Cuomo’s Damaged Star

NY Governor Andrew Cuomo delivered a good speech yesterday at the Democratic National Convention, and it was well received. His focus on New York’s handling of COVID-19 was smart, as his handling of the crisis was widely praised.

Whispers which have circulated for months about his potential run at the White House in 2024 or 2028 seem to have gained strength. They may be unwise. Cuomo’s response to the novel coronavirus has been generally successful, but it was also deeply flawed – so much so that it leaves him vulnerable on what would be likely to be his key issue.

The most obvious attack against him is the fact that under Cuomo’s directive, more than 6,300 recovering COVID-19 patients were sent to the state’s nursing homes.

Per NBC News, the Cuomo administration has denied any culpability for those deaths, instead insisting they were due to sick staffers:

Gov. Andrew Cuomo’s administration, which has taken intense criticism over the policy, instead contended the virus’ rampant spread through the state’s nursing homes was propelled by more than 20,000 infected home staffers, many of whom kept going to work unaware they had the virus in March and April. Another 17,500 workers were infected through early June.
“Facts matter. And those are the facts,” state Health Commissioner Dr. Howard Zucker said in a news conference.

Their problem is that the facts in this case only support their contention by supposition in the absence of sufficient contact tracing. They require people to accept that health workers in nursing homes throughout the state – often in places where there had not yet been a significant viral outbreak – consistently happened to be among the first people in their communities to come down with the illness, and that the transfer of infected people into their care facilities was coincidence.

The belief of scientists and governments throughout the world was that the most common vector of transmission was surfaces, with direct air contact a trailing second, at the time Cuomo issued his directive. It has since been learned surface transfer is less likely than air transmission, and that indoor transmission is far more likely than outdoor because the virus can transmit via aerosolized particles. This suggests that aerosol transmission was the most probable cause for the infections which raged through New York’s nursing home communities.

That view is bolstered by the fact that the nursing home deaths, as provided by New York’s Long Term Care Community Coalition, do not track with NY state community deaths but do show the overwhelming majority of losses up to a month out – the typical incubation period – from the decision to house recovering COVID-19 patients at the care facilities.

Put simply, Cuomo’s decision likely caused the unnecessary deaths of about five thousand of his citizens, a result which will hand his opponents an effective rhetorical club to beat him with regarding his signature issue, should he decide to run for President.

This fact has not escaped Cuomo’s critics – and there are many, particularly among the Trumpist faithful who resent Cuomo’s informative daily updates during the worst of the New York outbreak, and the way Cuomo’s efforts consistently upstaged Trump and exposed both his gross incompetence and his ignorance. They consistently overstate the number of deaths which resulted, framing it as “tens of thousands” or even a nonsensical “majority”, but five thousand deaths is still a devastating number.

It is true that precautions were being taken for surfaces and basic air transmission and that the belief at the time was that the virus did not aerosolize; this is problematic because it understates the risks that Cuomo was willing to take with the lives of his elderly citizens. Faced with the same guidance from the CDC and armed with repeated warnings that transmission vectors were still uncertain and being investigated, only a handful of Governors issued rules similar to Cuomo’s when they created their response plans for potential coronavirus outbreaks. For most, not knowing how the virus was transmitting kept them from putting ill patients in the vicinity of the most vulnerable members of the population.

This is a single flaw in what was overwhelmingly an excellent response to the disease, but it is a huge single flaw… and the possibility remains for another.

Governor Cuomo has recently decided to open New York’s schools, believing that the disease is controlled enough within the state (which still sees about 700 new cases per day, more than many countries) to allow in-person education. The guidance for the school openings is excellent, focusing on minimizing all known vectors of transmission. New York may lead the country in showing how to properly pursue school openings amidst the coronavirus crisis. But critics of school openings in other states have been highly dubious of the ability to contain the spread – and those suspicions have borne out, with new cases and outbreaks shutting down both classes and entire schools shortly after their opening. If the same happens in New York it will be another failure in Cuomo’s response, and one which shows that he is not always willing to learn from the mistakes of others. That is far from a disqualifying trait among Presidential contenders, but it would render him even more vulnerable on his signature issue.