COVID-19 State bans large gatherings, locks down nursing homes

PHOTOGRAPHER: Peter R. Barber

A masked security guard speaks to an arriving motorist at Ellis Hospital in Schenectady on Thursday.

ALBANY — The state took significant steps Thursday to halt the spread of COVID-19 and began laying the groundwork for treatment of what is expected to be a surge of infected New Yorkers.

In just the 24 hours between Gov. Andrew Cuomo’s daily briefings Wednesday and Thursday, confirmed cases in the state jumped 50 percent, from 216 to 325. The total includes the first two patients in Albany County, a third in Saratoga County and the first patient in several other upstate counties.

Fourteen percent of the patients have been hospitalized, which is a more important number than the total because it gives a sense of how far the state’s medical infrastructure will be stretched when the outbreak peaks, Cuomo said.

No deaths have been reported in New York state.

Cuomo broke the state’s response into two strategies: Reducing the number of New Yorkers who contract the disease and treating those who do.

To slow the spread, the state is barring gatherings and locking people out of sensitive sites.

Notably, all nursing homes in New York are now closed to visitors except in extreme circumstances such as end-of-life situations.

And effective 5 p.m. Friday, facilities with a single-room capacity of 500 or more cannot operate and those with a capacity of up to 499 must reduce their capacity by 50 percent. The rule took effect Thursday evening at Broadway theaters in Manhattan but not until Friday at places upstate such as Proctors in Schenectady.

There are exceptions. Large workplaces are exempt if their space is divided into rooms. Schools, hospitals, mass transit, retail stores, government facilities and nursing facilities also are exempt.

Churches are not exempt.

To increase treatment ability, the state is working with hospitals statewide to increase surge capacity, Cuomo said. State health officials expect the disease to follow the same pattern in New York as it did in China, Korea and Italy, with infection counts spiking much higher than current levels.

Cuomo listed the following steps, some that are being pursued now and some that are being prepared as options should the situation warrant:

The state Department of Health is accelerating the process of getting medical personnel trained and certified.
It’s asking retired doctors and nurses to seek re-certification and be available as needed.
It’s identifying Reserve and National Guard members with medical training as possible reinforcements.
It’s asking medical schools to identify staff members who could switch from teaching to treating.
It may order cancellation of elective surgeries, which would free up 25 to 35 percent of hospital beds and increase the availability of hospital staff.
It is reviewing state-owned sites for potential conversion to temporary emergency medical facilities.

Cuomo acknowledged that some of the steps might seem severe, particularly blocking people from the nursing homes where their elderly relatives live.

“Look, if you care about somebody in a nursing home, the last thing you want to do is endanger that person,” he said.

Some facilities, such as the Wesley Community in Saratoga Springs, are setting up videoconferencing equipment to serve in place of in-person visits as long as the ban continues.

The potential risk posed by visitors was underscored this week at Ellis Hospital in Schenectady, which announced Thursday that a vendor who had been in the facility later tested positive for COVID-19 and went into quarantine. Ellis said it has begun searching out hospital employees and patients who might have come in contact with the vendor.

The hospital noted that exposure does not mean certain infection and said no patients at Ellis are known to be infected with COVID-19. It also repeated the now-familiar directive: If you have any of the COVID-19 symptoms (cough, fever, trouble breathing or pneumonia) check with your primary care provider. Don’t come to the emergency room unless there’s a pressing emergency.

Here are some other developments and details announced Thursday:

New York’s COVID-19 case tally has nearly caught up with Washington state, which has the most in the nation.
Cuomo wouldn’t be surprised if the number of cases increases tenfold.
Public grade schools must close for 24 hours for cleaning after a student or employee tests positive but they are not being ordered to close down as other mass gathering places are. Cuomo gave two reasons for this: Children so far appear to be much less vulnerable to COVID-19 than adults, particularly the elderly. Also, extended mass school closures would be tremendously disruptive to society.
Any business or venue that can’t comply with the new requirements to reduce the number of people on-site or can’t maintain diligent facility hygiene should contact the Empire State Development to obtain a Close Order, which will be important to them for legal reasons, Cuomo said. Any business or organization that violates the 500-person ban will be fined or shut down.
New York is studying hospitalization rates in Italy, Korea and China to gauge what might happen here as the pandemic spikes in this state. If a shortage of hospital beds develops downstate, upstate hospitals — and/or the temporary medical facilities now in contingency planning — will need to take the overflow.
The limiting factor in treatment is likely to be medical personnel more than medical facilities, because a hospital room can be quickly sterilized but doctors and nurses cannot be replaced so easily when they get sick, and some will.
The state is contracting with BioReference Laboratories to add capacity for 5,000 more virus tests per day, starting next week, and will begin drive-through testing in New Rochelle, which has the greatest concentration of infected persons.
New York and the other 49 states need federal help paying for the response they are undertaking. There is no way states can make up lost wages for people who lose their jobs or cannot go to work.
Planning for the 2020-2021 state budget due in three weeks has been thrown into disarray, as it was based on tax revenue projections created in January. The figures have changed repeatedly since then, and will continue to change repeatedly.
Mass transit would appear to be another situation where a shutdown would be profoundly disruptive to everyday life, especially downstate. Asked why mass transit is exempt from the ban, the governor noted that it already is a lot less crowded than it was before COVID-19 was confirmed in the state. The most glaring example is Metro-North commuter ridership, which is down 48 percent.

Where the virus develops from here is unknown, Cuomo said, but he offered no hope for a quick resolution to the crisis.

“This is going to get much worse before it gets better,” he said. “That was always the fact. That was always the necessary mathematical conclusion to this.”