The New York Times - USA (2020-12-01)

THE NEW YORK TIMES, TUESDAY, DECEMBER 1, 2020 N A

Tracking an OutbreakU.S. Fallout

ing dusted off, the governor said,

adding that capacity would also be

evaluated between hospitals in

different parts of the state, an idea

known as “surge-and-flex,” an-

other measure the governor put in

place in the spring.

Similarly, Mr. Cuomo also an-

nounced that he was ordering hos-

pitals to stop elective surgery in

Erie County, in Western New

York, which is currently enduring

the highest weekly positive test

rates in the state. The county led

the state in number of deaths re-

ported on Monday.

Despite rising rates of infection,

Mr. Cuomo has resisted imple-

menting the kind of widespread

shutdowns seen in March, when

hundreds of New Yorkers began

to die every week and much of

New York’s economic activity

ground to a complete halt.

Rather, Mr. Cuomo’s strategy

has been to utilize targeted re-

strictions on individual areas —

known as his “micro-cluster initia-

tive” — which has now expanded

to nearly 30 locations around the

state, including in all five bor-

oughs of New York City, its subur-

ban counties and major upstate

population centers.

The announcement on Monday

came after weeks of steadily more

worrying news in New York. The

state’s daily rate of positive tests

on Sunday topped 4 percent for

the first time since May, and the

number of more serious cases

continued to grow. The positivity

rate was reported to be 4.57 per-

cent on Monday.

The death toll has also started

to rise again: On Monday, the gov-

ernor said 54 deaths were re-

ported by the state. All told, al-

most 1,000 people died in New

York in November, according to

The New York Times’s tally, mak-

ing it the deadliest month since

June. The state has suffered more

than 34,000 deaths since the dis-

covery of the first case in March,

the most of any state.

Warning that New York had en-
tered a “new phase in the war
against Covid,” Gov. Andrew M.
Cuomo said on Monday that the
state would implement a barrage
of new emergency actions, some
of which echo the strict measures
taken this spring, to stem a rising
tide of infections and deaths.
Mr. Cuomo said that the
strength of the virus’s second
wave had forced the state to rely
less on test positivity rates as the
determinant for restrictions and
focus more on hospital capacity.
On Monday, the governor an-
nounced that hospitalizations
topped 3,500 over the weekend, a
level not seen since May.
The governor said that if hospi-
tals become overwhelmed, he
could impose a regionally based
shutdown, or “pause” order, as he
did statewide in the spring. He
also asked hospitals to begin iden-
tifying retired doctors and nurses
to help staff medical facilities,
where he said burnout was an in-
creasingly common problem.
The governor said he wanted to
prevent the conditions that led to
Elmhurst Hospital in Queens be-
ing inundated by coronavirus pa-
tients this spring, with beds filled,
doctors overworked and refriger-
ated trucks posted outside to hold
the dead.
“We are not going to live
through the nightmare of over-
whelmed hospitals again,” Mr.
Cuomo said during a briefing in
Manhattan.
Mr. Cuomo said he would ask
hospitals to increase the number
of beds by 50 percent, and hospital
chains to evaluate where there
was capacity inside of those sys-
tems, to help redistribute patients
where there was availability.
Plans for field hospitals are be-

In his remarks on Monday, Mr.

Cuomo noted that the current

surge of cases had been more

widespread than in the spring,

when cases and deaths were

largely concentrated in New York

City and its suburbs.

He recalled how some upstate

regions sent reinforcements and

resources to downstate medical

facilities in the spring, and sug-

gested that would be difficult now.

“Every region is dealing with a

hospital issue,” he said.

Mr. Cuomo, a third-term Demo-

crat, has been touting the state’s

response to the crisis for months,

releasing a book in October about

“leadership lessons” drawn from

his experiences. The governor has

also repeatedly made a point of

saying that New York is doing well

in comparison with other states.

On Sunday, however, the gover-

nor seemed to modify his thinking

on that point somewhat, saying

that while “it’s nice that we’re do-

ing better in a national context,” it

is also “irrelevant.”

“Because we have to deal with

the issues that we have here in

New York relative to New York,

right?” Mr. Cuomo said.

Mr. Cuomo praised efforts by

Mayor Bill de Blasio, who ap-

peared at the news conference via

Zoom, to reopen elementary

schools, while voicing broader

support for plans to keep students

in kindergarten through eighth

grade in classrooms.

The city will no longer use a 3

percent test positivity threshold

that it had adopted for closing the

school system; instead, the city

will increase testing in schools

and close those that have multiple

confirmed virus cases.

And with the state’s test positiv-

ity rate now above 4 percent, Mr.

Cuomo — seemingly aware of how

relying solely on rising infection

rates could lead to economically

detrimental shutdowns — had

been indicating that a statewide

shift in strategy was coming.

On Monday, the governor said

new metrics — including hospital-

ization rates, death and case rates,

and available hospital beds —

would be used to determine lock-

down levels under the “micro-

cluster” strategy, the state’s color-

coded restriction system. Mr.

Cuomo said those new numbers

would be set this week, after the

state evaluates the effects of peo-

ple congregating over the Thanks-

giving holiday.

“I don’t believe we’ve seen the

hit from Thanksgiving,” he said,

adding that he believed the in-

crease in cases “will be dramatic.”

It’s still unclear how the gover-

nor will reconcile positivity rates

and hospital metrics to determine

new restrictions, but state offi-

cials said homing in on hospital-

izations was a useful way to deter-

mine the severity of the disease in

any given location. There are ar-

eas in the state where the number

of people testing positive has in-

creased, for example, but hospi-

talizations have not, lessening the

urgency for new restrictions

there, officials said.

With Mr. Cuomo ordering the

redistribution of patients across

hospitals, the state plans to track

hospitalizations by a patient’s

home address, not only where the

person is hospitalized, to better

ascertain which parts of the state

are driving hospital admissions.

Officials said that the gover-

nor’s renewed focus on hospital

capacity, harking back to the grim

projections of overrun hospitals in

the spring, is a deliberate tactic to

underscore the severity of the sit-

uation and prompt citizens to be-

have responsibly.

Indeed, Mr. Cuomo predicted

that the rates of infection would

continue to rise through Decem-

ber and into January, while still

expressing confidence that the

state could withstand the second

wave.

State officials believe a majority

of new cases in the state stem

from small gatherings in homes,

with people increasingly congre-

gating indoors as temperatures

drop, rather than in public set-

tings like bars and restaurants.

Changing that behavior, the gov-

ernor said, will require a robust

public messaging campaign simi-

lar to the one employed around

mask wearing.

“It is all in our control,” Mr.

Cuomo said.

Gov. Andrew M. Cuomo said he would ask hospitals to increase
the number of beds by 50 percent and search for excess capacity.

MIKE GROLL/OFFICE OF GOVERNOR ANDREW M. CUOMO, VIA ASSOCIATED PRESS

Applause in May for workers at Elmhurst Hospital in Queens, which was inundated by coronavirus patients during the spring.

ERIN SCHAFF/THE NEW YORK TIMES

NEW YORK

Overwhelmed Hospitals

Could Cause Shutdowns

By JESSE McKINLEY

and LUIS FERRÉ-SADURNÍ

Troy Closson contributed report-
ing.

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WASHINGTON — Dr. Scott W.
Atlas, the former Stanford Univer-
sity radiologist who espoused con-
troversial theories and rankled
government scientists while ad-
vising President Trump on the co-
ronavirus pandemic, resigned his
White House position on Monday.
The move was not entirely un-
expected. Dr. Atlas joined the
White House in August as a spe-
cial government employee for a
limited term after he caught Mr.
Trump’s eye with his frequent ap-
pearances on Fox News over the
summer. Dr. Atlas’s term was set
to expire this week.
“I worked hard with a singular
focus — to save lives and help
Americans through this pan-
demic,” Dr. Atlas wrote in a letter
that he posted Monday night on
Twitter, adding, “I always relied
on the latest science and evidence,
without any political considera-
tion or influence.” Fox News earli-
er reported his resignation.
But some of Dr. Atlas’s Trump
administration colleagues would
most likely contradict that assess-
ment, citing views starkly differ-
ent from those put forth by offi-
cials at the Centers for Disease
Control and Prevention and by
other government scientists. Dr.
Atlas has argued, for example,
that the science of mask wearing
is uncertain and that children can-
not spread the coronavirus.
Even more contentious was his
libertarian vision of the role of the
government in the pandemic. In
Dr. Atlas’s view, the government’s
job was not to stamp out the virus
but simply to protect its most vul-
nerable citizens as Covid-19 took
its course.
His argument was that most
people infected with the coronavi-
rus would not get seriously ill, and
at some point, enough people

would have antibodies from

Covid-19 to deprive the virus of

carriers — so-called herd immuni-

ty. Dr. Atlas also railed against

anything that smacked of a lock-

down or business closure.

“Protect the high-risk; open

schools, society,” he tweeted in Oc-

tober. “Alternative? Confine

healthy people, restrict business,

close schools... kills people, de-

stroys families, sacrifices kids.

#RationalThinking.”

Public health experts were ap-

palled and warned that his ideas

were dangerous and would have

disastrous results.

But that did not stop Dr. Atlas.

In mid-November, he called on

people in Michigan to “rise up”

against coronavirus restrictions.

The state’s governor, Gretchen

Whitmer, who had faced death

threats and a thwarted kidnap-

ping attempt over the restrictions,

denounced him as “incredibly

reckless.”

But in his resignation letter and

the accompanying tweet, Dr. Atlas

defended himself.

“We also identified and illumi-

nated early on the harms of pro-

longed lockdowns, including that

they create massive physical

health losses and psychological

distress, destroy families and

damage our children,” he wrote.

“And more and more,” he added,

“the relatively low risk to children

of serious harms from the infec-

tion, the less frequent spread from

children, the presence of immuno-

logic protection beyond that

shown by antibody testing, and

the severe harms from closing

schools and society are all being

acknowledged.”

Inside the administration, Dr.

Atlas clashed in particular with

Dr. Anthony S. Fauci, the govern-

ment’s top infectious disease spe-

cialist, and Dr. Deborah L. Birx,

the coronavirus response coordi-

nator.

While Dr. Atlas was playing

down the necessity of wearing

masks, Dr. Birx was traveling the

country preaching the opposite.

She implored governors and pub-

lic health officials in hard-hit

states to take more aggressive

steps. The two also clashed re-

peatedly in private.

But Dr. Atlas’s disagreements

with Dr. Fauci were more visceral

— and more public.

After the election, Dr. Atlas ac-

cused Dr. Fauci of being a “politi-

cal animal” who changed his as-

sessment of the threat of the pan-

demic after it became clear that

Mr. Trump had lost. Dr. Fauci re-

plied in kind.

“I don’t want to say anything

against Dr. Atlas as a person, but I

totally disagree with the stand he

takes,” he said recently on the “To-

day” show on NBC, after Dr. At-

las’s comments about Michigan.

“I just do, period.”

But Dr. Atlas had the ear of the

one person who mattered: Mr.

Trump.

“He has many great ideas,” the

president told reporters in August

at a White House briefing, with Dr.

Atlas seated feet away. “And he

thinks what we’ve done is really

good, and now we’ll take it to a

new level.”

THE WHITE HOUSE

Trump Adviser Who Rankled Scientists Quits

By SHERYL GAY STOLBERG

Scott Atlas, criticized

for his virus theories,

had a limited term.