Cuomo to Trump "You Pick the 26,000 Who Will Die"

Mish

New York is short on hospital beds and respirators. Governor Andrew Cuomo wants to know is pleading to Trump for help.

Please consider ‘You Pick the People Who Are Going to Die’.

Gov. Andrew Cuomo sounded his loudest alarm yet on New York's coronavirus crisis Tuesday, warning the curve was showing no signs of flattening out and was in fact rising faster and more dangerously than projected. He said last week that peak infection was 45 days out; now, he says, the state may see it in two weeks.

It looks like the wave will be bigger, and crash harder, than expected. "We have exhausted every option available to us," Cuomo said Tuesday, declaring with unprecedented urgency that New York needs help now — and far more than it has gotten to date.

"The apex is higher than we thought and the apex is sooner than we thought. That is a bad combination of facts," the governor said Tuesday. The rate of infection is doubling every three days. "We're not slowing it -- and it is accelerating on its own. We're not looking at a freight train. We're looking at a bullet train, because the numbers are going up that quickly."

New York state saw its case total hit 26,348 by Tuesday as the death toll climbed to 271. New York City has more than 15,500 cases alone, adding another more than 3,000 since Monday as its death toll surged to at least 192. The five boroughs now account for 60 percent of the state's total and about 35 percent of all cases in America.

Cuomo initially projected the state would need 110,000 hospital beds at the peak of the crisis. Now he believes New York will need up to 140,000 hospital beds. That's more than double current capacity. The intensive care situation is worse; the state has 3,000 ICU units and may need up to 40,000, Cuomo said.

"What are we going to do with 400 ventilators when we need 30,000? You pick the 26,000 people who are going to die because you only sent 400 ventilators," Cuomo said.

Western Country Cases

New York Cases Doubling Every Three Days

Both Italy and Spain are so short of supplies, both countries are deciding who get treatment and who doesn't.

Shortage of Supplies

The chart of acute care beds shows the dire setup for the United states.

We are short of beds and short of respirators.

That relatively few in the US have died (so far) from the coronavirus is not the issue.

When you run out of beds and respirators deaths soar.

Calling Next of Kin

Without enough ventilators, NYC doctors now calling next of kin to EXTUBATE (remove breathing tube) of low probability survivors to help save high chance survivors.

1 Million US Cases, By When?

For further discussion, please see 1 Million US Cases, By When?

Mike "Mish" Shedlock

Comments (66)
Casual_Observer
Casual_Observer

There is a tsunami coming for large metropolitan areas. It will start on the coasts and work its way inland once people start traveling again in the spring. Expect multiple outbreaks from coast to coast over the next few months IF normal life is resumed. We should be in a country-wide lockdown right now but we aren't. Fortunately where I live things are not too bad because 85-90% of people are in a lockdown. This is an upper to upper-middle class suburb where college educated people don't want to inundate our hospitals. I feel bad for any place where state or local government is not taking this seriously. Poorer areas will tend to fare worse because they are less educated and have sicker people in general. Good luck to all here regardless of what you believe, where you are or what you think.

No. 1-15
BrettDyer
BrettDyer

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Sechel
Sechel

Frankly Trump's response was reprehensible. Not only for refusing to use the defense authorization act but to claim Cuomo messed up because in 2015 he didn't purchase the equipment. Huge failure on the part of the Federal government

Jc52
Jc52

I think the “hospital beds” chart is very misleading. We have thousands of outpatient clinics that other countries simply don’t have. They “hospitalize” their patients for everything - even out patient procedures. So when taking this into account we have MORE hospital beds per capita than any other country. As for ventilators, we have more of those per capita as well.

Realist
Realist

Jc52 is partially correct. The US is better prepared than any other country. You are rated #1 in the Global Health Security index. Korea is #9 by comparison.

That doesn’t matter much, if you ignore all the early warnings, and the botch your eventual response. For example, the US does have a lot of ventilators. They need to get to New York.

Plus more beds, ppe, and health care workers. Someone needs to coordinate to get them to New York.

For the rest of the country:

If you ask an infectious disease expert, he would recommend:

Step 1: isolate as close to 100% of the population as possible for 3 weeks.

Step 2: identify any isolated people who develop symptoms; test them; monitor them and retest if necessary; if symptoms worsen, hospitalize them; extend the isolation period for those who shared accommodation with the infected; test and monitor them

Step 3: after 3 weeks, providing the health care system is not overwhelmed by cases, all isolated people without symptoms can be considered virus free and allowed out of isolation; however, it is important to continue social distancing, hand washing, etc as a precaution, as there are always outliers; however, if the health care system is overwhelmed, you must extend isolation until such time as it is no longer overwhelmed

Step 4: once isolation is over, it will be important to carefully monitor for any new cases; any new cases must be traced back quickly to find others at risk; if you can get to this stage you can easily manage isolated cases because now you are actively looking for them

Step 5: The problem is not yet “solved”, but it is now managed. Meanwhile, treatments and vaccines can be developed over the coming months and years. Once vaccines and natural immunities spread, the problem is effectively contained. (Like measles, it will be difficult to eradicate.)

There is one crucial thing that is required for this standard practice to be successful: a population that is willing to follow the rules of isolation, social distancing, washing hands etc

USAFoxes
USAFoxes

I've yet to find data that people who reach the ARDS stage with COVID-19 and get placed on a ventilator actually survive. I believe the prognosis for this situation is quite poor. Maybe Mish can use his skills interpretating data to enlighten us? Are we shutting down our economies to try and control something we cannot - the outcomes for the unlucky few who get the most severe cases?

tz3
tz3

Which 26,000? Are there not that many at risk Social Justice Warriors in New York who like AOC? Can we get Breyer and RBG to visit NYC?

RonJ
RonJ

There was a doctor who treated some 350 patients with hydroxychloroquine. The group of patients required no hospitalization, thus no need for ventilators and there were no deaths among the group.

ajc1970
ajc1970

False narrative
Most the people who need a ventilator will die even if they get it.
You're not choosing who lives and dies with those, you're choosing who is treated, with a historically low success rate of treatment
At least for those treated, they get to make one last 6-figure donation to our health care system

klausmkl
klausmkl

Cuomo is an idiot. God chooses who lives and who dies. Blame the folks who didn't even care enough to take care of themselves when they had the chance, big fat obese smokers. Now folks blame trump or whomever. Let the fat folks reap what they sow.

LegitJerry
LegitJerry

I thought New York was rich enough to order these equipments with a massive expedite fee. Cuomo is just another socialist bum crying for free stuff. Pay $500k per respirator, they will appear from every state in the union and every nation on the planet. Just sell some NY Bonds to fund it. Cuomo is only willing to pay $10k per respirator so he’s going to let New Yorkers die. It’s his own fault.

awc13
awc13

i bet cuomo is regretting his decision last year to not stock pile respirators like the ny epidemic preparedness report recommend the state do

Sechel
Sechel

Cuomo had a good proposal. NY will get its peak weeks before other parts of the country. His suggestion is send the ventilators to NY, then when NY is past its hump it sends them to the next hot spot

Alyoshak
Alyoshak

Pretty clear what's going on here. Cuomo didn't plan or think clearly to protect his people, so before he gets crucified he starts shouting, "It's the President's fault! It's the federal government's fault!" Typical politician. We will be waiting forever for Cuomo, or any of his ilk, to say, "I blew it."

NewUlm
NewUlm

Will anyone ask the darn question "What is the survival rate of people on ventilators?" The answer is Wuhan was 5%, crappy odd. Even if we are better I still bet it's less than 10% which will only marginally change the rate of deaths

Now Cuomo, slammed the door on anti-viral that drugs that have some old positive clinical data and directional success in other countries - the death are on his hands.

Let the front line doctors and patients make the decision - not governments.


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