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Future Shutdowns Will Hinge on Hospital Capacity

Mon, 12/07/2020 - 14:57
Dr. Anthony Fauci, right, weighed in on New York's response to Covid-19 during Gov. Andrew M. Cuomo's briefing on Monday.

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, joined Gov. Andrew M. Cuomo for a press conference on Monday in which the governor outlined more steps New York is taking in the fight against Covid-19.

Governor Cuomo said he is closely watching hospital capacity because it is the primary vehicle of defense until the Covid-19 vaccines can be widely administered. He said he and his cabinet are looking at data on regional hospitalizations and capacity every day. Whether or not a region can have indoor dining is now tied to hospital capacity, which will be reduced from 50 percent to 25 percent or even zero if its hospitalization rate spikes and does not level out within five days.

Hospitalization rates could impact indoor dining and not gyms or personal care businesses because the evidence shows that the latter two are not where Covid-19 is spreading. Rather, Governor Cuomo said, it's "living-room spread" -- small gatherings among family members and friends, particularly where travel is involved -- that now accounts for more than 70 percent of new Covid-19 cases.

"If our hospital capacity becomes critical, we're going to close down that region, period," he said, defining "critical hospital capacity" as 90 percent.

To overwhelm the hospital system "means people die on a gurney in the hallway," Governor Cuomo said. Earlier in his remarks, he compared the field hospitals the state had set up in the spring to that which one might expect to see in military combat situations, and said there was the potential to do it again if the virus is not brought under control soon.

Currently, about 4,600 people are in hospitals with Covid-19 across the state, occupying about 8 percent of the 58,000 beds across New York.

The state has now mandated that hospitals increase their bed capacity by a minimum of 25 percent, and hospitals must recruit retired doctors and nurses to step back into the field to help existing health care workers. The state expects to have about 20,000 more professionals reenter the field this way.

"They have had a long year," Governor Cuomo said about the state's healthcare workers. "They have had the longest year of anyone." 

Governor Cuomo later engaged Dr. Fauci in a question-and-answer session.

Dr. Fauci called the governor's strategies a "really sound" plan, and noted that the state has "a lot of backup contingencies, which I like. You're not going to get caught shorthanded on this."

Asked by the governor when he expects the worst of the holiday-induced transmission of Covid-19 will be, Dr. Fauci said he believes it will peak in mid-January. "Without substantial mitigation, the middle of January can be a really dark time for us," he said.

Governor Cuomo also asked Dr. Fauci to address the Covid-19 vaccines that are on the horizon. Recent surveys have shown, he said, that nearly half the population isn't yet willing to take the vaccine.

"When you have 75, 80 percent vaccinated . . . you have an umbrella of protection over the community," Dr. Fauci said. "The level of community spread will be very very low. The virus will not have any place to go. . . . If 50 percent of the people get vaccinated, then we don't have that umbrella of immunity over us." Front-line essential health workers and residents of nursing homes and long-term care facilities would likely be first in line to get the vaccine. And average people with no underlying health issues that might move them closer to the front of the line would likely be able to be vaccinated near the beginning April, Dr. Fauci said. 

According to the state, 6.2 percent of the test results reported yesterday in Suffolk County -- 748 people -- were positive for Covid-19. It was the fifth day in a row that the county's positive test rate was 6 percent or higher, according to state data. The county's seven-day average of positive Covid-19 tests had reached 6.1 percent. 

“While the number of new COVID-19 cases is slightly lower today, there is no cause for celebration," Suffolk County Executive Steve Bellone said in a press release Monday afternoon. "This week we saw four straight days of new cases over 1,000. To put this in perspective, during the height of the pandemic this spring, Suffolk County only saw 12 days over 1,000 new cases." He urged people to avoid small indoor gatherings. "If we don’t change our behaviors quickly our hospital system will be at risk of being overwhelmed and we will lose more lives."

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