Cuomo's New Coronavirus Strategy: More Capacity, Load-Balancing

NEW YORK, NY — Gov. Andrew Cuomo on Monday announced five strategies he hopes will beat back a looming surge in coronavirus hospitalizations over the coming weeks as the statewide infection rate surpassed 4 percent.

The sweeping announcement included initiating emergency hospital procedures, improving testing capabilities and preparing now for widespread vaccinations. It also tweaked how the state will designate yellow, orange and red zones, which add restrictions for dining, businesses, schools and houses of worship.

"It’s a new phase in the war against COVID," Cuomo said, calling it a war of attrition, preparation and mobilization. "The chess board has really changed."

The announcement came as the number of New Yorkers hospitalized with COVID-19 climbed to 3,532. That's up from 429 on Aug. 29 and up from 1,085 on Oct. 29. Unlike in March, the increase in hospitalizations has affected both upstate and downstate.

Cuomo's first — and perhaps most robust — strategy focused on managing hospitalizations and hospital capacity.

The state will add metrics to its criteria for determining whether a community should enter a yellow, orange or red zone. This includes rates of hospitalizations, death, cases, as well as available hospital staff, beds and intensive care units. Health officials are waiting for what Cuomo called a "post-Thanksgiving effect" to set those numbers, believing the rates will drastically change in the next week.

The first prong of Cuomo's plan detailed the state's emergency hospital procedures and includes these nine directives:

1. Address potential staff shortages by immediately identifying retired nurses and doctors.
2. Stopping elective surgeries in Erie County, where hospitals are nearing capacity thresholds.
3. Mandating that hospital systems immediately install a load-balancing system so patients can be moved to other hospitals within that system to prevent one from becoming overwhelmed.
4. Preparing a plan to install emergency field hospitals that can add hospital bed capacity.
5. Have hospitals plan to add 50 percent capacity.
6. Prepare to implement a statewide "surge and flex" policy that would enable hospitals to transfer patients to other systems completely.
7. Prepare to staff emergency field hospitals.
8. Confirm that hospitals have a 90-day stockpile of personal protective equipment, such as masks, gloves and gowns.
9. Launch hospital capacity emergency tracking system.

"Hospital capacity is the top concern in the new battlefield," Cuomo said. "It’s about hospital beds, ICU and having enough staff and equipment."

New York will add an emergency stop provision that can implement an NY PAUSE-style shutdown or rapidly move a zone to another zone if hospitals face a dire crisis.

The second prong of Cuomo's coronavirus plan focused on improving testing.

This includes working to increase the gross amount of tests, but also balancing the distribution of those tests so an equitable amount get to health care workers, nursing homes, schools, essential workers and business professionals.

The third prong focused on how to safely keep schools open. Research shows viral transmission is low in schools, Cuomo said, and he wants to keep them open as long as they're safe, particularly in kindergarten through eighth grade, as well as special education. The plan calls for creating a sustainable, ongoing testing protocol in schools that will stay long-term.

In schools, Cuomo envisions testing on a weekly basis for schools in orange and red zones. Schools in orange zones would have to test 20 percent over a month while those in red zones would have to up that number to 30 percent. Both would be on a rolling basis.

He stressed that these testing requirements would be the minimum number to remain open. The state could adjust testing requirements for districts that have special circumstances, and local districts could do even more testing. Additionally, local districts would be allowed to shift to remote learning before reaching the state threshold, though Cuomo advised against such a move.

The fourth prong in the state's strategy focused on small, at-home gatherings, or "living room spread," as the governor has called it. Cuomo noted that the state's tools for curbing the spread have become blunted as 65 percent of cases come from small gatherings at private homes, including from the holidays, cooler weather, and people gathering at home because they can't do so at local establishments.

Just as the state held a public education campaign on wearing a mask, the state will do so again on limiting small gatherings.

The fifth prong of the state's strategy focused on preparing for a vaccine program. Delivery could begin in the next few weeks, and Cuomo said New York will focus on how to ensure delivery of the vaccine is fair, equitable and safe. He stressed the need for having an inclusive process that focuses on Black, Brown and poorer communities that lack sufficient health care resources.

Until the vaccination program reaches a critical mass, Cuomo said the economy will continue operating with strict safety regulations, such as limiting capacity, mandating testing, and required mask-wearing.