Governor to take ventilators for NYC as hospitals buckle

[Omaha Steve]

Source: AP

By MICHAEL R. SISAK, JOHN LEICESTER and ARITZ PARRA

NEW YORK (AP) — With coronavirus deaths climbing rapidly in New York, the governor announced Friday he will use his authority to take ventilators and protective gear from private hospitals and companies that aren’t using them, complaining that states are competing against each other for vital equipment in eBay-like bidding wars.

“If they want to sue me for borrowing their excess ventilators to save lives, let them sue me,” Gov. Andrew Cuomo said.

The executive order he said he would sign represents one of the most aggressive efforts yet in the U.S. to deal with the kind of critical shortages around the world that authorities say have caused health care workers to fall sick and forced doctors in Europe to make life-or-death decisions about which patients get a breathing machine.

The number of the people infected in the U.S. reached a quarter-million and the death toll climbed past 6,000, with New York state alone accounting for more than 2,900, a surge of over 560 dead in just one day. Most of the dead are in New York City, where hospitals are being pushed to the breaking point.



A Covid-19 patient wears a ventilated respiratory device over his head as he lies in a hospital bed at Bergamo's Papa Giovanni XXIII hospital, northern Italy, Friday, April 3, 2020. The new coronavirus causes mild or moderate symptoms for most people, but for some, especially older adults and people with existing health problems, it can cause more severe illness or death.(Claudio Furlan/LaPresse via AP)


Read more: https://apnews.com/9625f2983ac615d631a64e3e99b0e69e

[The Magistrate]

1. A Proper Action By Governor Cuomo, Sir

If any firm manufactures or holds in store stocks of ventilators or protective gear, he ought to simply seize them and control distribution. National Guard troops ought to be up to, and by now up for, the task.

It could well be not quite legal, but the thing could be a fait accompli before any court could rule, and even then enforcement of a court order is an executive, not a judicial function....

[bucolic_frolic]

2. I don't have enough information to comment on whether this is a good or flawed decision

Those other hospitals may need them in a few weeks, and NYC patients will be using them, in addition to most or all hospitals running out of them. So the temporary good for one locale may come back to bite the Governor on the other side. But he is in a giant, life-or-death game of Whack-a-Mole.

[stopdiggin]

4. this is why you have a "team"

of disaster response people to make these thorny "best guess" kind of decisions. And in this crisis .. those teams would be heavily weighted with epidemiologists, public health experts, systems delivery experts, numbers crunchers .. and others that would have some idea on how those questions (and they are valid ones) can best be answered.

(also has the added benefit of keeping the politicians at a bit of hands length from the nuts and bolts decisions. probably a very good thing.)

[not fooled]

5. And the cases will peak in different areas at different times

especially since the orange maggot refused to implement a nationwide stay-at-home order early on. Hence, there will be rolling waves of infection throughout the nation--so ventilators and other critical supplies could be moved around as needs arise (why a coherent, strong Federal response was so important).

[bucolic_frolic]

7. Patients can be on ventilators as long as six weeks

This is not a matter of moving them around as we have been led to believe. It is a matter of who gets his hands on them first, wins.

[SheltieLover]

3. 👏👏👏👏👏👏👏👏👏👏👏👏

Appropriate!

[Stuart G]

6. Number infected in U.S.A. - 250,000..Number Dead in U.S.A.- 6000...from above article

[MineralMan]

9. We don't know how many are infected.

We aren't testing people. Those who have milder cases are not being tested, either. That number is just a guess. I suggest that it should probably be multiplied by 10 at this point.

[bubbazero]

8. A true illustration of what SHOULDN'T HAVE TO BE DONE

Don't get me wrong, I think Gov Cuomo is going on the best data, science driven predictions, and medical advice possible. I would back his decision, but it's risky. Risk is simple, if you take equipment from an upstate hospital--and it's then creates a shortfall when the pandemic hits THAT hospital---and their equipment is still in use in NYC--the long term political and social ramifications are staggering. (I sincerely hope and pray this kind of situation doesn't happen; tho other countries have seen it b4--food in some). The best LONG TERM SOLUTION as someone smarter than I pointed out, is to have these "preparedness commissions" staffed by real experts...medical, scientific, logistic, etc.... Have emergency plans in place--monitored, practiced, constantly updated and analysed. Yes, include the cost-accountants when and where necessary. The legislators and elected officials then need to listen to the experts--I don't listen to the local idiot about my herd's health decisions--even if he/she is a teaparty popular county commissioner--I listen to the experts to stay prepared! IT AIN'T CHEAP, IT AIN'T EASY-----AIN'T SUPPOSED TO BE. THIS IS LIFE, AND THE PROTECTION OF LIFE; AIN'T NOTHUN CHEAP OR EASY 'BOUT LIFE!

[McCamy Taylor]

10. GOP--the party of "We can steal your land" will have screaming fits

and declare that the Democrats are trying to "kill white people" by taking idle ventilators.

[stillcool]

11. in New York?

if the GOP gave a sh*t about 'white people' in New York, there would be no problem. I don't get it.

[EarthFirst]

12. As a NYS resident (WNY) I can support this measure...

With the contingency that New York commits to far more stringent isolation guidelines with stiff penalties for violators.

We’ll need to lock the state down even further; clean up the list of essential services to bare bones and hope it works...

We couldn’t afford elsewhere in the state to have a surge while that equipment is out on loan downstate.

I’m not opposed to this idea; but some contingencies need to be established before I’m fully on board...

[wnylib]

19. As another resident of western NY

I can't agree with this planned action by Cuomo. He has done an excellent job in the face of deliberate obstacles from the federal government. He is under great pressure now, so I understand why he would take this desperate move.

But Cuomo has said that he does not want to have to ration ventilators, to choose who will live and who will die. I understand that concern. But this action would only shift the rationing to another part of the state. In effect, it pits NYC residents against the rest of the state. Cuomo has promised to return the ventilators or pay for them. Payment means nothing if there is nothing available to buy. If they were available, they would have been bought up for NYC.

I do not blame Cuomo, even though I disagree with this decision. He should not have been put in this position by Genocide Don.

Cuomo is sending the National Guard to collect these items from companies and hospitals. I predict opposition if he does. Some places will hide them. There is a chance that RW militia groups (there are plenty in rural NY) will threaten violence.

Confirmed cases in the Buffalo area (Erie Co NY) are over 700 and rising. Erie Co officials have stated bluntly that there are no "extra" PPE or ventilators in the county so there will be none taken from this area.

I imagine that other cluster areas, like Rochester, NY will react the same.

[eilen]

48. Agreed.

I think maybe if my hospital can, they should put everyone they don't need on the floors on furlough--many of them have very low census. With the idea of calling everyone back in as the census increases. Meanwhile they can send busloads up to our hospitals that have the capacity like they have already in Albany. I see they are taking maybe 20% of available vents so it is not a total confiscation.

[William769]

13. Kick & recommended.

[NoMoreRepugs]

14. My son has a sourcing company in China and has

been working 24/7 for weeks to try and facilitate purchases of PPE for med supply distributors here and everywhere.

He just sent me this text ....” I just had a supplier say that their KN95s got confiscated by customs and were actually given to the Fed government for usage… Total racketeering shit“

[JudyM]

42. !

This administration represents the biggest assault on the US citizenry in our history. I now believe Trump and McConnell need to be ousted.

What hell is this to have a federal government that is not only responding negligently in its misleading and lack of action, but also tying the hands of its governors in the biggest public health crisis we’ve faced?

Why is this not incompetence that warrants removal? If not intentional or wanton neglect of duties?

[SleeplessinSoCal]

15. I read that the ventilators are no panacea.

They still need them and use them. But this is terrifying.

"Most coronavirus patients who end up on ventilators go on to die, according to several small studies from the U.S., China and Europe."


https://www.npr.org/sections/health-shots/2020/04/02/826105278/ventilators-are-no-panacea-for-critically-ill-covid-19-patients

[pnwmom]

18. Part of that is they're restricted in numbers so they've only been using them on the sickest of the

sick. They haven't had enough to use them on other people who could benefit.

[SleeplessinSoCal]

21. the report says some cannot be taken off the ventilator.

That is terrifying. Among many other terrifying aspects of our alt truth reality.

[pnwmom]

22. During the decades of polio there were people who lived for years that way. n/t

[SleeplessinSoCal]

23. Sad state of affairs going back to the 50's

MAGA redefined.

[sheshe2]

29. Here.

It is called triage. Heartbreaking. Yet that what is happening. They are in fact taking them off the respirators. They are now choosing who will live or die.

You code. You die. They have no choice. They move on.

https://www.democraticunderground.com/100213227134#top

I have a family member on the front line. Her PPE is a rain slicker and donated face masks from a friend. I can't even. I am far to upset.

[Juneboarder]

31. Please thank your family member from my household?

I feel for those that are on the front line, and I hope your family is doing well right now.

[eilen]

49. About 50% die that have to be vented.

I think I read or saw that on one of the Cuomo updates.

[SergeStorms]

16. He shouldn't even have to ask.

If these hospitals have excess equipment they should offer it without being asked. We're all in this together for chrissakes!

Another great move by Governor Cuomo. He's doing a fantastic job of leading during this crisis, unlike some other men who think they're more powerful in the Federal Government. Little Donnie Trump, I'm talking to YOU.

[wnylib]

20. Sorry but I cannot agree. Yes, Cuomo is

doing a great job in the face of horrfic obstacles created by Genocide Don. But, outside of NYC, there are two other cluster areas, Rochester in Monroe Co, and Buffalo in Erie Co. Just as Cuomo is preparing for a peak in NYC, these other areas will also peak. We will not be able to treat our own people if we send everything to NYC.

Should not be necessary to make these choices. The fault is Trump's for being deliberately obstructive.

But Erie Co, NY officials have already announced firmly that that there are no unused or extra supplies in the area and they will not turn over anything. They need their supplies for their own 700+ and rising cases.

[SergeStorms]

24. I live just outside of Rochester....

and they're having nowhere near the spike in cases that NYC is having. I think there have been 14 deaths in Monroe County to date. I haven't kept up with what's going on in Erie County.

I was talking about getting equipment from outside of the state, not inside. There are areas of the country that have extra equipment at the moment, and they actually have a minimum of corona cases in those states. Let New York borrow that equipment until/if they need it. Having equipment sitting around doing nothing when people are dying elsewhere is ridiculous.

[wnylib]

25. But that is not what Cuomo is doing.

Last edited Sat Apr 4, 2020, 12:59 AM - Edit history (1)

He is sending the National Guard to force communities INSIDE the state to give up their equipment to NYC. Erie county has 727 cases and the numbers jump up each day. Monroe Co has over 400 cases.

It won't work to "borrow" ventilators from "upstate." They will never be returned because cases will continue to rise in NYC. They will not be replaced for the growing cases outside of NYC because there aren't any to buy anywhere. So Cuomo's plan puts NYC residents above other NYers.

It's an awful situation and I understand his desperation. But not at our expense.

[FBaggins]

27. The peak is projected for a week from now in the city

Plenty of counties in the state are expected to peak much later and/or well below the number of ventilators that they have on hand.

This is a smart move. If I were president I would require something similar before national stockpiles were tapped beyond a certain point.

[wnylib]

33. I think your view would change if

you lived in Erie Co, NY.

People are on ventilators from 6 to 8 weeks. Buffalo and Rochester will peak while NYC residents are still on ventilators. So there will be no equipment available in Buffalo and Rochester when they need it bc it will still be in NYC.

But, hey, if you are so confident that this is the right thing to do, I invite you to settle in Buffalo for the next 8 weeks.

[FBaggins]

39. Math doesn't change based on where I live

People are on ventilators from 6 to 8 weeks.

That's nonsense. A small percentage of people may be on for that long... but the vast majority are not.

Buffalo and Rochester will peak while NYC residents are still on ventilators.

There are counties in the state that are not projected to need all of their ventilators at any time during the crisis. If Erie isn't one of those, then the surge should come from somewhere else.

But the IHME-projected peak for the entire state is just days away... while merely a week after that, the projected need is only 2/3 of the peak amount. That means that whatever your assumptions are about how long some people spend on a ventilator... there will be thousands of them available to return to other counties - that are needed now in the city.

[wnylib]

44. At 737 cases and climbing, there

are no spare ventilators or PPE for Erie Co to donate to anyone.

Regarding the "nonsense" about people on ventilators for several weeks, and only "some" people needing long oeriods, Chinese medical staff reported to Bloomberg that frequently they had patients who remained on ventilators for 4 to 5 weeks before recovering enough to breathe independently - or succumbing to the virus and dying. A few weeks ago in a press conference, governor Cuomo cited one reason for the ventilator shortage was the number of people who remained on one for several weeks before it became available for use by another person.

Regarding a projected peak "for the entire state," Governor Cuomo has said more than once that there is no definitive date for a peak for NYC or for the state because the data used for the projections is variable. His anticipated peak for NYC is an estimate. Some put the peak later, some sooner.

I am all in favor of sharing equipment and PPE whenever possible. My point is that, due to the number of cases for the available facilities in Erie Co, there is nothing to spare. In fact, the Erie Co region could use some loaners to prepare.

Math, as a system, does not change geographically in the US, but mathematical figures do change geographically regarding an individual's likelihood of catching covid 19 and having adequate facilities for treating serious cases of it.

[eilen]

50. Oregon just sent us 140 I think. nt

[wnylib]

54. Yes, Cuomo mentioned it in his

press briefing this morning. I mentioned it in another post.

[FBaggins]

26. Hold on...

You’re saying that you would approve of a governor offering his state’s National Guard troops to go to another state and steal medical equipment?

[wnylib]

34. Why is anybody bringing up other states?

NY Governor Cuomo did NOT say ANYTHING about other states. He said that he is sending the NY State National Guard to collect equipment from other regions within NY to give to NYC.

Where is this talk of NY's National Guard invading other states coming from?

[FBaggins]

40. That was the context that I was replying to

SergeStorms's #20 interpreted Cuomo's move as getting equipment from out of state.

Where is this talk of NY's National Guard invading other states coming from?

Actually... that was part of the conversation here a few days ago. If Trump has ventilators in warehouses and won't give them to NY... the thought from some was that Cuomo should just go take them. It was a knee-jerk response that wouldn't be legal... but is certainly understandable.

[wnylib]

45. This whole topic of sharing equipment

in NY has not been understood or reported very well by DU posters. I usually catch Cuomo's daily press conference, but missed it yesterday and did not check my e-mail for my daily update from the NY government site, which is a summary of the daily presser.

So, getting my "news" on this from DU posts threw me off, too. Not about crossing state lines with the National Guard. I knew Cuomo would not do that. But some posts gave the impression of a military state takeover.

I read my NY gov e-mail late last night and learned that Cuomo is not taking all supplies from other locations for NYC. He REQUESTED that communities around the state donate 20% of excess supplies, if they have them. The National Guard will collect them to take to NYC because they have the vehicles and manpower (human power) to physically travel the state for pickups. He said the same thing in this morning's presser.

This morning he reported that Oregon is lending NY 140 ventilators which should help.

[IcyPeas]

17. I heard another sobering fact yesterday

I was listening to NPR's Fresh Air with Terry Gross. She was interviewing trauma surgeon David Nott . He said in the interview that 50% of patients USING A RESPIRATOR still die within 2 weeks. That number shocked me.

Trauma surgeon David Nott, shown above in Bangladesh, has volunteered in war zones and disaster areas around the world. Now he's treating COVID-19 patients in London.

But unlike in his work abroad, Nott says, the health care workers treating COVID-19 did not volunteer for this duty. He warns that many will face profound challenges in the weeks and months to come — especially with shortages of critical supplies.

"You will see things that you have never seen before," he says. "You will have to make very difficult decisions — which are those difficult decisions you actually make in war zones — about saving somebody's life."

Nott's memoir, War Doctor: Surgery on the Front Line, recounts his experiences treating patients in troubled areas throughout the world. He also works to train front-line surgeons through the David Nott Foundation and the Royal College of Surgeons.

It's a 40 minute interview but very good. Listen here if you'd like:

https://www.npr.org/sections/health-shots/2020/04/02/824703205/war-doctor-says-treating-covid-19-is-like-fighting-an-invisible-enemy

[FBaggins]

28. I don't know whether it's true, but it doesn't surprise me

An 80 year old gets to the point that he can’t breathe any longer? That’s definitely life-threatening.

Think of it another way... they would almost all die without one. So a week or two on a ventilator can save half of the people who needed them.

[wnylib]

35. Exactly. Just because half of them

die is no reason to stop using them. Afterall, half of them live, too.

[eilen]

51. Thanks for the link

One of the nurses I work with and I had a discussion about this and while we know there will be nurses who will walk out if not given appropriate PPE, neither of us think we can do that. We also know we will probably get sick. Nurses (and other healthcare workers) everywhere are getting the virus, for some they have mild symptoms and others more serious. I hope that if we need a ventilator, there will be one available for us. We don't currently work in a patient care floor but she is getting assigned to an ICU and I will be deployed to a step down floor (according to the hospital's nursing dept. COVID plan).

[eilen]

30. Man, we better do some strict social isolation

and not get sick here upstate.

It makes me think, maybe I should quit. I work in a hospital. Sick people go there and I take care of them. Today a Dr. wanted to do a procedure on a R/O Covid pt. The anesthetist talked him out of it (to save the PPE) and wait for results first.

[Juneboarder]

32. This right here makes me sad.

[eilen]

46. Well, he was right. The procedure was not urgent.

The patient can rule out and follow up after this scourge. It is highly possible that the apex will pas NYC and the vents will come back in time for our apex. Who knows? The models change every day.

As far as my concern- as a healthcare worker, I am put at risk. What happens if I get sick? I tell you, I will probably get sick, and I will just pray everything goes right and I don't need an invasive airway. That's what I will have --hope, thoughts and prayers.

[DeminPennswoods]

36. A real commentary on our

healthcare system that 15,000 people in the hospital and 3700 in ICU can overwhelm a hospital system in New York state with it's population of 19M. (Data per The Atlantic mag's covid tracker project).

[OldBaldy1701E]

37. but but... insurance!

Face it, healthcare in this country is no different than sneaker manufacturing. It is all about money and influence. You want healthcare? Remove the 'pay to play' attitude and you might see some improvement. But, people are brainwashed to believe that insurance will save them. MOney will save them! (Ironically, money is probably one of the biggest reasons this thing has spread so fast.)

[DeminPennswoods]

38. It certainly makes a good argument

for a govt run national health care system with planning not motivated by profit.

[FBaggins]

41. Not necessarily

On a per-capita basis, the US has more ventilators than just about any other country. The same goes for lots of other medical hardware (e.g., MRIs, CT scanners, etc.).

[DeminPennswoods]

43. When the for-profit healthcare and insurance system

cannot support a fraction of 1% of a population being sick at the same time, something is seriously broken.

A national health system would have combined resources, including medical staff, that could be redeployed where, and as, needed.

[eilen]

47. Even in the best equipped system

No one would have that many ventilators. That is an insane amount to have on hand.
Also, for a higher than normal infectious flu season, we had enough PPE. Just not for some crazy pandemic which honestly, most hospitals don't necessarily keep stock for that possibility. What complicated matters was the great demand of many other countries dealing with the pandemic at the same time.

We need to have manufacturing here of these things though--capacity to ratchet it up etc.

We also need central leadership when our nation is threatened.

[Steelrolled]

55. It is no different from grocery stores

We have more than enough food, but when people buy more than normal (even a little, not excessive hoarding), the shelves quickly go bare.

[Steelrolled]

53. not sure how much to trust https://covid19.healthdata.org

but it shows NY with a low amount of ICU beds compared to other states, considering their population.

[Steelrolled]

52. Seems the fighting for equipment going on at the international level

is also going on between states, and within states.

Self preservation is our most basic drive.