What to Know
- A number of New York regions have topped a 9% rolling positivity rate; Gov. Andrew Cuomo says those regions can keep schools open if in-school testing shows lower rate than community avg
- He is working aggressively to expedite the vaccination process; going forward, providers that don't use their allocated doses within seven days of receipt could be disqualified for future distributions
- The developments come as COVID rates continue to rise across the tri-state area and the United States; New York became the fourth state to top a million confirmed cases over the weekend
Tri-state officials are pushing to accelerate the vaccination process, expanding access points and eligible groups, as a feared January surge upon surge looms behind a December that was the deadliest month of the pandemic for the U.S.
In his first COVID briefing of 2021, Gov. Andrew Cuomo declared the dreaded holiday increase is already setting in and a "consequence of our actions."
New York topped 8,000 total hospitalizations (8,251) statewide for the first time since May 7 on Monday, Cuomo said, a number that has doubled in a month. Over the weekend, it became the fourth state in the U.S. to top a million confirmed cases after smashing its single-day case record Thursday with no corresponding record number of tests conducted. Add in that the state found its first confirmed case of the more contagious COVID variant in a man from Saratoga County, and the war against the virus did not seem to be going too well for New York.
Cuomo has heralded the vaccine as the weapon that will end that war. But that won't happen overnight, he says; and right now, the process isn't moving nearly fast enough to keep pace with the increasing rate of viral spread.
Thus far, the state has administered about 300,000 initial doses of three-quarters of a million doses distributed, according to the CDC and Cuomo. The governor says the ratio should be higher. Hospitals statewide had only used 46 percent of total allocated vaccine doses thus far as of Monday, he added -- another issue.
“This is a management issue,” Cuomo said in a teleconference call with reporters. “They have to move the vaccine and they have to move the vaccine faster.”
The governor said while hospitals like New York Presbyterian (99 percent), Oswego Hospital (99 percent) and Richmond University Medical Center (93 percent), have distributed nearly all of their supply, others are far behind. Samaritan Hospital, just north of Albany, had only distributed 15 percent of its dosages, Cuomo said. Other health care providers closer the city — like Montefiore Healthcare System (30 percent), New York City Health + Hospitals (31 percent) and Westchester Medical Center (32 percent) — were also not administering vaccines at a high enough clip. The city's public hospitals has 11,000 health care workers still waiting for shots, he said.
To drive the point home, Cuomo established new vaccine rules on Monday. Any provider must use its inventory this week or receive a fine up to $100,000, he said. Going forward, providers must use all doses within seven days of receipt -- and if they fail to do so, they could be disqualified from future vaccine distributions.
"Some hospitals do 99% of allocation, they're much better at administering. I want to get needles in arms," Cuomo said. "If you can't do that within seven days, then raise your hand. I'd rather have the faster hospitals [administering]."
Effective Monday, the governor also expanded vaccine eligible groups to include all doctors, nurses and healthcare staff who come into contact with the public. (Not sure if you're eligible? Check the state's vaccine page here.)
New York City also expanded eligible vaccine groups Monday to testing site workers, contact tracers, dentists, physical therapists, NYPD medical staff, specialized clinic workers and outpatient and ambulatory care providers.
Next week, home care and hospice workers and more nursing home staff will be eligible to receive their first doses, Mayor Bill de Blasio said Monday. Meanwhile, his office slammed Cuomo's threat to fine hospitals over vaccine administration.
"The mayor has been clear that our public hospitals must show aggressive, forward momentum and get as many vaccines in arms as possible," City Hall spokeswoman Avery Cohen said. "We've put a plan in place to help [Health and Hospitals] go faster as we wait for the state to allow more people to be vaccinated. But threatening to 'revoke' the 'privilege' of vaccination from the city's public hospital system is punitive and unnecessary."
"Clearly the governor saw the criticism he was getting from across the state about being overly restrictive as to who can get the vaccine and decided to point fingers," another City Hall source said. "That's a shame, because tough guy antics don't cure COVID."
The mayor himself kicked some of the blame for the slow distribution back up to Albany, saying the state has yet to authorize vaccines for police and teachers.
"We are not allowed legally to give the vaccine to (police and teachers). I want to give them the vaccine right away, when I have that authorization we will be doing that on overnight shifts," de Blasio said.
But Cuomo pointed fingers as well, saying the hospitals have no one to blame but themselves if there are vaccines sitting in cold storage, as people are waiting to receive it. He said the chief reason for the delays was bureaucracy, at public hospitals in particular.
"I do have a problem with a hospital saying they're going to participate, receiving a scarce vaccine, and not administering it," the governor said. “This is a matter of life and death, so yes I’m impatient."
Later Monday night, the mayor said Cuomo's comments were "just arrogance," and told him to trust in those heath care workers who have been working throughout the pandemic to keep people healthy and alive.
"Does he think that our health care professionals are uninterested in vaccinating people? How about trusting the people who have been our heroes? This is what I say the Governor ... respect and trust are health care professionals," de Blasio said in an interview on NY1. "They are the people who do the work. They are the people who know best. They want to get people vaccinated. No one's more motivated than them. Help them, support them. Don't fine them, don't threaten them. Respect them and help them. So, for example, what he said about Health + Hospitals is just blatantly inaccurate."
Holiday Increase Upon Us, Cuomo Says; Gov Offers New Guidance on Schools
Monday's developments on vaccines, numbers and more come as Cuomo declared in no uncertain terms that the much dreaded holiday increase is already setting in.
Cuomo says the recent jumps started with Thanksgiving and any potential increases associated with the latest round of holidays will only continue to compound the post-Thanksgiving effect. Daily COVID hospital admissions in the state, over a seven-day rolling average, are up 28 percent this last week (12/27-1/2) compared with the immediate post-Thanksgiving period (11/26-1/2).
With statewide hospitalization totals rising to levels not seen since the first week of May, the governor said Monday he continues to closely monitor capacity. That's a "red line" he has tied to potential new economic restrictions. Right now, no region has less than 30 percent capacity, Cuomo said. If any gets "within striking distance" of 15 percent capacity, Cuomo says, that triggers a regional shutdown.
"It's a consequence of being smart and being responsible. Those numbers go up, you overload the hospitals, the region will close down. There's no unknown here, there's no arbitrary decisions being made here. If the infection rate increases, the region closes. And that's the last thing anybody wants."
No one wants to lose more lives either, especially not a state that was losing 800 people a day at the height of the crisis in April. Yet that's already happening. Significant increases in cases lead to more hospitalizations, which lead to more deaths by default. To date, the state has well topped 30,000 confirmed fatalities, which is likely an undercount by thousands.
On Monday, Cuomo added 170 new daily deaths to the mounting toll, which is the state's highest single-day death count since May 16, according to the COVID Tracking Project. New York's rolling positivity rate, meanwhile, is up to 7.8 percent.
By the mayor's data, New York City's rolling positivity rate is up to 9 percent as of Monday. More than 100 education centers, including elementary schools and early childhood programs, reverted all remote Monday amid the latest positivity rate jumps. Mayor de Blasio said he had no plans to expand the closures, punting the ball back to Cuomo, who set a 9 percent positivity rate threshold in August to move schools all-remote once they reopened to in-person learning.
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
State data varies from city reporting on core COVID metrics, and Cuomo's account of New York City's rolling positivity rate varies from its own. As of Monday, it was 6.2 percent. Asked about the schools issue Monday, Cuomo said counties with rolling positivity rates of 9 percent or higher could keep schools open if in-school testing shows the rate is still below the community average.
"My opinion, leave the schools open, but that's up to the local school district to decide," the governor said, effectively punting the ball back to local officials.
While New York City's numbers remain below that benchmark via state data, other regions have well topped it. Capital Region, Finger Lakes and Mohawk Valley have reported a rolling positivity rate average above 9 percent for at least 14 days and haven't seen region-wide school closures. It's not clear if they were waiting on the governor for additional guidance, but he provided that to them on Monday.
Even when de Blasio moved schools all-remote in November, a switch necessitated by a prior agreement with teachers unions, Cuomo said they should reopen sooner rather than later, citing glaringly low in-school transmission rates.
COVID-19 at New York City Public Schools
This map shows all known cases of COVID-19 at New York City public schools. It is updated Sunday through Friday at 5:30 PM.
Building that has been closed
One or more classrooms has been closed
A member of the school community has tested positive but the school community was not exposed
As he has said, schools appear to be the least of the problems, which are mounting. New York City, the former epicenter of the national crisis, is faring better than most of the state's 10 regions as far as hospitalization rates per 100,000 residents, though the density that makes it one of the world's most vibrant places also makes it more vulnerable to spread. That isn't lost on officials -- and it's why indoor dining remains shuttered in NYC by gubernatorial order.
While New Jersey has battled its own increases as of late, Gov. Phil Murphy has remained averse to sweeping new restrictions in any area, instead opting to go with what he describes as a "surgical" approach to precise problem spots.
According to New York Times data, daily case averages in his state have decreased by 3 percent over the last 14 days, compared with a 36 percent increase in New York over the same time period. That may soon change.
Murphy included the first antigen, or rapid testing, case results in his COVID briefing Monday, which fell exactly 10 months to the day the state reported its first confirmed case. The addition adds more than 50,000 probable cases to New Jersey's total from March, which has now surpassed 500,000 and then some (545,155 as of Monday, with probable cases included).
Hospitalizations, though, have stayed relatively "consistent" after an initial late fall increase, Murphy said. He called on New Jerseyeans to do their parts to help keep them stable, noting "that's the one thing we can't allow to be overrun."
"We begin the new year much where we ended the old, so we must begin the new year in the same war footing and taking the same precautions as we did the old," Murphy said. "This remains a fight we must engage in together to save every life we can, to push these numbers down and to gain the upper hand against this virus."
Tracking Coronavirus in Tri-State
Vaccine Race Ramps Up in NJ, NY
At the same time, they're working to contain viral increases associated with the holidays, tri-state officials are ramping up the vaccine rollout plans that first launched last month. A number of New Jersey frontline healthcare workers became the first in their state to receive their second doses Monday, an achievement Murphy celebrated.
To date, Murphy says total doses administered in New Jersey in the last month have exceeded 101,000. More sites for vaccination continue to expand, starting with two "mega-sites" -- one each in Morris and Gloucester counties. Those will each have 1,000 doses a week to serve the 1a population, which is the first phase.
There were some lower test numbers over the past two weeks, but Health Commissioner Judith Persichilli attributed that to people not wanting to run the risk of feeling unwell over the holidays.
Officials said New Jersey expects to vaccinate most of those in long-term care by the end of January.
In Connecticut, Gov. Ned Lamont said the state is on track to deliver shots to 22,000 nursing home residents and 210,000 frontline health care workers by the end of the month. He said that the state is faring far better than its neighbors ub getting vaccines administered quickly.
"We're one of the first states to get over two percent of our population at least their first vaccine dose," Lamont said.
Meanwhile, the race to vaccinate 1 million New York City residents in January is officially underway. If the mayor's goal is to be achieved, the current pace needs to be quadrupled. He says the vaccine program needs to scale up to a 24/7 operation -- starting right now.
That said, de Blasio acknowledges vaccinating 1 million New Yorkers, at least with an initial dose, in a month is an aggressive goal but insists it is an achievable one. He also offered a much more modest projection, saying the goal was 1 million doses, not 1 million vaccinated. He expects the city to administer 100,000 vaccine shots this week and take that to a clip of 450,000 a week by the end of the month. The groundwork is being laid.
"Getting it right in the first few weeks was the trend-setter. Now it's time to sprint. This has got to be a seven-day-a-week, 24/7 reality going forward," de Blasio said Monday. "We're going to do it in the public sector. We need our private sector partners to do the same."
On Monday, the Queens nurse who three weeks ago became the first American to receive the initial dose of the vaccine was among the first to get shot number two.
"It feels like I've completed the cycle, closed the loop so to speak," Northwell-Long Island Jewish nurse Sandra Lindsay said.
When Could I Get the Vaccine?
Answer the questions to calculate your risk profile and see where you fall in your county's and state's vaccine lineup. This estimate is based on a combination of vaccine rollout recommendations from the CDC and the National Academies of Sciences, Engineering, and Medicine.
For a more detailed breakdown of who is included in each priority group, see this methodology.
Source: the Vaccine Allocation Planner for COVID-19 by Ariadne Labs and the Surgo Foundation
Interactive by Amy O’Kruk/NBC
The city plans to more than double its access points over the course of the month, establishing vaccine hubs at school gymnasiums and other pop-up locations starting this upcoming weekend. The ultimate goal is to hit at least 250 access points citywide by the end of this month, he said -- and plans to focus on establishing them in the hardest-hit communities to ensure access.
With that in mind, the first pop-up "vaccine hubs" opened Sunday in Brooklyn (Bushwick Educational Campus), Queens (Hillcrest High School) and the Bronx (South Bronx Educational Campus). By month's end, de Blasio said the greater challenge won't be public access but ensuring federal supply meets his demand.
A new vaccine site will open Tuesday at Nassau Community College on Long Island, in order to get vaccination numbers up there. One hospital in the county, Nassau University Medical Center, had only used 19 percent of its dosage allotment, according to the state, which has led to County Executive Laura Curran to demand their distribution plan. For their part, the hospital said that figure was inaccurate due to technology interface issues, and they had distributed 34 percent of the vaccines they received — but agreed it was "not an optimal percentage."
Another core challenge: Getting the public to trust taking the shots in the first place. Cuomo says he expects 85 percent of nursing home staff in New York state to have their initial doses by the end of this week, but not all are willing.
State Department of Health Commissioner Dr. Howard Zucker said roughly 10 percent of nursing home residents and 15 percent of staff have refused shots.
Both Cuomo and de Blasio have said they won't take the vaccine until it's their respective turns in line for their respective age groups. The governor says he'll hold off until Black, Latino and poorer communities in his group have access.
Nationally, about 4.2 million Americans have gotten their first vaccine dose thus far, well short of the 20 million goal that President Donald Trump set for December, according to data from the CDC. The race couldn't be more urgent.
December was the deadliest month of the coronavirus pandemic yet for the United States -- and officials have warned January could be worse, given dual threats of holiday travel and spikes stemming from more indoor activities due to the winter weather.
To date, more than 350,000 coronavirus-related deaths have been reported in the U.S., along with more than 20 million cases, according to a tally by NBC News. The head of the CDC warned last month that a total of 450,000 people could die by February if aggressive measures weren't taken to control the spread. That'd add another 100,000 U.S. lives in less than four weeks.