Transcript: Mayor de Blasio Holds Media Availability on COVID-19

March 6, 2020

Mayor Bill de Blasio: Okay we have updates for you. First of all what you heard from the Governor earlier I want to emphasize here in the city. Obviously, this is this a new reality of community spread. So the fact is, even compared to a few days ago, we have a very different reality. When we began the week, our focus was on people who had traveled to effected countries overseas and those who had come in contact with people who traveled to those countries. What's happened in just the last few days is the initiation of community spread, meaning that these cases now are coming from within our communities in an untraceable fashion. That's going to lead to a series of changes.

So starting now, I'm going to offer some specific things that are starting to change in our approach. You'll hear more in the coming days. But let me first start with the overall numbers at this hour. At this point, still five confirmed cases of coronavirus, five individuals in New York City. We have an update on testing that will show a big jump in numbers compared to yesterday. This is the beginning of numbers starting to expand rapidly. So we have 47 negative now. That's about double where we were yesterday. And that's good. The number of negative tests continues to be strong. We have 40 outstanding tests at this moment. Now these numbers are very dynamic as new cases are being discovered, but right now that's the pertinent scorecard and we'll keep giving you updates as we get more information.

The community spread means we're going to have to determine some new strategies and it means it's going to be particularly dynamic. As we get more information, we're going to constantly update because sometimes we will learn something and it changes the approach and we want people to understand it in real time. What we have now that we didn't have as well, is our own information. So when we started dealing with this crisis, we were dependent on information from the World Health Organization and the Center for Disease Control and the broader medical literature. Now over these last days, we've started to get direct information from our own disease detectives and they have every day more and more information to work from. And we also are working, of course, very closely with the State Health Department and the cluster in Westchester is crucially providing us a lot of information. We of course, wish there were no cases at all. But when we see more and more cases, we actually learn from them and it helps us to understand how what's going on with this disease and how to address it.

A reminder to everyone, this is a brand new disease. The global medical community is still trying to understand it. There are still things that we just don't understand about this disease and again, it is a disease with no cure at this moment and no vaccine. So it is clear that we will learn by doing, our health professionals will learn by doing and get a better sense of this. We know one thing now from experience for sure, community spread means a greater ease with which this disease can be transmitted because it's just in more places. Even compared to a week ago, the likelihood of being in a place where someone had been infected by coronavirus was less than it is now. It has grown in the last week, so there's a volume issue here. There's just more places where more New Yorkers might come in contact with someone because the disease has been spreading out in the community. Now I remind you over the vast majority of people, they experienced very mild symptoms and have no lasting impact from this disease. There are people who may have it, don't even realize they have it. We've certainly seen that in some of the cases already. One of the children in the Westchester family had almost no manifestation of the disease. But the fact is it has spread substantially.

The other thing, and this is going to be a little graphic, so forgive me, but you will certainly understand what I'm saying. How it transmits from people to people. We've said from the beginning, it is not like the measles and I've asked our health professionals to be really clear and specific about this. Everything we know about this kind of disease, because it is part of a family of diseases is you're never going to have a situation where it becomes an airborne disease. Meaning it hangs in the air like measles does, like some other diseases do and can be contracted hours later after its presence in a room, for example. That is not coronavirus. What it is, is something that transmits through bodily fluids, but not all bodily fluids. So again, forgive the bluntness – a sneeze, a cough, if you spit and remember sometimes people spit inadvertently just talking energetically. That's how it can transmit, but not just that. It actually has to get into your body, which means basically your mouth, your nose, your eyes. Hands can also be the path.

If something's on your hand and you often, all of us have, we're touching our mouth, we're touching our nose, we're touching our eyes. People do it all the time. They don't even realize they're doing it. That's how it gets into you. It cannot just be any place else on your body or any place else in the air. It has to get directly into you. So the point being you kind of need a direct hit because it doesn't just hang in the air. It's also important to know, I’m sure people will have common sense questions. What if someone sneezed on a countertop? The disease doesn't last long, literally minutes and it's gone. I asked earlier, what if someone sneezed into someone's drinking water? It doesn't transmit through anything you ingest. What if someone sneezed on your soup? It does not transmit through something you ingest. It has to have come in mouth, nose, eyes, through directly breathing it in, directly breathing in someone sneeze or cough or spit. Or it gets on your hand, hand there to your body, but really soon thereafter because it doesn't stay alive very long in the open air. So just to make sure we are abundantly clear about what they call transmissibility.

So I'm going to go into some of the specific cases in a moment, but in light of the community spread, here is where we start to give some new guidance. And again, this is not yet invoking emergency powers and I hope we don't get to that point. This is guidance right now. We'll be very explicit day after day with any changes and if we ever get to the point of needing to use emergency powers. So I'm going to separate the guidance into two categories. Folks who are well and folks who have symptoms. And again, the symptoms are the symptoms you would normally associate with a common cold or flu.

If you're well and you don't have any symptoms, it's just go about the basic precautions. Wash your hands, use alcohol based hand sanitizer. Try not to be touching all the parts of your face that allow in the disease. Avoid handshakes. So I'm someone who shakes a lot of hands all day. Our Health Commissioner saying she would really prefer people tap elbows, not do handshakes while we get through this part of it. And be vigilant about symptoms. If you do get symptoms, if you get a fever, if you get a cough, if you get a sore throat, don't assume it's nothing. Assume it's something in this atmosphere.

Again, community spread has caused us to want to up the ante on our guidance to New Yorkers. So in light of that, if you do have the symptoms, if you have a fever, if you have a cough, if you have a runny nose, if you have congestion, stay home. Simple voluntary point, just do the smart thing. Stay home, don't go to work, don't go to school, don't go out on the town, don't go to a restaurant, don't go to a theater, just stay home. If it is the normal kind of sicknesses we have this time of year, as everyone knows over a few days that passes by and then you can go back about your life. If it turns out it's something more serious than obviously we want to get you help, but in the first instance, just a simple symptoms and nothing else. Stay home. Obviously the parents, the same guidance for your kids if your kids are sick, and we've said consistently and it still remains true, this disease again seems to be much more prevalent in the older folks than in kids. But if your kids are sick, just abundance of a caution. Keep them home. Alert your doctor as soon as you're sick. Again, if there's no extenuating circumstances like a travel nexus or other things that – or preexisting conditions, it was just an average healthy person having these kind of diseases we typically have this time of year. That's those kinds of symptoms. Call your doctor, let the doctor know what's going on. Give it a day or two. If you're getting well, that's great. If you're not getting well, we want you in.

We're going to talk about testing and the expansion of testing that has occurred. And the good news is for folks who are going to need testing, we have more capacity. Again, alerting your doctor immediately to everything. I want emphasize this folks, if you have travel history, if people in your family have travel history, that's still pertinent here. Even though the community spread is the new powerful reality we're dealing with, there's still that travel nexus, that's important. Also, preexisting conditions, crucially important – respiratory problems, heart disease, immune system problems. The doctor needs to know exactly what they're dealing with. And in the case of preexisting conditions, that's a case where probably they're going to want you to get tested right away. So as to the testing – we now have substantial new testing that has come online through the private sector. That is changing the numbers rapidly. So we've said in the course this week we could do dozens of tests in a day. As of now that is turning into hundreds of tests a day as we speak. We want to get up to thousands of tests per day capacity. We're on the way there, but what would help us immensely, and this is still where we need help from the federal government. We need the FDA to approve testing that is faster and more efficient than that, which is currently available. They have the capacity to do that. We've obviously made that request. So the number of tests we can perform is getting, those numbers are getting better. But the speed and efficiency of the test is still not what we want it to be. We need the FDA to help us. The faster we can get turnaround on results, the more we can do to address the situation.

Let me do an update on some of the individual cases. So, I talked about this morning, we have a man in Manhattan. And this directly relates to the original Westchester case. The gentleman who works at the law firm in Midtown, lives in New Rochelle. This is a direct nexus to that case via New Rochelle. The man in question is 51 years old. From what we know, no preexisting conditions, lives on the Upper West side, mildly symptomatic at this point and isolated at home. Married, his wife is 47 years old, has three daughters, ages eight, 10 and 11. All are mildly symptomatic. Essentially showing the kind of symptoms associated with a cold. All tested today. We're going to have the results later on. And the disease detectives have interviewed the families – the family members I should say, to clarify any contacts that they need to trace. And obviously we'll have that information ready and then we'll judge accordingly related to the test results.

Another case, which I think has been talked about publicly, and this spans a New York and New Jersey. 32-year-old health care worker, at Hackensack University Medical Center, in isolation, in stable condition. This individual has an apartment in Midtown, Manhattan that is his primary residence and also an apartment in Fort Lee, New Jersey. The health officials in New Jersey have been working with us very closely and obviously with New York State Health officials as well. The disease detectives have done the interview in this case. I'm going to give you some of the information. There's some other pieces we're still confirming. We'll have more for you at the next briefing. He worked on February 29th, seeing patients while symptomatic. But also while wearing a mask and gloves, saw ten patients but then went for care the next day. All patients had been identified and monitored. None are symptomatic. So none of those ten patients are symptomatic at this point. And this has obviously been a number of days since then. So that's a very good sign that so much time has passed. We are tracing any other contacts now. We'll have an update on that tomorrow.

Finally I'll just give you some quick Spanish in a moment, But one more update. The teachers that we talked about previously. So yesterday we talked about a teacher from James Madison High School, Brooklyn tested negative. That was the teacher went on the trip to Italy. 44 kids, and six other staff, still none have any symptoms. And again, we're almost at the two week mark. There were two other teachers who were on their own personal vacations over the winter break. One is a teacher and I will, let me say the most important part first. Both tested both negative. The second and third teachers both tested, both negative. One teaches at PS 369 in Brooklyn. One teaches at PS 130 in Lower Manhattan. So as soon as those teachers, who do not have coronavirus, but have been just generally sick, as soon as they are fully well, they'll all return to the classroom. But none of those teachers have coronavirus.

So to conclude, just a few words in Spanish,

[Mayor de Blasio speaks in Spanish:]

So that's the update. My colleagues are with me. Deputy Mayor Raul Perea-Henze, Deputy Mayor Laura Anglin, Dr. Oxiris Barbot, our Health Commissioner, Dr. Demetre Daskalakis, our Deputy Health Commissioner, Chancellor Richard Carranza, our Emergency Management Commissioner Deanne Criswell. And we are ready for questions.

Question: Thank you. I actually have two if you don’t mind. The first would be probably for Dr. Barbot, actually. I'm wondering, there’s obviously, you know, community spread is here. A lot of people are concerned about kind of how widespread this might be. And I guess, I'm wondering if you have a sense for how widespread the asymptomatic group might be? Like if you were to swab this room, would you expect to see it? Would you expect to see flu if you were to swab this whole room? Like, I mean what you try to – can you put this in context?

Commissioner Oxiris Barbot, Department of Health and Mental Hygiene: I think right now as the Mayor has said, we are pivoting into what we're seeing with regards to person to person spread in the community. And so what that means is that New Yorkers are probably more likely to contract, or less likely to have contracted coronavirus from someone that had a travel nexus than from someone who had contact with an individual who had the disease. And so we're not at this point looking for asymptomatic – excuse me, because the literature, the experience from other countries doesn't bear out that those are the individuals that are responsible for this explosive growth across the globe.

Question: [Inaudible] transmitted as easily as somebody who is symptomatic or?

Commissioner Barbot: Yeah, I think the science is still out, but there's nothing convincing that would lead us to believe that going after asymptomatic individuals would give any fruitful information. We're focused on ensuring that New Yorkers get the message that if they are sick, if they have symptoms of a, cold-like symptoms, they've traveled, we want them to reach out to the doctors. Even if they haven't traveled, we want them to have a lower threshold of staying home when they're sick. Because as we pivot into this new, early phase where we're having community transmission, one of the most effective ways to nip that in the bud is if people really take to heart the advice. Stay home if you're sick, don't go to work. As the city's doctor, what I'm asking them to do is to have a lower threshold. You know, we have a habit of wanting to power through if you've got a cough, a scratchy throat. I'm saying don't. Do us all a favor. Stay home. Stay home for 24 to 48 hours. And if you're not feeling better, make sure that you've reached out to your doctor. We've now increased the availability of testing. As the Mayor said, you know, we have commercial tests online. And so the important thing to note is if you're sick, stay home. If you're sick for more than two days, reach out to your doctor, ask for the test if you think you've got concerns.

Question: Thank you. My other question was, and this is really more I guess for you Mr. Mayor. You know, you see Wall Street firms are now splitting up their trading operations. They're putting personnel kind of elsewhere so they don’t all get sick at the same time. Have you had that conversation in terms of city government, in terms of a continuity of government? I mean you're all sort of standing here. If this gets that widespread, what did you do?

Mayor: Look, I think this is the kind of thing we're going to start scenarioing. In fact, yesterday we had one of our exercises where we talked about what the impact would be on the total number of city employees who will be available to us at any given point in time? So we're starting to run those scenarios. We have not yet gotten to the point of saying we want to split up people in different locations. But you know, we're going to put everything on the table and decide what makes sense. The community spread dynamic requires us to consider any and all possibilities. You know, if this really started to ramp up intensely, we would definitely need the ability to make sure we had enough personnel at all times. Go ahead.

Question: Mr. Mayor, there was a –

Commissioner Barbot: Yesterday, I issued a commissioner’s order ordering that first responders, educators, health care workers who are from the City, stay home if they're sick. And so that is our way of ensuring that A.) Those individuals that are in the closest contact with people who may be at risk for other reasons who may be sick, don't transmit the illness. And it's also a way of protecting our workforce because the work of the City has to continue. And so in that same vein, what we're asking is for businesses to look at ways in which they can help support workers heading this advice. So, for example, if they've got options for telecommuting or using video conferencing, we want them to be looking at the possibility of putting those things into place.

Question: Both Gap and a WeWork office had employees who tested positive and shut down their workplaces in Manhattan. Or are those the 40-year-old and 50-year-old man or are those additional cases?

Mayor: I don't know those specific ones. You're saying here in the city, had cases that tested positive. Those are not in the numbers I have. So I want to make sure we're saying the same thing. I don't know where they live. Do you know this one or not?

Deputy Commissioner Demetre Daskalakis, Department of Health and Mental Hygiene: If they are not New York City residents you are going to hear about them from another jurisdiction.

Mayor: Let's confirm and get that back to you.

Question: So I have two quick questions. The first is if you can give an update on the quarantine number? I know it was about 2,700 yesterday. And the second is, I know Governor Cuomo said he's not concerned about the number of tests, but you and your administration is concerned. So is there a disconnect between the concern of the available tests?

Mayor: I think we're saying – we're talking about two different categories. I watched some of the Governor's press conference and I saw the exchange. On the pure numerical level, we've seen a really great improvement in this week. Went from, you know, literally Monday morning we could not do our own testing, to Monday afternoon we could do our own testing but not the numbers we were hoping to get to. Now the private capacity is coming online as we speak. That's revolutionizing the situation. Hundreds of tests per day will be possible, on the way to thousands. Good news. The bad news is a test takes too long compared to where we want it to be. And we want the fastest, most efficient test and that requires FDA to approve the next step of evolution, if you will, and allow those faster, better tests. We need that to happen. We made that very clear to FDA. We're waiting for answer.

Question: [Inaudible]

Mayor: I think it's the same as this morning. A 2,773 is the number I have. Yes.

Question: Do you see any more schools in the city closing down out of precaution?

Mayor: You know, we're constantly monitoring for any instance of a teacher, a student, a staff member with symptoms that links back to this. We're not finding any others at this moment. So no, we're continuing, but that's something people should keep in – You know, I'm asking all parents, constantly keep aware of the latest news because if we get to a point where we have to make any kinds of closures, we'll get that out immediately. But at this point, thank God we're not seeing it in the school system.

Question: Kind of, you know, looking at the strain of the virus, that the multiple people have had and if they're connected, do they get it from the same, or do we know anything about the sequencing of the disease at this point?

Commissioner Barbot: So through the work of our disease detectives, we have established clear what we call epidemiological connections, which means that we have been able to determine instances where a symptomatic individual who was positive transmitted to another individual. And so when we talk about community spread, I think it's important to note that now what we're seeing is contact spreading the illness to other contacts. And that puts us in a different situation that we're going to be paying very close attention to.

Question: [Inaudible] in Washington within a few days we knew that, there were estimates that the disease had been circulating for six weeks. Did we have any kind of estimate for how, like when it came here?

Commissioner Barbot: To date we do not have that estimate.

Mayor: Who has not gone? Way back.

Question: Regarding the MTA and their approach, you have a comment on the cleaning of the trains and the buses and the stations? And does their approach need to change now that we're in this space?

Mayor: I mean my understanding is they're intensifying their cleaning efforts and that's right. But again, I want to, you know, we're constantly trying to get really, really clear if there's any new information about this disease and I want to be clear, the entire global medical community is trying to get more information, get around, you know, this is a, this is going to change potentially, literally day by day even. But as of today in terms of cleaning and everything else. It doesn't get transmitted hanging in the air. It would only get transmitted in a surface and kind of a perfect storm where you instantly touched it and touched your mouth. You know it’s a very rare dynamic. The thing to be concerned about is person to person, close contact, you know, liquid fluid going from one person into another person. Sorry for the bluntness. That is how it gets transmitted. So I think of the MTA, which I have every reason to assume is happening is doing intensified regular cleaning. That's good. But I think that you know, the heart of the matter here is something that's much more about the experience people have as individuals rather than in a big open space.

Question: Yes, please, the Commissioner [inaudible] you know, talk about the transmission in Spanish, please?

Mayor: Sure.

Question: Thank you. You know the body fluids and everything?

Mayor: Sure. You can ask it in Spanish.

[Laughter]

[Commissioner Barbot speaks in Spanish:]

Mayor: Who has not gone, one call on that. Okay, let's go around again.

Question: Thanks Mr. Mayor. As we're sitting here, Amtrak put out a statement that they're pulling down three Acela trips a day because of reduced demand. Airlines are fighting service, you know, I mean everybody knows what's going on with the economy. Where are we headed here in New York? And based on this that you guys are saying that it's, it has to be [inaudible] from person to person. That it's not, you know, sitting around on the subway pole necessarily. What do you say to New Yorkers and to people who might think about visiting New York as these numbers grow and presumably will continue?

Mayor: Look, I think first of all, there's just no place in America that’s better able to handle a situation like this than New York City. We have the strongest health care system anywhere in the country by far. We have the strongest public health capacity. I really believe New Yorkers are heading these warnings and acting accordingly. I just continue to see people doing the right thing and I appreciate that very, very much. So, I also would tell you the vast majority places I'm going in the city, I'm seeing people going about their business. Which I think is also New Yorkers are, if I may editorialize particularly resilient and tough and tend to keep going through all sorts of things. Now I agree with the Commissioner. We want people to be tough as they always are, but recognize that if they're sick it's smart to stay home. But I'm going to be going out around the city like normal. I think people should. I think people who want to visit this is damn good place to visit. But those companies that are making decisions based on reduced demand, that's just common sense, right? I mean if people aren't showing up, then you're going to alter your behavior. I think that the thing I want, I want all this energy to go into action. So the cleaning your hands, the alcohol based hand sanitizer, the new cool way of greeting people. There's your example. You know, being smart, if you happen to be sick. Filling your prescriptions now, which we mentioned yesterday is a really smart thing to do. Just get that done. I think that's a smart thing to do.

The where's it going? Look, we are now going to do – we're running scenarios that are the total shutdown scenarios and everything in between. But we also are going to be really specific. Like we have to see evidence of something that causes us to want to get to that point. And I'm still not seeing that, you know, we have a slew of new tests here. Obviously a huge number of them came back negative. That's great. You know, the teachers came back negative. That's great. But it's going to be a day to day, hour to hour thing. Go ahead.

Question: I'm going to need you to clarify. I know you said that the coronavirus can only lasts a few minutes on surfaces, but the World Health Organization and Governor Cuomo had actually said that it could survive on some surfaces for a few hours or several, several days. Could you?

Deputy Commissioner Daskalakis: Very often when new viruses are identified there are studies that are done in laboratories that don't actually look like real life conditions. So we think like other coronaviruses and cold viruses, this one also has a life on surfaces that's short. Not as long as quoted by the WHO.

Question: [Inaudible]?

Deputy Commissioner Daskalakis: In the lab –

Mayor: Apples and oranges.

Deputy Commissioner Daskalakis: Apples and oranges. So in the laboratory I can make anything live long in the laboratory.

Mayor: I'm not saying you can get it from apples.

[Laughter]

Deputy Commissioner Daskalakis: No apples, no apples, no apples!

Mayor: I’m going to work with you. A laboratory is a rarefied environment?

Deputy Commissioner Daskalakis: Correct.

Mayor: So you're saying it's easier for something to survive there as opposed to the rough and tumble of the outside world where there's air circulating and all sort of stuff happening. So let's just describe, let's go to the positive version. If I were to sneeze on my kitchen counter or my desk, how long is it going to survive on that surface?

Deputy Commissioner Daskalakis: On the order of minutes.

Question: Ten minutes?

Deputy Commissioner Daskalakis: On the order of minutes.

Mayor: Right, but you've got to give some –

Deputy Commissioner Daskalakis: 10 minutes seems long.

Mayor: So what’s typical?

Deputy Commissioner Daskalakis: Somewhere – a couple of minutes. Two, three minutes. That’s like a typical coronavirus.

Mayor: So the two, three minutes and then it's inactive. That's your typical experience?

Deputy Commissioner Daskalakis: Correct.

Mayor: Okay. And we, look, we try – I’m going to editorialize and I want you to work with me and modify. One, we're dealing with something where there's no one on Earth who has all the facts about this disease. Two, we really respect the World Health Organization. We really respect the CDC, but I want to kind of take you to, we especially appreciate our own local expertise. Particularly when it's based on our own experience. So I mentioned that the disease detectives are bringing back our own information, not someone else's study, but what they're seeing. So Demetre the go-to-guy on what happens with diseases. So the New York City understanding is on a surface, it's a few minutes.

Deputy Commissioner Daskalakis: All of our scientific advisors within the Department of Health agree that it's on the order of minutes.

Mayor: Go ahead.

Question: I have two questions Mr. Mayor, I'm going to ask what I think is the easier one first. We have confirmed that a hardware store in the Garment District is selling two liter bottles of Purell for $109.

Mayor: I would like to have the name and address of that hardware store. I know our Department of Consumer Affairs would like to pay them a visit immediately.

Question: And why is that? Can you just explain why?

Mayor: I mean price gouging, they put out the guidance disallowing price gouging. So you know, I don't have the guidance in front of me, but that sure sounds like it would be a hit. So I would – you've sometimes had brought up other individual cases, which I appreciate. This is one where we'd like the information and our team will follow up immediately.

Question: And then secondly, the Westchester attorney because he has so many cases associated with him. I know early on he was in critical condition so you couldn't get information directly from him. Now he's in stable condition. Have you learned any more about where he might have contracted the virus?

Mayor: And let's confirm he has been getting better, but has he been better enough to interview?

Deputy Commissioner Daskalakis: The answer is he's not better enough to interview, though he is getting much better. So we're very reassured by that. But not quite ready for interviews.

Mayor: In terms of the question, from his family or other sources, do we have a sense of the origin point of him where he contracted it?

Deputy Commissioner Daskalakis: We think he's part of the larger Westchester cluster that we're hearing about.

Question: [Inaudible]?

Mayor: Not from travel as far as we know.

Deputy Commissioner Daskalakis: No, oh yeah, absolutely not. No travel. There's no travel nexus that would indicate this is from a travel related infection.

Question: Several of the health care workers that were in contact with the Westchester lawyer have now confirmed to have the virus. And there's the health care worker in Manhattan. We obviously have a patchwork of different facilities that treat people. We have family doctors, we have urgent care centers and we have private hospitals. I know that there's protocol at the City hospitals that people come in and get like a respiratory thing right away.

Mayor: A mask. Not a respiratory thing. A mask. We're going to put out a press release, every time we're going to refer to it as a respiratory thing just to see if you're catching. Go ahead.

Question So what there – is there a common guidance going out to all these different places? How are we going to make sure that health care workers are not exposed to this?

Mayor: Yes, distinctly yes. Go ahead.

Commissioner Barbot: Yeah, so all providers are trained on universal precautions, knowing when to use gloves, mask. Beyond that, we have sent numerous bulletins to the health care community to ensure that they are fully up to date on the requirements, the recommendations for the use of masks, for gloves, for gowns as needed. Additionally, we have held several webinars with physicians. Dr. Demetre Daskalakis did one earlier this week where 3,000 doctors participated in this webinar. We did it in collaboration with State partners. Beyond that, as part of our ongoing emergency preparedness work, we do secret shoppers at hospitals where we send folks who show up with scenarios of a novel respiratory virus to make sure that unannounced, institutions are taking the proper precautions. And if they're not, we take it as an opportunity to reeducate them. Because one of the things that we are critically focused on is ensuring that all of our health care workers have the equipment that they need and that they know how to use it consistently and effectively.

Question: What do you have to say to those who may be experiencing the symptoms and they're afraid to go to the doctor because of the bill, medical bill, even with insurance or even worse, with no insurance?

Mayor: Very, very important question. And I want to emphasize again. This is a city that now is guaranteeing health care for everyone who needs it, including undocumented people, regardless of ability to pay. And anyone who's not sure what to do or is confused because I don't have insurance or they're not sure where to go. Call 3-1-1, which can speak to them in multiple languages. And they will be told the best facility to turn to. And again, everything will be, if people are unable to pay, we're still going to treat them. If they're able to pay, we'll work with that. If they have insurance, great. If they don't have insurance, we're still going to treat them. Okay. Last call. See if there is anything else.

Question: Thank you. I just wanted to nail down the lawyer, the New Rochelle guy. So it sounds like, I just want to, what I heard was he's not the one, you know, he acquired it from someone.

Mayor: He acquired it from someone somewhere. But, but not as far as we can – we have no, it was his travel, because of the timing and everything. And we have no evidence it was from someone else's travel in his life. But as you heard, we still will, we'll learn more. We've interviewed his wife but we haven't interviewed him. So you know, there is more to learn. But community spread is community spread. There's a certain point where it's just out there and the travel nexus is in the past.

Question: Yes, my question is I think you had said that you think it was somewhere in that New Rochelle cluster. Is it, do you think it's somebody who's already been identified as a patient?

Mayor: We don’t know. We just don’t know.

Question: Okay.

Deputy Commissioner Daskalakis: I really have nothing to add to that. So I think this is the point of, of what community transmission can look like. So though not the most satisfying answer, there'll be answers where the index patient, the first patient is unknown.

Mayor: And I want to note, I mean obviously travel is going to become less and less of a nexus just because fewer and fewer people are traveling. But when we get this interview done, if something new comes up, we will absolutely put it out. Yes.

Question: Just two more quick questions. The New Jersey man, I believe he got it at a conference in Manhattan on March 3rd?

Mayor: I don't think we know – do we know he got at the conference or we didn't, or we're not at that level of specificity? Please come on over.

Deputy Commissioner Daskalakis: I can confirm that he was symptomatic before the conference.

Mayor: Okay, so he didn't get it at the conference?

Deputy Commissioner Daskalakis: Correct.

Question: [Inaudible] where it was?

Deputy Commissioner Daskalakis: I don't want to comment on that right now. We're investigating. So it's we want to not compromise our investigation.

Mayor: Right. We will, the ground rule is the same. Very fair question. Our job is to one, lock down facts. In some cases, again, there's notification issues. But I'm going to say to our communications team to keep a running list of specific questions and our job is to fill in the blank as quickly as possible, hopefully as early as tomorrow.

Question: Are either of the AIPAC attendees who tested positive in New York City –

Mayor: We don’t have evidence they're in New York City but we don't have –. In other words, no one has said they are from New York City. No one's alerted us that. That doesn't mean they aren't from New York City. We just don't have that.

Question: I have a question for Chancellor Carranza. So there are some students in the public school system who go to internships in nursing homes and other facilities. Is there any plan from the DOE to dial that back or to kind of remove some of those programs? Especially [inaudible] programs?

Schools Chancellor Richard Carranza: No plans at the moment to do away with those programs. But we have provided guidance around just common sense at this point. And the guidance is really based on the Department of Health. If they are presenting or they're sick or there's somebody at that place that is sick, there's an issue. Just common sense. And again, as a situation and circumstances warrant, we'll adjust.

Mayor: I want to emphasize to that question. We're watching every single day. We keep coming back with the same basic fact. Can it afflict a young person? It can, but it seems to be with very, very limited impact. The central question I want to make sure, and we should make sure this is in all our guidance, the students who need to be treated differently and with deference are if they have preexisting conditions, and those would include a compromised immune system, a severe respiratory problem, or severe heart problem. Those students, I want us to set a higher bar and I would not take chances on them being out and about, unless absolutely necessary. Yes.

Question: Is there anything more you can say about the two people that were diagnosed yesterday? If there's any indication where they got it or any of their contact tracing, if they rode subways or if they were in public gatherings? The 83-year-old woman and the man in his forties, and also their condition. If we have any update on that?

Mayor: So, Demetre, do you have condition? Okay. And I don't think we have more on if you know, more on origins.

Deputy Commissioner Daskalakis: The 40-year-old male has been discharged and is isolating now at home. The more elderly patient is doing better but continues to be in critical condition.

Mayor: And do we have anything on origin in these cases?

Deputy Commissioner Daskalakis: We do not have an identified origin for either case. We have done appropriate contact tracing and close contacts are being are being handled appropriately.

Mayor: We'll have an update on that.

Question: Mr. Mayor. The Governor had said four cases in New York City. And you're saying five, was he just not updated?

Mayor: I can't speak for him. We're all getting constant flowing information. So you know, I'm, I want to emphasize and we're working very, very closely with the State. There's one, ever-changing details. Two, we have interesting situations like the New Jersey health care worker. Literally the health officials are trying to determine whether to call that a New Jersey case or a New York case that has not yet been determined. It has been determined? Okay, well as of an hour ago, it hadn't been determined. Okay. New Jersey gets that one. Okay. Breaking news. Thank you. So that's New Jersey.

We're five with the addition now earlier today of the 51-year-old man from the Upper West Side, that's five.

Commissioner Barbot: [Inaudible] Westchester.

Mayor: Right. Thank you. That's where the other confusion is. The individual lives on the Upper West Side but contracted it in New Rochelle. So that's where these are very valid, you know, you could count one way, you could count another way. Last call.

Question: We talked about this a little bit a couple of days ago, but now that we have over 2,700 people in home isolation, can you just walk us through the do's and don'ts of what you should, should or should not do? You know, can you go down and do your laundry if you live in an apartment building? Can you, you know, should you go out and walk your dog? Can you take a food delivery at your apartment door or that sort of thing?

Mayor: I am going to start with a little bit of common sense. And then Demetre jump in on the specifics. Look, an asymptomatic person who is in voluntary quarantine, out of abundance of caution. I mean, obviously our expectation in the vast majority of cases is they're just going to ride it out and they will have run out the time limit. And then we know they're fine. I will state the common sense reality for everyone. Maximum isolation possible. A person can stay in their apartment, can get, you know, if they're able food deliveries or friends or relatives can bring them food, whatever it is. They should minimize any contact with anyone else. Abundance of caution. So I think that's the standard. That doesn't mean you can't, you know, get a little fresh air for a minute, but you should, to the maximum extent possible, avoid contact with other people. Have I gotten my medical degree? Thank you. Okay. This was the moment where I got my medical degree. Okay. We will certainly be updating you regularly. There's a lot more to follow up on from today. We'll get that to you tomorrow and let's keep going. Thanks everyone.