by Andrew Cuomo
In the scope of things, it was chump change, or should I say “Trump change.” He says de Blasio was nice. How delusional. De Blasio decimates him regularly.
But the idea that I should be “gracious” for Trump doing the bare minimum to meet the federal government’s responsibility was bizarre. It wasn’t his money, it was tax dollars, and it wasn’t his largesse we were asking for, it was for him to fulfill his basic constitutional duty. But with Trump, everything was always political and personal. It was all transactional. He gave me money, so I should be “gracious,” meaning I should say nice things that he could use in his campaign videos. It was a proxy for political support. He would make Tammany Hall blush. “I give you government money and you agree to give me political support.” No political support, no government money. It was a reality show of an unsophisticated politician’s criminal enterprise.
In June, Trump would give Governor Murphy of New Jersey $2 billion for a New Jersey bridge. Ironically, the bridge was an element of the Hudson River tunnel replacement program that Trump consistently refused to fund. I asked the White House why they would do that, since the tunnels were the priority and the bridge replacement without the tunnels was virtually pointless. They said the funding for the bridge was in repayment to Governor Murphy because he was “gracious” and always said many positive things about Trump, and that’s what Trump needed.
Murphy’s comments will be in a campaign ad, I am sure. I told them I had said New York was “grateful” for the things they did do for New York, such as the Javits Center and the USNS Comfort. They said yes, but I also said negative things, and they wanted only positive. I said frankly, I just can’t do that.
I will be grateful for the things they do, but I must point out the needs they refuse to address, which I believed were basic federal responsibilities and were being withheld for political reasons. They were giving us crumbs, and I had to say New York needed more. This was not an acceptable stance.
My only remaining option was to go the other way. When Trump said he needed gratitude, he was exposing his insatiable need for affirmation. Going the other way meant openly criticizing him. If he needed affirmation, it meant he couldn’t take criticism. My weapon was to criticize his failure and neglect. I did it often and loudly. He hated criticism and couldn’t handle it, and this discomfort caused him to deliver more for New York than we would have otherwise received. A sick, disturbing, unethical federal posture, but in battle we pursue the strategy that wins.
APRIL 20 | 4,726 NEW CASES | 16,103 HOSPITALIZED | 478 DEATHS
“The beast will not destroy us.”
I ALWAYS ENJOY IT WHEN A technical expert can simplify a complex topic so a “normal” person can understand it. I was talking to a WHO official who had been working in China on its reopening, and he was explaining the pros and cons of different reopening schedules. He then said to me, “Governor, think of it this way: When you are home sick with a virus, you want to get back to work quickly to make money. But if you get out of bed too fast and get back to work too soon, you will have a relapse and wind up back in bed longer. What would you have accomplished?” The analogy stuck with me and helped me communicate our situation to people.
Above all, the reopening had to be calibrated. We wanted to reopen as quickly as possible, but the question was how to define “as possible.” The key was testing and tracing. I remained obsessively focused on testing. Testing could provide real facts, and facts could allow me to make a decision. Facts could also give people information and allow them to understand the basis of decisions. Facts are how I would defeat politics.
Anytime there was a function that needed to be performed by government, Trump instinctively withdrew. He had no knowledge of what government could or could not do. Trump’s instinct was also to avoid liability by refusing to be responsible for any quantifiable or specific task. He was still bristling over the criticism that he did not have enough ventilators. He was not about to now become engaged in establishing or operating a true nationwide testing system, which would be necessary for reopening.
So Trump developed a new mantra: “Testing was up to the states.” He was distancing himself as far as possible from this urgent challenge. His position was absurd. States had to handle the closedown and emergency operations. He wanted to handle the economic reopening, but states had to handle the testing to make reopening possible! The factual problem was the states couldn’t perform the testing because the national manufacturers controlled the actual testing kits and chemical agents. And the federal government controlled the national manufacturers.
The lack of a national testing system was just another component in the revelations about our failure to have a national public health system. There is no “national testing system.” There are private laboratories located across the nation that buy testing machines from different private companies that operate proprietary testing programs. Supplies are provided by specific manufacturers and can run only on that specific machine. In New York State we have 250 laboratories that purchase equipment from approximately ten large national manufacturers. Each national manufacturer then supplies that lab with materials needed to operate its machine. To increase testing capacity required each national manufacturer to provide more testing supplies for its specific equipment.
Once the 250 laboratories agreed to increase production on a 24/7 basis, the obstacle became their inability to secure the supplies from the national manufacturers. I called the national manufacturers. They told me their issue was the supply chain. They needed certain chemical reagents, and their main supplier was…wait for it…China. We needed the federal government to work with China and open up the supply chain.
The White House was frustrated with some states for not taking control of the testing function on the ground. They wanted the states to be more aggressive in setting up testing sites and marshaling local laboratories. They were not wrong: New York was unique in the way we had marshaled our private labs in our state to conduct our testing. Many states had not done enough with their own lab systems. New York had established eight hundred testing sites across the state and organized the 250 labs for maximum output. But we did not have the national manufacturers providing our labs with the necessary supplies to meet the capacity we had developed. We needed the federal government to intervene.
APRIL 21 | 4,178 NEW CASES | 16,044 HOSPITALIZED | 481 DEATHS
“Some of the most tragic situations actually forged the character and resolve of this nation.”
THE BRIEFINGS WERE REALLY GOING well. They were informative and even entertaining at times. And while occasionally the press questions could create great theater, some were just nasty and uninformed. Sometimes I would ask Melissa to answer. She grew up immersed in politics and has a computer for a mind. She would undress the reporter when the question was based on incorrect assumptions, always methodical in her dissection. Melissa was involved in all aspects of the crisis so she, like me, saw the whole field of engagement. This helped me immensely because I relied on her as a sounding board and I knew her advice was smart and informed. Her instincts are better than mine. Melissa is the only other person who did every briefing, so she heard everything I heard. She never took a day off. Many women across the country wrote that they loved seeing her in action at the briefings. She is a tremendous advocate for women and girls and was a great role model during those stressful days.
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THIS WAS ONE OF those days when developments necessitated a second briefing. The morning briefing was in Buffalo. I talked about how our curve was starting to plateau, although we were seeing variations region by region across the state. New York City, one of the densest cities on the globe, had one infection rate. Upstate, where many of the counties are rural, had different infection rates. Each region had its own need for testing. Watching the news with my daughters the previous night, I saw that Governor Larry Hogan of Maryland had purcha
sed test kits from South Korea, and one of my kids turned to me and said, “Why didn’t you think of that, Dad?” While I did momentarily feel chastened, it wasn’t realistic or productive for fifty governors to go scrounging for testing all over the globe. Once again, I called on the federal government for help with the supplies we needed to get the testing done.
The president was telling his people to slow down testing because he didn’t like the higher numbers of positive cases. If you reduce testing, he figured, the number of reported cases went down, and then you can reopen. It was a child’s logic and the continuation of his policy of denial. He just wanted the good press of the economy coming back from reopening; he didn’t care about the virus. He was constructing his political narrative that COVID was a Democratic problem and was not a problem for the Republican states. A few weeks later, Ron DeSantis of Florida would give a press conference with Mike Pence at his side affirming this narrative. He demanded an apology from the media for fearmongering, because his state of Florida was doing fine on COVID. (And in late July, Vanity Fair would publish an article saying that the White House believed there was no need for a national testing effort because they could just blame blue-state governors for their own problems. Also in late July, Florida’s infection rate was exploding, then at nearly half a million confirmed COVID cases, with no end in sight.)
After the briefing that morning, I would head to the White House to make the case for why they should be doing more to help New York meet our testing goal. Up until that point, the president had demonstrated little interest in helping the states ramp up testing capacity, but I knew they controlled the supply chain and we couldn’t get what we needed without them. It was a long shot, but life is options and I didn’t have any. Melissa was opposed to the trip. She was convinced that the only reason they had agreed to the meeting—conspicuously scheduled for 4:00 P.M., an hour before when the president normally conducted his press conference—was to corner me into appearing at the president’s daily briefing, and that we would return with nothing but a positive political press hit for the White House along with a promise for help that would never be fulfilled.
Nevertheless, I flew down with Jim Malatras and Gareth Rhodes for the meeting with Jared Kushner; Admiral Brett Giroir from HHS, who was their testing czar; Dr. Deborah Birx, the White House coronavirus response coordinator; and others to discuss how the states and the federal government could work together on testing. We showed up with a PowerPoint presentation complete with actual quotes from our labs, such as “We could run at full capacity but we don’t have reagents.” Boom, boom, boom, one slide after another.
Birx oversees a task force at Walter Reed that allocates the national manufacturers’ reagents to the states, and as a result of that meeting, she opened up the allocation to us. Afterward, I was brought to the Oval Office to meet with the president. I said that we had a good meeting on testing and that I would advocate with other governors for the state-federal partnership that we had discussed. (I had also served as the vice chairman of the National Governors Association and in that capacity had dealt with both Democratic and Republican governors.)
The president, as usual, just wanted positive public relations about his COVID response. We were joined in the Oval Office by Hope Hicks, who was setting up the president’s COVID press briefing later that afternoon. And sure enough, as Melissa had predicted, during the meeting they asked me if I would join Trump at his press briefing to communicate how the federal government was helping on testing. The president also reiterated his claim that hydroxychloroquine was going to be the silver bullet and pushed again to accelerate the New York hospitals’ testing of the drugs. Also in the Oval Office was Dan Scavino, who was the president’s social media and Twitter maven. I asked Scavino whose idea it was to continually lambaste me in the president’s tweets. I never got a clear answer. Jim Malatras would later say he felt the Oval Office visit was like going onto a TV set and playing a part, after which they would move on to the next scene. I had seen how the president had run the video using the positive statements I had made about him, and I was not going to be in the same situation twice. I politely demurred from joining the briefing. I restated my position that I would call it straight and when the federal government fulfilled its role I would say so, and if he abandoned his role I would say that also. For good measure, I also brought the president a bottle of our special New York State Clean hand sanitizer and left it on the Resolute Desk.
The situation was becoming more and more clear in my mind. We needed him to do more than he wanted to do. The president didn’t understand the federal-state relationship and the true capacity of an engaged federal government. He didn’t see this as his problem. I was tempted to say to him that if the federal government was not responsible for a national crisis affecting all fifty states, what was it responsible for? What was the federal government’s role if not the interests of the states? It was all absurd to me. But I had promised myself I would bite my tongue. The president had agreed that they would help us with the testing supply chain, and that would be an accomplishment for the state. I would hold him to it. It was also becoming increasingly clear to me that while I knew COVID would be a fifty-state problem, the White House still believed COVID would be only a blue-state problem. That was the disconnect.
Six days later, he would make a statement in the Rose Garden promising to help states with the reagents.
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IN ADDITION TO diagnostic testing, which tells you if a person is positive or negative at that moment, we had started antibody testing in early April all across the state, and the results were very interesting. Antibody testing tells you if the person had the virus in the past. Our April antibody survey showed that in New York City 19.9 percent of those tested had antibodies, meaning they were infected at one point in time. On Long Island, 11.4 percent; in upstate New York, 3 percent.
We also aggressively tested all the essential workers. I had never gotten over the philosophical issue of having the essential workers show up so that other people could stay home safe. I wanted to make sure they were okay. Every death of an essential worker resonated with me. Expert opinion and common sense assumed essential workers were exposed to greater risk. Testing would tell us. We decided to do thousands of antibody tests of essential workers to find out what was going on. We tested police officers, nurses, doctors, and transportation workers all across the state. If essential workers had a higher infection rate, we would know.
We did the police departments first, both state and local. The New York City Police Department had an infection rate of 10.5 percent. Amazingly, New York City itself had an infection rate of 19.9 percent. That meant the NYPD actually had a lower infection rate than the general population. How was that even possible? We tested nurses and doctors next. These were people who worked in emergency rooms and were obviously exposed to COVID-positive people in the most dangerous circumstances. The infection rate for New York City doctors and nurses was 12 percent. That was even lower than the infection rate in the general geographic area.
Two thoughts came to mind. First, what a relief. It was the best news that I had personally received since this began. Yes, I asked essential workers to step up to the plate, but by the grace of God they were at no more risk than people within their community. A major weight was lifted from my chest. Knowing the low infection rate of essential workers lifted the morale of my whole team. The second thought was, how could this even be possible? How could people working in an emergency room have a lower infection rate than the general population? It became my new obsession to find out.
The global experts were somewhat surprised, but they had also seen lower infection rates among health-care workers in other countries compared with the general population. The only explanation was that the PPE worked. Of the PPE, the face shields and gowns were helpful no doubt, but the masks were the most critical piece of equipment.
Early on, disease experts warned of surface transmission. We took significant precautions to minimize surface exposure. However, as time went on and the experts had more data, emphasis turned to airborne transmission. Medical professionals stressed that the masks were helpful to stop positive people from transmitting it in their breath. But some experts had been telling me that the masks might also help prevent the particles from being inhaled.
This antibody testing data confirmed their theory. Many of the positive people coming into an emergency room didn’t have masks. The health-care professionals did. The masks were stopping people from inhaling the virus. Health-care professionals were equipped with N95 masks. These are different from surgical masks. N95 is a designation referring to the size of the particulate matter stopped by the filter in the mask. N95s are the highest-level masks in general use. Interestingly, they are used not just by health-care professionals but for industry applications as well, including applying fertilizers, paints, and other potentially dangerous chemicals that could be airborne. The N95 mask has two straps, and it had to be molded to the nose, cheeks, and chin to make sure there were no air pockets. Any gaps would reduce their effectiveness.
The run on N95 masks was so significant that they were hard to get even for health-care workers. I would venture to say that health-care experts would have recommended everyone in the general public wear N95 masks if they were not afraid of worsening the scarcity. There is also an argument to be made that an N95 mask is overkill for a member of the general public. They are uncomfortable and hot. Pictures of the health-care workers who wear them sometimes show marks on their faces from the tightness of the masks. They originally cost about seventy cents per mask before the price gouging began. In an ideal world there would be enough supply for all Americans. Again, health-care professionals might disagree and say they should be prioritized for health-care workers.
