Caesar on the Hudson
No, Andrew Cuomo didn't handle COVID-19 well.
Did Andrew Cuomo and New York state really get the response to COVID-19 right?
To judge from the almost universal acclaim in which the governor basks, he must have.
Cuomo had emerged āAmericaās governor,ā according to U.S. News & World Report, with his ātake-charge attitudeā and ācomforting manner.ā His daily briefings, which the New York Times described as reliably āarticulate, consistent and often tinged with empathy,ā had become āmust-see television.ā āSometimes the crisis makes the leader,ā the Wall Street Journal's glowing April profile of the governor read.
But while Cuomo may have handled the intangiblesāhis attitude and manner and empathyāitās not clear his handling of the crisis deserves the praise it has received.
Itās easy to forget that Cuomo, like certain other politicians, downplayed the threat from the novel coronavirus in the early days. āWe went through this before: Zika virus, Ebola, et cetera,ā he said on February 7. āBut letās have some connection to the reality of the situation,ā he added, ācatching the flu right now is a much greater risk than anything that has anything to do with coronavirus.ā
And once Cuomo moved to a war-time footing in Aprilāas New York hospitals were being overwhelmed and makeshift triage centers were being erected in New York City parksāa Wall Street Journal investigation concluded that the disaster had actually been exacerbated by the governorās guidance.
Public bickering and naked hostility between the governor and his nemesis in Gracie Mansion, New York City Mayor Bill de Blasio, ācontributed to an uncoordinated effortā to combat the virus, the Journal declared. The governor was, for example, quick to contradict de Blasio who, on March 17, recommended New York City residents āshelter in place.ā Like so many of the mayorās pronouncements, Cuomo quickly went about undermining it. āNo city in the state can quarantine itself without state approval,ā the governor said. āI have no plan whatsoever to quarantine any city.ā By March 19, with California in full lockdown, New York continued to resist that option despite having more than five times the Golden Stateās active caseload.
Cuomo reversed himself five days later, reluctantly shuttering his state.
The very public conflict between New York Cityās mayor and its governor also contributed to a failure to coordinate hospital transfersāthe result being that patients sick with COVID-19 were removed to environs that had not been previously contaminated.
Hospitals lacked sufficient isolation protocols. āState, city government, and hospital officials kept shifting guidelines about when exposed and ill front-line workers should return to work,ā the Journal reported. Hospitals that relied on state stockpiles of ventilatorsāa device that turned out to have far less utility in treating the deadly disease than was initially thoughtāfound that equipment to be āfaulty or inadequate.ā The public sectorās focus on ventilators resulted in a reduced supply of other critical medical equipment, such as vital signs monitors and dialysis machines.
A ProPublica investigation concluded in May that officials in Albany appeared to have exacerbated the conditions plaguing New York City in an almost deliberate fashion. In February, ProPublica revealed, the state Health Department ceased routine information sharing with its city-based counterpart. Basic data, such as ventilator counts or the number of available hospital and long-term care facility staff, was not on offer from the state. One city official claimed that, in early May, they were abruptly and inexplicably informed by Albany that their assistance in identifying and responding to the devastating outbreaks in nursing homes within the five boroughs would no longer be needed.
Perhaps the biggest mistake was Gov. Cuomoās March 25 directive that forced nursing homes to readmit residents who had been sent to hospitals where the coronavirus was ranging as long as they had been deemed āmedically stableā and the facility was properly equipped.
Those facilities that failed to follow this mandate risked excess regulatory scrutiny and the potential for lost revenue. And, thus, senior-care facilities were overrun with COVID patients, transforming them into what Cuomo later called a āfeeding frenzy for this virus.ā
More than 6,400 long-term care facility residents died from COVID-19, with thousands more infected. And the numbers might be worse than that, since the state only considers a nursing home death to be someone who perished inside a nursing homeāand does not count residents who died off-site.
The State Department of Health later insisted that the carnage in New Yorkās nursing homes was less attributable to public policy than the over 37,000 nursing home workers who became infected and unwittingly transmitted the disease to their charges.
This explanation is unconvincing. Sure, New York was not the only state to pursue this policy: New Jersey followed Albanyās example, and the Garden State currently leads the nation in deaths per capita at nursing homes. But other states which took a different approach avoided these grisly outcomes.
California, which briefly pursued a Cuomo-like policy, abandoned it early on and averted disaster. Florida refused to allow nursing homes to intake residents who could have been exposed to the virus in hospitals, even at the risk of violating Medicare reimbursement policy. And even today, despite having more active COVID cases than New York and a much larger elderly population in long-term care facilities, the number of staff or residents who have succumbed to this virus is roughly 40 percent of New Yorkās total.
And if Cuomoās directive on nursing homes wasnāt a problem, then why was it rescinded in April?
The nursing homes were just the most glaring example of New York state rushing to shut the barn door after the stables were empty.
On April 13, a working paper published by an economist with the Massachusetts Institute of Technology strongly indicated what many had suspected: that New York Cityās subways were and remained a āmajor disseminatorā of the virus.
Indeed, the outbreak in New York City was so bad that, by early March, it was responsible for seeding much of the rest of the country with the coronavirus. By April 22, with 83 Metro Transit Association workers dead from the disease, the city blamed āthe CDC and the World Health Organizationā for their predicament, while insisting that the subways could and must remain open.
This denial didnāt last.
On April 30, Cuomo made a conspicuous trip to New York City to tour the subways and announce a āhistoric moveā to cease the transit serviceās 24-hour operation schedule so that cars could be cleaned and disinfected.
Again: too late.
To some extent, Cuomoāand every other administrator and elected official in the countryāis due some understanding. Particularly in its earliest stages, public officials were operating blindly in an environment that was confused only when it was not total chaos. Officials around the country experimented with policies tailored to their stateās relative exposure and the policies they adopted varied as wildly as did rates of infection.
It is incumbent on us to forgive some of the excesses to which politicians were prone, especially in the early days of the outbreakāand particularly if they were pursued out of an abundance of caution. Even today, six months in, public officials are still improvising their way through the kind of crisis we have not seen in a century.
But that slack ought to be returned with some humility on the part of the politicians who, though erring on the side of caution, erred, nonetheless.
Andrew Cuomo has exhibited very little humility.
While the economic hardships associated with New Yorkās lockdown mounted, the psychological toll on self-isolated New Yorkers threatened to bring about a new crisisāone marked by ādeaths of despairā resulting from suicide or substance abuse. Cuomo angrily dismissed the prospect.
āThe cure canāt be worse than the illness itself,ā one reporter said, summarizing the case. āThe illness is death. What is worse than death?ā Cuomo asked. Pressed to respond to the observed uptick in suicides, Cuomo replied, āyeah, but the illness may be my death, as opposed to your death.ā
For those who were desperate to get back to work, the governor had one flippant response: āYou want to go to work? Go take a job as an essential worker.ā
At the height of the outbreak in New York, states up and down the eastern seaboard quickly began to look upon New Yorkers as radioactive. Rhode Island's Governor Gina Raimondo adopted a measure that would have allowed local law enforcement to stop and question motorists with New York license plates, and even to go house-to-house hunting for anyone who might confess to having been to New York, all so as to make sure they are self-quarantining. āI think what they did is wrong. It was reactionary. I think it was illegal,ā said Cuomo, who threatened to sue Rhode Island to have the policy reversed. The ACLU seemed to agree with the governor, arguing that Raimondoās order represented a violation of Fourth Amendment protections against unlawful search and seizure.
Cuomo was probably right. But his objection to this kind of prosecutorial executive overreach proved entirely situational. By mid-summer, with states around the Sunbelt reporting an uptick in cases while New Yorkās active caseload declined, Cuomo adopted a variation of the same policy he had attacked when it was directed at his stateās residents: The governor mandated that travelers coming to New York from states experiencing a surge of COVID infections, such as Florida, would be required to quarantine themselves for 14 days or face a $10,000 fine.
As conditions in New York continued to improve following a nightmarish spring, Cuomo took a victory lap. During a late June press briefing, he produced a visual aid to illustrate the breadth of the Empire Stateās success in handling the pandemic: a giant foam mountain illustrating the rates of COVID-related deaths in the state.
Cuomo had repeatedly likened to his stateās battle with coronavirus to climbing a mountain, and here it wasāa to-scale model of a steep spike and gradual, sustained decline. The only problemāone that would have occurred to anyone with a sense of proprietyāwas that the mountain Cuomo produced was composed of dead bodies.
At the risk of sounding overly stern: When more than 32,000 of your fellow citizens have died over the course of a single season, you have not won any sort of āvictory.ā All you have done is come out the other side of a devastating tragedy. Instead of boasting, you ought to be figuring out what you could have done better so that you can do better in caseāGod forbidāthere is a next time.
But Cuomo wanted to keep spiking the football. Two weeks later, the governorās office produced a second mountaināthis time in the form of an artful poster depicting New Yorkās experience with the coronavirus as though it was an epic poem with the governor playing the role of Odysseus.
The mountain of dead was back. It was accompanied by a calendar marking out key events in the ā111 days of hellā through which New Yorkers slogged. It featured demons blowing the āwinds of fear,ā the āsea of divisionāāwhatever that isāplaneloads of COVID-bearing Europeans the governor routinely blames for seeding his state, President Donald Trump sitting on the edge of a crescent moon downplaying the virus as ājust the flu,ā and even a self-referential nod to his own extemporaneous diatribes about his daughterās vexing love life deemed āthe boyfriend cliff.ā
This was not, the governor insisted, a side project he had outsourced to a graphics design team. It was an undertaking he took personal interest in developing.
You did not have to be an anti-Cuomite to have found the entire exercise deeply inappropriate. āI mean this with 0% snark: how is this not wildly offensive,ā asked Brooklyn-based Democratic state Sen. Zellnor Myrie. āThis is an artful monument to death and tragedy being sold by the state. Iām legit perplexed.ā The second-ranking Democrat in the state Senate, Mike Gianairis, was equally nonplussed: āAre all the people about to be evicted not represented because they're drowned under the Sea of Division?"
Cuomoās stubbornness rankled even one of his Democratic predecessors.
Former Gov. David Paterson noted, as gently as he could, that it was the governorās own guidance that contributed to his stateās devastating death toll: āI think some of the people sent back to the nursing homes with the virusāand nursing homes werenāt equipped to quarantine them from everyone elseāand I think it had some difficult consequences,ā Paterson said. āHe seemed to be blaming the nursing homesābut he gave the order.ā
The governorās imperious tendencies reached the point of absurdity by late July when, despite minimal rates of infections in his state, he suddenly mandated that barsāwhich were only recently allowed to reopen as part of the stateās long-planned phased recapitulation scheduleāhad to become restaurants if they wanted to operate.
What possible rationale could there be for this dictum? If the bars were a danger to public health, then having those establishments start serving food, in addition to alcohol, would provide no remedy. And so New Yorkers were treated to health security theater, with bars offering $1 menus with paltry fare, many of which featured derisive and mocking comments about the governor.
At which point Cuomo went back again, this time insisting that the bars must offer what he determined was a āsubstantiveā meal along with alcohol. That could include sandwiches, āthe lowest level of substantive food,ā in the governorās estimation.
But not chicken wings.
There is no way to read this absurd episode except as the governor playing politics with public health.
The only remaining question is not whether Governor Cuomo made mistakesāhe did. Or whether he is over-invested in his egoāhe is. No, the question is whether it was all worth it. Did 32,000 New Yorkers die as an unavoidable result of a national calamity, or were at least some of these deaths preventable?
The short answer is that we do not know.
Why was New York so badly hit when, for example, most of the West Coastāwhich experienced its first infections at around the same timeāhas had far fewer deaths?
Perhaps, as Gov. Cuomo suggests, it is because the strain of the virus to which New Yorkers were exposed was deadlier and more virulent than the strain emigrating from Asia.
Or maybe itās because we now have a better understanding of how to treat the disease. We certainly do know now, thanks to some lamentable experimentation in New York, that itās unwise to compel institutions dedicated to treating high-risk individuals to warehouse likely COVID-cases. Otherwise, though, we do not know why New York was hit as hard as it was.
āWe followed your goddamn models,ā one exasperated official close to Cuomo told ProPublica in May. āAll the models were wrong.ā
That is, to a substantial extent, true.
New York and its governor were no doubt victims of unforeseen circumstances. But it does no one any favors to paper over the actions Governor Cuomo took that proved counterproductive and, at times, deadly.
For partisans on the left, the cult of personality that sprang up around Cuomo was a necessary contrivanceāhis response to the pandemic had to contrast favorably with Donald Trumpās, even if the governor did not deserve the adulation heād received.
But it was always a fabrication, and New Yorkers deserve a thorough reckoning with what they endured as a result of both uncontrollable environmental circumstances and misguided public policy.
