American Crisis

by Andrew Cuomo

  A rumor would emerge in mid-March after the briefings had become popular nationally that I might be interested in being vice president on a Biden ticket. Although I specifically denied it several times, the rumor was difficult to kill. I could anticipate President Trump’s tweet: “Andrew is just running for vice president.” Nothing was more important to me than my ability to do my job in this moment. Therefore, in Shermanesque, absolutely clear, and specific language, I would repeatedly state that I had no political aspirations beyond being governor of New York. I would not run nor accept the nomination for vice president. Never satisfied, the New York press asked the next question: “Did I want to go to Washington in a Biden administration?” My answer was again definitive: I wanted no position in the Biden administration; I was governor of New York. I would not let politics get in the way. If they wanted to attack my analysis or plan, they would have to do it on the merits.

  MARCH 7 | 11 NEW CASES | 10 HOSPITALIZED | 0 DEATHS

  “I have officially declared a state of emergency.”

  ONLY SIX DAYS AFTER OUR first reported case in the state, we got word of two confirmed cases in Saratoga County, thirty miles north of Albany and at the foothills of the Adirondack Mountains. One of the patients was a pharmacist who had been working out of different pharmacies, so he was in contact with hundreds of people in the area. That changed the tenor of fear upstate.

  Meanwhile, the virus was spreading in Westchester, following the trail of patient zero.

  The following day, a Sunday, we got in the helicopter and visited the main lab at Northwell in Nassau County, one of the largest hospital systems in the state. We were federally authorized to conduct tests only at the state lab at Wadsworth, but not at Northwell and other labs, although I already knew we needed to utilize them. The early kits provided by the CDC produced false positives, and even when the kinks were corrected, the CDC didn’t have the capacity for the number of tests we needed. The WHO had been offering test kits to “underresourced countries” but deemed wealthy countries like the United States capable of developing their own.

  We still needed FDA approval before we could run the test that Wadsworth had developed at other labs in New York State. Dr. Dwayne Breining, executive director of Northwell Labs, showed me the instruments that, once the FDA approved, would be used to run the Wadsworth test, doing a few hundred a day and requiring a lot of labor and time. Next he showed me a machine called the Hologic Panther, which was a fully automated high-throughput machine and capable of running thousands of tests per day—but would need separate FDA approval! Seeing this machine, I knew we hadn’t been thinking big enough. We didn’t just need the FDA to approve our private labs to run the Wadsworth test; we also needed them to approve fully automatic testing on machines like the Panther, and fast.

  Back in Albany, I inquired about what might be done to get fully automated machines like the Hologic machine I had seen at Northwell up and running. I was told that Roche, a Swiss company with a U.S. headquarters and manufacturing facility in Indiana, was in line for FDA approval of its fully automatic testing system in the coming days. This would be a major breakthrough that would allow one machine to do thousands of tests a day. I spoke with Matt Sause, CEO of Roche North America, on the phone along with Joe Lhota and Bob Grossman of NYU and Steve Corwin of NewYork-Presbyterian.

  “Matt, how many Roche instruments can you get to New York and how fast?”

  He agreed to have several delivered within the next week along with the chemical reagent allocations that would be a critical piece of ramping up early testing.

  When visiting Northwell, I had made the case for the FDA to approve the lab to run the Wadsworth test, as well as approve several other of the state’s most sophisticated labs. Hours after the event ended at Northwell, the FDA approved Northwell’s lab to use the Wadsworth test. In thanking the FDA for their approval of Northwell, I noted that it was a good first step, but they needed to go further and expedite approval of the fully automated machines like the ones made by Roche and Hologic that would exponentially increase our testing capacity.

  MARCH 9 | 28 NEW CASES | 8 HOSPITALIZED | 0 DEATHS

  “New York Empire State. Progressive capital of the nation. You are a problem solver.”

  I WAS JUGGLING THE BRIEFINGS IN the morning and then the operations in the afternoon. For me the two functions demanded two very different aspects of my personality. The briefings required me to be calming and confident and emotionally connected. The operations meetings needed me to be persistent, detail oriented, and aggressive. Switching gears quickly that way was not easy.

  In a situation where everything is out of control, we seek to control anything we can. I needed something that I could actually control and get done myself, and quickly. One of the significant issues was that stores were running out of hand sanitizer. The fear of the virus was everywhere by this point, and the immediate response was to stock up on disinfectants, cleaning products, and hand sanitizer. The government had suggested using it as a precaution in addition to regular and thorough handwashing, and now you could not find a bottle on store shelves. On the internet a bottle that sold for $3 before the pandemic could now be priced as high as $50. The media was reporting on the scarcity, which only further increased the growing anxiety. Hand sanitizer is important, but washing your hands is just about as effective. If you want to be hypercautious, you can wash your hands with some alcohol.

  I wanted to show people—and myself—that I could actually solve a problem, even if the problem was just the availability of hand sanitizer. I also needed a break from what I was dealing with. The first order of business was to find out what exactly hand sanitizer was. I figured it couldn’t be that hard. It turned out hand sanitizer is more complicated than you think. I called several manufacturers (yes, me), and it turns out there is a variety. There are different scents and differing lotion capacities. A good hand sanitizer not only cleans your hands but also leaves them feeling soft and smooth. My hands have never been soft and smooth. I was interested only in the virus-killing capacity of hand sanitizer.

  Someone suggested I contact our prison industry division, which employs prisoners to make various products, and it turned out that the prison industries program already made hand sanitizer. Who knew? Prison industries made a number of products including industrial cleaners, furniture, and clothing. And yes, they made hand sanitizer. Problem solved. Now we just had to focus on bottling and distribution.

  Not so fast. It turned out the hand sanitizer made by prison industries was 50 percent alcohol based. The CDC had said that for hand sanitizer to be effective against COVID, it had to be at least 70 percent alcohol based. I called the CDC to figure out where they got the information leading to the 70 percent figure, but after being transferred to eleven different people, I gave up. I concluded that we would make hand sanitizer with a 75 percent alcohol base to be safe.

  The prison industries made products for large-scale commercial use. Therefore, they used large drums to contain their products. We had to retool the industry. We needed small bottles and new equipment to fill the bottles. We needed additional holding tanks and large quantities of alcohol and lotions. It also appeared that alcohol was in short supply—of course, because all the manufacturers were increasing hand sanitizer production in an effort to meet soaring demand. After calling a dozen suppliers, I secured a significant amount. I spent hours getting the entire operation in gear, but it was actually a worthwhile distraction, though I could not have done it without Kelly Cummings, my director of state operations. As crazy as this hand sanitizer project was, Kelly never flinched and made it all happen.

  Our hand sanitizer was called New York State Clean. It came in several sizes, including an easy-to-use gallon jug. Over time, we produced millions of bottles. You couldn’t walk around New York without seeing a New York State Clean hand sanitizer bottle. We flooded subways, buses, and more with free hand sanitizer.
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  But make no mistake, our hand sanitizer has no floral scent. It smells like embalming fluid and has a slight burn to it. After application one is tempted to make sure the skin is still intact. But it surpassed CDC guidelines and resolved the anxiety people had about running short of hand sanitizer.

  Of course, in New York you get criticized for everything. There were complaints that it was an exploitation of the prison population to have inmates making hand sanitizer. I agree inmates are paid too little for the work they perform, and I have supported a higher minimum wage for inmates. But the fact that the prisoners were already making hand sanitizer and had been for years fell on deaf ears. The fact that the prison industry program was voluntary also fell on deaf ears. But as I have learned, an executive must make a decision that is right even if not everyone agrees. It is a difficult balance to do the right thing rather than the popular thing when your position is dependent on support of the people. The only path and rationale that I have found is to always assume that you are serving your last term and that what matters most is your legacy of success and integrity. There are no great political leaders who have followed the course of political expediency. There may be long-serving politicians who followed the path of political expediency, but none whom I would call great.

  * * *

  —

  TRICKY CURVEBALLS COULD be thrown at us at any moment, making an impossible situation even more difficult: For instance, Rick Cotton, the executive director of the Port Authority, tested positive for COVID. Rick, like me, is not a young man, and I had asked him to keep an eye on the airports when the crisis first started unfolding. Rick’s agency, the Port Authority, has administrative responsibility for the airport facilities themselves, even though the federal Department of Homeland Security and Customs and Border Protection had screening jurisdiction. I felt personally responsible for Rick getting infected because he was there night and day at the airports under my instruction. He was at home and doing fine, but it was still scary, although a photograph of him in his silk bathrobe snapped by a photographer lurking nearby when he opened his door to accept a delivery ended up gracing the pages of the New York Post and lightened the moment. True to form, even with COVID, Rick looked good. Nonetheless, I was asking people to literally risk their lives.

  As we could see the oncoming wave of infections slowly building, I boiled down my role to two parts. I had to communicate with the people of the state the scope of the problem and the plan forward. And I had to marshal a government that could actually execute the plan. The last time government needed to rise to a challenge of this magnitude was when the federal government had to retool the economy to produce tanks, missiles, bombs, and guns and draft an army for World War II. Government doesn’t do big, bold things anymore. It doesn’t even try. The lack of national unity and the lack of a competent government go hand in hand. One precedes the other.

  This was beyond the scope of a state government and would have been highly challenging even for a competent federal government. The systems and functions necessary to fight a virus don’t exist. There is no adequate operational public health system in this country. Large-scale testing for a disease and contact tracing exist only in textbooks. No government in this country is capable of building new hospital structures on an emergency basis. We don’t have the manufacturing companies to make new medical supplies. Government is not equipped to develop and build large systems quickly. But, I told myself, we are where we are. The moment is here, and we will fight the battle with what we have.

  I assumed and hoped the federal government would do its job. I at least assumed the federal government would try to help. I prepared a small note card on one of the first days that I carried with me at all times. It reminded me of the four priorities I must focus on: First, communicate with the public and develop a relationship of trust so they accept and follow the plan. Second, focus on government operations necessary to execute the plan. Third, get as much help from the federal government as possible. Fourth, keep my head focused and in the game, and stay positive. It all sounded so easy at the time.

  MARCH 10 | 63 NEW CASES | 14 HOSPITALIZED | 0 DEATHS

  “When you politically interfere with science, that’s when you tend to make a mistake.”

  I CALLED INTO MY CONFERENCE ROOM the leadership of the Wadsworth Center, Dr. Michael Ryan, Dr. Jill Taylor, other health department officials, and members of my executive team including Melissa, Gareth, and Simonida. I began the conversation with my usual salutation: “Pardon my ignorance, but I don’t know what I’m talking about and I have to be educated. So excuse me if I ask simple or stupid questions.” First question, “What is large-scale testing?” The blank faces let me know that we were in trouble.

  Wadsworth had done groundbreaking work over the years. However, the lab does not do high volume or mass testing, and that was exactly what we needed.

  “This doesn’t work,” I told the team assembled around the big table that was in my father’s conference room as well. When I became governor, I asked the Office of General Services if they had any idea where my father’s conference table was. They found it in a warehouse in Schenectady.

  The conference room is filled with other things that are meaningful to me. There is a humidor gifted to me by President Clinton and a piece of original terra-cotta from the New York State Capitol roof signed by a workman in 1867. On the wall hangs an original sepia-tone poster from FDR’s reelection campaign in 1930 that reads, “Re-elect Governor Franklin D. Roosevelt for Progressive Government.” I also have the official Senate roll call from my confirmation as HUD secretary in 1997 and the flag that flew over the Capitol in Washington that same day, a gift from the late, great senator Ted Kennedy.

  Sitting at my father’s table, surrounded by these mementos, I was reminded of my father telling me that in the midst of the daily tumult, as difficult as things seemed in the moment, tomorrow will come. It also reminded me that it’s not about the destination; it’s about the journey. There will always be more to do. There will always be more to accomplish. There will always be more wrongs to right. But we do the best we can every day, and we are committed to the battle.

  “A week ago, I said we’d be doing a thousand tests a day. How do we bring this to scale? Forget a thousand a day; we need to be doing ten thousand or more a day.”

  Several people in the room looked at me as if I were asking for a cure for cancer by 10:00 that night. My role in meetings like this is to be the aggressive CEO. I have a policy I’ve named “constructive impatience,” which promotes an aggressive posture in problem identification and resolution. Unlike at the morning briefings when I was trying to be calm and assuring, in these meetings I was more activist and probing; in other words I could be a pain in the heinie. That’s why I called these meetings “peeling the onion.” They are to strip away issues to get to the essence of the matter, and someone usually cries in the end.

  In large institutions and organizations, people often create a culture that is nonconfrontational and adopt a behavior of avoidance. That can be the enemy of problem solving when time is of the essence. The Department of Health’s senior team were all experienced long-term civil servants. They knew the state health regulations backward and forward. They had worked in the bureaucracy for years and were well versed in the culture. The Department of Health developed and promulgated regulations, but they were not known for rapid deployment or rigorous timelines. That mentality was incongruous with the skill set necessary to address COVID.

  The FDA had approved Northwell to test after my Sunday visit and this afternoon had authorized just a handful of other labs—NewYork-Presbyterian, Memorial Sloan Kettering, University of Rochester Medical Center, Roswell Park, and SUNY Upstate Medical University—to test. But this was still not getting us to where we needed to be.

  “How many labs do we have in New York State?” I asked. Again, blank stares. No one was sure. “About two hundre
d,” Dr. Ryan said. “How many of those labs can test for COVID?” Silence. Then Dr. Ryan spoke up with a suggestion. “Of the two hundred labs, there are about twenty-eight that are the ones we know and trust completely.”

  I asked Melissa to put together a team to immediately go make phone calls to each lab. I have total confidence in Melissa, and it is a great luxury for me. I asked Dr. Zucker to call the FDA that night to ask for the ability for Wadsworth—not the FDA—to approve each of these labs to test, removing an unnecessary roadblock.

  At the end of the meeting I said, “Well, one thing is clear: It’s up to us.”

  MARCH 11 | 44 NEW CASES | 32 HOSPITALIZED | 0 DEATHS

  “New York State is going to take matters into its own hands.”

  WE ANNOUNCED THAT THE PUBLIC colleges would be closing for distance learning for the remainder of the semester. We’d already recalled students in study abroad programs; now teachers and administrators were nervous that students at upstate schools might be visiting family downstate for spring break, or hitting the beaches in Florida and Laguna Beach, and then unwittingly bring the virus back to campus. At first, we talked about moving up spring break, but we realized that we’d need to shut campuses down for two or four weeks at minimum, and there wasn’t much school year left anyway, so we said, “Forget it, let’s just close.”

  Closing state colleges was my signal to private colleges that they should consider the same. Many people thought I was overreacting, but I would rather err on the side of caution. I would prefer to be blamed for unnecessary inconvenience than have to give condolences to the grieving parents of a dead student.