU Beds Available in Region

Capital Region

314

167

44%

Central New York

290

189

33%

Finger Lakes

659

246

62%

Long Island

801

579

25%

Mid-Hudson

728

368

48%

Mohawk Valley

131

99

26%

New York City

2290

1687

27%

North Country

67

33

54%

Southern Tier

129

82

35%

Western New York

559

293

50%

NYS TOTAL

5,968

3,743

37%

At a press conference Monday morning, Gov. Andrew Cuomo and National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci updated New Yorkers on the coronavirus spread. (Images courtesy of the Office of Gov. Andrew M. Cuomo)

Image courtesy of Erie County

 

 

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