American Crisis

by Andrew Cuomo

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  THE STATE’S WADSWORTH Laboratory had the capacity to do about four hundred tests per day. Now that we had permission from the federal government to conduct tests ourselves, we announced the ambitious goal of increasing capacity to a thousand per day within a week and said that tests would be free to the public. Given the current state of testing in the United States, this number was ridiculed as pie in the sky by some folks, and several of my own team thought I was crazy for setting such a high goal. What we didn’t know was that ultimately we would need to perform in excess of fifty thousand tests per day.

  New Yorkers, some of whom can be a neurotic group, were quick to analyze the potential exposure risk. For months, we’d thought the risk was from the West Coast, where it seemed the virus first took root in late January. The CDC was allowing tests only for people with symptoms who had recently traveled from Wuhan, China. Of the few people who were being tested, the nasal swab was performed in New York, then mailed to Atlanta. I knew we were in trouble when four of my family members called asking how they could be tested. Meanwhile, the World Health Organization (WHO) declared a global emergency on January 30, and San Diego and then San Francisco declared states of emergency in February. But the CDC had claimed there were no cases in New York. An FDA press release on February 4 said, “At this time, federal health officials continue to believe that the threat to the general American population from this virus is relatively low.”

  All through January and February, the Department of Health sent us updates of people under investigation, or PUIs, in New York. These were people who had traveled to Hubei Province in China or had had contact with a relative who had traveled and now had a temperature. All the tests went through the CDC in Atlanta. And every day, the New York State Department of Health would put out a press release saying, according to the CDC, there were no confirmed cases of COVID in New York. It gave people the sense that the situation was being well monitored, but it was completely false because there were so few tests and they were testing the wrong people! On top of that, they didn’t know that the enemy had already been arriving from another part of the world, probably earlier than the first week in February.

  Given the density and crowding of New York City, once the virus had officially arrived, the possibility of coming in contact with a COVID-positive person was very real. If a positive person took the subway, people immediately wanted to know what train, at what time, and what car. Maybe they had held the same pole in a bus or train as a COVID-positive person. Maybe they rode in the same cab. Maybe they were in the same Uber. The possibilities were endless, so we quickly instituted new cleaning protocols for public transportation, schools, and so on.

  For months the federal government told us the COVID spread was from symptomatic individuals, that transmission was from sneezing, coughing, and touching contaminated surfaces. However, that was a half-truth. We would later learn that the virus also spreads from asymptomatic individuals.

  Yet as early as January 27, a doctor named Camilla Rothe, exploring Germany’s first coronavirus case, concluded that the patient was infected by a person from China. The doctor also found that the visitor from China exhibited no symptoms whatsoever. Thereafter there was a viral spread in French churches, Italian soccer stadiums, Austrian ski barns—all also apparently from asymptomatic or presymptomatic spreading. One of the first international outbreaks of the virus was on a cruise ship, the Diamond Princess. Interviews with the health professionals on the ship pointed to symptomless spread: Of the 454 people who tested positive, about 70 percent showed no symptoms whatsoever.

  The health community debated the concept of asymptomatic spread for more than two months before they were willing to accept it. There were articles published in The New England Journal of Medicine as a caution to countries around the world. The World Health Organization noted in early February that patients might transmit the virus before showing symptoms, but also said patients with symptoms were the “main” cause of the spread of the epidemic. Chinese health authorities had also explicitly cautioned that patients were contagious before showing symptoms.

  Why would federal health officials be hesitant to acknowledge symptomless spread? And why would the orientation not have been toward being overly cautious, assuming the worst, and acting accordingly? Because the ramifications were too colossal. If we assumed people must show symptoms if they were positive, it made the diagnosis and containment much easier. It also limited the population that required attention. If we assumed a person without any symptoms could be positive, massive amounts of testing would be required at extraordinary expense.

  Too many federal officials were oblivious to the conversations about how the virus spreads. As is the case with the spread coming from Europe, if we had known that people without symptoms could spread the disease, we would’ve acted much differently and much sooner, and many lives would have been saved.

  In the last week of January an adviser to the president, Peter Navarro, sent an internal memo that should have set off alarm bells. It said that the coronavirus was not contained to China and could possibly affect 200 million Americans. There are only 330 million Americans total. The memo went on to say the virus could result in one to two million lives lost—more casualties than have been sustained in any war the nation has ever been engaged in. Navarro is not a junior staffer. He is a senior political aide with direct access to the president. Who read the memo? What was done as a result of this memo? Absolutely nothing.

  MARCH 3 | 1 NEW CASE | 1 HOSPITALIZED | 0 DEATHS

  “Every day matters.”

  NEW YORK CITY IS UNIQUE, and people often assume that situations in New York City can’t happen “somewhere else.” When New York had its second positive case, this time in New Rochelle, in Westchester County just north of New York City, I knew that attitudes would change. Despite New Rochelle’s proximity to New York City, it was really Anyplace, U.S.A. This area would quickly become the nation’s first “hot spot,” due in large part to the fact that patient zero, a lawyer named Lawrence Garbuz, was infected well before he knew it.

  Patient zero attended a Bat Mitzvah ceremony and a funeral as a member of a congregation at a local temple, along with hundreds of other guests. In his other interactions over several days—working at his law office, taking public transportation, and visiting a doctor’s office—he spread the virus to dozens of people. The New Rochelle man was the first known American “super-spreader,” an infected person who happens to be in the company of a large number of people and can spread the virus in a short period of time.

  If COVID could explode in New Rochelle, it could happen anywhere. I knew this would strike a troubling chord in people, and so I explained the situation carefully at my daily briefing. As I had the previous day, I presented the facts, including dates and medical information. I didn’t hold back any information because I thought it was too difficult or frightening. It’s not my place to filter or edit the truth. The people of New York are not children, and I am not their father. In fact, I don’t even filter the truth for my kids. People will make the right judgment if they know the facts.

  The facts from New Rochelle were startling. Patient zero was critically ill, and the virus was spreading like lightning. He could have been anyone’s husband, brother, uncle, or friend. There was no malice or irresponsibility on his part. Not only was the situation in New Rochelle a wake-up call for people all over the state, it was the first time the state government needed to answer questions because the federal government was quickly doing an about-face on taking control.

  A local doctor was among those infected soon after patient zero. We were telling anyone who tested positive that they couldn’t go to work. Local health officials told him to shut down his office, but the doctor refused. He said closing would hurt his business. The state Department of Health also told him to shut down, and he said, “On what authority?”

&nbs
p; That’s when I heard about it. The last thing I wanted was a lawsuit, which would take weeks of hearings to get a resolution. We didn’t have weeks. So I called him myself.

  He wasn’t impressed; in fact, he was really angry.

  What mattered was persuading him to do the right thing, to protect other people, so I let him vent, and then I talked him through the reasoning. “We’re all doing things we don’t want to do,” I said. “We have to do this.” Finally, he agreed to close.

  Next, we talked with local officials about shutting down the schools. The pushback was fierce. The Orthodox community didn’t want to shut their schools, and they felt discriminated against. They were a sizable political constituency, and the local officials were intimidated. The head of the local public school board also called us, enraged. She said they shouldn’t have to close, because the kids testing positive didn’t go to the public schools. She emphasized how many of the kids in the public schools were food insecure and that school was a major source of meals. As a result, the state elected representatives were against shutting the schools, fearing it would be too disruptive.

  What really stood out was that no one thought the outbreak itself was a big deal. So a few people got the bug, why shut everything down? It was the first manifestation of the disconnect people had about the threat. I realized we were going to have to make some incredibly tough decisions and work vigilantly to achieve public support for them.

  We were already talking about creating a containment zone in New Rochelle, where we would close schools and religious gathering places and focus our testing on residents. Gareth Rhodes, a longtime trusted aide, and Melissa printed out a map and laid it on the conference room table. The three of us, along with the health commissioner, Howard Zucker, talked about how big to make it. There was no playbook, no guidelines coming from the federal government; it was up to us. We decided on a uniform mile from the center.

  We got on the phone with Noam Bramson, the mayor of New Rochelle, and George Latimer, the Westchester County executive, explaining where the line was going to be drawn. Noam pointed out that the line went right through the middle of a golf course. “Do you know which side of the line the golf course clubhouse falls? Depending where the line is, a wedding this weekend may have to be canceled.” All politics is local! We went back and forth negotiating but concluded we just had to make the zone indiscriminate and fair. We spent all day on the phone with businesses who called to say, “We’re right on the line. What should we do? Should we stay open? Should we stay closed?” We said, look at the map and make a decision by your location.

  At this point, it was only a few days since the first positive test, and no one had died. The president was saying this was a flu, that our concern was a Democratic hoax. There was a lot of skepticism from the public as well as officials. No one was ready to accept that they needed to change how they were living.

  I knew we weren’t going to get anywhere if we couldn’t persuade people to accept the situation before we took action. So we scrambled to fly down and meet with the Westchester County local officials in person. The operational gymnastics of my travel and schedule were incredible. Every hour had to count. Jill DesRosiers is my unflappable chief of staff and has been with me for years. Annabel Walsh is my director of scheduling. She has the joy of talking to me twenty-four hours a day. I always try to get done more in a day than twenty-four hours permits. Annabel never fails to make sure it happens.

  As we saw in Westchester that day, local parochial concerns would butt up against major, wide-ranging changes that had to occur in order to combat the virus. This pattern would play out over and over again in the coming weeks. Most local politicians seek to make people happy; that’s the business model. If something doesn’t make people happy, they don’t want to do it. As we were instituting this lockdown on New Rochelle, one Democratic assemblywoman who represented Westchester came to my office demanding a meeting; then she simply sat in the second row at a press conference and scowled at me.

  I would make my first major communications mistake when I used the words “containment zone.” I also said I would call out the National Guard to help deliver food to students after we closed schools. The combination of the words “containment zone” and “National Guard” frightened people. To be clear, there was no actual “containment” of people; they could come and go as they pleased. The “containment” was of the virus. But the term was misunderstood, and I soon realized that a poorly worded phrase was very dangerous.

  The quick escalation from mild concern to high anxiety surprised even me. People were panicking, asking, what if the shelves in the store were emptied and not refilled? What if the grocery store owner, truck driver, gas station attendant, cashier, stayed home because they were afraid of the virus? It is terrifying how quickly society can unravel. Communication was everything in this situation, and I couldn’t make any more mistakes.

  And in case you’re wondering, the clubhouse was inside the line, and the wedding was canceled.

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  I AM A student of history, and it amazes me how the old adage “past is prologue” still holds true. No matter how the facts change, the fundamental dynamic remains the same. I now live in the Executive Mansion in Albany. It is a great big old house that really should be a museum. Al Smith, TR, FDR, Grover Cleveland, and my father, Mario Cuomo, lived here. I think about them often—what they faced and what they accomplished.

  There are two themes that differentiate periods of national accomplishment from periods of national crisis. First, the solidarity and unity of the American people. Second, governmental leadership and competence. Periods of great accomplishment occur when the country is unified behind a goal with inspired leadership and extraordinary government capacity. Problematic periods are a sign of a divided nation, social unrest, failed leadership, and an incompetent or corrupt government. Even with an external threat, the result is determined by the nation’s internal forces.

  COVID is in many ways a symptom and not the illness. The human body is attacked by literally dozens of viruses per week. A healthy body with a functioning immune system will fight off and manage the attacks. Science, in and of itself, has never killed a virus in the body, but science has worked with the human body to defend against attacks and managed to resolve them. A viral attack is most damaging when the body is weakened.

  COVID attacked this country at a time of extreme weakness on every level. Since 2016, a political strategy of fearmongering and division has been furthered and normalized by President Trump. Behavior long festering underground has been validated and allowed to reach the surface.

  In the years following Trump’s election, racial and religious prejudices boiled over; the KKK removed their white hoods and took back to the streets. Unresolved tensions around policing and criminal justice were exacerbated. Inflammatory anti-immigrant policies have divided the nation. Anti-Semitism is increasing. Income inequality is at an all-time high. Discrimination in housing, education, and unemployment has deepened the divide. Hyper-partisanship and demagoguery are destroying democracy and have rendered government institutions paralyzed.

  The degradation of our government is both an aggravating cause and a contributing effect of the country’s division. Faith and trust in our government have continued to dissipate for decades. It is a self-fulfilling prophecy. People believe in government less, support government less, and thus government produces less.

  I do not blame President Trump for creating this situation; that would give him too much credit. I do, however, believe the Trump presidency is the product of this downward trajectory. And, as a master marketer and salesman, he recognized, seized, and exploited it. A unified country that believed in itself and in the strength and capacity of government would never have elected Donald Trump. He is the symptom of an illness untreated.

  Trump’s slogan “Make America Great Again” was a
dog whistle recalling a time of white dominance and small government. Trump sensed growing racial and economic divisions and discontent, and he capitalized on them. A unified country that believed in the strength and capacity of government would’ve repelled the Trump candidacy.

  Trump senses the marketplace and rides the wave. He sees where the public is marching, runs to the front of the parade, and bangs the drum the loudest. We have reached a point where people don’t even remember what government has accomplished. Generations have come and gone since government won wars, produced the GI Bill of Rights, passed Social Security and Medicare, built bridges and a national highway system, and enacted the Civil Rights Act.

  If you don’t believe government is capable of performing, you don’t bother electing people who can make it perform. Trump never promised any positive performance. He never laid out an affirmative goal, mobilized public support, or developed the government that could achieve it. House Speaker Sam Rayburn used to say, “Any jackass can kick down a barn, but it takes a good carpenter to build one.” He was right. Getting government to actually deliver a quality product on time is no small feat. Passing a new piece of legislation is not easy. Trying to move government quickly or precisely is like driving a tractor trailer on a race course. Its design is the obstacle. That does not mean it’s impossible, but it is difficult.

  I know the challenge well. I’ve spent much time in the bowels of the beast. As a young man frustrated with government’s lack of performance, even when my father was governor, I set up a nonprofit to provide housing for the homeless and get them out of welfare hotels. I spent eight years at HUD, the most dysfunctional of all the federal agencies. I’ve spent ten years as governor. I know that government can make a difference. I also know all too well how hard it is, how much skill and effort it takes, and that government is only as strong and effective as the level of public support and unity it inspires.