NYT: Cuomo "all but declared war" on health experts in COVID-19 crisis

Some experts, anyway — in large part determined, the New York Times suggests, by how politically useful they were to Andrew Cuomo. After a series of high-profile departures in state health agencies and an angry retort by Cuomo at a press conference on Friday, the NYT reports that Cuomo has “all but declared war” on the agencies fighting the COVID-19 pandemic. Following a series of autocratic decisions to override the plans set up for months in vaccinations, resulting in a terrible start to the rollout of the Pfizer and Moderna vaccines, Cuomo suddenly has stopped being a media celebrity and more of a target:

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Even as the pandemic continues to rage and New York struggles to vaccinate a large and anxious population, Mr. Cuomo has all but declared war on his own public health bureaucracy. The departures have underscored the extent to which pandemic policy has been set by the governor, who with his aides crafted a vaccination program beset by early delays.

The troubled rollout came after Mr. Cuomo declined to use the longstanding vaccination plans that the State Department of Health had developed in recent years in coordination with local health departments. Mr. Cuomo instead adopted an approach that relied on large hospital systems to coordinate vaccinations not only of their own staffs, but also of much of the population.

In recent weeks, the governor has repeatedly made it clear that he believed he had no choice but to seize more control over pandemic policy from state and local public health officials, who he said had no understanding of how to conduct a real-world, large-scale operation like vaccinations. After early problems, in which relatively few doses were being administered, the pace of vaccinations has picked up and New York is now roughly 20th in the nation in percentage of residents who have received at least one vaccine dose.

“When I say ‘experts’ in air quotes, it sounds like I’m saying I don’t really trust the experts,” Mr. Cuomo said at a news conference on Friday, referring to scientific expertise at all levels of government during the pandemic. “Because I don’t. Because I don’t.”

Nine high-level officials have left their positions in the midst of a once-in-a-lifetime pandemic, which itself seems very curious — even if the media has been rather incurious up to now. As grim as these circumstances are, it’s precisely why these experts get into this field in the first place. As the NYT notes, these crises usually makes people in these fields feel more job satisfaction and creates more opportunities to feel valued. Instead, “morale certainly was and continues to be at an all-time low,” one of the people who have departed under Cuomo’s leadership reports.

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Cuomo’s plan for mass vaccinations seems to have become a tipping point. The state of New York and New York City put plans in place for biological warfare scenarios after 9/11, setting up widely distributed vaccination points and laying out logistics for distribution. Cuomo abruptly canceled those plans as the vaccines reached the end of their Phase 3 trials in favor of using regional hospitals for mass vaccination hubs instead. Why?

Perhaps donor money mattered more than efficiency:

In the fall, Mr. Cuomo shelved vaccine distribution plans that top state health officials had been drawing up, one person with knowledge of the decision said. The plans had relied in part on years of preparations at the local level — an outgrowth of bioterrorism fears following Sept. 11 — and on experience dispensing vaccine through county health departments during the H1N1 pandemic in 2009. …

In his own planning for the vaccine rollout, Mr. Cuomo spoke with hospital executives, outside consultants and a top hospital lobbyist in closed-door meetings. In December, Mr. Cuomo announced that the state would rely on large hospital systems as “hubs” to coordinate vaccinations, not simply for their own staff but also for ordinary New Yorkers.

The state designated as a regional vaccination hub in New York City not the city’s 6,000-person Health Department, but rather the Greater New York Hospital Association, a trade group with a multimillion-dollar lobbying arm that had been a major donor to the governor’s causes.

If one wants a nimble vaccination response, hospitals are the least effective choice — at least for running the effort. It’s true they have the best storage options, and also true that the Pfizer vaccine’s special handling needs doesn’t lend itself to wide distribution. It’s equally true that hospitals have higher priorities at all times, but especially now, than doing vaccinations. Hospitals have done heroic work in the pandemic, but they’re buried by care for acute cases along with their normal workloads. They simply don’t have the resources that state health agencies could bring to bear, let alone prioritize those for vaccinations.

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Perhaps Cuomo should have spent more time listening to his own experts rather than act like a tinpot dictator. Cuomo, who wrote about bragging about his leadership in supposedly conquering the pandemic between the first and second waves of it in New York, also bragged about his dictatorial style:

Mr. Cuomo said in an interview that the scale of the pandemic had overwhelmed the state’s public health planning.

“It’s the Mike Tyson line: ‘Everybody has a plan until I punch them in the face,’” Mr. Cuomo said.

Janice Dean is aghast:

So much for the science. And so much for the “Love Gov,” as his brother Chris christened him on one of his many self-promoting appearances on CNN. The New York Times pulls the mask off a petty tyrant, months longer than should have been the case, but still useful today. The only question will be whether the rest of the national media stops fawning over Cuomo and when they start reporting more responsibly on the disaster Cuomo created in New York.

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