The first political dogfight surrounding COVID-19 occurred last spring between President Trump and New York Governor Andrew Cuomo. At issue: the nation’s ventilator supply.
Alarmed by inaccurate scientific models warning the United States lacked a sufficient stockpile, Cuomo blamed the president for the alleged dearth of breathing machines. “I operate on the data and on the numbers and on the science,” Cuomo boasted March 27, as his state was under siege from the virus. “And every projection I have, from multiple sources, and these are worldwide health experts, say that we have to be prepared for an apex of . . . 40,000 ICU beds with ventilators.”
The president disputed Cuomo’s exaggerated demand. “I think their estimates are high,” Trump said in the duo’s escalating war of words.
Cuomo for weeks fixated on the need for more ventilators. Claiming a lack of ventilators was his “most significant challenge,” Cuomo’s state health department authorized the conversion of BiPAP machines into ventilators; New York, Cuomo warned on April 2, would run out of the machines within a week. He signed an executive order to seize ventilators from private hospitals and redistribute them to overwhelmed facilities.
“Am I willing to (do this) to save a couple of hundred lives? You’re damn right I am,” Cuomo preened.
But like nearly every decision and prediction he made during the crisis, Cuomo was wrong—and gravely so. At the same time his administration was forcing nursing homes to readmit infected residents with fatal results, the braggadocious executive, along with his equally incompetent “experts,” encouraged heath care providers to intubate COVID-19 sufferers.
It’s possible the early rush to place sick people on ventilators unnecessarily killed thousands of New Yorkers. A study released in late April 2020 showed nearly 90 percent of intubated patients hospitalized in the state’s largest health care system died in the first five weeks of the pandemic; during that same period, at least 4,000 New Yorkers, according to one data source, were put on the breathing machines. (The state’s website, oddly, does not disclose how many New Yorkers were intubated from the start of the pandemic through early May.)
Ventilators can cause a variety of other serious health concerns; patients must remain heavily sedated so they don’t wake up and attempt to remove the tube. The machine can lead to fatal infections such as pneumonia. Some COVID-19 patients who recovered after being intubated describe the ordeal as being “buried alive” and many suffer severe physical, emotional, and mental after-effects.
By mid-April, after widespread use of ventilators, a handful of courageous New York health care providers started speaking out; one Brooklyn emergency room doctor posted a video explaining how the practice was killing people or causing lifelong lung damage.
An April 14 New York Times article, headlined “What Doctors on the Front Lines Wish They’d Known a Month Ago,” profiled several New York City doctors who expressed regret at how they handled the pandemic early on. “Don’t jump to intubation,” Dr. Nicholas Caputo told the Times.
Doctors instead chose to “keep patients conscious, having them roll over in bed, recline in chairs and continue to breathe on their own—with additional oxygen—for as long as possible.”
But the damage had been done, especially in low-income areas of New York City. Elmhurst Hospital in Queens, the epicenter of the city’s outbreak, “came perilously close to running out of ventilators several times,” in late March. The public hospital serves the city’s poor and foreign-born residents. It’s unknown how many Elmhurst patients died after being intubated.
After hospitals largely abandoned the practice of automatically placing sick patients on ventilators, the city’s fatality rate dropped dramatically between the initial spring outbreak and a fall surge. “In the earliest days of the pandemic, hospitals in New York City tended to intubate patients early. Now, if possible, they avoid intubation, in which a mechanical ventilator breathes for a patient who is deeply sedated. Instead, doctors first attempt to give patients oxygen by less invasive means,” the Times reported in October 2020. One study showed death rates among infected New Yorkers decreased from 25.6 percent in March to 7.6 percent in August.
Of course, health care providers in New York weren’t the only ones intubating COVID sufferers. In a shocking Wall Street Journal exposé last year, many doctors expressed regret for using ventilators and confessed the practice wasn’t for the benefit of the patient but to prevent the “spray [of] dangerous amounts of virus into the air” that could infect doctors, nurses, and other patients. “That felt awful,” one Michigan critical care physician told the paper.
One person who doesn’t feel awful is the man governing the state most culpable for spreading the virus throughout the country—Andrew Cuomo. Hailed as a hero for months due to his theatrical handling of the crisis, Cuomo finally is under long-delayed but well-deserved scrutiny for his incompetence and now apparent cover-up of nursing home data.
It’s unlikely, however, that Cuomo, who refuses to take any responsibility for the deaths caused by his inhumane decisions, will revisit the consequences of his early push for ventilators in an effort to score political points against Donald Trump.
“Who cares? They died,” Cuomo infamously said earlier this month about the thousands of nursing home residents who died on his watch.
Maybe he can write another book.