"Treat it Like a War"

Themes from a March 19, 2020 CNN interview with NY Governor Andrew Cuomo

A CNN interview with New York governor Andrew Cuomo the day before he issued shutdown and stay home directives is a good example of how he & other officials used war-time rhetoric, imagery, and orders to implement a response that looked nothing like a disease outbreak plan and every bit like a bomb-attack drill.

Recorded on March 19, 2020, just as deaths in New York City started to rise, the audio segment seems to have disappeared but a transcript is still posted on a state website and copied below. Ideas, phrases, and words most closely-connected to fighting or being in a war are in bold text as my emphasis.

Following the transcript, I comment on five themes: wartime mentality, promulgating a panic story, pushing for ventilators, the launch of mass testing, and shelter-in-place.

Earlier today, Governor Andrew M. Cuomo was a guest on CNN's New Day to discuss New York's plan to combat the novel coronavirus crisis.

Alisyn Camerota: Joining us now is New York Governor Andrew Cuomo. Governor, we appreciate you coming on. There are so many developments every morning. What about that? This is just - Sanjay Gupta just reported there are two new guidelines on the CDC website this morning that say healthcare workers who are asymptomatic, but who have been exposed to a patient with coronavirus, can continue to work if they wear a face mask and, by the way, here is the other new guidance, if you don't have a proper face mask, you can consider using homemade masks like bandannas and scarves. Will this - will we see this in New York hospitals?

Governor Cuomo: Good morning, Alisyn. I'm not a doctor, obviously, but I hope we don't see that in New York. But it is making the right point, where this is going to become real and we have been saying this from day one, but we're seeing it now, s this is a crisis for our healthcare system management. it is our -- the capacity of our healthcare system. Do we have enough beds, do we have enough gloves, enough PPE equipment and the answer is no. And that's why the federal government is now fully engaging, and I believe the president now gets it. That's where they have to focus. We shouldn't have to go to scarves and bandannas. There is something called the Federal Defense Procurement Act. This is a war. Treat it like a war. Say to the manufacturers in this country, I need you to build these pieces of equipment quickly, certainly the gear, the machine next to me, the ventilator, this is going to be the matter of life and death for people. We now have about 5,000, 6,000 ventilators in New York State. We are going to need about 30,000 ventilators because these people who have come in all have respiratory illnesses.

Camerota: I hear your plea. How fast do you believe those 30,000 can be built?

Cuomo: Well, that's the war time mentality. You can't buy a ventilator right now. Globally, you can't buy them. We're going to have to make them or make something like them. And that's why the federal government is stepping up and ordering the manufacturers to now come together and make this happen is going to be imperative.

Camerota: Governor, the last numbers we had from New York that had spiked overnight again, of course, we expect that: 1,871. Do you have any new numbers this morning?

Cuomo: We have - we did 8,000 tests overnight, Alisyn, which is probably a new record in the country. We don't have the results of the 8,000 tests, but when you do 8,000 tests, the numbers are going to go up exponentially. And, again, reality in all of this, it doesn't mean that it is indicative of how many people have the virus, it is how many people you are testing. And when you do 8,000, you're going to see a major increase.

Camerota: Governor, there has been a rather public debate going on between you and the Mayor of New York City, Bill de Blasio, about shelter in place policies and whether or not that's appropriate for New York City. As you know, San Francisco and the Bay Area has implemented that, basically people should stay in their homes and just on - that's their thinking and that I think is the Mayor's thinking - and so just on Tuesday, you had said at a press conference the people should get out of the house, they should go to a state park, the state parks here are still open, there are reports of people in Central Park still. Do you still feel as sanguine as you did on Tuesday that people should be going out to parks and not sheltering in place?

Cuomo: Yeah, Alisyn, this is an important point. What I am least sanguine about is that we are battling two things, a virus and fear and panic. And I'm as afraid of the fear and the panic as I am of the virus and I think that the fear is more contagious than the virus right now. You take a place like New York City, we are at near panic levels, so what you say and how you communicate is very important. Should everybody stay home? Of course. Are we imprisoning people? No. Can you stay inside 24 hours a day? No. When you go out to shop or go out to take a walk and get exercise, social distancing. But look at your words, shelter in place, you know where that came from? That came from nuclear war. What it said is people should go into an interior room of their home with no windows, stay there until they get the all clear sign. Now, that's not what people really mean, but that's what it sounds like. And I spent half my day knocking down rumors that we're going to imprison people in their homes, there is going to be a roadblock around New York City, you will panic, 9 million people who will be fleeing New York City in 24 hours if we don't clearly communicate what we mean.

Camerota: I hear you, but Governor, I'm sorry to interrupt, but then we also hear we are on a war footing. President Trump says we are on a war footing. This is being likened to war time, and so it is very hard for people to know whether they should be going out to a park or staying home on their version of lockdown, whatever that looks like in your house.

Cuomo: Yeah. Yes, I agree with that. But say that, don't say I'm imprisoned in my home. And let's take a step back, we are on war footing. Build ventilators, manufacture PPE and gloves, et cetera. People stay home. Reduce density. Close businesses. But you're not imprisoned. You're not quarantined. You're not a prisoner. We're not going to put a roadblock around New York City so you have to pack up and get out today. This is going to go on for months. Communicate what you mean without using terms that nobody understands and only incites panic, because that's what we're doing in too many situations. You can get -- you can communicate what you want, but just say it in a more clear way, rather than using these buzzwords that are panicking people. I am not going to imprison anyone in the State of New York. I am not going to do Martial Law in State of New York. That's not going it happen.

Camerota: Governor Andrew Cuomo, we really appreciate you coming on, so many mornings and giving us all the latest information. Obviously we'll speak to you again very soon. Thank you.

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Themes

Wartime Mentality

With phrases like This is a crisis, Treat it like a war, We are on wartime footing, and We are battling, Cuomo was positioning himself as a wartime governor, just as Donald Trump had positioned himself as wartime President and promised “total victory” over “the Chinese virus” the previous day (March 18).

The language and ethos of war was not improvised, in my opinion, and was part of a March - May 2020 “script” that elected/appointed officials, media, and other “stars of the show” used repeatedly and with gusto to create a sense of urgency and mobilize/galvanize citizens to take the virus seriously (so to speak) and do what government was commanding them to do.¹

Fear-mongering around hospitals not having “enough” for the war (enough ventilators, enough PPE, enough tests, enough oxygen) and being overwhelmed also helped convince the populace to do what they were told.

Promulgating a “New Yorker Panic” Storyline

Both in this interview and in the days and weeks before it & after it, Andrew Cuomo consistently delivered the message that fear was spreading and that New Yorkers shouldn’t panic.

Based on my interpretation of various time series datasets and conversations with New Yorkers, I’m not yet convinced New York City writ large was descending into true mass hysteria in those weeks. People report feeling uncertain, afraid, tense, and anxious as the city emptied and the air filled with incessant ambulance sirens (which data corroborates). A veteran NYPD detective told me “People were scared. Would I call it panic? I wouldn’t go that far.”

But I’ve also spoken to doctors & nurses who say they felt like their co-workers inside New York City hospitals were very stressed and “panicking”.² Health department bulletins to hospitals and internal hospital communications to administrators and “frontline” workers show messages which were suddenly and increasingly intense. Reports in mainstream and social media also likely contributed to angst among workers inside the facilities, regardless of what their individual hospital was experiencing in term of patient volume or condition.

Conflicting recollections and differential experiences notwithstanding, the idea that New Yorkers were panicking served the government & media story about the most disaster-prepared & rehearsed city in the country (if not the world) being under siege.

Push for Ventilators (but not paralytic agents/sedatives)

A “need” for 30,000 ventilators appears to have been based on estimates in the state’s 2015 ventilator allocation guidance for a pandemic influenza outbreak and other disasters. The projection was a source of conflict between Cuomo and President Trump, with Trump contending the number was far too high.

On March 19 (the same day as the Cuomo interview above) NYC Mayor Bill DeBlasio sent a request for an additional 15,000 ventilators to HHS secretary Alex Azar - an incredible number equivalent to 75% of total bed capacity.

I doubt it was ever an intention to supply or use that many ventilators in New York, nor do I think authorities at the highest levels actually believed thousands more ventilators were needed to battle a coronavirus. The fight between Cuomo and Trump seems contrived, and the inflated estimate makes more sense if the federal government activated a chemical- or bomb-attack live-exercise/simulation in New York (as I suspect might have been the case), assuming that having so many ventilators would be helpful and necessary in such a scenario.

The state’s incomplete dataset shows projections far exceeded use and the number of ICU-intubated patients in New York City peaked at ~2,700.³ New York state acquired 8,555 ventilators total at a cost of $166 million.⁴

Putting people on ventilators requires the use of paralytic & sedative agents (such as those I named in a recent FOI request to NYCHHC), so it’s curious that Cuomo did not mention a need for more of these drugs along with the need for more ventilators. This might suggest “enough” drugs were already available and/or had been stockpiled & planned for, or it might point to the ventilator estimate being a bluff. A midazolam (versed) shortage was reported in the U.S. on April 2, only two weeks into the NYC death event. Hospitals were not overrun with patients, raising the question of how the supply could be depleted so quickly.⁵

According to a veteran of the medical-supply purchasing industry I’ve spoken with, by the time such shortages are reported by the FDA, it’s “old news” to those doing the purchasing — which makes the April 2 date even more curious, because it implies a lot of drugs were used in the first few weeks of the emergency period and/or earlier in the flu season. Assuming the shortage was real, it could imply such drugs were also being used in nursing homes and by paramedics at high levels.

Launch of Mass Testing

The 8,000 tests in one day Cuomo bragged about in the interview was a lot of tests back then. Data on NYC flu tests given during 2019-2020 flu season shows a January 2020 peak of ~15,000 in a week (~2,100/day).

If data reported in a Northwell Health Systems study are any indication, most testing was being conducted in hospitals, including on patients already admitted for other reasons, as well as on staff.

Ironically, Cuomo seems to have been told that testing doesn’t fully capture “spread” or prevalence because he said, “doesn't mean that it is indicative of how many people have the virus, it is how many people you are testing. And when you do 8,000, you're going to see a major increase.”

Nearly half of those 8,000 tests returned positive and daily rates climbed to over 70% by the end of March. (For comparison, weekly percent positivity for NYC flu tests in 2019-2020 did not exceed 38%.) Seropositivity was also high and genomic sequencing showed variants connected to those sequenced Europe even among New Yorkers with no recent travel history.⁶

I’ve yet to hear a sensical explanation for any of these high rates that accounts for such a sudden and explosive transmission rate of a pathogen alleged to be spreading silently, but not impacting all-cause mortality until the Federal government enacted drastic measures. The same pathogen did not explode with the same fury nearly anyplace else in the world, and there’s every indication that the deployment of mass testing accompanied by deadly measures “sank” thousands of damaged ships in hospitals and nursing homes and helped create the illusion of a spreading deadly pathogen.

New York State was using its own COVID/SARS-CoV-2 test, approved on February 29, 2020, which makes the high positivity rates even more suspect and is one of many reasons the tests should be investigated.

Shelter-in-Place

The dialogue between Cuomo and Alisyn Camerota (CNN host) around shelter-in-place orders is a premier example of how federal and state officials were side-stepping the law.⁷ Notably, this interview was the day before Cuomo issued a shelter-in-place order, a term he correctly noted is connected to nuclear war/radioactive fallout, which fits with the idea that a bomb-response plan was activated - not a pandemic response plan.⁸ He also issued Matilda’s Law - which was not a law but a [illegal] quarantine order for New Yorkers over age 70 and/or immune-compromised individuals.⁹ Mayor DeBlasio sent out “guidance” the same day that basically told NYC residents to follow the Governor’s orders and warned that NYPD would be in city neighborhoods “to ensure compliance with the policies.”¹⁰

Cuomo rationalized in the interview that because people weren’t being/wouldn’t be imprisoned inside their homes and martial law was not being instituted, there were no restrictions on freedom of movement to be concerned about. In reality, the federal government had essentially directed him and other governors to use the pretext of a disease-spread emergency to “order” and “guide” citizens to stay home.

Cuomo also said, “This is going to go on for months” - which is exactly what a governor would say in the event of a war.

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Post subject to ongoing additions/revisions.

1. Other examples: Andrew Cuomo (March 15, 2020); Mike Pompeo & Donald Trump (March 20, 2020); Donald Trump (March 31, 2020); Bill DeBlasio (April 2, 2020), and Pierre Kory speaking to the U.S. Senate Governmental Affairs & Homeland Security committee on May 6, 2020 (“we are at war right now with this virus”). WHO Director-General Tedros Ghebreyesus compared the power of a virus to that of a terrorist attack. (February 11, 2020) Much earlier, in April 2018, Bill Gates also invoked the war metaphor to talk about preparing for a pandemic.

2. See “Pietro’s” comments in “The Silent Witness” (with

Martin Neil

&

Jonathan Engler

)

3. See data in “We Still Don’t Know How Many People in New York City Were Killed by Ventilators”

4. Source: “New York spent $250M on tech to fight Covid that no one uses” (POLITICO)

5. A study of medications used in selected hospitals throughout New York State during the spring 2020 emergency period (Dabestani, et al, 2020) shows significant increases in medications used to place and keep patients on ventilators, including midazolam and propofol.

6. See data in “New York - It Was Widespread Well Before Anyone Knew It”

7. The Mayor of San Francisco had issued a shelter-in-place order on March 17, 2020. This CNN article about what it entailed is illustrative of how government officials and media alike were trying to present such orders as necessary and legal.

8. “Stay Home, Save Lives” - a slogan/directive used in countries such as U.S., UK, Australia, & Malaysia - is also evocative of a nuclear attack.

9. Named after Cuomo’s mother

10. Two weeks later, DeBlasio was calling for troops to come to the New York City battlefront.