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

March 8, 2020

Mayor Bill de Blasio: Okay. We have a lot of information for you here. So, this is going to take a while to go over and then we'll take your questions.

I want to start a couple of things. First of all, the information we're going to provide today is based on the latest information that we have here through our public health agencies and we are constantly assessing what we're experiencing here in New York City. This is again another reason to appreciate the work of our disease detectives at the Department of Health who are not only working on specific cases and helping to address the specific individuals, but they're also gathering a huge amount of new information. This is basically research that's happening right here in New York City, giving us direct knowledge of how this disease is acting so that we can make the best strategic judgements. There is a lot of information out there in the global health community, national health community, but everyone understands there's still a lot that is not understood about this disease. Again, this is a disease that this moment does not have a cure, does not have a vaccine.

So, the fact is the ability to constantly gather new information and understand the way the disease acts in real world conditions is crucial. We talked about this yesterday is a real difference between real world conditions and the laboratory. So, we are getting more and more information and it is affecting our understanding and therefore our strategies. You'll hear those updates as we go along. Also want to emphasize this of course is an ever-changing situation. There are times we get guidance from the World Health Organization, from the CDC, State Health Department, obviously our own health officials. Sometimes there are areas where there is not clear guidance or there's different guidance different levels of government. We're constantly assessing, refining. So, this is an ever-changing situation. We will update you constantly. You will see variations. We'll try and identify those variations of why they're happening, but you should expect it. You should expect changes in information, changes in approach as we go along. Therefore, the things we say in many cases are preliminary because the information about the disease is preliminary. We hope over time to get a much deeper understanding, but we can say some things with you know, a high level of certainty based on actual experience. So far, and I'm going to repeat today and probably several other times in coming days, what we understand about what is called transmissibility, which is literally the process through which the disease goes from one person to another because there's still a lot of misunderstanding out there and a lot of mythology out there.

So, I'm going to put it again in very plain graphic terms because I think New Yorkers, we are blunt and straightforward people. People want to hear the truth about this stuff. And the way I try to explain it as sort of what it is versus what it's not. So, what it's not is a disease like some that hang in the air for a prolonged period of time, that you can come into a room hours later after someone has been there with the disease and you have a danger of contracting disease. That is not what we're talking about here. This is a disease that requires a very direct level of contact. The question of surfaces has come up a lot. The best understanding of our public health officials is that this is a disease that does not live long on a surface. Certainly, on most surfaces like metal, plastic you know, a desk, a kitchen counter, a subway pole. It's only a matter of minutes before the disease dies, the virus dies in the open air.

If it got on a part of the human body that's not the mouth, the nose, the eyes, might live a little bit longer, but still a very limited period of time and the only way it can become active and affect you is if it gets into the mouth, the nose, the eyes. If the disease got on your leg, but nowhere else, you don't get infected. We talked yesterday about if somehow it got someone's sneezed over some soup they were serving you and then you drank the soup, you're not going to get infected. Same thing with a glass of water. It has to be direct fluid from one person right into you, which means a cough, a sneeze right at you that you received directly into your mouth, your nose, your eyes, or potentially onto your hand and then immediately onto your mouth, nose, eyes.

A lot of us and I am one of them, often touch our face. It's kind of a normal human reaction, normal human habit. You want to try to do that less nowadays in addition to all the other precautions to washing hands and the alcohol-based sanitizer. It's great to try and reduce that contact between your hand and your face, but if it doesn't get into those parts of your face, it doesn't get in. That's what we understand at this point

And when we talk about the close contact, we've seen this in cases. Again, we understand if someone sneezed right at you, they coughed right at you. They did not do this like they're supposed to. You're supposed to cover your mouth, your mouth. When you cough or sneeze into your elbow, someone does sneeze or cough right at you. Yes, direct hit. That's a real problem. If you're deep in conversation with someone right up next to you and they're vehemently talking and some spit comes out and it gets right into you, that's a problem. It is not a problem. If someone is 10 feet away and they sneeze, it's not going to reach all the way over to you. But if it's close to you, that's where the problem occurs and that's where we want to be mindful of. So those are just basic points I want to say upfront.

The other thing I really want to emphasize, and I've been working with our health officials on this because there's been a lot of misunderstanding and we really want to get right to people – who's vulnerable and who's essentially not now. I'm going to say on this one again, I'm going to use the – I'm the layman here. I've been talking to these public health officials now for days and days and days. I'm trying to composite the information, make it simple and clear for New Yorkers to use. I'll put an asterisk on and say, there are always exceptional cases. So, I'm not saying I'm giving you, you know a perfect rule that affects every single time, but this is the basic rule, overwhelmingly consistent rule based on what we have seen globally from this disease. So, I want to start with who is most vulnerable – it’s abundantly clear, who is most vulnerable to contract coronavirus. It is people who have preexisting serious conditions and are over the age of 50, and those preexisting conditions, and our team has really been working to get this definition clear for everyone because we think it's helpful if it's very, very clear. So, the preexisting conditions in question are heart disease, lung disease, cancer, immune system vulnerability and I – diabetes, thank you. And diabetes, those five I'll do it again. Heart disease, lung disease, cancer, compromised immune system and diabetes, those five preexisting conditions. And then one other thing we could call a factor is not a preexisting condition but it is a factor that we are concerned about and we've seen already – if you are a smoker or a vaper that does make you more vulnerable. And we'll say it probably several times today and in the days to come, if you are a smoker or vaper, this is a very good time to stop that habit and we will help you.

Our Health Department and our colleagues in the state have a lot they can offer people who want to quit smoking or want to quit vaping. If you can do that, if you want to do that, please do that now. It is a very good time to take that vulnerability off the table. Call 3-1-1 if you need help. So, for folks who have one of those five preexisting conditions, or God forbid more than one, even more, for folks who have that reality that they’re smokers or vapers, they're in particular danger. And if they're over 50 that is the category where we're seeing the biggest problems by far. That's where the real danger is. Those are the folks, God forbid anyone passes away, but overwhelmingly the folks in greatest danger, the folks we have the greatest concern about whether they will still be alive at the end of this is the folks who are in that category.

Okay. The next category to think about is folks who have those preexisting conditions but are under 50 years old, so the preexisting condition is a deep concern at any age, but a much deeper concern that if you're over 50 years old. The next category is a healthy person over 50. Now, a healthy person over 50 in most cases is going to do fine, but there is somewhat more vulnerability if you're over 50 and then the last category, thank God, is the biggest category of New Yorkers under 50 years old does not have one of those five preexisting conditions or smoking and vaping. That's the single biggest category of people and for those people, by and large, if you contract coronavirus, you're under 50 you don't have those preexisting conditions, you will generally experience it the same way you do a common cold or flu and there'll be unpleasant, but you'll be okay in the end.

We see very consistently with children, again, this is not a perfect rule, but it has been a consistent reality. Children who do not have preexisting conditions, their general experience again will be that of something like a common cold or flu. So, I want to reassure parents on that point, but I also want to say to parents who do have children with those preexisting conditions that we want you to be very vigilant. Make sure that you do not come in contact with folks who have symptoms. And obviously if any child who does have those symptoms develop, we want to be very careful to get them care right away. But I want to be clear about where there is some good news. And the good news is for the vast majority of New Yorkers, they are in the less vulnerable categories.

Okay, let's go over numbers. But first, one other thing that was going to be constant flow of information in lots of different forms for folks who want to get connected to information, you can text the word COVID – C-O-V-I-D to 6-9-2-6-9-2, and you will get regular updates from the city.

Let's go over numbers. As of yesterday, we had 12 positive cases since the beginning of this crisis. There is one new one and I'm going to say up front we are gathering information on this new case. We need a little more time to get all the facts a 100% clear. So, we'll have an update on the new case later on today. I can only tell you, tell you in New York City, in the Bronx, but I want to get all the facts straight before we give you a more. So, 12 as of yesterday plus one, 13 as of today, seven new cases since Friday. Negative tests, we are now at 146 tests that have come back negative and that is 60 new tests since yesterday.

So we'll keep giving you those updates as long as we can. Now, the numbers – I'll just finish it and say we also have 76 tests outstanding that we're waiting for results on that we'll know by the end of the day. I'll go over specific cases in a little bit. Our goal is to keep giving you the numbers and the case breakdowns as long as we can. There well could be a point where the number of cases gets so large that becomes impractical to be able to give you that level of detail. We'll keep giving you updates as much as possible.

I think it's fair to say, you know, right now for a crisis that's been going on six weeks or more in this city, we're at 13 positive cases. I think we could well be at a hundred cases or hundreds of cases over the next two or three weeks. We have to be prepared for that reality, so we're going to – today I'm going to give guidance and updates, but as we end up in a situation where there are more and more cases, again, we'll be able to give updates but maybe not as fine tune in real time. It's also important to say that our public health apparatus is already planning on the assumption that we will be at hundreds of cases soon and is ready for that reality and we'll talk about that as well.

Fundamental change has occurred in the last few days. This was overwhelmingly until this week a problem related to travel and there still are travel cases coming in the last few days, in the last 24, 48 hours. Several of those new cases we have one that's related to travel to Italy, one related to travel, a Chile, one related to travel to Egypt, so it's not that the travel issue is entirely over but what is coming up now unfortunately is the community spread reality and that's where you're going to see much greater numerical growth.

There are things that we can do to address community spreads, so I think that the way to think about this is phase one was travel essentially and there were very specific strategies we could use to address something that was being brought in by travel. We're going into phase two now where the dominant reality is community spread and we're going to have instructions of how to deal with that. You'll get guidance today and the guidance will be constantly updated. But finishing on travel because it is still pertinent, we had canceled school trips to five effected countries. We are now taking the next step and we're banning school international trips across the board, out of abundance of caution. Also, for our City workforce, there will be no non-essential international travel at this point

We're going to put some other actions into place. Again, this is a lot of different pieces. They won't flow in perfect order, but bear with me, a lot of concern has been raised about our small businesses, many of which are really hurting right now are seeing fewer customers. I'm going to just tell people we're going to give you guidance every single day. We'll update it. I am still going out to small businesses. I am saying to my fellow New Yorkers, unless you have particular vulnerabilities or you have symptoms, I believe you can go about your life continue to patronize our small businesses and I urge you to, but we have to provide some relief for the businesses that are hurting right now. So, we have two forms of relief we're going to implement right away
For businesses under 100 employees that can document a decrease in sales of up to 25 percent, they will be eligible for no interest loans and those loans will be up to the dollar figure or $75,000. So, we will be able to get money in their hands to tide them over. The details of that initiative we’ll put out, this is something we've just got approved. We just finished the process on. We'll get you further details on it in the course of the day. For our smallest small businesses under five employees, a lot of mom and pop stores, neighborhood-based stores under five employees, we will offer grants of up to $6,000 to help them retain employees. That's a literal, a direct cash grant to very small stores that are at a point where they may have to lay someone off. We'll get some money in their hands as a grant to help them keep people employed. And any business under five employees that suffering immediate crisis because of what's going on can call 3-1-1 and they will get help getting that assistance.

In the schools, again, emphasizing children in general at low risk, but children with those preexisting conditions, we are very vigilant about, we want parents to be vigilant as well.

We're going to add 85 nurses in the course of the week to ensure that every school building will have a nurse on call, on duty during the school day, remembering that some buildings have one school in them and some buildings have multiple schools in them. Every building will have a nurse and that will be implemented in the course of the week.

Continuing with the guidance, we want to provide people and remembering again that real clear distinct difference, preexisting conditions, especially above the age of 50. So, the issue here is to think in terms of symptoms. And the particular concern would be if someone had a fever plus either cough or shortness of breath. So, we're going to keep providing more pinpoint information. If you have fever plus cough or shortness of breath, we are particularly concerned and then much more concern if that's accompanied by those preexisting conditions. And again, our Health Commissioner will go into more detail. Crucial point, if you're not in a high-risk category. Again, that biggest high-risk, I mean, excuse me. The biggest category of people, low-risk, biggest low-risk category under 50. No preexisting conditions, particularly for folks in that category. If you've got symptoms, first thing to do is to alert your health care professional. If your symptoms are moderate, you can stay home. If they improve that says everything. If they don't improve, we want to get you in. We want to get you tested.

There's been a lot of questions about public events. This is going to be a question we're going to ask ourselves every single day and update you every single day. Based on the information we have today we are not, not altering our stance on public events. But we are making clear people, I think it's straightforward and obvious, but it bears being said in a straightforward fashion. If you are sick, you shouldn't be going to a public event. If you are sick, you shouldn't be going to work. If you're sick, you shouldn't be going on the subway. Now, if you are not sick, but you're in that particularly vulnerable category, over 50, preexisting conditions, you should avoid unnecessary public activity. There are some things someone may have to do, but you should avoid unnecessary public activity. We'll go over the basics every single time. Commissioner, will say it again. Wash your hands. Use alcohol-based hand sanitizer. Dan Nigro is going to be my test model. Come forward with your elbow. Let me see your elbow. You can do this. 

[Mayor de Blasio, Fire Commissioner Nigro tap elbows:]

Okay, do it again, Dan. That's our new handshake, until further notice. And just be very aware of symptoms. Don't ignore them. Don't explain them away. We have a couple of things we want people to make adjustments on and for some people and some employers this will be something they can do readily, for others more challenging. But this is guidance and it's pretty much common-sense guidance at this point. For employers, if you can institute telecommuting or more telecommuting, you should. So if that, if you have the kind of work where telecommuting is a possibility or if you're using it now and think you can use it more, we'd like to see you do that. See how much of that you can do. The more the better.  Employers who can stagger their work times, that would be very helpful. Right now, at the height of rush hour, obviously people, we've all experienced it, we've all been the sardines in the subway. We're in super close proximity. We'd like to open that up a little more. And one of the good ways to do it is to stagger work hours. So any employer who is in the possibility of staggering work hours, that's helpful. If people typically come in at 9:00 am and they can come in instead at 10:00 am that helps. Or if you have different people that can come in at different hours a little more, that helps.

And then everybody, of course, following the basic rule, if you're sick, stay home. If you become sick at work, get out of the workplace. If it's mild, go home. If it's more serious, get to health care. Remember we have a Paid Sick Leave law in this city that grants people five days annually. And as you’ll hear from Dr. Barbot, typically the symptoms we're talking about here manifest and give us a clear sense of direction within two or three days. So the Paid Sick Leave is there to give people the opportunity to be home in just these kinds of situations. 

If you are traveling by subway and the train that comes up is all packed and you can possibly wait for the next train in the hopes it might be less packed. Please do, very common-sense measure. Something a lot of us do anyway. If you have the option of walking to work or taking a bike to work, please do. Buses can be very crowded, probably pound for pound, a little less crowded than a lot of subways. If a bus is a less crowded option and you can use that. Please do.

In terms of the guidance to health care providers. Obviously we're making very clear that we are now in this next phase, this phase two which is where community spread will be where the vast majority of cases are coming from, not travel. Specific guidance is being given to providers, to max extent possible to have health care professional meeting patients as they enter health care facilities or just outside, I should say the health care facility. The Commissioner will clarify to make sure that if they need a mask put on them, that that happens or they need to be handled in a particular fashion, that happens. 

In terms of the federal government. We've made multiple appeals. And I think, yes, here we go. This is the letter we've sent to the FDA. This is one of many communications we've sent to the federal government asking for help on testing. This relates to the issue of automated testing that would allow us to do not only hundreds, but potentially thousands of tests in a single day and get same day results. Can't do it without FDA approval. We've asked for days now, we are awaiting that approval. We need that approval. It's one of the best things the federal government could do to help us. Everyone knows this has been a really persistent problem. The federal government has been slow and elusive on all questions of testing. But this is one where they could finally get it right. FDA approval would make all the difference in the world for us. 

Also we're putting out in this kind of — summarizes a lot of what I've said. We're putting out this simple flyer. You'll see it a lot. The basic rules that I've outlined here. We're going to be doing an advertising campaign to get the word out on this as well. 

Okay. I’m going to go through some numbers and some cases. The number of folks in mandatory isolation has gone up to 19. They get a daily call to check on them. They get unannounced visits, in person twice a week. If they violate the standards of the quarantine, they will be fined and they will find a police officer at their door on a regular basis. And that will either be NYPD or the Health Department police. Again, I'm saying that out of abundance of caution, I think overwhelmingly we are seeing people are honoring quarantine. They have like everybody else, heard weeks and weeks of warnings about coronavirus. We don't find a lot of people taking quarantine lightly so far. Thank God. The voluntary isolation number has gone down substantially and that is related to the fact that we are getting fewer and fewer travel cases and people have gone through the full 14 days. But of course, that number will continue to change. You'll see fewer and fewer travel cases. You will start to see more community spread related cases. But as of today, in voluntary isolation, 2,176. They are now getting a regular communication pattern. In the beginning, they're provided information including a robo-call and a text on how to approach the quarantine and what to do if they develop symptoms. They get repeated texts and constant requests to know if their condition has changed. What to do if it does. If they need immediate assistance, we're going to be continuing to deepen that communication. We'll have more to say on that.

A couple of updates on some other issues that come up. On schools -- in addition to our traditional public schools, we have made clear to charter schools, religious schools, private schools that if they need any additional cleaning supplies, they will be delivered tomorrow. And we have requests. And we have requests from 132 Catholic schools, 59 Jewish schools and one charter organization. Which means multiple schools and those deliveries will be made tomorrow. In our traditional public schools, the mandate is abundantly clear and obvious. Every bathroom has to have soap and towels in abundance. Sinks have to be working and school personnel will be held responsible for that being kept consistent. Officials of the DOE will be spot checking schools on a regular basis.

We had one case that was particularly notable of price gouging, a hardware store known as Scheman & Grant in Midtown. They have been fined. What they did was unacceptable. We're using them as an example. The inspectors have been on site. The case has been referred to the Attorney General as well. Any price gouging, we want reported immediately to 3-1-1 so we can act on it. And just saying to all store owners, absolutely unacceptable. Come on, this is a crisis. Help your fellow New Yorker, this is not a time to try and profit. And we'll be giving plenty of messages to people in different elements of the business community about how to be responsible at this moment. 

As I said, we have seven new cases since Friday. One of which you will get the update on later, which is the Bronx case. The information we're providing you is what we have and it always keeps evolving. So, it's preliminary, but we'll give you updates as we get more. The family on the Upper West Side – the father had tested positive, age 51. This is a family that has a nexus to that cluster in Westchester County. Of the family members, the mom of the family and one daughter, mom's 47, the daughter's 11, tested positive. None of them have preexisting conditions to the best of our knowledge, the dad or the mom or the daughter. All had been symptomatic. All are doing well now. Isolated at home. Two other daughters, ages eight and 10 have tested negative. No other close contacts per the work of the disease detectives. We have, and again, I'm just going to, we'll try and keep this a little bit of a numerical order. Those were cases six and seven. Positive tests. 

Case eight — the Uber driver in Far Rockaway, 33 year-old-man. He is an Uber driver. He is not a TLC Uber driver. He works on Long Island so he's not under TLC jurisdiction. Had pneumonia related to coronavirus. Now in stable condition at the hospital in Far Rockaway. Family has been contacted by the disease detectives. All family members in isolation. All family members, asymptomatic. That is his wife. Three children, mother-in-law, father-in-law, brother-in-law, sister-in-law, all asymptomatic, all in isolation at home. The hospital in Far Rockaway, St John's Episcopal, they have a situation there were 41 staff members, and this is again one of these abundance of caution situations, that may have experienced exposure. They're all now in voluntary isolation, being monitored regularly. None symptomatic at this point. The hospital has been provided with support to have additional resources and personnel. And at this point reports normal operations.

Cases nine and ten — two women who went on a cruise to Egypt. So here's travel now coming back as a factor. Two women from Brooklyn, they are 66 and 71 years old. No preexisting conditions. Returned to New York City, February 20, so that's now over two weeks ago, they were symptomatic. They did the right thing. They immediately isolated themselves at home. They are now asymptomatic and still at home. No close contacts who require follow-up. Those are cases again, nine and ten.

Case 11 — 39-year-old man from Brooklyn who was in the affected area of Italy, came back March 2nd. Symptoms manifested March 3rd, in serious condition in a voluntary or private hospital in Manhattan. Does have preexisting conditions. Serious condition now as I said. One close contact, business associate tested negative and is an isolation.

Case 12 — 58-year-old male returned from Chile. Apparently contracted coronavirus during a lunch with a confirmed coronavirus patient in Chile. Lives in Manhattan. I need a reality check because I don't have this much fine tuning. Hypertension, Dr. Barbot is in the group of preexisting conditions or not? Okay. So does not have one of the preexisting conditions. Was in a hospital in Manhattan, has been discharged doing well now at home. No close contacts to follow up. So that's the cases to date. We'll get you more on the Bronx case later. 

Just some other follow-up from ones we've reported earlier. The Westchester family, all doing well now. And then the employees at the law firm, Lewis and Garbuz. Four New York City resident coworkers, all negative as we've said before. The four non-New York City coworkers – we have one Westchester coworker negative, one New Jersey coworker positive, two remaining coworkers, one from Westchester, one from Nassau, both asymptomatic. And then another piece of news because we had talked before about the health care worker from New Jersey who had seen patients in New York City. 32-year-old male, specific information we want to give you now. He saw 11 patients while symptomatic, but he did wear a mask and gloves during that which is important and lessen the chance of transmission. 11 patients. All 11 are asymptomatic now. It's been a week. That's a good sign. And they have all been carefully monitored and will continue to be. We are working with the State Health Department on this right now and we believe we have a low-risk situation. But it is important to confirm that this occurred at a nursing home, specifically in Brooklyn at 2266 Cropsey Avenue. The King David Center for Nursing and Rehabilitation.  The health care worker from New Jersey also attended a small medical conference at the Westin Hotel in Midtown. Based on the follow-up of our disease detectives, the attendees are all asymptomatic. Also, his family is asymptomatic.

A couple more points and then I'll turn to my colleagues. We reported a man in his 40’s who was a smoker and vaper. He was hospitalized. He has been discharged, now at home, mild symptoms. Has a partner, the partner’s under mandatory isolation, is a symptomatic, is the only contact of interest to our disease detectives. The last of the previous cases, this is the one we're most worried about right now. This is the woman in her 80’s, it is not going to come as a surprise to anyone. We're really concerned for her. She is hospitalized and continues to be in very serious condition. So, we are hoping and praying for her. There was a report in the media about an employee of the Gap. Best of our understanding that report was erroneous, came up Friday. We have followed up with the company. The individual to the best of our understanding, not from New York City and does not have coronavirus. So, any company that is, has concerns and wants to connect with the City to report information or has rumors that are not accurate and wants to help us dispel them, please reach out. And there's a specific place to go online. The wordspublicprivate@oem.nyc.gov, publicprivate@oem.nyc.gov. And Deanne, let's make sure if they call 3-1-1. That gets routed as well. 

Finally, I'm going to say a few words in Spanish and I want you to hear from three of my colleagues.

[Mayor de Blasio speaks in Spanish]

With that, let me turn next to our Health Commissioner. Want to thank her and her extraordinary team at the Department of Health. They've been working very, very hard these last days. Want her to give you an update, Dr. Barbot – and I want her to be taller. Okay, there we go. Do it again. Look at that smile. Okay. There, that's much better. You could be the spokesperson for elbow bumping.

[Laughter]

Commissioner Oxiris Barbot, Department of Health and Mental Hygiene: That and alcohol-based hand sanitizers are going to be my – good afternoon. First of all, let me start off by acknowledging that there may be many New Yorkers who are feeling frightened or sad because of all of this information that's coming at them. Every day we hear about new cases worldwide. We are, in the city, sharing information on a real time basis. And so, I want to just acknowledge that there may be some New Yorkers out there that are having those feelings. I want to encourage them to call NYC Well. It's an important resource that – I think that especially at this point in time can provide valuable supports.

The other thing I want to say is that fear is no excuse for propagating stigma. This is not a time for us to be buying into false information on the internet. I want to encourage New Yorkers to visit our website at nyc.gov/health for all the best information on COVID-19. They can also visit cdc.gov. The best way to guard against fear, against stigma is by having the correct information.
And so we are very much committed to transparency.

The other thing I want to just emphasize that I think the Mayor touched on is that this is a situation that is evolving on an everyday basis. We've been learning almost every day something new about how this virus behaves. And I anticipate that over the coming weeks we will continue to learn more information about this virus. And so that's why it's so important to have the information, but also to know that this is, for the foreseeable future – at least for the next couple of months – something that the Health Department will need the support of everyday New Yorkers in order to really turn the tide.

Last thing I want to say is – and just to really reemphasize that we are marshaling all of our resources, but we need New Yorkers to do their part. In that vein, I have talked about what I want New Yorkers to do. As the city's doctor, I need to make sure that if someone is sick with fever and cough, or fever and shortness of breath, they do not go to work. Beyond that, I want to make sure that New Yorkers are also paying that same advice to their children. If your child is sick with fever and a cough, fever and shortness of breath, do not send them to school. That's baseline advice. But especially important here during the COVID-19 season. There are things that we can do and that we are doing. And then there are new things that we want folks to do.

So for example, we want people to continue washing their hands often covering their mouths and their nose when they cough and if they don't feel well, call the doctor. And I'll say more about that in a moment. But there are other things that over the course of the last few days we have been changing advice on. And the first thing you'll notice is we said don't shake hands anymore but do the elbow bump. And that's a way in which we can minimize the risk of transmission. The other thing I will say is that none of these measures that we are recommending are effective in isolation. We need to do all of them at the same time. So, the frequent cleaning of surfaces, the frequent cleaning of hands, the covering of your mouth, for the foreseeable future the elbows, not going to work. So that's – I want New Yorkers to get used to the fact that that's our new normal for the next couple of weeks.

The additional thing that I will say is – and let me just sort of reemphasize what the Mayor said in terms of the folks that we are especially concerned about. And it's those individuals with chronic underlying diseases, heart disease, cancer, diabetes, an immune compromised system –

Mayor: Did you get lung disease?

Commissioner Barbot: Chronic lung disease, cancer, diabetes, immuno-compromised, heart disease.

Mayor: You get them.

Commissioner Barbot: Yeah, I got them. And so – and being over the age of 50. If you are sick, don't go to work. Call your doctor if you're not better in two to three days. We want you to make sure that you access care quickly. The other thing I want to emphasize is that beyond the individuals with these chronic illnesses, there are other individuals that we are particularly concerned about and that is the elderly. So, we want to make sure that individuals who are symptomatic and who may have a loved one in a long-term care facility, in a nursing home, don't go visit them. If you are symptomatic, the best thing you can do for your loved one who's in a nursing home, in a long-term care facility is don't go visit them until you are better. The other thing is if you've got, you know, a grandparent that you haven't seen in a while and you want to take the kids to go see them and they are symptomatic, don't even do that.

We want to make sure that elderly folks who have chronic underlying illnesses, we do everything that we can together as a community not to increase their risk. The other thing I will say is again to emphasize to the Mayor is if you're sick and your company has a telecommuting policy, we want you to take advantage of that. This is a great time – well, it's always a great time to stop smoking, to stop vaping, but this is especially a great time. And I want to remind New Yorkers that they can call NYC Quits – 8-6-6-NYC-QUITS – and they will be provided support.

The next thing that I want to talk about is the importance of our health care delivery partners. And so we are communicating with thousands of doctors across the city. Tomorrow, we will be issuing additional guidance about what we want them to be aware of. And so first and foremost we want them to be aware that there is now COVID-19 testing available at commercial labs and how it is that they can go about accessing. We want them to prioritize patients in their practices who have chronic diseases, are over 50, and are symptomatic for that testing. We want to especially remind them of the importance of infection control. And this is one where, again, we don't want to take anything for granted.

When you call your doctor, tell them about your symptoms. We – the best practices for them – they want to see you in the office to make sure as soon as you walk in and you've got those symptoms to put a mask on you. Right? Because the – I have said in the past, there's a place and time for the use of simple surgical masks and that is when someone is symptomatic and they're going to a health care facility, so that they don't potentially infect other people. The other thing is we want to make sure that the – all hospital facilities, all outpatient centers have all of the supplies that they need. We reach out to them on a regular basis. But again, ensuring that we leave no stone unturned.

And the other thing is I'm hearing more and more that medical practices are putting in place what we're calling electronic visits. So, if you can do over the web, if you can do FaceTime, that also is a measure that can help all of us in this shift that we're taking. The measures that we are emphasizing are so that we reduce the number of potential cases but also reduce the potential harm to New Yorkers. And that's why it's so important for us that all New Yorkers are a part of this response to COVID-19. Thank you very much.

Mayor: The Commissioner made a really important point. I just want to say, anyone who is worried, anyone who's afraid, it's very, very normal. It's a confusing situation. It's a situation where people are being bombarded with information that – if, you know, that doesn't make you worried, I don’t know what would. So, it's really natural to be concerned and it is an ever-changing situation. So, there's that uncertainty. The Commissioner made a really good point. If folks are feeling anxiety, they're feeling stress, if they're worried, and they don't have a mental health practitioner that they turn to normally you can call 8-8-8-NYC-WELL. You get a trained counselor 24 hours a day who can talk it through with you. If you need ongoing mental health services, they can help you get to it. So very normal and natural to be deeply, deeply concerned in a crisis. Don't suffer in silence if you need mental health support and you need someone trained to talk to – 8-8-8-NYC-WELL. Now I want to turn to our Commissioner for Emergency Management. I want to thank her team, which has also been doing an amazing job coordinating so much around the city, and they are hosting us here for our many strategy meetings, tabletop exercises, etcetera. Commissioner Deanne Criswell.

Commissioner Deanne Criswell, Office of Emergency Management: Thank you, Mayor. Good afternoon, everybody. Yeah, I just wanted to take a minute to update everybody on what is happening here in our Emergency Operation Center. And so, for several weeks now we have convened more than a dozen interagency task forces that have comprised personnel from agencies across the city as well as some of our partner agencies to look at those impacts that we may expect from COVID-19. One of those key task forces that I want to talk about has been focusing on our continuity of operations and our continuity of government plans. So, New York City's agencies provide key services to millions of New Yorkers every day, and we want to make sure that that work can continue uninterrupted and that all City agencies have their plans updated and in place. All City agencies have always had a continuity of operations plan. And so, what we have been doing over the last several weeks is really fine tuning those plans so they specifically address the impacts that we may expect from COVID-19. For example, City agencies are now putting processes in place that can support essential functions through telework, scheduling adjustments including staggering work shifts as well as the possibility of cross training if we see a reduction in personnel.

Our remaining task forces that we have here are also tailoring City response plans to meet the unique need of COVID-19 response. Some of these task forces are working upstairs right now in our Emergency Operations Center and they include health care and 9-1-1, New York City health and worker safety, special populations and homelessness, transportation, and education. These task forces will continue to support this response as long as needed.

We're also sharing information and guidance to our cultural institutions and our tourism partners, our faith-based community, to decrease the COVID-19 exposure and limit disruption to their services. As our senior New Yorkers, as you've heard today, are especially vulnerable to the effects of this virus, we are also working very closely with the Department for the Aging and our other human service partners to ensure our senior centers, adult care centers, nursing homes, receive up to date guidance on how to limit the spread of the disease.

One other thing that we have done here at the Emergency Operations Center is activated our Logistics Center. They're working closely with the Department of Citywide Administrative Services, our city, state, and federal partners, our private sector partners, and they are tracking and prioritizing any resource requests that we get. We are also keeping a close eye on the global supply chain and monitoring any potential impacts that New York may see. During emergencies, New Yorkers always help their fellow New Yorkers and COVID-19 is no different. We all have a role to play in keeping our city safe and healthy by staying home when sick, covering your mouth and nose when you cough or sneeze, and we want to be able to show – we want to make sure that we can connect with New Yorkers and give you the vital information that you need as this progresses.

So, as you heard the Mayor say, we are launching today a Notify NYC that is specific for COVID-19. We want you to text COVID – C-O-V-I-D to 6-9-2-6-9-2. Again, that's COVID – C-O-V-I-D – to 6-9-2-6-9-2, and we will be pushing out important information as this progresses. Thank you.

Mayor: Thank you, Commissioner. Finally, I want you to hear from Dr. Mitch Katz, CEO of Health + Hospitals. Want to say, by way of preface, right now our team at all of our Health + Hospitals facilities are doing their job. They're not only dealing with this, they're dealing with all the other health care needs of the people of this city. But the important point to recognize is the capacity we have. We have the biggest public health system in America by far. Dr. Katz and his team are doing a great job preparing. We've already talked to you about how many beds we have available if we need them, but Dr. Katz is going to further explain, in addition, to broad guidance he'll give, he's going to explain the point of how we would respond as needs intensify around Coronavirus, how we can reduce some of the other work that's being done to free up staff, to free up capacity to address this crisis while without compromising health care. And that is a pre-planned protocol that Health + Hospitals has in place. We want you to understand it. Dr. Katz.

President and CEO Mitchell Katz, NYC Health + Hospitals: Thank you, Mr. Mayor. This is a moment when New York City can be proud that it has always maintained a robust public hospital system. We have 11 acute care hospitals. We have 60 other outpatient sites where we're able to provide care. Today we are seeing people who have symptoms suggestive of COVID-19, people who have cough and fever or shortness of breath and fever, and we are able to see them in our facilities. We are able through our commercial lab to test those people who turn out not to have influenza or another cause.

As the Mayor spoke, we've spent the last several weeks preparing all of our facilities so that if there is an influx of tens of patients, if there's an influx of hundreds of patients, we are prepared to do that. The way that you do it is by having protocols that first look at who is in the hospital for some other reason, who can be cared for at home, and you rapidly discharge them.
You cancel elective surgeries – this is not a moment where we will be doing elective gallbladder removals, doing hernia repairs, important surgeries – surgeries that have major impacts to the quality of people's lives. But we can do them, we can reschedule them for after this outbreak.

During the time of the outbreak, if we are having tens or hundreds of new patients, those patients will be rapidly discharged. Outpatient services will be canceled and we will pull all of our doctors and nurses into our inpatient areas so that we can provide adequate care to all those who need it. Every single hospital has a plan of where that care would be provided if there are hundreds of more patients. In some cases, it's a cafeteria. In some cases, it's an auditorium. In some cases, we have tents that are specially made for creating clinical areas in parking lots.
Each hospital knows exactly what it would do depending upon how many patients we have. We have enough supplies and we have access to those supplies. We watch them every day. I participated in a call about face masks, about antibiotics, about fluids, and we are prepared if this pandemic gets much worse in New York City. Thank you.

Mayor: Thank you. Dr. Katz. Okay. Covered a lot. Thank you for your patience everyone. Let's take questions. My colleagues will come up to help answer.

Question: Mayor, have you spoken to President Trump or Vice President Pence, who is leading the coronavirus response?

Mayor: No, our team has been in touch with federal officials. We've continued to make clear, you know, we obviously have a lot of capacity to deal with this situation. We're working very closely with the state. That's a crucial partner here. What we need from the federal government is very straightforward and it's been the case for weeks and weeks. We need help with the testing. If they will take care of that part of the equation, we can take care of our share, for sure.

Question: You haven't had any thought – I know you're holding firm on public gatherings in the city, but next weekend is a half marathon –

Mayor: We're assessing that. We're talking to the folks who are running the half marathon. That's a decision we're going to make pretty soon. We'll make it with them. We obviously want to give prior notice, but we're not there yet.

Question: Can you give us details on the testing, your capacity, how many tests you've done to date, what your [inaudible] capacity is –

Mayor: Sure.

Question: [Inaudible] you’re using, whether it's CDC, local, state labs –

Mayor: I'm going to start, my colleagues can jump in. So right now, in terms of – our public health labs have been going nonstop and luckily just as they were reaching capacity, the private labs have come online. What we want to see is faster testing. So, in terms of pure numbers with the private labs now we are well ahead of the level of testing that we need numerically, but not in terms of speed. We want a lot faster than we can get with the current protocol. But to give you the overall numbers, and I don't have the math in front of me, but it's easy enough to do. We have, you know, 13 positive cases, 146 negative cases, and 76 pending tests since the beginning. So, we're pushing up towards almost 250. But we've been able obviously to get all those done. The pendings we'll have in the course of the day. We need to be – right now we can handle hundreds of tests in the day, but not as fast as we want. Our goal is to get that FDA approval to be able to do hundreds of tests same-day, ultimately thousands of tests same-day. That's where we need to get to. Did you have another part of your question? I'm sorry.

Question: How long do you think it would take to get – how long do you think would take you to get to hundreds [inaudible] –

Mayor: If we got FDA approval, what I'm told is, it would be a day or two before we'd be up to hundreds that could be same-day. Yes, sir.

Question: [Inaudible] public schools also ask for [inaudible] and get a nurse in their building?

Mayor: If a nonpublic school needs medical assistance, we're going to work to get them help. We have just – the first thing we had to do, of course, was account for the public schools. We're happy to work with any nonpublic school to see what we can get them. Obviously, we're trying to draw in whatever capacity is out there in the community, but any nonpublic school that needs help should immediately communicate with the DOE. Yeah.

Question: Another question, tomorrow evening Purim begins?

Mayor: Yes.

Question: Is it safe for people who have no symptoms to visit parents and grandparents?

Mayor: Yeah. The point is – and the Commissioner can jump in – yeah, if no one has symptoms, neither the visitors nor the people being visited, yes.

Question: Two questions. One for you. So, we're now at 13 cases.

Mayor: Yeah.

Question: Will there be a point where you will consider closing schools? [Inaudible] we get to that point? If so, what number are you –

Mayor: So, look, the important point here I'm going to keep emphasizing, literally each day we're getting new information and we're dealing with a disease that's not fully understood. So, it's a very unusual situation. We're going to everyday ask ourselves the whole set of questions about what we should do. But I will say definitively, everything we've seen so far, this is a disease that for a healthy child presents minimal risk. We do have a concern about children who have one of those five pre-existing conditions. We want to take special care with them. So, the schools is not the place we'd be looking first in terms of trying to address this problem. Obviously, I'm saying this as a parent as well. I think parents want to see the schools keep going so long as it's safe, want to see their kids getting educated. And we do have a tremendous interest in avoiding the disruption of this city unless there's a very specific reason to act otherwise.

Question: [Inaudible] specific like number of cases where you say, okay, maybe we should?

Mayor: It's not as simple as that. It's very much about the combination of what we're seeing in terms of the numbers and what we're seeing in terms of the constant flow of information about the disease. The point Dr. Barbot has made over the last few days, her disease detectives are literally gaining new information in real world conditions. You know, a lot of what we're getting out there from the guidance is based on other places. And I assure you the dynamics in China and Italy, South Korea are different than here. But also, a lot of it is theoretical. It's academic research, etcetera. This is the real world, frontline New York City, no place like it on Earth. And our public health officials are getting real world information about how things are playing out here. We're talking about it every single day and making adjustments.

So, there is no simple algorithm. When we get to the point where we think anything needs to be adjusted, we will. Now, what I have found is New Yorkers are really doing a fine job of listening to guidance. So, we're telling people now if you're sick, don't go to work, don't go to school, make adjustments if you can. If you can telecommute, do it. If you can do different staggered work hours and take the subway at a different hour, do it. If you don't need to take the subway, you don't have to. That's great. I guarantee you, a lot of people are going to make those adjustments and that's going to put us in a stronger position.

Question: The two ladies in Brooklyn that were in Egypt on the cruise ship, were they on the cruise ship that is currently under quarantine in Egypt or a different cruise ship?

Mayor: I don't know if we know that. Do we know that? Anyone? We’ll confirm that back.

Question: The Uber driver who is hospitalized in Far Rockaway, can you tell us where he drove on Long Island and whether any of his passengers are being screened for symptoms?

Mayor: We – all I understand is Long Island registered and did all his driving on Long Island. We can see if we have more than that. So, this is important to understand about car services, taxis, Uber's etcetera. So basically, again, remembering that you need that kind of direct hit for transmission. Obviously, anyone who is a driver has every reason to be concerned and vigilant, but you would need, you know, that cough or sneeze to get right into you. We don't have an indication of any customer being affected, but we're certainly going to be looking at that. But we are giving guidance to TLC drivers, not only about continually keeping their vehicles clean and sanitized, but also this is really simple and really important, this is what our doctor said immediately when they started talking about drivers, open your windows. The circulation of air. And I know that's not always possible but whenever possible, if you're a professional driver, keep your windows open, the circulation of air literally disrupts the possibility that that projection of a cough or sneeze might get to the driver. It's a simple, important step that they can take. Let me come over to this side. Yes?

Question: There were reports that there was an Asian man in Brooklyn who was stabbed in a suspected coronavirus hate crime. And I was wondering if you could provide any more information on that and if it is being investigated as –

Mayor: I need to get more on that. I don't have – we've heard some, obviously, some very unacceptable instances of discrimination and hate speech, all of which is inappropriate, a lot of which is illegal, and we're going to follow up on, but I don't have that specific connection you're talking to. Let us confirm that.

Question: You mentioned that we could see hundreds more cases in the next few weeks. Is there a tipping point where the capacity for say disease detectives or something to that effect – is there a tipping point where the number of cases just overwhelms City resources and if so, when do you anticipate that might –

Mayor: I would say there are a couple of different pieces. In terms of the work of disease detectives, we're going to use them in different ways depending on what we're dealing with. [Inaudible] health professionals that right now they're doing the thing we need the most because we are able to trace and we have a finite number of cases. As you see, so far the contacts have been limited in each case and the precision has been intense and the follow-up has been quick and that's a great thing. We want to keep doing that. If we get to a point where we need to shift all health professionals towards direct service of folks who have contracted the disease, we'll make that shift. That's a day-to-day decision. That's something that would be, as you see, a major uptick.

But in terms of the overall capacity of the system, you know, as we talked about days ago, we have 1,200 beds that we can activate readily. We can go farther than that if we take additional measures. We have the biggest public health capacity in America. We have a lot of voluntary hospitals, nonprofit organizations helping us. We got a lot of capacity and what Mitch said has not really been introduced into the equation. I want to emphasize it. There's so much that happens in a hospital every day that if it had to wait, could wait. I mean, I was just in a hospital getting arthroscopic surgery a few weeks ago. You know, if we're in the middle of a really intense challenge around coronavirus, we're not going to be doing arthroscopic surgeries. People like me are just going to limp a little more for a while. Right? So, there's a lot that can be opened up where our existing facility – all of our existing capacity then gets turned to this challenge. And there's just no place in America that has anywhere near this much medical capacity. So just the fact that you'll turn off a lot of non-essential things and turn all that talent and capacity to a crisis, should give New Yorkers a lot of confidence that, you know, even with hundreds of cases we'd be able to handle it.

Question: Mayor, is the test a blood test [inaudible] –

Mayor: I’m sorry?

Question: Is the test and blood test or something –

Commissioner Barbot: So, the test is essentially putting a medical grade Q-tip up a person's nose, swishing it around, taking it out, and then putting it into a medium. So, it's not blood, it's something that's very easily done. And we also take oral swabs.

Question: [Inaudible] go to their primary care doctor, will their primary care doctor test them there at the office or do you have to go somewhere else to get tested?

Commissioner Barbot: So right now, with the commercial labs being able to do the testing, providers will have the opportunity to do the test and to send it directly to a lab. They can visit the websites of the various labs to know sort of the nitty gritty. The important thing here though is that we still want providers to go through the history and ensure that there are the symptoms of fever and cough or fever and shortness of breath. We're not encouraging asymptomatic New Yorkers to go to their doctors and ask for the test.

Mayor: And can you – I'm sorry, just let me help you with this on terms of like news you can use. Talk about BioFire as the first step too.

Commissioner Barbot: So, BioFire as we've been saying all along is a very simple test that's also done through the nose and nasal swab that can help rule out the 26 most common viruses that can account for someone's cold-like symptoms. So, there's a whole range of them. If that tested negative and the person is symptomatic, then we would go to the COVID-19 tests.

Mayor: And if it is positive [inaudible] –

Commissioner Barbot: And if it’s positive, then that explains the person's symptoms.

Mayor: And you don't need to do –

Commissioner Barbot: You don't need to do the COVID-19.

Mayor: I’m your coach.

Commissioner Barbot: Thank you.

[Laughter]

Question: [Inaudible] question, the transmission facts that that were given earlier, are those agreed upon science with the CDC, the WHO?

Commissioner Barbot: Say more about what you mean by transmission facts.

Mayor: The spitting, the coughing, the sneezing, the –

Question: Right, that it only lives for two minutes on certain services, all of that stuff.

Commissioner Barbot: Correct. So, we are learning about how this virus is transmitted on an everyday basis and to give you a very concrete example, initially we thought it was just prolonged household contact that was the biggest risk factor. With the work that the disease detectives have done and documented how it's being transmitted in the community, we are adjusting that guidance, right. It's not just prolonged household contact, it's the very graphic description that the Mayor has given. And so that's one. What has not changed is that it's only by droplet spread. This is not like measles where if you come into a room where someone with measles was there an hour ago and they left, it's still hanging in the air and if you haven't been vaccinated against the measles, you can get it. So, this is by droplet spread.

Mayor: Direct.

Commissioner Barbot: Direct.

Mayor: Can I add one thing just to clarify the surface point, because this came up on Friday. We had a different interpretation on surface life. Then I think the WHO when we were – and Dimitri spoke to this – we were pretty clear about that. We do have a different interpretation.

Commissioner Barbot: Right, the other thing to note is that the – this is a brand-new strain of a known family of viruses. And so, some of the guidance is based on how those other strains within that family behave. And so, there's no scientific studies that I'm aware of that have studied this new strain to get exactly, you know, is it 10 minutes, is it 20 minutes. But from our best-informed scientific information, from learning, from scientific partners around the world, in real world situations it's a few minutes, anywhere from like two to three minutes, a little bit more, a little bit less. But I think that's an area that still needs further scientific investigation.

Mayor: Hold on, let me do that one. I'll come back to you. Go ahead back there.

Question: I wanted to get more information on the FDNY order regarding [inaudible] calls and Commissioner Nigro, feel free, if you would like to speak as well. Why was that order made and when might that be taken off the table? Some might see this as resources coming off the table when they're needed most.

Fire Commissioner Daniel Nigro: Well, I think as you've heard, this is not a situation that's likely to end tomorrow or the end of next week. So, an agency's biggest resource, most important resource is their people. And so, we have trained medical personnel, EMTs – all of the calls to 9-1-1 are say – well over 90 percent result in a transport. All those transports are done by our EMTs and paramedics and ambulances. So, our firefighters are still going to the most serious calls of cardiac arrest, of choking, of major traumas, but we've taken them off some other call types that are less likely to be life threatening in order to play this game – play the long game. So if it was a sports analogy, we'd say if you use all your resources in the first half, you're likely to lose the game in the second half. The Fire Department can't afford to lose a game. You know, we've transported folks with measles and tuberculosis and Ebola quite successfully. Our people are highly trained and highly skilled. So, I think the department is being prudent, being proactive and we'll see how – as you've heard, each and every day we learn something else and we'll review everything on a daily basis.

Question: All of the EMS unions have said they are stretched thin, that it's essentially not fair for firefighters to be taken off the job when there could be a lot more activity –

Commissioner Nigro: Well, I think we have to keep in mind the EMS unions are perhaps not as happy as they may be in their plight lately. You've heard that before this came out and that may play into what they're saying publicly.

Question: Has there been any discussion about maybe putting some of the work on subway trains aside because particularly on trains like the L which don't run regularly on the weekend, they are packed to capacity, like multiple –

Mayor: When you say work you mean like track repair and stuff like that?

Question: Yeah, like to make trains, you know, come more frequently and not be as crowded?

Mayor: I think that's a great question. Obviously, I will say this for the record, we don't run the MTA but I think it's a great conversation for us to have with the MTA as to whether in this environment there are maintenance efforts that could be delayed to keep more frequency, I think is a fair question. Now obviously if the maintenance is to keep the trains running and you might lose capacity without the maintenance, what we want – you know, we want to play the long game there too a bit, but it's a great question. We will pursue that and have an answer on that tomorrow. Go ahead.

Question: Commissioner. I wondered if you could say some words in Spanish –

[Question is asked in Spanish]

Commissioner Barbot: [Speaks in Spanish]

Mayor: Is it [inaudible]?

Commissioner Barbot: [Speaks in Spanish]

Question: Sorry another question – 

[Question is asked in Spanish]

Commissioner Barbot: [Speaks in Spanish]

Question: [Speaks in Spanish]

Commissioner Barbot: [Speaks in Spanish]

Mayor: So, everyone just – I think we've covered almost everything that Oxiris has said previously in English except just to clarify that, you know, we're in this for months. We don't have the exact number of months for you yet, but months is the way to think about this. We'll be at this for a while. Okay. Let me see if there's anything else before we close down. There will be regular updates obviously.

Question: There's a lack of hand sanitizer around the city. You cannot find any hand sanitizer or any supplies like this. 

Mayor: Well, I'll tell you something. I've been in a lot of places where I see hand sanitizer out. I agree there's less and less in the stores, but I think a lot of people have stowed it away and are rationing it out. We certainly want to make sure that working with the private sector, working with the federal government, that we continue to see that supply. So that's something we'll be following up on, working with the State, working with the federal government. It's still being produced out there and we're one of the places that needs it more than most. So, we want to work to see the supply come in. And this is the point about the federal government again. I learned this a long time ago, you know, no one should have the assumption in mind that the federal government actually comes to the ground and helps in a crisis except for the most dire emergencies when the military is mobilized. Basically, the federal government provides financing and provides logistical support. So, we've been asking — and then, you know, legal approvals, things like that. We've been asking for approval on the testing incessantly. It's really troubling that that hasn't come. But the other thing we've talked about is the supply of masks. And now I think hand sanitizer is another great example. This is where the federal government needs to step up. They can ensure that the supply that's available in the country is appropriately distributed to where the need is greatest. I think pure math tells us we're one of the places that needs help compared to a lot of their places in the country that thank God, don't have cases. So I'd like to see the federal government step up, help us get the masks we need, help us get the hand sanitizer we need. Those are simple steps and if they would do those things and just stay out of the way otherwise we would be able to handle this situation.

Question: So is that what you would personally want to say to Vice President Pence or President Trump or anyone from the federal government?

Mayor: Yeah, but I want to, it's great — I mean I'm happy to talk to any of them and we are scheduling a call with the Health and Human Services Secretary. But again, I think this stuff has been said so many times, so many ways. It's just time for them to do it. I don't think this is mysterious stuff. We've been talking about the need for masks for weeks. It's just time for them to create a distribution structure and enough of a command and control that these things get to where they need it.

Question: Are you hopeful?

Mayor: I'm hopeful that here, we can handle a lot because we have a lot of talent and we have extraordinarily strong agencies and the best medical capacity any place in the country. We are just legendary hospitals, both public and private. And I think New Yorkers are listening and I think they're making the right adjustments. So I am hopeful about what we're doing. I am confused about what the federal government is doing and am I hopeful they will get their act together? I'd like some more evidence. I will quote as I often do, Ronald Reagan and say trust, but verify. I would like to see some evidence. So how about the FDA approval? If they could get that done today, tomorrow, that would be a real sign of progress. A few more and then we'll shut down for today and get you more tomorrow. Go ahead.

Question: Going back to the, sort of expecting hundreds of cases in the coming weeks. Could you elaborate on that a little bit? Meaning is that based on some specific modeling that you have? Say hundreds, we're talking about obviously positive cases. Weeks, we're talking about three weeks, four weeks, eight weeks?

Mayor: Yes. So I would say the best guest today, but ask me again tomorrow, is in the next two to three weeks, we'll be at at least a hundred cases since day one. So we're at 13 today that's played out over the last week or two. That you know, that pace is going to pick up because of community spread. So if we were guessing right now based on, and I say guess, based on, you know, a lot of data and modeling, we would say we'll get the case number 100 somewhere in the next two to three weeks. But again, we're watching every day. We might change that estimate up or down each day, but at some point it could easily be hundreds of cases. And that's daunting except against the backdrop of all the capacity that we've just outlined to you. And a reminder -- so let's go back to these overall facts. This has really been pretty consistent, that 80 percent of the cases result in very mild symptoms, 20 percent more serious. But of that the vast majority, even if it's a more serious challenge, it still ends with the resolving of the disease and people going back to their normal life. For a very small number, very tragically, it can be fatal, but that's a very small number still. So given what we can tell you right now, the vast majority of our cases are going to be people who come through fine with limited impact. And that breaking out into categories, I really asked you all to share it, that the number one largest population category in New York City, under 50-year-old people who don't have one of those five preexisting conditions. For those folks with very few exceptions, it's going to be a very mild experience. So that's where we think when you add all those facts together, we have the capacity to handle this crisis. Last call.

Question: You've mentioned the military, they do a lot of research of [inaudible] stuff. Do they know anything about this virus? And also, can they rule out that there's nothing [inaudible] with any terrorism?

Mayor: I can't answer those questions effectively. I doubt my colleagues can too. If the military has research, I want to believe, you know, meaning that would be helpful in addressing it. I would assume the federal government would bring that into play. I don't think they would hold it back. I have not heard anyone suggest that this is anything but an organic disease that developed as we've seen in the past. And I think its history is pretty well documented. So I have no reason to believe it's anything but unfortunately something that derived in nature.

Question: This is concerning the 11 patients from the Brooklyn nursing home, how are they being monitored and are they in voluntary isolation?

Mayor: I, we can get you more. They are being monitored. They're all asymptomatic. It's been a week. They're certainly being watched carefully. Want to speak to it Doctor?

Commissioner Barbot: So they are all in private rooms and being monitored daily. So they're in the appropriate level of isolation.

Mayor: Last call? Yes.

Question: So you just mentioned there’s two types of tests [inaudible] virus [inaudible] is it possible the person get the flu or coronavirus [inaudible]?

Commissioner Barbot: To our knowledge, that hasn't been studied enough and we don't have a good indication that that's commonly occurring. And so our guidance, the guidance that the World Health Organization and others have been giving is that if the BioFire is positive, that is the definitive diagnosis. However, I will add, you know that we always want doctors to practice good clinical judgment and if someone does have influenza and they're not getting better, then certainly that would be a situation where we would want them to contact us and have more in depth conversation. But again, it's not to my knowledge, something that has been seen in the literature.

Mayor: Respectfully, I think that a little restating there might be helpful to everyone. Your general view, if you get a, if you've got a positive on the BioFire, which is the other more traditional, if you'll forgive the phrase, more traditional known diseases. If you've got a positive on the BioFire, what does that generally mean?

Commissioner Barbot: Positive BioFire means you have one of the 26 viruses that it's counting for the symptoms that you have.

Mayor: And not coronavirus?

Commissioner Barbot: Not coronavirus. 

Mayor: Based on what we know now.

Commissioner Barbot: Yes. 

Mayor: Yup.

Question: Just a little more color on small businesses. In order to introduce these grants and loan programs, they must be hurting pretty bad. What have you heard from small businesses in terms of what they may go -

Mayor: Gregg or James? Who wants to speak to that? 

Commissioner Gregg Bishop, Small Business Services: And so first I just want to encourage New Yorkers to support our small businesses. We've heard from mainly restaurants, catering halls, et cetera, sales declines of 40 to anywhere up to 80 percent. We're getting inquiries now from small businesses about what to do with their employees. So, these two programs will adjust that. 

Mayor: Okay. Last call.

Question: Could you elaborate on the smoking and vaping, does that also include the medical marijuana patients?

Commissioner Barbot: It's always – well, let me start there. Smoking and vaping are always major concerns. If someone is taking medical marijuana by vaping, I think we would want to look more into that. But if they're taking it through other measures, then I don't think that that would be a situation.

Question: So, you don't think that that would be a factor?

Commissioner Barbot: Vaping and smoking combustible cigarettes are the major factors.

Question: The 80-year-old woman, she's the one in the most serious condition. Is there anything you can tell us about her? Was that transmitted through travel or through the community? 

Mayor: Yeah. We don't have the profile in front of us. We'll get that to you quickly, but that's, yeah, that's the patient we're most concerned about right now. Okay. Everybody, we will get you more updates tomorrow. Thank you very much.