Governor’s Office, Health Department launch ‘winter plan’ to combat COVID surge

Gov. Andrew Cuomo on Monday said his administration is preparing for a new battle in the war on the coronavirus pandemic — a battle that will take place in the hospitals, clinics and urgent care centers across the state, which are preparing for a surge in patients in the coming weeks and months.

During a press conference in Manhattan on November 30, Gov. Cuomo, state Health Commissioner Howard Zucker, and other members of his cabinet talked about a five-pronged plan for hospitals, schools, testing, vaccination and public education.

The Governor’s Office and the state Health Department will begin using metrics such as hospital admissions and hospital staffing ratios to determine if regions in New York are deemed a hot spot, and in need of additional restrictions.

“It’s a new phase in the war against COVID. I think of this as a war. It’s a war of attrition. It’s a war in terms of preparation and mobilization. It’s a war in terms of mindset. COVID is an enemy that we’re dealing with. it’s attacking people. it’s killing people. So, I talk about it and think about it in terms of a war. And the war has changed.”

The new “winter plan” consists of five strategies: identifying areas with high infection rates and hospital admissions and adopting tougher restrictions on businesses and schools in those areas; increasing testing and “balancing” testing across all regions; keeping schools open safely; trying to reduce small gatherings in people’s homes through public education; and implementing an equitable vaccination program.

The top priority right now is preparing hospitals and emergency rooms for the expected wave of new COVID-19 cases.

“In the new battlefield, hospital capacity is the top concern, period. It’s about hospital beds, it’s about the ICU and it’s about having enough staff and enough equipment,” Cuomo said Monday. “That’s the effect and that’s what we’re going to have to deal with.”

Hospital-related metrics will be used to provide a clearer picture of where a particular region of the state stands and how each neighborhood, municipality, and other geographic area contributes to daily hospital admissions due to COVID.

The New York State Department of Health will include factors such as regional hospital bed capacity, ICU capacity, staffing ratios, and daily hospital admissions as part of the analysis used to determine which geographic areas qualify as micro-cluster zones.

In addition to the three existing micro-cluster zone levels — Yellow Precautionary, Orange Warning and Red — New York will also add a new ‘Emergency Stop’ level, which will effectively put that area under the New York Pause guidelines, if needed to preserve hospital capacity. Hospital metrics associated with these zones will be identified in the next week to 10 days, once data from the Thanksgiving holiday is received and analyzed.

The Department of Health on Monday also initiated emergency hospital measures to prepare the state’s hospital system for an expected surge in new admissions over the upcoming weeks.

Specifically, these measures include:

• Identifying retired nurses and doctors to bolster staff;
• Hospitals in Erie County must suspend elective surgeries to create new bed capacity for COVID patients;
• Balancing patient loads across their individual hospital facilities;
• Preparing plans to build emergency field hospitals;
• Preparing plans to increase hospital bed capacity by 50 percent;
• Implementing statewide “surge and flex” operations, similar to how hospitals transferred patients during the spring surge
• Confirming availability of resources in existing stockpiles.

The governor also hopes to increase the amount of testing available statewide, in a way that ensures distribution is balanced with testing sufficient across different segments of the population, including: healthcare workers; nursing homes; schools; essential workers; business professionals; personal services testing; and general population, returning students and travelers.

“I expect, as I’ve said before, you’re going to see the rate going up through the holiday season, which ends after the New Year. So, after New Year’s Day, look a week or 10 days afterwards, hopefully the social activity slows at that point and the infection rate starts to level off,” Cuomo said.

“And then you get to a vaccine which is the answer ultimately, but the vaccine, then you have to have discussion about how quickly and distribute it and how effectively, and what’s the critical mass point of the vaccine. But that is months away by every professional’s estimate. So that’s what we’re looking at.”

One of the most problematic and confusing aspects of managing the COVID-19 pandemic for both government leaders and parents has been the question of how and when schools should remain open.

Under New York’s “winter plan,” efforts will be focused on keeping K-8 and special education schools open as long as it can be done safely.

But that will depend on whether officials can maintain a consistent and sustainable testing program for schools so that they can continue operating in the long-term.

“New York City announced that they are reopening schools. I think that’s the right direction,” Cuomo said. “The schools, we do have new facts and new information on schools. Just about every professional says the schools, especially K-8, should be kept open whenever it’s possible to keep them open safely.

“We have done testing in schools and we now know what we’re looking at in schools. The positivity rate is much, much lower. It’s literally safer for a child and the teacher to be in the school than in the community,” the governor said.

Schools located in Orange and Red micro-cluster zones will be required to conduct weekly testing. Schools in Orange Zones will be required to test 20% of in-person students, faculty, and staff over the course of a month and schools in Red Zones will be required to test 30% of in-person students, faculty, and staff over a month. Pool testing will be allowed as well.

These protocols will be the minimum standard required for schools to stay open and the state may adjust requirements for specific districts based on any special circumstances which may arise.

While local districts are able to close at levels under the state’s mandatory closure rule, they are urged to keep K-8 schools open whenever it is safe.

With the holiday season now here, small gatherings have been identified as the number one spreader of COVID-19, with at least 65 percent of all new cases originating from these settings.

Cuomo said behavioral shifts must be observed by New Yorkers to mitigate the spread.

Sixteen states, including New York, have already instituted gatherings limits of less than 10 people, with Kentucky recently moving to gathering limits to 8 or less. While government’s ability to monitor small gatherings is limited, public education on the safety concerns of small gatherings is crucial, Cuomo said.

As New York state did with public campaigns urging mask compliance, New York State will be launching a public education campaign to highlight how small gatherings can lead to the spread of COVID-19 in the community.

“The really bad news: family gatherings and smaller social gatherings have exploded as places where the virus is spreading,” Cuomo said. “Seemingly the safest place — my home, my table, my family — yeah, even that place is not safe and we’re going to have a new public education campaign that speaks just to this.

“This is not government being overly dramatic, these are just facts. Look, I’ve heard the political back and forth. Oh this is Democrats saying this. First of all, this is probably the only issue President Trump’s people and Joe Biden’s people have agreed on. Both of their health advisors say small gatherings are the problem.”

While a vaccine is expected to be released in the coming weeks, it will be months before a critical mass of available vaccinations for the general public will be available.

“While the holiday season often brings joy to many, the increase in social activity and mobility will also bring an increase of viral transmission. We understand the cause and effect, and the effect is dramatic,” Cuomo said. “We must adapt to this reality and have a plan in place that specifically addresses the challenges that come with it.

“We’ve been through the worst, and while we’re not done yet, we are moving forward with the lessons we learned in the spring to come through this together.”