Tuesday, April 21 update

NYS update: A day of travel for Governor Cuomo. All the way over to Buffalo for an update on elective surgery restarts, followed by what must have been a squicky meeting at the White House. The “natives” were restless, circling their F350’s before he even arrived in town, but (annoyingly) the Buffalo press corps only wanted to ask about the upcoming encounter with Trump, not really for any details on the map of New York State’s states (provinces? — the ESDC map of economic regions). This map has now newly entered the public, and perhaps even the national, consciousness — as Cuomo drew a parallel between the states needing to take the lead in a sensible national pandemic reopening response, and different regions of the state being ideal to do likewise on the NYS level.

Unfortunately for Buffalo, the elective surgery news he had to announce — the first sign of reopening anywhere — amounted to a womp, womp for the WNY region, as Erie County did not make the cut of the counties that would be allowed to resume elective surgeries. Almost all of downstate, along with a few other scattered upstate counties (Clinton, Yates and Schuyler among them) did not make the list either. (Surprisingly, Monroe apparently did). Presumably, if your county was not included in the no-fly zone, you get to have elective surgeries again. The guidance:

Hospitals will be able to resume performing elective outpatient treatments on April 28, 2020 if the hospital capacity is over 25 percent for the county and if there have been fewer than 10 new hospitalizations of COVID-19 patients in the county over the past 10 days. If a hospital is located in a county eligible to resume elective outpatient treatments, but that hospital has a capacity under 25 percent or has had more than 10 new hospitalizations in the past 10 days, that hospital is not eligible to resume elective surgeries. If a county or hospital that has resumed elective surgery experiences a decrease in hospital capacity below the 25 percent threshold or an increase of 10 or more new hospitalizations of COVID-19 patients, elective surgeries must cease. Further, patients must test negative for COVID-19 prior to any elective outpatient treatment. 

This was a quietly important day for Upstate New York, and perhaps the beginning of the end for the very concept. For the first time in a broad and meaningful way, it was demonstrated that “Upstate” is no monolith. Central New York, the Mohawk Valley, and the North Country, along with most of the Finger Lakes, are free to resume at least some economic activity (based on hospital services and COVID impact, dependent on many factors both obvious and also yet to be fully understood). Western New York must, at least for the next couple weeks, hang behind. Is there a shape of things to come to be discerned in this map of (staggeringly awful) YOY unemployment claims?

(It remains to be seen if the number of claims filed partially have something to do with people in different regions being able to get through quickly to the Department of Labor, but it’s worth following up on.)

Some years ago, I wrote a post on this blog called “Upstate conversation killers, and how to get past them.” The greatest conversation killer of the future, however, may be the term “Upstate” itself.

Onondaga County update: Cuomo’s freeing of the regions today was very good news for the three hospital systems of the county, but there was also upsetting news from Washington. At least as of this morning, CNY has lost out on millions of dollars in federal aid to counties, something that NYSAC was stumping very hard for (I saw Marc Molinaro making the case on CSPAN this morning). However, if this blow actually did hit, CE McMahon did not comment on it and wasn’t asked about it during the daily briefing.

The phased-in resumption of elective surgeries was the focus today, but also of note was that the “VSIP” (Voluntary Shelter in Place, the alternate-day plan advanced two weeks ago) has now been discontinued, having caused “confusion and anxiety,” but also having done its work reasonably well as an effective temporary device for public focus on social distancing. (Week-over-week stats were offered.)

As odd as it was, the “VSIP” scheme — which spread to at least two other counties — must have had a certain effect. I went out so infrequently during the last two weeks that I never had to make decisions based on membership in Team Odd or Even; but nevertheless, I knew what “my days” were — Tuesday, Thursday, Saturday. I did go out this past Saturday, and I felt satisfied that I just happened to be going out on “my allotted day.” The fact that the county has pre-trained its citizens to think of this already, may become very useful during any second or third virus waves.

The VSIP scheme felt weird, yet clever when it started, although it seemed hard to believe anyone would actually follow it; and now I understand why it felt that way. Keeping the focus of the public is a crucial part of leadership, by any means necessary. As dog trainers know, you have to “dazzle the dog.” McMahon has shown an admirable facility for reaching into an evolving bag of tricks, from reading “mean tweets” (Cameron, where art thou?) to introducing new, relevant metrics every week as developments warrant, and explaining why they have become worth looking at. (Numbers getting numbing? Present flowers to Dr. Gupta for Public Health Professionals’ Day.) Watching various styles of leadership — including Cuomo’s and Trump’s — during this crisis has been most interesting. Trump also “dazzles the dog.” The difference is that Cuomo’s and McMahon’s tactics are firmly rooted in reality and science. Trump’s tricks merely swirl around a terrifying nothingness.

At his press conference, Cuomo announced “regional leaders” for WNY and the Finger Lakes — present and former Democratic lite-guvs Hochul and Duffy. It isn’t a stinging accusation to say that at times like these, it is still about Who You Know and where you can deploy them; naturally, Republican county execs will do the same, which is why Onondaga and Suffolk counties are suddenly great friends. (McMahon also let it slip that we’ve been lending test kits to Steuben County, which was pretty random.) But who is Cuomo’s designated leader of Central New York?

We’ve been in contact with the governor’s office on a daily basis. They’re very well aware of our meetings and how we’re going to put a plan in front of them. Where we are is that Ryan McMahon, the county executive of the largest county in Central, is taking the lead. And Tony Picente, executive of the largest county in Mohawk, which borders Central, is taking the lead. If the governor wants to give us a point person to work with, fantastic… But we’re going to have a document in front of them in short order, and we are coordinated within our counties, not just with elected leaders but with our health commissioners, our emergency management, our purchasing… we are ready to work together more than we ever have before, going forward.

McMahon was also asked about the hiring of the tracing team (the so-called counterpart to food inspectors), and responded with the implication that this could be a shared health service (a health district?) between the seven CNY counties and their respective city governments.