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Saturday, April 25, 2020

New York State Governor Andrew Cuomo's COVID-19 Nursing Home Scandal

During the past week newspapers in New York and around the world have read about the horrible number of deaths from COVID-19 in nursing homes, which we have documented in previous posts.

Howard Zucker
In sum, Governor Andrew Cuomo said in a press conference that he knew nothing about what happened to nursing home residents when they tested positive and asked his health commissioner Howard Zucker to tell the public where the person was placed.

Mr. Zucker said that everyone who tested positive was returned to the nursing home and given proper protection from spreading the virus to others, including staff.

The extremely high number of deaths from the virus in NY State's nursing homes is proof that Zucker's statement was a lie. The newly tested positive people were not given proper protections from spreading the virus. Too many people have died, including staff.

On the list of bad management actions that will now follow Cuomo into, we hope, forced retirement from political life, we have the scandal of the Comfort, a Navy hospital ship equipped to take in 500 COVID-19 patients yet had only 62 patients and the Javitz Center with only 134 patients but 1000 beds available. 

There will be lawsuits for the next 20 years to remedy these deaths and political mismanagement. 

The accountability is all on Governor Cuomo.

Betsy Combier, betsy.combier@gmail.com

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New York refused to send nursing homes COVID-19 patients to nearly empty USNS Comfort


New York health officials were warned in writing that a Brooklyn nursing home where 55 patients have died of coronavirus was overwhelmed — weeks before it began topping the state’s official list of resident COVID-19 deaths, damning emails show.
Cobble Hill Health Center CEO Donny Tuchman sent a desperate email to state Health Department officials on April 9, asking if there was “a way for us to send our suspected COVID patients” to the hospital built inside the Javits Convention Center or the US Naval hospital ship Comfort — the under-utilized federal medical facilities on Manhattan’s West Side.
“We don’t have the ability to cohort right now based on staffing and we really want to protect our other patients,” Tuchman wrote in a chain of the emails reviewed by The Post.
He was denied.
“I was told those facilities were only for hospitals” to send their overflow patients, Tuchman said.


At the time Tuchman sent his plea, only 134 of the 1,000 beds at the Javits Center were full and the Comfort — which had just been reconfigured to treat up to 500 COVID-19 patients — had a mere 62 on board.
Adding insult to injury, the Navy hospital ship wound up treating just 179 patients before Gov. Cuomo on Tuesday said it was no longer needed.
The Comfort remained docked at Pier 90 with 29 patients on board Friday but was expected to return to its homeport in Norfolk, Virginia, as soon as possible.
Cobble Hill has led all state nursing homes in the number of residents killed by the coronavirus since the state Health Department began releasing those figures last week.

That figure remained stable as of Thursday, the latest date for which statistics were available, and was followed by 51 at Parker Jewish Institute for Health Care and Rehabilitation in Queens.
Kings Harbor Multicare Center in The Bronx, Franklin Center for Rehabilitation and Nursing in Queens, and Carmel Richmond Healthcare and Rehabilitation Center in Staten Island were next, with 45 deaths each.
Tuchman’s April 9 email wasn’t the only time that the state was put on notice about the dire conditions at Cobble Hill.
In an email one day earlier, Tuchman told Health Department officials that the facility had “over 50 symptomatic patients scattered through the building and almost no gowns.”
Tuchman said Cobble Hill had been asking the city’s Office of Emergency Management “daily” for more gowns, but “gotten only a few hundred delivered.”
“There is no way for us to prevent the spread under these conditions,” he wrote in desperation on April 8. “Is there anything more we can do to protect our patients and staff? Thank you for any help you could be.”
Tuchman got a response 20 minutes later, but all it offered was an attachment with advice on how to conserve PPE, the email chain shows.
“Many facilities have built this guidance into their contingency plan in the event of PPE supply shortages and depletion of supplies. Thanks,” a health official wrote.
A follow-up response about two hours later added, “Please be sure to submit your request through the local OEM daily” — even though Tuchman had said he was already doing that.
Tuchman said Friday the shortages of protective gear grew so severe staffers resorted to wearing trash bags as protection — echoing the situation that scandalized Mount Sinai West hospital in Manhattan when The Post exposed the practice there last month.
“This has been a very sad and painful experience,” Tuchman added. “Once the virus gets into the building it is very, very hard to control.”
Cuomo sparked widespread outrage earlier this week when he said that providing private nursing homes with PPE was “not our job,” with Mayor de Blasio, a longtime rival, saying there’s a “moral imperative to protect our seniors.”
Cuomo also said Thursday that any nursing home that can’t provide a coronavirus patient with an “adequate level of care” could ask the Health Department to transfer the patient elsewhere, and Health Commissioner Howard Zucker said he was unaware of any nursing home having made that request.
Under a controversial March 25 order, the Health Department barred nursing homes from refusing admission to “medically stable” coronavirus patients.
In a prepared statement, Health Department spokesman Gary Holmes said, “To be clear: We engaged in conversation with Mr. Tuchman on more than one occasion regarding staffing. He wanted additional help, but stated he was able to meet basic needs under the directive – which included having adequate facilities.”
Holmes also said officials “conducted a focus survey at Cobble Hill and found no deficient practices” and that it would soon be receiving “more than 1,400 gowns and approximately 1,500 face shields.”
“Additionally, as we track inventory for all facilities daily, our records indicate they have more than a week’s supply of N95 masks, two month’s supply of surgical masks, and nearly two week’s supply of gloves,” he added.


The fix is obviously in on Cuomo’s ‘investigation’ of nursing-home horrors


News that Team Cuomo ignored warnings about the nursing-home disaster only confirms that the gov’s call for an investigation is pure deflection. He’s trying to make care facility owners the fall guys for the state’s choices.
The Post reports that a Brooklyn nursing home that’s seen New York’s greatest number of COVID-related deaths (55, on the latest list) wrote the state Health Department on April 8 to plead for help.
Cobble Hill Health Center CEO Donny Tuchman e-mailed four officials to report that his facility had “over 50 symptomatic patients scattered through the building and almost no gowns” and warned, “There is no way for us to prevent the spread under these conditions.”
His closing, in hindsight, is heartbreaking: “Is there anything more we can do to protect our patients and staff? Thank you for any help you could be.”
Someone wrote back 20 minutes later — with a standard attachment offering advice on how to conserve personal protective equipment. (In reply, Tuchman repeated the fact that Cobble Hill didn’t have anything to conserve.)
The concerned CEO made another plea the next day, asking if he could send the home’s suspected coronavirus cases to the field hospital at the Javits Center or the USNS Comfort. No dice, came the answer.
So much for the claims from Gov. Cuomo and his health czar, Dr. Howard Zucker, that overwhelmed facilities just needed to ask for help if handed patients they couldn’t safely handle — thanks to Zucker’s March 25 mandate that all homes accept coronavirus-positive cases.
We expect more damning evidence will surface in the days ahead.
Cuomo has asked Attorney General Tish James to lead an investigation that seems fixed from the start: It will find that nursing homes weren’t remotely prepared to respond to a pandemic.
The real investigation should be into why Zucker insisted on sending coronavirus-positive patients to nursing homes, when it’s been clear from the start that the elderly are most at risk from the virus.
And when any health pro must know, as Rochester’s Hurlbut Care Communities CEO Bob Hurlbut put it this week, that “Physical distancing is nearly impossible in the nursing home environment, due to room sharing and the fact that we provide the most intimate level of care, from brushing teeth to bathing and incontinence care.”
Cuomo himself says the virus spreads in nursing homes “like fire through dry grass.”
Yet the gov refuses to admit any mistakes: “The regulation is common sense: If you can’t provide adequate care, you can’t have the patient in your facility, and that’s your basic fiduciary obligation — I would say, ethical obligation — and it’s also your legal obligation.”
And, says the gov, “it’s not our job” to ensure homes have the supplies they need to keep residents and staff safe. Isn’t that the line that drove Cuomo crazy when President Trump took it?
Now he wants his protégé James — and Zucker’s Health Department — to review the performance of the state’s 600 nursing homes and 500 adult-care establishments? Come on.
Yes, they can find some convincing scapegoats: Again, all too many these institutions were troubled before the crisis. Their profits, and the jobs they provide, bought the political power to get away with it.

And when the pandemic hit, Zucker & Co. actually made things worse — fatally so. It’s madness.

How USNS Comfort went from a symbol of hope with the president's blessing to heading back from NYC having treated fewer than 180 patients
by Ashley Collman, New York Times Business InsiderApril 23, 2020
  • The Navy hospital ship USNS Comfort was sent to New York City at the end of March to aid the city's overwhelmed hospitals during the coronavirus outbreak.
  • Three weeks later, it had just treated 179 patients, and on April 21 New York Gov. Andrew Cuomo said the city didn't need it.
  • President Donald Trump — who personally dispatched the ship to New York City — will soon be returning the ship to its home port in Virginia for another mission.
  • The ship made headlines during its short mission in New York, with multiple crew members getting sick, and outrage over the initial decision not to accept coronavirus patients. 
  • Earlier this week President Donald Trump announced he would be sending the Navy hospital ship Comfort home from New York City, cutting short a highly-touted but anticlimactic mission.
    USNS Comfort arrived in New York City — the epicenter of the US coronavirus outbreak — on March 30 to aid the city's hospitals by taking all of their non-coronavirus patients.
    But it turned out that the city didn't have many non-coronavirus patients to take, with only 20 patients were admitted to the 1,000-bed hospital ship in its first day. Meanwhile, New York City hospitals were still struggling to make space for a surge of patients.
    The Comfort eventually reconfigured itself into a 500-bed ship to take coronavirus patients, but never came to reaching capacity — by April 21, it had treated just 179 people. New York Gov. Andrew Cuomo said the city no longer needed the ship, and the Comfort is now ready to sail home to Virginia for a new mission.
  • Scroll down for a timeline of the ship's short-lived mission.
  • March 17: New York City was quickly becoming a hot zone in the US coronavirus outbreak. The US Navy dispatched one of its hospital ships, USNS Comfort, to aid the city's overwhelmed medical centers.

  • During a March 17 press conference, Defense Secretary Mark Esper said he had ordered the Navy to "lean forward" in deploying the Comfort to New York "before the end of this month."
    New York Gov. Andrew Cuomo welcomed the help as hospitals braced for a tidal wave of coronavirus patients. 
    "This will be an extraordinary step," Cuomo said the following day. "It's literally a floating hospital, which will add capacity."
    The Comfort is a converted supertanker that the Navy uses to provide humanitarian assistance and disaster relief. Its prior postings had taken it to Puerto Rico after Hurricane Maria, and to New York City in 2001 to treat people injured in the September 11 attacks.
    The ship includes 12 fully-equipped operating rooms and capacity for 1,000 beds. It is usually manned by 71 civilians and up to 1,200 Navy medical and communications personnel.

    March 29: President Trump saw off the Comfort as it left its port in Virginia to sail up to New York City. He remarked that it was a "70,000-ton message of hope and solidarity to the incredible people of New York.

  • Source: Military.com
  • March 30: The Comfort arrived in New York City the next day, a white beacon of hope for a city that had at the time seen more than 36,000 cases and 790 deaths. That number has since grown to more than 138,000 cases and 9,944 deaths.

  • April 2: The ship is up and running. The New York Times reported that it had accepted just 20 patients on its first day and that it wasn't taking any coronavirus patients.

  • Michael Dowling, the head of New York's largest hospital system, called the Comfort a "joke." He told The Times: "It's pretty ridiculous. If you're not going to help us with the people we need help with, what's the purpose?"

  • April 6: Following the outrage, Gov. Andrew Cuomo asked Trump for permission to let the ship take coronavirus patients.

  • Trump agreed and the Navy reconfigured the ship into a 500-bed hospital to space out patients and lower the risk of spreading the highly-infectious virus.

  • That same day, before the ship started taking coronavirus patients, a crew member tested positive for the disease. This is despite the fact that the crew was ordered to quarantine for two weeks before their departure.

  • That number grew to four in the following weeks. All of the sick crew members have since recovered and are back to work, a Navy spokesman later told The Virginian-Pilot

  • Source: Business Insider

  • April 21: Even after moving to take coronavirus patients, the Comfort didn't come close to reaching capacity — even as the city's hospitals remained overwhelmed. As of Tuesday, the ship had treated a total of 179 patients.

  • During a meeting with the president, Cuomo said that New York no longer needed the Comfort and said it could be sent to a more hard-hit area.

  • Trump said he had taken Cuomo up on his offer and would recall the Comfort to its home port in Virginia, where it will prepare for its next posting. The new mission remains unclear.

  • Trump admitted during a White House briefing that part of the reason the ship was never put to much use in New York City was because its arrival coincided with the opening of a temporary hospital in the Javits convention center.

  • April 24: The Comfort is still in port in New York City, even though Trump said it will be leaving as soon as possible.

  • Meanwhile, the situation in New York appears to be improving. Last Saturday Cuomo said New York may be "past the plateau" with hospitalizations on the decline. NYC Mayor Bill de Blasio said that he's seeing "real progress."

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