Talks focus on schools, restaurants, hospitals, hair salons & gyms
Gov. Andrew Cuomo on Friday said he is tweaking what goes into his micro-cluster action zones, and will look at available date this weekend to determine if more restrictions will be levied on any or all of New York’s regions.
“We're now talking about a winter plan, and when you're talking about the winter plan you have to take the full context into consideration,” he said. “Where we've been, where we're going. And it has been quite the journey, and the journey isn't over. It's not really going to be over until the summer and we hit critical mass with the vaccination. And we have to calibrate our way through the journey.
“You change strategies as the virus changes. Seasonal change, the growth pattern changes. And where the growth is occurring. The current numbers in New York State. The statewide positivity without what we call micro-clusters, 4.5. with the micro-clusters, 4.9. In the micro-clusters, 6.8. We did 212,000 tests. 87 New Yorkers passed away. They're in our thoughts and prayers. Hospitalization, 5,300. ICU, 1,700. Intubations, 546.
“Looking across the state, Finger Lakes, highest rate of hospitalization by population. Then, Western New York, Central New York, Mohawk Valley. Western New York, which we've been focusing on for quite some time, we've actually seen a flattening in Western New York. Not a reduction, but a flattening in the increase, and that's good news. But you see the varied picture across the state of New York.
“We have said from day one, for us, this is a constant calibration. We want as much economic activity as possible, and respect public health and the cost of the virus, right. So that's always the calibration. Yes, economic activity. Yes, as much as we can, social activity, balanced with public health. Some states have had these dramatic opens and closes, full open, full close, full open, full close. I think that's highly disruptive and it's not the best way to go through this. Our approach has been different, where we've always been following the data and the metrics. And we have more data than any other state. Maybe New Yorkers have a little PTSD, but what we went through in the spring, with all these experts giving us advise and the advice turned out to be wrong, all this anecdotal information, we invested very heavily in doing COVID testing, and we do more testing than any state in the nation. But, that gives us actual facts that we can base our actions upon. And we've now done 21 million tests. So we've actually done more tests than we have people in the state of New York, now.
“On the facts, what we're seeing: Schools are almost without exception safer than local communities in terms of infection rate. This was not what was initially expected. Initially some of the experts said, ‘Well, schools are like mass gatherings, and if you get a lot of students together there's going to be a spread.’ That is not what has happened. That's not what the facts say. The facts say that the schools are actually following the rules and following the guidance. The children are following the guidance. The teachers are doing a great job following the guidance, and the schools, the positivity rate tends to be lower than the positivity rate in the surrounding community. My point is, if it is safer for the children to be in school, then have the children in school. If it's safer for the teacher to be in school, then have the teacher in school. It's less disruptive, the children get the education, you don't have the same issues you had with remote learning.
“Now, this is a decision that has been left to the local school districts, and we've had a discussion back and forth. We had this discussion with New York City. My advice, although it's their decision, is that unless you have data that says the schools are at a problematic infection rate, the schools should be open. City of Buffalo recently announced they're going to keep their schools closed. I respect local governments. I respect the prerogative of local governments with education. I understand the balance. But, my advice, and if you look across the nation and you look across the world, most informed experts will say test in the schools, but if the schools are safer, then leave the schools open.
“By the facts, hospitalization rates are increasing dramatically, across the world, across the nation, and across this state. You see where we are now, and you see how quickly the increase has been, and this is the ultimate cause for concern, right. The ultimate cause for concern is an overwhelming of the hospitals. With the hospitals, the situation in the hospitals is better than it has been in the past. Compared to the spring, you have 30% fewer people in the ICU; we have 50% fewer people intubated. The length of stay in the hospitals has dropped dramatically. The length of stay was on average 11 days in the spring. It's now down to five days. The medical community has made the most progress over the past few months. Not only the development of the vaccine, but therapeutics and having to deal with this disease. That's what you see in the reduction of the length of stay. That's what you see in the death rate.
Image courtesy of the Office of Gov. Andrew M. Cuomo
“We had a 23% death rate in the spring. That is now down to 8%. This is probably the most informative data. Where are the new cases coming from? You want to know what's generating the new cases so you know where you can stop them. The troubling information in this is 74% of the new cases are coming from household gatherings. Living room spread. In many ways, you can understand what happened.
“You closed bars, you closed restaurants, you closed theaters, you closed stadiums, you closed mass gatherings. Where do people go? They go home. ‘Come to my house or go over to Robert's house. We'll invite our friends, we'll invite our family.’ Compound that by the holiday season, which is a natural, ‘Come to my house; my family, my friends I know will be safe.’ That is what is driving these numbers.
“You get past the 74%, health care delivery, which is incidental to the provision of service. These are in hospitals, etc. Then higher education, colleges, which we have been battling. This is partially college students going back and forth. This is partially college students who at that stage in life are superheroes and they don't believe that they're going to get infected. If they get infected they're going to be able to deal with it. We've been dealing with colleges. Education employees. Restaurants and bars, 1.4%. You're now down to small numbers basically.
“Travel, vacation; we've had quarantines, but people coming in – that is an imperfect system on travel. That's about 1%. Sports is basically school sports. Public sector: police, fire, EMS, military. Now, a big part of this is people by their job are exposed to the situation. EMS workers, National Guard – people who have been helping. Police, fire, they're out there all the time. I've said repeatedly police, especially, they need to wear masks. It's the law and it's smart. It's both.
“Transportation, private transportation. People who are in limo cars, call-in cars as well as public transportation. Manufacturing, religious activities, construction, retail, professional services, elementary school; .49. High school, .46. Prisons, correctional, .4. Middle school, .19. Auto-dealers, car rentals, .16. We're getting to very small numbers here now. Auto-dealers, car rentals and then hair and personal care, which was much worse earlier on.
“Wholesale trade, building services, real estate, entertainment, gyms, agriculture, hunting forestry, child care, power utilities, accommodations, media production. You're now in very, very small numbers. Stop the spread where it exists and stop it where it's being generated, but don't waste time on areas that are not generators.
“Indoor dining which many people have spoken about. It is a generator. We have made strides on Indoor dining by the restrictions we put in place and the safety protocols we put in place. It is still an issue, but it's much better than it was. Gyms are one of the lowest known spreaders now by the facts. We've increased the testing, we reduced the capacity. Gyms are now down to .06. Hair salons, barbershops, personal care .14. Again, small gatherings are the greatest individual issue and we believe this is going to continue to increase over the holidays.
“In general, also, you see compliance by people down. COVID fatigue, the holidays, the vaccine is coming. ‘I'm just tired of dealing with it.’ Government enforcement is down. One of the more troubling points in the data is the Rt is up 1.3. We haven't spoken about this in a while.
“Rt is the rate of transmission. 1.3 means one person will infect 1.3 additional people. Once that number is over 1 you're in a problematic state. This is a problematic situation. We want to calibrate to the new material, the new facts, the new data.
“The criteria, the metrics we use, what is the positivity rate? What is the hospitalization rate? What is the hospital capacity in that area? You don't want to overwhelm the hospitals. Considering the Rt rate, what is the density and what is the crowding? Which is a factor we have not been considering because the Rt was below 1 for some period of time. Then the risk level of that economic activity going back to the chart that shows where the cases are coming from.
“You're calibrating the risk level of the economic activity. The density level, the Rt rate and the hospitalization capacity and the positivity rate. A ‘red zone’ is ‘New York on PAUSE.’ It is stop all but essential services and business. It's where we were. We don't have any ‘red zones’ in the state. We don't want to go back to a ‘red zone.’ Other states have gone back to closure. We don't want to go here. The only reason you would close the economy is because you're going to overwhelm the hospitals. If you get to 90% of hospital capacity, then you are effectively at the point where you're going to overwhelm the capacity. The capacity here includes staff and equipment, etc. If we see that we're on a glide path towards overwhelming the hospitals, you have no choice but to close down the economy. You cannot overwhelm the hospital system.
“Short of that is an ‘orange zone,’ which is 4% positivity over 10 days, or you're at 85% of hospital capacity, or the rate of growth in the hospitalizations is dramatic and as determined by Department of Health. ‘Yellow zone’ is 3% positivity, and you are one of the highest percentage growth clusters in the state in terms of hospitalization.
“We're calculating the data of this and this weekend and, by those metrics, any new zones we'll announce on Monday. If you are ‘yellow zone’ or if you are an ‘orange zone,’ this is all determined on the facts, and what it is saying is in your community you have a problem. It's not somewhere else. It's your community. It's your grocery store, it's your church, it's your temple, it's your mosque, it's your block, and you can make a difference in your community and it means you have to take it seriously.
“Yes, I'm tired. I've been doing this for a long time. I feel it myself. I get it but we can't relax until COVID relaxes and COVID is not relaxing. We have the vaccine, we're going to beat it, but we have to finish the game and we have to finish the war. …
“We're also changing rules for the hospitals in the state. We've already announced that all hospitals have to do a 25% increase in staffed beds. Hospitals must remain under 85%. They can remain under 85% capacity by either adding an additional 25, up to 25% of beds, or reducing elective surgeries, or both. They have that flexibility, but we want every hospital to remain under 85% occupancy. Over 85%, that hospital is now in a critical situation. As we said, 90% riggers a ‘red zone’; and every hospital has to have a 90-day PPE supply.
“The increasing RT is a problem, rate of transmission. It's more of a problem in the most dense areas. We learned this lesson in the spring the hard way. …
Image courtesy of the Office of Gov. Andrew M. Cuomo
“CDC last week did a caution on indoor dining. In New York City, you put the CDC caution on indoor dinging together with the rate of transmission and the density and the crowding, that is a bad situation. The hospitalizations have continued to increase in New York City. We said that we would watch it. If the hospital rate didn't stabilize we would close indoor dining and it has not. We're going to close indoor dining in New York City on Monday. Outdoor dining and takeout continues.
“Outside of New York City and in the ‘orange zones,’ we're going to watch the indoor dining data. The numbers are down in the chart, but we're going to watch over this weekend and we'll make any adjustments next week if the data suggests.
“Federal government must provide relief to these bars and restaurants in this next package. I understand battling COVID. I also understand you're wiping out businesses. We'll do what we can in New York. We're going to extend the commercial evection moratorium, so if a business can't pay the rent because of this situation they won't be evicted.
“In gyms and salons, as you also see, they are not the problem that they were. We have restrictions. The restrictions made a difference. We're going to allow them to operate in ‘orange zones’ with reduced capacity and additional testing. They're at 33% now, capacity. We'll go to 25%. They do biweekly testing. It would be weekly testing, but they can operate in an ‘orange zone.’…
“If the facts change, we will adjust to the facts. We're going to look at the data over this weekend for determinations of zones. We will look at it for indoor dining; we will look at it for all those categories that we were seeing on the chart. Facts change, opinions change. Facts change, we adjust to the facts and will continue to do that.
“What's the optimal goal? To remain one of the lowest spreads in the nation. The tide is coming up. The boats are going to go up. You're not going to stop the tide, but you can do as much as you can, and this state has one of the lowest infection rates in the United States of America. Our highest infection rate in the state is lower than 40 states. Our highest infection rate is lower than 40 states. So, God bless the people of New York, because this state with its density, with its diversity, is really doing an extraordinary job and we have to continue to do it because we determine our future. Right? We determine the curve.”
Image courtesy of the Office of Gov. Andrew M. Cuomo
Updated Zone Metrics
As New York has grappled with the COVID-19 pandemic, the governor and New York State Department of Health have made it a priority to continuously calibrate the metrics governing restrictions to protect public health, without causing undue harm to the economy. The updated metrics unveiled Friday and over this past week continue to focus on limiting viral spread in communities with the highest rates of case growth and hospital admissions, and factor in a region's hospital capacity.
Under these updated metrics, micro-cluster zones will now be determined as follows:
√ RED ZONE
A red zone will be implemented in a region where hospital capacity is within 21 days of reaching 90%, even after the cancellation of elective procedures and a 50% increase in bed capacity in hospitals in the region.
√ ORANGE ZONE
A geographic area will be eligible to enter an “orange zone” if it has a 4% positivity rate (seven-day average) over the past 10 days and it is located in a region that has reached 85% hospital capacity. Alternatively, a geographic area may also become an “orange zone” if the State Department of Health determines the area or region's rate of hospital admissions is unacceptably high and a zone designation is appropriate to control the rate of growth.
√ YELLOW ZONE
A geographic area will be eligible to enter a “yellow zone” if it has a 3% positivity rate (seven-day average) over the past 10 days and is in the top 10 percent in the state for hospital admissions per capita over the past week and is experiencing week-over-week growth in daily admissions.
Updated Hospital Directives
Earlier this week, the governor the State Department of Health to begin implementing the state's "surge and flex" protocol and a number of steps were initiated as part of that effort. Specifically, all hospitals were mandated to begin expanding their bed capacity by 25% to further prepare hospitals for a future COVID-19 surge. 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, and hospitals were of the requirement to report data and to ensure they maintain a 90-day stockpile of personal protective equipment.
On Friday, the NYSDOH is issuing a directive for hospitals to take steps to remain below 85% capacity by either adding an additional 25% of capacity, eliminating elective surgeries, or by taking a combination of both steps.
Updated Business Restrictions
Suspension of Indoor Dining in New York City
Beginning Monday, Dec. 14, indoor dining will be suspended in New York City. This measure comes after the federal Centers for Disease Control updated its guidance to say, “Exposures at nonessential indoor settings and crowded outdoor settings pose a preventable risk to all participants. Indoor venues, where distancing is not maintained and consistent use of face masks is not possible (e.g. restaurant dining) have been identified as particularly high-risk scenarios.” New York City continues to see increased positivity, cases per capita, daily hospital admissions, and total hospitalizations.
This suspension will continue to be reevaluated based on updated data over the coming weeks, and to provide additional support to the industry during these difficult times, the governor is extending the state's moratorium on commercial evictions and is renewing his call for Congress to include support for bars and restaurants in the next stimulus package.
Updated Rules for Gyms and Salons
Gyms and personal care services were originally higher risk environments for viral transmission, but the state's latest data shows that the rate of spread has been reduced in businesses that are operating in accordance with the NYSDOH's “New York Forward” guidance. Following the state's principles of recalibration and balancing public health measures with economic impact, these businesses that are within “orange zones” may operate with additional services restrictions, starting Monday, Dec. 14. Specifically, gyms and fitness centers – which are currently closed in “orange zones” – will be allowed to operate at 25% capacity, reduced from 33%. Personal care services – for example, salons and barbershops, which are also currently closed in “orange zones” – will be allowed to provide services so long as the employees performing services are tested for COVID-19 on a weekly basis, and obtain a negative test result prior to opening.