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Cuomo Orders Hospitals Into Crisis Management Mode as NYC Mayor Calls for PAUSE

The governor has ordered hospitals to boost capacity by 25 percent, as he said the state is seeing alarming trends that could threaten to overwhelm the hospital system if not contained

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What to Know

  • NYC Mayor Bill de Blasio is pitching a full shutdown akin to PAUSE for a two- to four-week period starting after Christmas to clamp down on soaring viral rates; any decision on that belongs to the governor
  • Gov. Andrew Cuomo has hinted more aggressive actions may come soon; he ordered hospitals into crisis management mode Wednesday but said an NYC or larger shutdown is not inevitable
  • Hospitals have also been ordered to boost capacity by 25%; as Cuomo said the state is seeing alarming trends that could threaten to overwhelm the hospital system if not contained

Restrictions akin to PAUSE in the spring could shut down New York City again as early as the end of next week if COVID-19 numbers continue to trend in the wrong direction, Mayor Bill de Blasio says. At least, he thinks they should come.

The mayor emphasized in three briefings this week that he felt it was necessary to impose some sort of shutdown on nonessential business right after Christmas for a few weeks to contain the surge, but noted the decision was the governor's.

For his part, Gov. Andrew Cuomo isn't willing to call any shutdown inevitable just yet. He said Wednesday that while officials predicted the Thanksgiving surge, he believes New Yorkers actually saw it happen and will act more prudently this time.

It's simply a function of people's behavior, Cuomo says: "If New Yorkers are responsible and hospitals step up their game, we may not have a shutdown."

In the city, de Blasio says the hospitalization increases are growing increasingly concerning relative to where they were. He's worried about overwhelming hospitals, which could trigger an even longer, more drastic shutdown comparable to the months-long closure from earlier this year. The mayor suggested a post-Christmas start to not interfere with holiday shopping but said he'd be comfortable shutting down sooner if the state chose to do so.

"Everybody's really concerned. The number of cases is too high. The infection level is too high. The hospitalizations are too high -- and unfortunately, it's just growing," de Blasio said Thursday. "None of us likes restrictions, but I think we need them sooner rather than later. It's something that has to be put into effect soon based on the very consistent information we're seeing."

The city's rolling hospitalization rate per 100,000 residents is now at 3.06, de Blasio said. That's the highest it's been since he debuted the new indicator as part of his regular briefings earlier this month. The seven-day rolling positivity rate hit 6 percent Thursday, another months-long high.

The mayor has been sowing the seeds as to the need for additional restrictions for weeks, and lately, for the most part, Cuomo has been planting them alongside him. Shuttering indoor dining in New York City may have been just an initial move.

Gov. Andrew Cuomo warned it was coming. The same day he announced New York approved Pfizer's coronavirus vaccine, he said New York City's indoor dining would close Monday. NBC New York's Andrew Siff and Gaby Acevedo report.

Hospitalization rates continue to rise in New York City and across the state; the total surpassed 6,000 Wednesday for the first time since May 15. The total statewide stood at 6,147 as of Thursday. At the same time, Cuomo reported more than 100 COVID deaths (120) for the second time in three days.

That tragic toll has been climbing slowly, along with the other numbers increases. New York has seen an 83 percent increase in deaths over the last 14 days, a 62 percent increase in hospitalizations and a 37 percent increase in its daily case average, according to New York Times data.

Those, Cuomo and de Blasio say, are alarming trends that could threaten to overwhelm the hospital system if not contained.

Cuomo said Wednesday statewide hospitals were being told to shift to crisis management mode, which involves transferring patients as needed to ensure a balanced load and prevent any hospitals in the system from being overwhelmed.

He has also ordered hospitals to boost capacity by 25 percent. NYC Health + Hospitals initially said they would do that by suspending elective surgeries, but on Friday revised their guidance to say that because of their current available capacity (35 percent), elective procedures could continue. The city's Department of Health instructed that as long as hospitals were able to increase the number of staffed beds by 15 percent within 72 hours of a COVID spike, and had level loading procedures to move patients between hospitals if necessary, then elective surgeries could continue. Cuomo has told hospitals to statewide to shift to crisis management mode. That involves transferring patients as needed to ensure a balanced load and prevent any hospitals in the system from being overwhelmed.

The governor's goal is to ensure no individual hospital is overwhelmed, which is what happened at the height of the pandemic earlier this year.

"We had one hospital overwhelmed and five blocks away we had a hospital with plenty of capacity," Cuomo said, referring to challenges from spring. "That can't happen again. They need to watch the numbers and they need to be prepared."

Earlier this week, he ripped critics who challenged his decision to close indoor dining in New York City on grounds bars and restaurants contributed to less than 2 percent of statewide exposures and the city's positivity and hospitalization rates remain lower than much of the state -- all but one region as of Wednesday.

Cuomo accused those and any other critics of having a short memory.

"The virus spreads much faster in New York City," Cuomo said. "Anyone who doubts that wasn't here in the spring or has the shortest memory imaginable."

Indoor dining operations will be suspended as of Monday, the same day wintry weather is expected to strike the tri-state, delivering not one, but two chances for snowfall this week. NBC New York's Ida Siegal reports.

At the same time, the governor warned that if current trends hold, some regions within the state would be poised to hit 90 percent hospital capacity within 21 days. That would trigger a red zone shutdown, closing nonessential businesses and schools, under his adjusted micro-cluster winter plan.

As of Thursday, New York City had 23 percent of beds available, up from 22 percent the day before and also up from the 19 percent it saw through last week. Long Island also had a higher share available (23 percent) than Wednesday.

The numbers amid this latest surge aren't nearly as stark as they were in the spring by any means, but new daily cases have been on the steep incline for weeks and the positivity rate has been rising steadily, along with hospitalizations.

While the respective rates are still much lower than most other major U.S. cities and states, they are disturbingly high by New York standards. As Cuomo has said, New York has seen how quickly the numbers can spiral beyond control; families along with business owners and workers have suffered the consequences.

Should any shutdown be ordered for a period of time, de Blasio does have one suggested adjustment from previous restrictions: Keep schools open.

Daily Percentage of Positive Tests by New York Region

Gov. Andrew Cuomo breaks the state into 10 regions for testing purposes and tracks positivity rates to identify potential hotspots. Here's the latest tracking data by region and for the five boroughs. For the latest county-level results statewide, click here

Source: ny.gov

They'll be closed anyway for the holiday break just before Christmas and through New Year's, which would knock at least a week off any potential two-week to four-week shutdown. The city's largest teacher's union isn't necessarily on board with that. Its president said Tuesday that if a shutdown was needed to curb soaring viral rates, it would be unsafe to keep school buildings open to in-person learning.

At this point, the discussion is moot unless Cuomo makes a move. The governor pointed to a series of headlines in his briefing Wednesday about a looming New York City shutdown.

"Is a close-down possible in January?" he asked rhetorically. "Of course."

A number of other states have already made that move to address ongoing COVID spread. New York fares better than all of them numbers-wise. Cuomo says it's too early to make any decision on a "close-down" in January, saying, "it's the future actions of New Yorkers that will decide what happens."

"I believe they're going to be more prudent through Christmas, Hannukah, Kwanzaa, etc., because they saw what happened on Thanksgiving," Cuomo said Wednesday. "We predicted the Thanksgiving surge but I think they actually saw that happen. I think they're going to be more careful through this holiday season."

He called once again for people to embrace personal responsibility, including not holding gatherings inside their homes. He also called on local governments once again to step up enforcement and launched a new holiday PSA campaign.

The potential restrictive approach being discussed by officials in New York differs starkly from the response in New Jersey, where the governor says he has no plans to implement new sprawling restrictions, much less close indoor dining, amid the latest surge. Gov. Phil Murphy has said most of his state is more similar to New York's Westchester County or even Long Island, suggesting the same density concerns that apply uniquely to New York City to do not apply to the Garden State.

The latter does happen to be the most densely populated state in the country, Murphy has acknowledged. New Jersey also has seen significant or notable increases in cases, hospitalizations and deaths over the last few weeks.

According to data from The New York Times, death reports are up 78 percent in New Jersey over the last two weeks (Murphy's Tuesday report of 97 new daily deaths was his highest in months). Hospitalizations are up 22 percent in that time, while the case average has increased 19 percent over the last 14 days. The governor says those numbers are manageable in terms of hospital capacity for now and urges people to keep up with proven COVID precautions as the state starts its vaccine rollout.

As of Thursday, total hospitalizations in New Jersey stood at 3,637, the highest number since May 14. Murphy reported another 77 deaths overnight, a drop from the prior two days but indicative of the overall higher trend in fatalities nationwide.

NBC New York's Ray Villeda reports.

The national increases over the last 14 days have been less stark than the New York percentage changes. By New York Times data, cases are up 28 percent over the last two weeks, deaths are up 60 percent and hospitalizations are up 17 percent. All the core numbers are at all-time pandemic highs for the U.S.

And this latest surge is expected to swell more before it ebbs. Dr. Anthony Fauci and Cuomo, among others, expect it to peak in mid-January following a holiday surge on top of the surge that has been underway for more than a month.

The country surpassed 17 million COVID cases Wednesday and has reported well more than 300,000 deaths, according to NBC News data. The U.S. also set new daily highs in cases (243,645) on Thursday and deaths (3,234) on Wednesday. Dr. Robert Redfield, the head of the Centers for Disease Control and Prevention, has warned the U.S. could see its tragic toll near 450,000 by February at this rate.

The arrival of the vaccine won't help stem the COVID tide for months, but officials are working to expedite their rollout plans and ensure equity and access for all. New York state and city have administered thousands of shots so far this week. Cuomo said New York has received 87,750 total Pfizer doses so far, including 77,025 just on Tuesday. He expects another 80,000 Pfizer does in the coming days and, if the FDA grants emergency use authorization to Moderna, the state could get another 346,000 doses from that pharmaceutical company next week.

To help expedite availability to the public when the time comes, Cuomo says the state is setting up Regional Vaccination Hubs that will be led by local hospital systems. Those hospital systems will develop plans in coordination with community leaders for a regional vaccination network that will launch once the state has enough doses to start vaccinating essential workers and vulnerable members of the general public (Phase II of his vaccination plan).

The hubs are required to submit their plans to the state for approval by the first week of January. The state Department of Health will review those and provide operational support as well as logistical direction in hopes of starting Phase II in late January. All that presumes continued flow of vaccine supplies, Cuomo said.

"No person will pay a penny for a vaccination," the governor said. "We want people to get vaccinated. It shouldn't be about wealth. No one will pay a penny."

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