March 9, 2020
Mayor Bill de Blasio: We have a lot of information for you today. I'm going to go into a lot of detail and we'll of course take questions, but let me start with what I think is really the bigger picture here because what's on everyone's mind is how do we all together get through this crisis, how do we get through coronavirus, when are things going to be normal again, how are we going to make sure everyone's okay? That's what's on everyone's mind. There's a lot of fear out there. There's a lot of anxiety, there's a lot of confusion, and people are looking to the government on all levels for answers. So I want to speak to the overall situation and I want to be the first to say we've seen some things that are really dissatisfying. Certainly a lot of people would say all over this country that we haven't gotten the answers we would have liked to have seen from our federal government.
But that being said, I think there's a bigger truth about the coronavirus and what we're experiencing here, which is that ultimately the people will be the solution. All of you. And I want to speak to all my fellow New Yorkers – you will ultimately be the solution to this crisis. So our job in government is to lead, it's our job to make sure that everything that needs to be put in place is there, that the answers to people's concerns and questions are there, that we do everything in our power to protect people and to see us through. But ultimately we're talking about something that's going to reach into every part of our community. And we're seeing that all over the world. This kind of crisis is not solved from on high. This kind of crisis is solved at the grassroots by the people. So our job is to help the people, to help people know what they need to do to support them, protect them, really give them the tools.
I want to empower the people of this city to be part of the solution here because that's the only way we're going to get out of this. Now, I have seen New Yorkers respond to this in a very, very powerful way. You know, there are places around the world and certainly even around this country where you see people radically changing their lives, where you see some panic starting to set in. You don't see that in New York City. New Yorkers are strong and resilient. New Yorkers, overwhelmingly, are going about their lives, taking smart precautions, making some adjustments, but going about your lives. New Yorkers are also listening and we are tough people. We're opinionated people, but New Yorkers do listen and we found that in other crises where we've put out guidance and people have really paid attention to it and followed it. I've been watching this for weeks and weeks and I believe New Yorkers have heard the importance of taking precautions, taking seriously if they have symptoms, reaching out to doctors, following through on the orders of their doctors.
We see a lot of evidence that people are really doing that, see a lot of evidence that people who are in quarantine are honoring those quarantines. We see a lot of evidence that people are changing their basic habits in a way that really will affect the trajectory of this whole crisis. You know, we talk about washing your hands, we talk about hand sanitizer, you've got all these basic rules right up here on this board. People are doing it. You see it all over. You see people using hand sanitizer all the time. You see people tapping elbows. You see folks taking the smart precautions that are going to make a world of difference. Talked a lot about making smart adjustments if someone in your life is sick or if you yourself are sick.
And I keep saying it, this is one of the big difference makers. Everyone can be a part of this. If you are sick, if you have those cold or flu-like symptoms, stay home. If your child's sick, don't send your child to school. Really basic stuff. If you're someone with vulnerabilities and we've talked about that, we'll go over it again, but certainly that means folks with pre-existing serious medical conditions, and particularly if they're over 50 years old, you don't want to visit folks who are sick. Even if you love your grandchildren, for example, you don't want to go see your grandchildren if they happen to be sick. Even with a common cold, you just don't want to do it, and so there are so many things that people can do that actually will determine the whole trajectory of this crisis.
This is a disease that came from far away and we don't fully understand all of it. The medical community is still trying to understand it and this was not something any of us bargained for, but even with those realities, that doesn't mean we will ever be defeated and certainly New Yorkers never accept defeat. We have to feel that we have the power to overcome this. And in fact it is something that everyone can participate in. So in all of our updates to the people of New York City, we're not just going to tell you what the government is doing, we're going to tell you what you can do. And I think people are listening. I think people are acting. I think it's making a world of difference. And if we keep it, we're going to see this to its completion, and get back to normalcy in this city.
It's going to take time. It's going to be a long battle, undoubtedly – months – but I am convinced we can do it. So with that, I want to just give you updates and I will say – you'll forgive me, I'm going to always give you some qualifiers besides the fact that we're still learning more about the disease, and you know what we talked about yesterday, our disease detectives, our Department of Health is getting first hand new information through practice, through actual work with patients. We're learning things that are now becoming part of how we approach this disease. We listened to the CDC, we listened to the World Health Organization, but we believe what we see in front of our eyes more than anything else. So our health officials are experiencing the reality of this disease in our neighborhoods. Making adjustments to our strategy and tactics accordingly. That's ultimately what is most important to us.
The evidence that we are seeing with our own eyes, the cases in our own city. We're getting a lot more information all the time and a lot of the time I'll be giving you updates on individual cases or new developments, but I won't have all the details because they're coming in. So I'll just consistently say to you when I have a complete picture, I'll tell you that. When I have a partial picture, I'll tell you that. When we're not yet able, as you saw last week, to give you some specifics because people have not been fully notified or prepared for it to be public information, we'll tell you that. But the goal is to constantly give you as many details as we can, as specifically as we can, as quickly as we can.
Also a reminder, all New Yorkers who want regular information updates can text the word COVID – C-O-V-I-D to 6-9-2-6-9-2. We just set this up recently. Text COVID – C-O-V-I-D to 6-9-2-6-9-2. Already 20,000 New Yorkers have signed up. We encourage people who want regular updates to do that.
Okay, so we're going to do some of the basics again because that's just something that people just constantly need to hear and I will dare say I've been watching as everyone has a lot of coverage and I'm not sure these basic facts are coming through as often as they should, so I'm going to make it my business to just always hit these notes. What the disease is, what it isn't. This is not a disease you can contract simply by being in some large open space where someone previously was who had the disease. There are diseases – take this room, measles. If someone with measles was in this room an hour ago, you could still contract it now or later. That's not the reality with coronavirus. Coronavirus is not something that hangs in the air. It is – requires, and I'm going to be graphic, forgive me, requires literally the transmission of fluids.
It has to go from someone who is infected to another person directly into their mouth, their nose, or their eyes. How does that happen? A sneeze that gets right on you. A cough that gets right on you. Someone's talking right up close to you and inadvertently spits a little bit while they're talking and then it has to get right into your mouth, nose, or eyes, not it got on your arm. That's not an issue. Not it was in the air over here. It has to get right into you. It is true, if somehow you get it immediately on your hand and you immediately take your hand to your mouth or your nose, your eyes, that is a way it can be transmitted, but a fact that our disease detectives are seeing is that this disease does not last long on surfaces, literally a matter of minutes. So there's understandably a lot of concern and we want to answer the concern, but there's also some mythology out there that's making the disease something it's not. This just takes a certain amount of intimacy and closeness, if you will, for it to be transmitted.
The other thing to come back to is who's vulnerable and who's not. Look, you've seen the numbers and we – our hearts go out to every family who has lost a loved one all over the world. But still what we're seeing as a matter of percentages, the vast majority of people who even do contract coronavirus have a very mild experience, very similar to just having a typical cold or flu. Even those who have more serious medical problems come through it overwhelmingly. So the fact is we can't miss the forest for the trees about this disease.
Who's most vulnerable? Folks with five pre-existing conditions – lung disease, heart disease, cancer, compromised immune system, and diabetes. Those five pre-existing conditions are the single most important indicators that someone who did contract coronavirus might be in danger of a very bad medical outcome especially if you have the combination of those five – one or more of those five pre-existing conditions and you're over 50, that's the group we're most concerned about. That's where we're seeing the biggest problems and God forbid, but the facts have proven it, that's essentially where we're seeing people who lose their life in that category. We are concerned about folks who are under 50 and have pre-existing conditions, but their chances are certainly better. We're concerned about people who are over 50 and have no pre-existing conditions, but their chances are definitely better. And the biggest single category of New Yorkers and Americans is also the category that is safest, that is people under 50 who do not have one of those five pre-existing conditions. An important additional fact is even though it is not a pre-existing condition, we do know that smoking and vaping makes it easier for the disease to have more negative impact on a person's body.
It's not the same thing as a pre-existing condition, but it is an important factor in the equation as well, but for the vast majority of New Yorkers under 50, healthy, even if you were to contract this disease, you will probably have a very limited experience with it, very limited impact on your health, similar to what you have with a cold or flu in any typical season. After a period of days you will be able to resume your normal life. Children in our experience, and I say as a parent and I know there's so much anxiety among parents all over this city, children in general have not been afflicted by this disease and even when they have, have had very, very limited symptoms and very few dangers, but the exception again is children with one of those five preexisting conditions and, again, smoking and vaping is a real issue.
Younger people are always going to have a more resiliency health wise, but we do want to note those are the areas of concern, but for a healthy child, the chance of a negative impact, thank God, is limited and that's going to be very important as we talk about schools later on. That is in the front of our mind. The first concern here obviously is health and safety for all New Yorkers. Everyone knows how deeply we care about children. Thank God we're dealing with a crisis where they – from what we know, healthy children are amongst the least vulnerable in this equation, the safest in this equation.
Okay. Bringing all these pieces together, we want people to take this information and act on it. Again, we want to empower all New Yorkers. So, if you're one of the categories where you're most vulnerable and you start to get symptoms that, again, are similar to cold or flu symptoms, we want you to call your doctor immediately and depending on the severity of those symptoms, we may want you to get to a facility immediately. Folks in that top vulnerability area, pre-existing conditions one or more and over 50, we are very concerned about you. We want you immediately – never brush it off, don't explain it away, get on the phone to your doctor. If you're really doing poorly, we want to get you the health care immediately. Anyone who feels like they have those cold or flu like symptoms, stay home immediately. If you start to experience them at work, go home. If you start to experience that at school, go home. Don't wait until the end of work. Don't wait until the end of the school day. Go home.
If you experience them in the morning right before you're about to go to work or school, stay home. This is so crucial to how we all get through this. Look, New Yorkers are very tough, legendarily the hardest working people in America. Every single person in this room has worked through sickness. I guarantee it. I don't even need to take a poll. It's a running joke pre-coronavirus at City Hall how many people would come to work sick because they thought it was their obligation to keep working no matter what. And I would usually give people a wonderful lecture about, thank you for your diligence and your devotion to public service and now you're making everyone else sick, right. That was in a more normal time, but it's true, obviously, as we're dealing with this crisis. New Yorkers – tough people, we want to keep going. This is a time to listen to your body.
So, if you're starting to get sick, stay home, do everybody a favor and stay home. It makes a crucial difference in this equation. If you're starting to get sick, don't go on the subway, don't go on a bus. If you have to get to health care, you have no other choice in the world, we understand. But remember, if you need to get to health care and you need help, you can call 3-1-1, if you need an ambulance, we'll get you an ambulance. I want as a general rule, if you're feeling sick, stay away from mass transit because we don't want you spreading it to other people. We want everyone to get through this and again, the vast majority of people, even if it is coronavirus, will have a very mild limited experience a matter of days and then it will be over.
We're going to give you updates every single day on the number of cases and that tells you a lot. We're also going to tell you about individual cases, the human reality, but we're going to show you the whole picture, which is not just how many new cases we have and not just how many times we got a negative on a test as well as a positive, but we're also going to start to tell you starting tomorrow some of the stories of people who got well and are starting to resume their lives because I want to emphasize that testing positive for coronavirus for most people, that is just a very brief period of their life and then it's over and then people go back to their lives. I want us to give you real life examples so you can start to – everyone can start to understand that.
As of today, and this is an update even since this morning, obviously an ever-changing situation and we receive regular updates from the state with information that's adding to what we have. So right now, New York City, 20 confirmed cases of coronavirus – 20 test positives. That is eight new since yesterday. If you include the one case that I mentioned yesterday in the Bronx that we didn't have the full details on, we'll give them to you now. Twenty new, that's eight since yesterday. Four come from the state from their briefing earlier. Two – from that four, two more in the Bronx that relate directly to that Westchester cluster. Two more in Manhattan and one has been publicized – the head of the Port Authority, Rick Cotton, who's a very good public servant and he is modeling good behavior. He immediately went home and isolated himself, which is exactly what everyone should do and he's working from home.
So there's 20 positive tests. Again, we're doing this from day one, from the very first time we got a positive test. But we're going to start to show you now that the – essentially the numbers that come off the board, we're going to start to show you that, the ones that are resolved. But I also think it's important to get the negative test results. We now have 205 tests that came out negative, which is great. 59 new since yesterday. So the rate of testing is really increasing rapidly. We have 86 pending tests right now, but again, the negative tests tell you some things. It does not tell you everything. Some of the people tested were in one situation. Now there's other situations. Certainly I'm happy to see only one out of 10 tests is coming back positive, but that's just one piece of information.
We have now 24 people in mandatory quarantine and they're being very closely monitored. In voluntary isolation, I'll give you the updated number and that number continues to go down for now, it could easily go back up again, but now that number is 2,019 – 2-0-19 – 2,019. Obviously we're seeing fewer cases related to travel. We are seeing cases more and more related to community spread. Yesterday I explained that we were beginning what we're essentially calling a phase two where we're giving people specific guidance that will have more impact on their lives, more impact on their workplaces. This is guidance. These are not mandates. We have the option of moving to mandates if we get to that point. But right now this is guidance and I believe people will take it seriously and will do their best to implement.
So again, for private employers – every employer is different. I want to emphasize this. Every employer is different. We want our employers to keep going. We want our businesses to continue to do their work. People need paychecks, they need a livelihood. We understand that for some employers because of the nature of the work, they have many more limitations on what they could do than others. Others have more flexibility. It all depends on the employer, but we all agree we want our businesses to keep going. So for a business that can allow more employees to telecommute, we want you to do that. If you can do it, it's a good thing to do. Why? Because we simply want to reduce the number of people on mass transit just to open up some more space. And this is really crucial. The challenge, which is more a New York City challenge than almost any place else in the country, particularly for the subways, particularly for rush hour, is people just packed like sardines.
We've all experienced it and in that atmosphere, as I told you, that direct transmission is just really, really close and a little too easy for someone to accidentally cough or sneeze and not cover it in time. We'd like to open up that space, so we're trying to get it that we – if there's folks who do not need to be on that train because they could work from home, that's helpful. If an employer says, no, we just can't do that, we can't effectively run our business that way, fine, understood. But if you can create some flexibility or even some days in the week for some employees, some more telecommuting is helpful. And then staggering hours is very helpful. For employers that usually have their employees all come in at one time, if you can mix that up, particularly get that away from the harder rush hour, very helpful. If you have a business where people typically all come in at eight o'clock or nine o'clock and you can get some of them to come in at 10:00 am and work later, that really helps us. So we're looking for either or both of those accommodations from employers to the maximum extent they can.
For everyone – remember, you're in a city that if you are sick and you need to stay home, this is a city, thank God, that has paid sick leave and typically, and obviously Dr. Barbot will speak to this, it only takes a few days to see where your symptoms are going if you have cold or flu-like symptoms. Paid sick days is five days per year. So it can cover that eventuality. Important to recognize this as something you can use so you don't have to worry about missing pay if you end up being sick. I mentioned earlier particularly for folks who are vulnerable, don't put yourself in the presence of people you know to have symptoms. But I also want to note for all New Yorkers, you know, even while we're being careful and cautious, we say in every challenge, every crisis, a heat wave, a blizzard, a hurricane, we always say, look out for your fellow New Yorkers, look out for your neighbors. If there's someone who is in your apartment building or on your block who has medical challenges or a senior that has trouble getting around, check on them.
Someone may need some food delivered. Do the things that neighbors do and if you're concerned to make sure it's safe, there are obvious ways to address that. If someone's not well, but they need food and they're your neighbor, you can bring food to their door, you can leave it right outside the door and ring the doorbell. There's still ways to help people, even if you need to keep a little distance, and we talked about in previous gatherings, folks have said, how do you do self-quarantine? Not always easy in a city where people live in apartments and small spaces, but even staying in one room, your family is in the other rooms, people can deliver you food, what you need. There's ways to do these things. Again, everyone has a role to play to help each other, but in a way that can stay – can be safe for everyone.
Okay. I mentioned some other basics. If you have a way to get to work that is not a subway train in rush hour, that's great. If you can walk to work, if you can bike to work, that's helpful in this environment. I said a very common sense thing. I'm going to reiterate it. It's something we all deal with all the time. If the train that arrives is really, really packed and you can wait for the next one, that's smart. Do so. We understand that doesn't always mean the next one is not packed, but we've all had the experience of, we see a train that's just too packed, we'll take our chances on the next one or the one after that. If you can do that, that's smart. We just want to spread people out as much as we can.
Now here's a new one which came up – we were constantly having meetings over here and really interesting information comes up in these meetings. Dr. Barbot can speak to the details of this, but we talked about hand sanitizer, what it can do and what it can't do. Hand sanitizer is fantastic for insuring in the rare dynamics where somehow someone coughed right onto your hand, sneezed right onto your hand, it was on your hand, you didn't want to put it to your mouth, nose, eyes – hand sanitizer immediately kills the virus. You don't have the problem. But we started talking about what if people misinterpreted. Because there's 8.6 million of us, everyone's got a different understanding. Do not put hand sanitizer in your mouth. Sounds silly, but you know what, we want to make sure everyone understands. Don't put it in your nose. God forbid, don't put it in your eyes. Dr. Barbot will explain that not only are you going to sting a lot, but it actually makes it harder for your normal body defenses to function. And the doctor will say it more eloquently than me.
Some updates and some of these will be from yesterday and some will be new ones. So, no non-essential international travel for City employees. No public school international trips through the end of the school year. Nurses being added this week to every public school building. Again, that may be multiple schools in a building, but there will be a nurse that will cover all the schools in the building. All public schools will have nurses this week that don't have them currently. And every school is being supplied as well as those other nonpublic schools that ask for supplies and there'll be regular spot checks to ensure all bathrooms in the schools have plenty of soap and paper towels.
Reiterating for small business – two new initiatives for businesses up to a hundred employees, we will make available zero interest loans up to $75,000 if they have experienced a decrease of sales 25 percent or more in recent weeks. For businesses with fewer than five employees, these are the mom-and-pop stores, neighborhood stores, we will do direct grants up to 40 percent of payroll costs. That's to help them continue to employ their employees even if they're seeing a downturn. Additional actions for senior citizens – we have outreach teams going to each of our over 600 senior centers to ensure that every one of them is observing the best health practices, checking all seniors who come in to the center, make sure if anyone is sick, God forbid, they're immediately isolated and gotten back to their home or if they need medical care to their medical care. But we're going to protect our senior centers to make sure that they are functioning well and they are a place only for folks who do not have any symptoms.
Related to the homeless – our outreach workers are now working on a systematic effort to go through all of their contacts with homeless individuals, reach them all, check on their health, see if there's any sign of symptoms, follow up where there is, get them health care. We'll have updates on the numbers related to that shortly.
In terms of our Department of Consumer and Worker Protection, we're giving designations to items that are available for purchase by consumers that we want to stop price gouging on. We have already done that with N95 masks. We're adding hand sanitizer and disinfecting wipes to that list. This means that from this point on any stores that charge exorbitant prices for those items will be fined. We need, of course, anyone who sees that happening to call 3-1-1 immediately and report it, and if you see it, take a photo that's helpful.
Fines up to $500 per incident, any case of price gouging. So we're starting with the N95 masks, the hand sanitizer, disinfectant wipes. Let me just say to business owners, and I think this is a very small minority of business owners, but don't even think about price gouging in the middle of this crisis. It's absolutely immoral, it's unfair to your fellow New Yorkers. They will not forget. By the way, if you do something like that and you're going to see a lot of customers not come back, but on top of that we will fining you and we'll keep fining you until you stop.
On the federal side. I don't know how many days we're going to go on where we keep pleading with the federal government, documenting to the federal government. I've been saying this here in these press conferences, I've been saying it on local television, national television, it's the simplest thing in the world. Approve the automated tests. The FDA needs to approve the automated tests. Right now we're bringing you back results every day. We could be bringing you back a lot more results a lot more quickly from these tests. If we had them automated, the FDA could do that in a stroke of a pen and help not only in New York City, but cities and towns and counties all over America. They should do that immediately.
Okay. A little bit more. And then we'll hear from our Health Commissioner and Speaker Corey Johnson and then we'll take questions. New cases. Okay, on the eight new cases – so we're going to start with the one we talked about initially yesterday, but we're waiting on the final details. Here are the details. And this is case number 13 – seven-year-old girl in the Bronx. She attends Westchester Torah Academy, which has been closed since March 3rd, directly related to the Westchester cluster. No pre-existing conditions, no nexus to travel. She is doing well. Minimal symptoms. She's quarantined at her home right now with her family. And her mom, her dad, her two sisters have all tested negative. And that is again – this is what our disease detectives do. Tracing those contacts, they're still looking to see if there's any other contacts that need follow-up, but those are obviously the most important.
Case number 14 – we have a 68-year-old man in Brooklyn, had symptoms, ended up being admitted to the hospital. He has traveled, so we're not sure 100 percent of the origin here, but most notably, and we're very concerned about this, has both diabetes and heart disease, so this is someone we're very concerned about. Critical condition, but stable in ICU in a private hospital in Brooklyn. We've tracked close contacts. A girlfriend who has symptoms and is being tested is in mandatory quarantine, a son also in mandatory quarantine. We have three other family members in voluntary isolation who do not live with the patient. That's that group as far as we know right now. And again, as these detectives do their work, oftentimes we get to a very finite number of contacts. Sometimes we find a few additional, but typically it's only been a few additional.
Case number 15 is a 22-year-old man in Brooklyn, had symptoms, ended up being transported by EMS to a private hospital in Brooklyn. Stable but remains hospitalized. Had some recent travel, but again, not to one of the places where – these last two cases both had travel but not to one of the nations where we have had the bigger outbreaks. Why is a 22-year-old man stable but hospitalized at this point? The one factor we know of is he has a vaper. So, we don't know of any pre-existing conditions, but we do think the fact that he is a vaper is affecting this situation. Two close contacts, lives with his mom and sister who are both quarantined.
Case 16 – and this is of the city residents. I want to remind people, we're going to – these cases are New York City residents. There are other people we've already talked about and we'll continue to talk about who don't live in New York City but have a connection in New York City. This is about city residents and case 16 is going to be the last one I have a detailed profile on. As I said, we've gotten some new ones recently. We will get you more details on each of those as we get them. Case 16 is a 75-year-old man in Queens, had fever, then developed pneumonia, had shortness of breath, there's a lot of activity here, ended up in the ICU, has a pre-existing condition of diabetes and now this individual is really in trouble, this 75-year-old man in Queens, critically ill at a private hospital in Queens. This is someone we're very, very worried about. In terms of contacts. His wife is asymptomatic and will be quarantined and we are waiting to know more on other contacts.
So those – that is the 16th case. We have an update on a Westchester County resident, part of the Westchester cluster, but important here because he is also a City employee. We'll have more details on this as we are able – we have more specifics we have to put together and notifications we have to do. So this one's going to be very broad, but a City employee who was in a City office last week but only for three hours was not symptomatic at the time, still not symptomatic – in quarantine now. So we'll have more to say on that. All family, all other family members negative.
There was one other point from yesterday that came up that we've done the follow-up on. There was a concern yesterday about an Asian man wearing a mask and the concern was that there was a physical altercation. The question was, was it being investigated as a hate crime. From the NYPD, we have an update that the NYPD based on their investigation believes it was an interpersonal dispute, not a hate crime. They're not at this point investigating it as a hate crime.
Okay. We are now going to– I'm going to say a few sentences in Spanish –
[Mayor de Blasio speaks in Spanish]
With that, I want to bring forward our Health Commissioner. She has been working nonstop and I hope she will get some sleep. It's been long, long hours. Want to thank you and your team, Dr. Oxiris Barbot. And you'll explain hand sanitizer, where it shouldn't go?
Commissioner Oxiris Barbot, Department of Health and Mental Hygiene: Yes.
Commissioner Barbot: So as the Mayor has outlined, we are in a new phase of this outbreak. And before I go into details about that new phase, I just want to acknowledge and emphasize that we are delivering a lot of information to New Yorkers. New Yorkers are hearing every day about new cases all over the world. They're hearing about an increasing death toll from this virus and so I want to just take a moment to say these times, it's normal and it's to be anticipated that some people may be frightened, some people may be sad and I want to remind New Yorkers that NYC Well is a resource during these times. If you are feeling – well, let me go back there. There are a whole host of potential responses to this. Some people may be in denial and say, oh, it's never going to happen to me. I'm just going to go about my daily life and I'm not going to listen to anything. There are other people who may get angry. Why is this happening here? There are some people that might say, well, you know, I'll wash my hands often but I'm still going to go to work because I have that important meeting. And as long as I wash my hands, everything should be fine. And then there are folks who will be maybe depressed and say, you know, the world is going to come to an end and I'm just going to stay home and I'm not going to do anything. What we want people to understand is that A, there are resources, NYC Well and B, that the best way for all of us to respond to this is by having accurate information. I want New Yorkers to know nyc.gov/health is the best place, our website, to get the most accurate up to date information. You can also get it at cdc.gov. They have ample information.
But I still want to be clear that lack of information is no excuse for spreading stigma. It's no excuse for spreading hate. Fear is not an excuse to do that and we want to allay people's fears. We want to acknowledge that we're all in a new reality, but I want to just sort of start with that. There's no room for stigma and fear in this.
The other thing that I want to sort of emphasize as I say that we're in a new phase. When we say that we are in a new phase, there are a number of things that we have learned through the course of our investigation. One is initially we thought that the main risk factor was travel. We know that that is no longer the case. We know that the virus is here in our community and we are taking measures to address that.
The other thing is from the work that we have done, we have also been able to document that it's not just prolonged household contact, as we initially thought. That we have evidence that there are other types of interactions that can occur that can transmit the virus and where people can become ill. And I think, you know, the Westchester cluster will go down in history as one of those classic situations where we have learned a lot. And so when we have person to person spread in a community, the things that we need to do change. And so I want to make sure that as New Yorkers we are all aware of the changes that need to take place. And I also want to emphasize something that the Mayor said earlier that we are in a phase where, because of the fact that this is a novel virus, meaning that no one has ever been exposed to this virus before, anywhere in the world. And so none of us, literally none of us, is immune. And it's important to note that we all have a role to play in addressing this outbreak. And so in that I want to be clear that while we are marshaling all of our public health resources, all of our health care delivery system resources, each one of us has a role to play.
First and foremost, I have been very clear that as the city's doctor, I need people to stay home when they are sick. And the symptoms that we are specifically concerned about are fever and cough, or fever and shortness of breath. And especially in individuals who have the five chronic illnesses that the Mayor spoke about. Which I will repeat – heart disease, cancer, diabetes, chronic lung disease, and having an immunocompromised system, along with the fact that if you, you have any one of those and you are over 50, we want you to take, have a lower threshold for staying home if you're sick. And having a lower threshold that if you stay home for 24, 48 hours and you're still not getting better to reach out to your doctor.
Now what happens when you're at the doctor because this question has come up a number of times. You have those symptoms, you reach out to your doctor. We want you to let your doctor know ahead of time that you have these symptoms so that your doctor can be ready to meet you or someone in your doctor's office, with a mask. Because the best use of a mask is to help symptomatic people that we still don't know whether or not they may have the infection, not transmit it to others. So your doctor's office or when you're at the clinic or at the hospital. That's what we want all of them to do. The second thing is that there's a very simple task that we have been talking about from the beginning. BioFire. First thing they will do, or among one of the first things that they will do is test you with BioFire. And that's to rule out any one of the 26 most common viruses that can be accounting for your symptoms. BioFire is positive. Stop, do not pass go. Provide appropriate treatment, send you home until you're better. 72 hours, 24 to 72 hours after your symptoms resolve, go back to work. That's it.
Mayor: And you don't have coronavirus.
Commissioner Barbot: And you don't have coronavirus. Now, different scenario. You've got those same symptoms. You go to the doctor, he or she does the BioFire test. It's negative. She or he in their clinical judgment thinks that you are sick enough to have the coronavirus test. They do the test. One of the things that now has changed is that we have commercial labs on board and so they send off the test. In the meantime they should be telling you to stay home until you get those results. Very important. Stay home until you get those results, minimize your outside interaction. Results come back negative, your symptoms resolve, go about going back to work, sending your kids to school, et cetera.
Your symptoms are positive. Let's go through that scenario. We have within the individuals that have thus far tested positive, a wide variety of individuals. And I just want to emphasize something that both the Mayor and I have been saying on a number of occasions. By and large, the vast majority, 80 percent of people will have mild symptoms, won't even have to go to the hospital. But they will have to go through coronavirus because again, none of us are immune. And so you stay home until your symptoms are resolved, 72 hours after those symptoms are resolved and then you can go back to work. You can go back to school.
If on the other end we have individuals who are more severely affected by coronavirus, and we have had a certain subset of individuals that have ended up in the hospital. Some of them have already been discharged and are doing well in their homes and they will continue to complete the isolation period. And then we have unfortunately, a certain subset of New Yorkers as you have heard, that are severely affected. They are in the intensive care unit. And we are working closely with hospitals. We're monitoring the situation closely, but the unfortunate reality is that while many, many, many people may end up getting COVID-19, there will be a certain number of individuals that will succumb to this virus. And so that's why it's so important that we pay attention and that we adhere to the recommendations of frequent hand washing, covering your mouth and your nose when you cough or sneeze. And definitely don't go to work if you're sick. Don't send your kids to school if they are sick. Because what we are now trying to do in this next phase of the outbreak is to reduce the number of individuals that are affected and to reduce the number of individuals who have bad outcomes as a result of the virus.
The next thing that I will say is that we are focusing intensively on communicating with our provider community. And just today you know, we have issued what we call a health alert. And this goes out to thousands of doctors in our city. And what we want providers to be up to date on is the fact that now commercial labs are doing these tests. We want them to be diligent about prioritizing individuals who present with symptoms and have chronic underlying diseases and are over 50, to make sure that those individuals are sick. We're focusing on folks who are symptomatic. We're not looking for everyday New Yorkers who have no symptoms to look for the test. It's not the best use of our resources. We are also making sure that our health care providers are up to date on ensuring proper infection control in their offices. Because as we transition to this next phase of the outbreak, it's critical that we maintain the resources of our health care workers. And so the same guidance goes to them. If they are sick, most definitely they need to stay home. Because we need them to get better soon and beyond that we need to make sure that there are no infections spread in hospitals. That's why it's critical that we get this message out.
Same goes for their medical staff, their receptionist, their nurse, anybody in that office. And also advising them that if they can, to do more of what I've heard is happening, which is tele-visits. Using FaceTime, using other vehicles through which they can interact with their patients on a face to face basis, but not necessarily have them in their offices. Beyond that, we want to make sure that the message goes out to individuals with chronic illnesses, that this is not the time to put off refilling your medications. That if you have a refill to do, make sure that you're up to date on that refill.
Beyond that, I want to just sort of re-emphasize as the Mayor has been saying. Oh, the last thing about the hand sanitizers, which I forgot. Yes. And you know, I learned the lesson that the Mayor was trying to sort of illustrate when I was a pediatrician in clinical practice where I took for granted that if I gave a parent antibiotics for their kid's ear infection that they were going to give it to them in their mouth and that they weren't going to put it in their ear. And so I think as health care providers, as public communicators, we can't, especially in this time, we can't take for granted that people will automatically understand what we are advising them to do. So very important that New Yorkers are very clear on the fact that alcohol based hand sanitizer, it goes on the hands. It doesn't go in the eyes, it doesn't go in the nose, it doesn't go in the mouth, it doesn't go anywhere else but the hands. And I haven't given this level of detail before, but I will now, we specifically want people to use at least 60 percent alcohol based hand sanitizer. And you know, many people ask me, well what about antibacterial soap? It looks just like alcohol based hand sanitizer. We don't want people to be using antibacterial soap for two reasons. We're dealing with a virus. Antibacterial soap isn't going to do anything about that.
The other thing is antibacterial soap will diminish the normal healthy bacteria that we all have and need on our hands. So I hope that clarifies it.
And the last thing that I really want to emphasize is that we are in this for a long period of time. We think our best guess is going to be sometime in September, but there is no indication of how long ongoing transmission will persist. And that's why it's important for New Yorkers to be prepared now that we don't have a lot of cases because it's inevitable that we will have more and more cases and we need New Yorkers to be prepared.
Mayor: Thank you very much, doctor. Before I call up the Speaker, just want to thank Councilmembers Steve Levin for joining us, and thank you – you've been very actively involved in your district and beyond trying to address this challenge and thank you for that. Now we've been working very, very closely with the Speaker and his team and sharing information constantly and thank you for the hearing you held the other day, which I think helped get a lot more information out.
Speaker Cory Johnson –
Mayor: Thank you very much, Okay, we are going to take questions. Yes.
Question: Yes. The discovery that the Health Department made about the longevity of the virus on surfaces that it dies after two or three minutes seems very important and it's been kind of understated. It would seem like an override the need to do, say, deep cleaning of arenas or subways or buses. I was wondering if the Commissioner or where you could talk about one, why it's been underplayed or if it's been underplayed. And two, what's the science behind this new theory?
Mayor: Sure, I'll do the broad part and the Commissioner will do the science and the part from her agency. Look, I want to emphasize again, there are studies, there are academic studies, there are global and national organizations providing the information they have. But you know, the old saying, God bless the child who's got his own or her own. This is the New York City Health Department, which is widely regarded as one of the best, strongest health organizations in America actually working with real patients here in real conditions in New York City. You know the reality in China, the reality in Italy, the reality in South Korea, they're all going to be different factors. All information is valuable, but the information that we're gleaning from our own direct experience is the most valuable to us. When you're talking about something where there's literally no one who has all the facts and that is a true statement.
So what we want people to understand is what we are seeing as the truth. It has been said from this podium many times, so I don't think there's any issue about downplaying. There is a dissonance in other parts of the medical community on the question of how long it exists on a surface. But we're giving the best information we have because we don't – we're very concerned about people having an impression that is not consistent with what we're seeing. The fact is – on your bigger question, which is a good one, so what is the purpose of the cleaning? Look, I think the cleaning is an abundance of caution concept. This is where and again, Commissioner, you'll forgive me, I'm always trying my damnedest to put things into simple, plain English and you can always refine or dare I say correct if I say anything that wasn't as good as it should be, but I think in the public mind there's still the assumption like diseases that hang in the air and we're using measles as an example. Commissioner, could you throw me another one? What's another example of a disease? Chicken pox. There are diseases we're all very familiar with that have like long shelf life, hang in the air, really easy to contract and it's not surprising that people are having trouble understanding the difference that we're trying to demystify may clear that there's clearly a higher bar for the transmission of this disease based on everything that we are seeing. We're a city of 8.6 million people. We've had community spread now for a substantial period of time. We're still at 20 cases that says something and the Westchester cluster is clearly the number one generator. I'm not saying we do not expect many more cases. We do, but transmissibility is not a layup to put it in my own term. It obviously, you know, take some effort if you will. The cleaning is just good practice. Everyone benefits from more cleaning. But I do think there is a bit of a fault line and I think some people think, well if you clean something that means that the disease that was there yesterday won't be there the next day when in fact transmissibility is a much more immediate thing. But I would never discourage more cleaning. I think it's reassuring to the public. I think it's just good health practice. And we are still learning. We think we're seeing real facts that are consistent but we are still learning. And so why not be even more cautious on that front?
Commissioner Barbot: Just to add to what the Mayor said because I think, you know, he nailed it. This is a novel virus that we're still learning a lot about and there is still science that's coming out and you will find in the literature that in a lab setting you can have the virus live up to a couple of hours but in everyday world scenarios what we're learning from our partners from around the globe is that typically it's in a range of minutes. Now as we learn more, that range of minutes may shift to the right or to the left, but I think focusing on the number of minutes is the wrong place to focus because we don't want new Yorkers to have a false sense of security that if a surface was cleaned two hours ago, that that then relieves them of having to keep their hands clean because this is an approach – I think of it as a layered approach. Every layer of precaution that we add helps us as a society, as a city, change our collective behaviors. It's always good as the Mayor says, you know, frequent cleaning of surfaces is always a good baseline practice. Frequent cleaning of hands is also a good baseline practices because there are other viruses and bacteria that cause other illnesses that benefit from frequent hand washing. Staying home when you're sick is a good general practice. But in this special situation, it's even more critical that we do that. So it's not just do this or do that. It's layering the approach.
Mayor: I'm going to do some on this side and then I'll go to that side. Go ahead.
Question: Does the city have any plans to cancel the upcoming St. Patrick's Parade in Manhattan? Today, Ireland announced that it's going to be canceling its St. Patrick's Parade, which draws about 500,000 people. The Manhattan parade brings about 2.1 million.
Mayor: Sure. No, we do not have a plan to cancel the parade at this point. This gets back to the trends, and this is a phrase I only learned the last few days, transmissibility, the how you actually get this disease. So we – look, we're all working nonstop trying to not only take in a lot information, analyze it, but test it against real life experience, make adjustments in our strategy. There's a group of folks here who we're constantly communicating, but one of the things I think is a fault line and it's an important distinction is the larger gatherings, the argument for canceling larger gatherings is a lot of people, and in principle you might have that many more people who have been exposed to disease in the presence of that may more people have not been. But when you think about the transmissibility, one of the things that's holding us back from wanting to go down that path is that it doesn't really fit with what we're understanding of about transmission. As Dr. Barbot said, what we thought originally clearly was true, we see transmission in the home as the leading element and transmission from people who had really continuous, intense proximity, close physical proximity. Because again, if I were to sneeze right now, it can only reach, you know, maybe some of you, it can't reach all of you, right? It just can't and it needs that direct connection. So that's where it doesn't entirely fit to say, let's cancel a bigger event. Now we're going to watch that day to day, hour to hour. At a certain point we may say the numbers are telling us something different, but there's another piece of this equation which is really important and everyone knows I've been at this now for more than six years. I'm always going to put health and safety first, but that does not negate the fact that people's livelihoods also matter. I am very resistant to take actions that we're not certain would be helpful, but that would cause people to lose their livelihoods. And that's a lot of people. There's a lot of people in this town. If they lost a week's pay or even a day's pay, it would be a big problem for them. There's a lot of parents that don't have a place for their child if the schools are closed. There's just a lot of human reality. There's a lot of businesses that might not survive if they didn't still have customers for a period of time. So there's a balance that has to be struck and, and you know, I'm watching how different places are handling it and I'm not sure the balance is always being struck everywhere, so.
Question: What would need to happen in order for the City to make that kind of call to cancel—
Mayor: Going to be day to day, hour to hour, it's a lot of factors. Clearly we're going to watch the progression, how quickly this disease progresses. And a number of other factors are going to tell us. All options on the table. We've talked about in some of the previous press conferences. I have a lot of different emergency powers I could invoke. We do not believe this is the day to do that, but it will be a day to day thing. I also want to thank Council Member Robert Cornegy for joining us. Thank you, you've also been actively involved in efforts to get the right information out to the community and to support and reassure your community. Thank you so much for that.
Okay. I'm going to stay on this side a little bit more and I'm coming to that side. Okay. Yes sir.
Question: Thank you, Mayor. Ford from PIX 11 News. Can you talk a little more about the seven- year-old girl who contracted coronavirus? Certainly we've been hearing plenty of information from you all that children tend not to be subject. Can you say how this case fits in with the overall picture?
Mayor: I'll start, and I'll always give you what I got, and Commissioner, jump in anytime you want to. If I see you moving this way, it means you want to jump in. So that – remember in the case of the original Westchester nexus that we found was through the lawyer worked at the firm and Midtown had two kids, one 14, so high school age one college age. You know, both came through this very, very smoothly. So now we have, and the family and Upper West Side, the same thing. Their kids, we're seeing if my memory serves, I think at least one tested positive. I think one or more tested negative, we can go back and give you all the details. But the same thing we're seeing so far early on early, but kids who don't have those five preexisting conditions are tending to have a very mild experience and then it's over and they go back to their lives. So the seven-year-old at this moment, exactly consistent with that pattern is not struggling, is having a mild case of something very similar to a cold or flu. And from everything we see will be fine.
[Inaudible] exhaust this side, come to that side. So you guys just chill for a little bit. We're going right to you. We take lots of questions and in please anyone who's gone just hold back. I'm going to do a round of everyone and then if there's still seconds needed, we'll do as long as we can take it. Go ahead.
Question: Beyond putting out this advice at these press conferences on that we should be staggering sort of the time we show up to work. What more could we be doing to make that a reality?
Mayor: We're going to – look, I think respecting that businesses, again, are trying to keep going and I really value that and this is, I would have felt that regardless of what we saw from the stock market this morning, I value it even more given what we saw from the stock market. I think we have to look, it's a real challenge, but we have to see coronavirus for what it is and what it isn't. And we cannot lose sight of everything else in our society simultaneously. People need a livelihood to pay the rent, to get food, to get medicine. We have to be really mindful of that. So our economy right now, although broadly strong, is going through a real shock and we don't want to inadvertently exacerbate that. We do want to take care of health and safety. So we want to make clear and I think employers are listening, employees are listening, people are listening. This is a really clear, important predicate. We're watching to see the level of adherence to instruction. We've been watching for seven weeks. People are paying attention because, and you guys deserve a share of the credit. They're getting wall to wall concern and warnings and information and they're heeding the advice overwhelmingly. We have clear metrics. We're watching the quarantines, we're watching what people are doing in terms of their habits. We see a lot of actions being taken by people conforming with the guidance. So we're saying employers loosen up if you can. I'm sure a lot will. We're saying to people, make some adjustments in your life. I'm sure they will. If at any point we don't think it's enough, we can be more stringent. Very quickly.
Question: Can you say about the Port Authority Executive Director, Rick Cotton? Do you know when he started showing symptoms?
Mayor: No, I don't have any details. We'll get them. I know Rick well, he's a good guy. I'm sorry he's going through it, but he did exactly the right thing. He got away from work. He's working from home, but we'll get you more details as we have it.
Question: Have you spoken to him?
Mayor: I have not.
Question: The US Department of Health says the country as a whole may only have half a number of intensive care beds that it needs. How are we, where do we stand on that?
Mayor: So as again, I'll start and if Mitch wants to jump in or Oxiris, we announced I think it's now a couple of weeks ago that we have a 1,200 bed, effectively a 1,200 bed reserve that we could put in play very quickly as Mitch described yesterday. In terms of the vast health and hospital system, we can immediately cancel a wide range of elective activities and open up capacity. So, you know, we have a right now and you know, knock on wood and we're all saying it's going to get worse before it gets better. But we have a handful of people hospitalized in New York City right now against a 1,200 bed reserve. We're in very strong shape right now. But we're also being vigilant.
Question: Are those high intensive care—
Mayor: No, not all intensive care. So you want to speak to intensive care capacity.
President Katz: Intensive care is all about staffing and equipment and I can make at Health and Hospitals any bed into an intensive care bed, including a bed in an operating room that's not being used, because we've canceled all our elective surgeries. So that we can take care of people. I can turn a lunchroom into an intensive care unit. What's important about intensive care and is relevant to this disease, is being able to provide people the level of oxygen, whether it's through a nasal cannula, which are those the little prongs in your nose, a face mask, all the way to intubation and the ventilator. And I can do that in any space, as can any hospital.
Mayor: Okay, I saw a way back and anyone's gone, you're not going to go now. You're going to go on a second round after all your colleagues have a chance. That's really fair and egalitarian. Yes.
Question: Thank you Mr. Mayor, for Univision. I was wondering if Dr. Barbot could say a few words kind of [inaudible] into what you're talking about, the decision of closing our schools to give some peace to parents, as far as what they can do to protect their children at schools.
[The reporter speaks in Spanish]
[Commissioner Barbot speaks in Spanish]
Mayor: Okay. This side, a few more and then we'll go switch to the other side. Jeff.
Question: Mr. Mayor, you've said a few times that you can't, you're not likely to catch this on the subway for example, but then you also are telling employers to stagger times so that the subways can be less crowded. So can you explain that again? Yeah,
Mayor: Absolutely, so again – it is an excellent question, but there's actually a real logic pattern here. So Jeff, again Dr. Barbot, Dr. Perea Hense, Dr. Katz, if I sneeze now, what's my chance of hitting Jeff right there? Who asked the question? Okay, so, okay. We have three leading public health officials. Very quick on the draw there. That ain't happening to you, Jeff. This is important because the space and the proximity issues are real crucial here. What we're saying is, you know, a kid walking through the hallway at school, a kid in the classroom you know, going to a sports event, getting on a bus or subway, those are not per se conducive environments. Where things get conducive is where you get very close to people who then happen to cough or sneeze or spit right at the three parts of your body that can take this in or right onto your hand that you then decide to bring to your face really, really quickly.
So that's what we understand at this moment. So what we want is not that people don't take the subway, we'd like to avoid the classic rush hour packed like sardines situation. So common sense way to do that is some folks who don't need to be on the subway, you'd have an option, the walk, you can take a bike, whatever. Great. If you don't need to be obviously 8:00 am, you know, prime time. If you could instead go at 9:30 or something like that where it's a little more open. That's good. So we're trying to ask and we, again, we expect a lot of support for employers on this because everyone wants to get through this. So it's in the interest. It's not only employers are wanting to help, but it's in their interest to get through this – staggering hours is going to help us spread people out, reduce that intensive proximity, make it less likely there'll be a spread. That's what we're – and obviously reducing number of people, if more people telecommute, fewer people on the subway. Same concept. Please, hold on one second.
Commissioner Barbot: So I just want to add to what the mayor said and just be clear that we're not saying that there's a particular place where there is zero risk, right? So I think we just need to be sort of clear about that. Unless you know you're hermetically sealed in your apartment, there is no place that's going to be zero risk and there's a graduation of risk, if you will. But the important part – and when we learn about new scenarios that provide risk as we learn through our investigations that it wasn't just prolonged households contact, that we now have other outside situations that provide that risk, we will share that with New Yorkers. So, the important thing, and I can't stress it enough, is that the adherence to those layers of prevention that we all do individually will provide that layer of support and having that social distancing is yet one more of those layers.
Mayor: And finishing the follow-through, there's no such thing as no risk in the world. No such thing as no risk if you're driving a car or walking down the street or anything else. But the fact is, we know definitively that if you are under 50 and don't have those preexisting conditions, even if you were to contract it, your experience with it's going to be very mild. What we are very concerned about, and this is why we're sort of saying, you know, we want people who if you have one of those five or more than one of those five pre-existing conditions, particularly over 50, we want you to be really mindful. Do not go near anyone you know to be sick, for example. Someone in that category should be thoughtful about situations they put themselves in. That's a person I would say, if you've got to get on the train, really, please do try to avoid the rush hour. So, we think these gradations make a big difference and sort of the guidance makes a big difference and people are going to honor it.
Question: Any plan to change the ultimate side parking, for example? And a follow-up question, what do you know that we don't that you're encouraging people not to put hand sanitizer in your mouth?
Mayor: Excellent question. Because when you're in, like, interminable meetings, thinking of every conceivable possibility, things come up you wouldn't have thought of it before. And we were having a discussion about the value of hand sanitizer and that it really was to try and avoid the secondary transmission. And then that led to the question of if everyone's being sort of – hand sanitizer is the new, you know, American idol, and that people might misinterpret and think, oh, if someone sneezed on you, like, say someone literally just accidentally sneezed on you, they tried to stop it in time, they didn't, and it got in your nose or out in your mouth – someone might think, oh, if I put hand sanitizer on it, it's going to fix it immediately, when, in fact, it's actually a really bad thing to do. So, we just out of abundance of caution wanted to get that out. Alternate side – there's no changed plan right now, but we're going to look at everything again day by day.
Mayor: That's a situation – and I'm – you know, I was a public-school parent. I've spent a lot of my life working on public school issues. So, what I believe is the right approach is we would be very pinpoint in our approach. If we found a positive case, we would be doing a temporary shutdown. That's a case where a re-cleaning of the school is valuable. And we would want to reopen as quickly as possible, but having isolated the individual with that case and done the disease detective work to see if there's any close contacts who need to be followed up on. And we would certainly make sure we followed up with the parents of any kids who might have one of the five preexisting conditions. And that's obviously a pretty small number of kids and we know who they are because our schools have enough medical records on kids to know something like that. But generally, it would be a brief shutdown or re-cleaning and that disease detective work about where there were close, close contacts. And now we're going to this side –
Question: I have a follow up on schools. First of all, the Governor said today that if there was any case in a school where either a staff member or student had tested positive, the school would be closed for 24 hours and there would be a reassessment. So, I have a three-part question. One, how do you feel about that policy? But two, can you address the concerns [inaudible] one, of parents who have no place to send their kids; and two, the number of kids – I think it's like three quarters – who get their meals in school and, if you were to close the school, may have no food?
Mayor: Marcia, this is very, very much on my mind. And I agree with the Governor's approach. In fact, our teams have been talking intensely over the last 24-48 hours on this very matter. So, a lot of these issues that are coming up around the State, there's close consultation going on between the State and City on how to approach them. Think what the Governor is doing is the right way to approach it. But the point is very consistent with your, your other questions. We want sort of pinpoint accuracy. We want to make sure that a school is closed only for the period of time it needs to be, because there are so many parents who depend on that school. We want our kids to get educated. You're right, there's a lot of people depend on not just for the kids to be in a safe place and to get their education, but also to get their meals. So, we want to keep those closures minimal. Children who need alternatives, we're going to work on that. Obviously, we are going to see any other way – and we have other ways of getting meals to folks, if that's one of the things that we can do. But my hope and prayer here is because we are not seeing a lot of transmission to children. And obviously everyone's getting the word about what to do. So, for example, if a staff member is sick, all they have to do is stay home for the substantial period of time it takes to see if they have ongoing symptoms and that school does not have a problem in that case. If someone does not manifest the symptoms, they're not going to have to be tested. If they don't – if they are tested and they come back negative, either of those cases you don't have a problem. That's obviously generally what we're seeing. We're not seeing this in the schools. So, I'm going to be hopeful, but my goal is to have minimal disruption of our schools.
Question: Given the fact that you're asking people who may be symptomatic to stay home, do you have any procedures in place to provide extra teachers or a substitute teachers for people who may decide to err on the side of caution and not go to school [inaudible]?
Mayor: So, we have our traditional approach to bringing in substitute teachers or personnel already in the school stepping in. Now, as of just a few days ago – a very important point – I asked the Chancellor repeatedly how attendance was looking. Attendance was absolutely consistent, in fact a little better than the same days last year. So, we're not seeing an attendance problem with kids, not having a problem that I know of so far with staff. But if we had a number of folks out, we do have a reliable reserve of substitute teachers. We do have staff in schools who can step in and play other roles. We would look to how to ramp that up if we needed to on a bigger level.
Question: [Inaudible] follow-up on that and that and then I have a separate question. To follow-up on that, are you doing any preparations for remote learning if, you know, that there did needs to be shut downs. And, in particular, in that case, how would you deal with kids who don't have broadband access?
Mayor: So, we are doing preparations, but again, that's not going to be our preference for a lot of reasons. That doesn't solve the issues we just talked about, about parents not having necessarily a good place for their child and not necessarily kids getting all the same meals. That's a fallback we are working to get ready. We have some of that capacity right now, but that's not our preference. Our preference is obviously do everything we can to avoid any shutdown. But if we had them, they would be very brief.
Question: Is the lack of internet, sort of, part of the reason that's not your preference?
Mayor: No, for the other reasons first and foremost, because, again, that starts with where does the parent send the child or take the child? A lot of workplaces you can't. I mean, some – look, I think there's a lot of people in professional roles who are used to a certain amount of flexibility nowadays where you could bring your kid to work. A lot of other places that's just not possible. A lot of parents are dealing with multiple kids going different places. It's really, we want to avoid the dislocation for so many reasons. We are working to have remote-learning capacity for, you know, a really intense scenario, but it's something we'd like to avoid.
Question: [Inaudible] question was about the testing. When Dr. Barbot described a pretty seamless process where you go and you get tested for the other viruses and if you don't have that, you'll get the coronavirus test. But there've been numerous reports that people who do have the symptoms and have traveled or have exposure in other ways who aren't able to get the test, they get turned away because they're not sick enough or they're getting a run around in one way or another. What do you say to these people and is the City doing anything to make sure that health care institutions are actually, you know, testing people appropriately?
Mayor: I will start and I'm sure Dr. Barbot will jump in. So, remember that you – this very day, an hour a week ago, we did not have testing in New York City. This is really important – this thing that was moving like a freight train, you know, we're really – a lot is changing quickly. So, we did not have our own independent testing capacity. Remember, it was very, very recently the tests were being sent down to Atlanta. And we had to wait for them the results to come back. As of Monday, late Monday, at last we our own testing capacity at the New York City Public Health Lab. As of later on Friday, we got the ability for a private labs to start coming into play and ramping up. That's helping to address that issue, because some of that issue was there just wasn't testing to be had. But now, if we can get the automated testing with the FDA approval, you're talking about an actual abundant amount of testing that's going to help sort out the issue. Now, the doctor will certainly tell you we still want prioritization, and why don't you speak to that?
Commissioner Barbot: The other thing I'll add to what the Mayor said, because he got it just right, is that in addition to that cascade, the guidance for who to test has also been changing. Initially, it was just individuals with a travel nexus to a particular part of China and then that increased. And so, it's been a moving target since the beginning. I think the important thing to note now is the capacity for the commercial labs to do testing did come online Friday, but they didn't start submitting samples until today. So, it has been a process of, I would have to say, fits and starts with regards to, you know, what originally happened with the CDC test kits that had issues with them. But the important thing to note now is that once we have established that there is what we call widespread community transmission, where travel is no longer the main risk factor, and now that we have established that the vast majority of people do have a mild course – 80 percent of them – there will soon come a time when we'll say, only if you're really, really sick do we want you to get tested because there'll be so much COVID-19 out there and most people will recover within a couple of days. So, where we are right now, we want more people to be tested, but we also want to keep in mind that as more people do become effected by COVID-19, it may make more sense for them to stay home, recuperate and go back to their regular lives once they fully recuperate and they may never get tested. So, we just need to be prepared for that reality.
Commissioner Barbot: Oh, sorry. And then for the priority groups – thank you very much – right now, we are prioritizing, as the Mayor said earlier, individuals who are symptomatic – fever and cough, fever and shortness of breath, are over 50 – and, or have the chronic underlying illnesses. Additionally, if there is someone who is in intensive care and has a pneumonia of unknown etiology, then those would – or, unknown underlying cause, sorry, I use [inaudible] words there – then we will test those individuals. But the important thing to note is that, as of today, it should be much easier for every-day medical providers to offer those tests through their offices, through commercial labs such as Lab Quest – Lab Corp rather, or Quest, which they already normally use.
Question: [Inaudible] test people then who have the symptoms and have some form of potential exposure but are under 50 without the underlying condition?
Question: We're asking medical providers to use their clinical judgment about whether or not someone has already tested negative through the BioFire and if their symptoms and the rest of their history gives them an indication that they should be tested.
Mayor: Yeah, I want to try some more – again, we're all dealing with a mysterious situation here and everyone's concerned, but the numbers, they're really speaking powerfully to us. If you're under 50 and you don't have the five preexisting conditions, and throwing in if you're not a smoker or a vaper – bless you – you know, the chances are just so overwhelming that you're going to have only a mild form of this, that that really has to be taken into account. But to the point that Dr. Barbot made, you're still in touch with your health care provider, and if something unusual is in the mix, you know, and the health care provider says, no, there's something going on here, I want that test for a specific reason, of course. But I think that the challenge here, which is really – I don't know, I'm not watching every TV show or reading every article, but I think the notion that this overwhelmingly for most people is very, very similar to a cold or flu, period, is still not fully getting through because of all the fear about the spread around the world and obviously the pain of the most extreme cases. We've got to help people to understand that for most people the impact is minimal. We want to help the folks who are most vulnerable first. So that's where the, you know, the sense – there is some sense of triage eventually. As Dr. Barbot said, we went from almost no local testing to now starting to have a substantial amount, but the number of cases is likely to go up intensely as well. At a certain point, the prioritization becomes ever more important.
Question: [Inaudible] didn't you order just a few days ago that City workers we traveled had to get tested? And now it sounds like you're saying they wouldn't even be eligible for testing.
Mayor: Which specific – which piece are you talking about?
Question: [Inaudible] educators and first responders –
Mayor: Right, but it's not just travel, it's folks who we think need to be tested. It's across the board. If there's a specific reason per the Health Commissioner – it gives the Health Commissioner absolute latitude to determine in any specific case if someone needs to be tested in those categories, it is broad because it obviously enclosed community spread.
Hold on a sec. Yoav?
Question: Mr. Mayor, on the school the school closure policy that Cuomo announced today, I just – I'm trying to understand what the purpose of a 24 hour closure would be given that that the City doesn't think the virus kind of lingers on surfaces. Is it just for deep cleaning? And if so – I guess I'm trying to understand what that 24-hour closure –
Mayor: Yeah, look, it's a regrouping opportunity, obviously. We are – I'm a parent, I understand that parents are going to be really concerned. I'm going to say, you know, a thousand times and I hope all of you will amplify how much consistent experience is saying to us that children are not in danger unless they have those preexisting conditions, God forbid. But nonetheless, many, many parents will only get some of that information or they'll just be so scared for the kids, which is absolutely a basic human instinct that they're going to be, you know, really worried if they hear there's a case in a school. So, I think the – this is sort of a common sense measure – a timeout. We're going to give people a lot of information. We're going to do the cleaning, which is abundance of caution, also, I think, reassuring to people. We're going to have the disease detectives identify if there are particular close contacts. Again, it's not that the kid walked down the hallway and there were – bless you – there were 20 kids in the hallway. It's, was the child working very closely intensely with a teacher or a tutor? You know, did the child have a best friend that they, you know, they're always together and you know, constantly really close to each other? Those are the kinds of things we're going to be looking for. So, I take that as a 24-hour kind of timeout where we get the information out, we do some of the work we have to do, and then any kid who needs to stay home who's identified by the disease detectives, we do that. Obviously, if there are children in the school who have those preexisting conditions, we want to alert parents so they can make their own choice. That might be, again, an abundance-of-caution dynamic for parents to say, let's hold kids back for a little period of time. That's the kind of thing that I think makes sense during that timeframe.
Question: Do you guys have an estimate for the number of people considered the most vulnerable folks over 50 those with those five underlying conditions? Do you have an estimate of how many said residence?
Mayor: Of total New Yorkers? Yeah, it's a great question and I don't think we have at our fingertips, but we can have it by tomorrow.
Question: You had mentioned a city employee from Westchester who had no symptoms and still has no symptoms, but still got tested. Why did that City employee get tested? Are City employees required to be tested?
Mayor: So, let me separate those two concepts. And again, the executive order – the Commissioner's order, I'm sorry, is online. So, anyone who wants to look at the provisions of it, it's there. Connection to the Westchester nexus – that's what – the first words out of my mouth about that case, connection to the Westchester nexus, which has been obviously the core reality of this whole trajectory in the last week or two. So, that's why the individual was tested. The Commissioner's order says, first responders, health care professionals, educators – that's where the Commissioner retains the right to order testing.
Question: [Inaudible] clarification. So, the State guidance that Cuomo talked about today does apply to New York City schools as well?
Mayor: Yes, we all worked together on it and we think it's good guidance.
Question: [Inaudible] 20 cases in New York City, does that include the Westchester attorney and I think –
Mayor: Again, I'm going to – guys, I'll try really hard to be consistent about the ground rules of the information for everyone's benefit. New York City residents – the numbers I'm going to give you are always New York City residents. As I said, we had the New Jersey guy who had been in New York City. We've had obviously the Westchester folks. But what our coin of the realm is going to be, New York City residents.
Question: And do you know of the 20, how many people are in the hospital currently? I counted five, but I just want to see –
Mayor: I want to get you an up-to-date count, because we have these four new cases we're still getting all the details on it. There has there have been more out of the hospital than in the hospital, that much I can say. And again, we're going to start telling you about the people who are no longer of concern from the original set of cases. We'll start giving you more on that, but want to make sure that the – oh, this is a technicality [inaudible] let's get that straight and come back on that. The – but again, most people, not hospitalized.
Question: Can I ask just one – also clarification on the testing. So, we know we've only had this capacity to test here for a week, but there was so much confusion before I heard from a lot of doctors and health care providers, they don't know how to get the test where they were [inaudible] on calling the Health Department, couldn't get through, just had the person go home and self-isolate. So, when a person tests negative for the BioFire, they can now conduct the test themselves and they've been given that guidance. Can you just explain that a little –
Mayor: Yeah, I mean, you – some journalists were here for other settings, other gatherings and others weren't. Explain the simplicity of the actual taking of the test.
Commissioner Barbot: Sure. So the health alert that went out today to all providers clearly lays out what providers can do in order to order that particular test through a commercial lab. And the – and most physician offices have those capabilities. In terms of the actual test, as I have described before, it's the equivalent of having a Q-tip up your nose kind of probably further than you would feel comfortable with, swish it around, put it into a liquid medium, and then run it through an analyzer.
Mayor: I think it was yesterday, the Commissioner used the now priceless phrase, a medical grade Q-tip, which sounds to me suspiciously like a regular Q-tip. Okay. Go ahead.
Question: Mr. Mayor, just to be clear on the Department of Health website, you are now counting the Westchester lawyer as a New York City case, is that no longer – has that changed?
Mayor: I think you are right. And that's – Freddi was also raising the point with what we're trying to do and it's getting – it's a fair point. That one was the origin for a lot of stuff. We're trying to do it based on residents because otherwise it's going to get kind of crazy if, for example, the guy in New Jersey was in here, we have people from Long Island who were in here. So, we're trying to do it based on residence. But I will let me accept humbly that our definition may be a little gray there and by tomorrow I'd like to get us 100 percent tight that it's going to be residents and if we vary from that, it'll be an asterisk and we'll clarify it.
Question: My actual question for you and I have a follow-up for Dr. Barbot. There've been a couple public employees who have tested positive and forgive me if this is in the Commissioner's order, but what exactly does the City tell workers who have come in contact with a person who has tested positive or think they may have been in contact? What is the directive there?
Mayor: The Commissioner can jump in. Every agency has been giving guidance to its employees on obviously all the precautions to take and, to the best of my understanding, on what to do in that scenario, and each agency has created its own guidance based on what the Health Department has told them.
Commissioner Barbot: So, the guidance to City workers is the same as the guidance to any New Yorker. And our disease detectives during the course of their contact tracing as it's called will determine with the individual who has been identified as a case who their close contacts are. And those close contacts may range from household contacts to individuals that spent a prolonged amount of time with him or her during their infectious period. So, that then translates into making decisions about who should be tested in addition to the index case and who doesn't need to be tested. And so, that guidance is the same for City workers as it is for City residents.
Question: So, does that person who thinks they have come in contact with someone who tested positive, did they tell their supervisor and then self-isolate? Like what is the immediate – what are the immediate steps?
Commissioner Barbot: That, let's say, contact tree, if you will, originates from the individual who has been diagnosed with COVID-19. And so, based on his or her history of who they came in contact with, what type of contact, how long the contact was, would then be the genesis for them determining who in addition to test.
Question: So, the individual employee who's saying that their wife has positive, they don't then tell their workplace like, you know, Department of Sanitation, oh, by the way, my wife has positive, what should I do?
Commissioner Barbot: So, what – that's a different scenario, right? Because the index case is not the City worker, it's the workers spouse. And so, in that situation, the same thing holds. The index case, we look up their close contacts, which would be their partner. And then, if that index case was positive, the partner, whether or not they were positive or negative on the test would be treated in isolation – they would be isolated for 14 days. And so, we would then take additional history to determine whether or not there were any additional close contacts.
Question: And then you said that it's not just prolonged –
Mayor: Hold on one second. Don't go away – continue. Just want to add on that, so – and I think it's fair to say we should go back over all the guidance. I think that's a very important scenario – family member makes sure – I think it's self-evident that if a City employee had a family member in their home test positive that yes, that is something their supervisor should know. But the point I think that Dr. Barbot is making is, every case is being watched like a hawk right now by New York City and New York State. The disease detectives are making immediate contact. You know, even in an instance where somehow the supervisor didn't know, the Health Department's going to know. But I do think to your question, it is very smart for supervisors to be alerted immediately in those cases because we just want more information than we should make that clear in the guidance.
Question: [Inaudible] you said it's not just the prolonged household contact as we initially thought, but other types of interactions. Could you just spell out what other types of interactions?
Mayor: So, they have ranged from close proximity and extended face-to-face contact as would happen in, let's say, a lunch or an interview type of scenario. And so, that we have seen in more than one case. And so, that's why we are alerting New Yorkers that it's not just prolonged household contact. It can be prolonged contact that can be constituted by what I just described.
Mayor: Let me be more graphic. Well, we have case that we think we understand pretty well. Two people deep in conversation for a half-hour, animated conversation. The best thinking of the medical personnel is that in animated conversation sometimes people project some saliva and that may have been the contact. Obviously, another option is someone sneezed or coughed, like looking right at the person they were deep in conversation with. So, that's the evolution – that is still close proximity and you need that direct hit with the exception, again, of right to the hand, right to the face in fast proximity, because otherwise the virus just wouldn't live that long. But we do think this is an area of concern. It's not people in the stadium, it's not people in the big open area or a conference and all, it's people close up to each other, deeply engaging each other to the point that the inadvertent spitting that comes with a conversation sometimes, or a sneeze or a cough directly goes at the other person in close proximity.
Question: [Inaudible] which case that was?
Mayor: I've got to get back to you on which one that was. Okay. Who has not gone? Not gone – Courtney?
Question: So I know you want to get away probably from these extreme measures, but obviously over the weekend we saw what happened in Northern Italy. And I imagine you and your administration are sitting around every day and talking about, and doing tabletop exercises in those scenarios. In any way are you talking about that kind of scenario in which New York City could potentially be –
Mayor: Yeah, but I, you know, I was asked the question earlier on CNN and then I saw a lot of reporting said, you know, like we're thinking of a citywide quarantine. That's just not accurate. I want to be clear. We are obliged to scenario everything. So I know headlines are headlines. I know a lot of you are not responsible for the headlines. But you know, let's be clear here. We're far from that at this moment based on the facts before us. I mean we've been talking about this, the first press conference on this was January 24th in this building. And today we're at 20 cases, most of whom have not been hospitalized. And even among the hospitalized, we have some that are coming through fine. So I just have to put it in perspective. I think – I feel deep pain for Italy. Obviously I feel emotionally very connected to Italy. They were playing from behind from day one. I mean they had a major outbreak before they even could start to imagine something was happening. They never had a day where they were ahead of the action because it just was suddenly upon them. We had a long time to prepare. We have the best hospital network anywhere in America, I would argue anywhere in the world. Right here we have the most health care professionals. We've been messaging to New Yorkers for weeks and weeks. They appear to be really consistently abiding by the messages overwhelmingly. So I think we're in a much, much stronger position than some of the places. Obviously the ultimate example, China was playing wildly from behind and then didn't tell people what was going on. But here we've had time to really get ready and handle this in stages. That said, we talked about this yesterday, we'll be at a hundred cases relatively soon. And then, you know, we'll be at hundreds of cases relatively soon in a matter of weeks, based on what we know now. But that's, you know, every single day we're reassessing that trajectory. And so we're table-topping everything you name it. We're basing it on everything we know from previous you know, natural disasters and every other kind of situation, getting ready for different eventualities. But the school answer is very indicative here. Some places like Italy are doing mass school closures. That's not on the menu here. Is there a theoretical scenario where that could happen? Of course, but is it anywhere near to where we are now? No
Question: And just a quick a follow up. And I imagine it's the same answer as the St. Patrick's Day parade, but there is a Brooklyn half marathon coming up on the 20th, maybe. I assume that's still on?
Mayor: It is still on. We're in conversation with them. You know, we're going to make our best judgment very shortly on that. Now again, you know, because obviously we want to give people guidance at this point. I don't see a reason to cancel. That could change at any point, but right now I don't see a reason to cancel. Okay. Is there anyone who has not gone in the first round? All right, let's do a few second round. Go.
Question: Is there – are you looking ahead to maybe take over a hotel or something if you need to enforce some sort –
Mayor: If we need to we can.
Question: Yeah, on that question. You said you have 1,200 beds in HHC. I mean that doesn't really actually sound like that many beds as a reserve, given the current rate of transmission. I mean, at what point does the City, will the City face like serious strains to its capacity?
President Katz: Remember that Health + Hospitals represents about 20 percent of the inpatient capabilities. So you have five times more in terms of capability. There is a lot of space in hospitals including for emergency preparation. Our hospitals have tents that would allow us to turn a parking lot into an intensive care unit. So, when you look at the numbers and consider what the Mayor has said, that the vast majority of people actually do not need to be in the hospital. 80 percent of people are going to be fine. Only about 20 percent of people might have symptoms serious enough to be in the hospital. And it's even a much smaller number, perhaps four or five percent that actually would require intensive care or intubation. There is enough capacity to handle that in New York City.
Question: Commissioner, you'd mentioned that you thought virus might be with us until I think September. Can you walk us through the modeling or predictions [inaudible]?
Commissioner Barbot: You know, it's our best estimate based on experience from what we're seeing abroad in China. Our learnings from what happened in H1N1, which was the last time you know, that kind of a virus presented itself. So there isn't something that we can necessarily, you know, hang our hats on if you will, but it's our best informed estimate of how long the transmission will take.
Mayor: Yeah. And look, we're going to constantly give people updates as we receive them. But I think the Commissioner is absolutely right to give folks a sense, you know, this is not going to be quick. We'll be at this for months, but we'll update as we go along.
Question: You mentioned that the 68-year-old, 22 and 75-year-old men who tested positive for the coronavirus were being treated at private hospitals. Is there a reason why they opted to go to private hospitals and not –
Mayor: I don't know. In each case, I mean we've seen people go to public hospitals, we've seen them go to private. Again, we want to respect confidentiality, give you broad profiles, but I don't know the specifics in this.
Question: Also what's happening to the 2,000 plus, people who are at home in self-quarantine?
Mayor: Again, as we've talked about in previous press conferences, so there's a check-in system for those folks. The mandatory quarantine folks get a very regular, they get a daily call, they get spot checks in person. The voluntary get information updated to them and you know, they're constantly asked if they want to make contact and get more guidance. Or if they need help, they can connect readily and get help. We're, again, I'm happy with what I'm seeing with the voluntary, that people seem to be following it through and coming out of it well. But we're going to intensify the outreach to the voluntary just out of abundance of caution and anyone who needs additional help, will get it.
Question: I know you mentioned that tomorrow you'd have more details about people that have gotten over the virus, but for right now, can you explain the progression in health for some of these folks? Like are they, are these folks that we're going to talk about tomorrow, are they back to work now or are they completely fine? Is it just like coming – like recovering from the flu?
Mayor: Yeah, you're going to see different people in different situations. But the real –and what the Commissioner – and this is, I think the crucial thing for people to hear is, how many days, and again think about typical cold and flu dynamics. So for the folks who are not having a more serious experience, how many days until people typically feel better and the standard you hold for knowing that people can go back to work?
Commissioner Barbot: So you know, the range of days that someone will be symptomatic varies. But what we understand from what we understand, the vast majority of folks will become symptomatic within about five to six days of being exposed. And the range of symptoms can include, as I have mentioned, fever and cough, fever, or fever and shortness of breath. You know, there have been reports of other potential symptoms, but the vast majority of folks who will become ill because of exposure to COVID-19 will develop those symptoms. You know, how long individuals remain ill is something that I can't answer because everybody's different. Everybody's got different – I think we're still learning. You know, we've got folks who present with very, very mild symptoms and they may clear their symptoms in two or three days. Where, and it goes back to what we're learning from real world experience here in New York City. And then we have other individuals who present in severe condition who require intensive care support and their care may last longer than the average individual.
Mayor: Let me give you a lifeline on just one piece of this. You stay where you are. I think the cases we're talking about in this specific question are the folks who go through sort of the simpler recovery and go back about their lives. I think helping people understand the range from symptoms manifesting, typical range of how long until you are a quote unquote, well. And then how long until a doctor, like you would say you have evidence that it's okay for someone to go back into the workforce, for example.
Commissioner Barbot: So typically it's a couple of days of being sick. And what we are advising is that once a person no longer has a fever, then they can return to work after three days.
Question: Has anybody gone back to work after recovering from the coronavirus?
Mayor: We'll give you those tomorrow.
Commissioner Barbot: Yeah, we'll give you those details –
Mayor: And again, some people are still in the quarantine situation. Even if they are well. We'll explain that to you. But the point is we are starting to see a phenomenon of people coming out of it. And that's an important piece of the equation too.
Question: In a letter that the Deputy Mayor wrote to the federal government, it said that we received two test kits. Do you know how that compares to other cities and states? And also I'm curious, what is our, what's left? Like how many samples are left and how many people do you think that New York City can test before we run out of tests?
Deputy Mayor Raul Perea-Henze, Health and Human Services: The original request generated those two test kits. Each one can do about a thousand tests.
Question: How many people, that's like 600 people?
Deputy Mayor Perea-Henze: That's about 600 people. You know, considering that many times you actually do two tests per person. Now with the new commercial labs coming online, that just expands our capacity significantly, threefold.
Question: They get their own kits then?
Deputy Mayor Perea-Henze: They get their own kits.
Question: Okay, I understand.
Mayor: Okay, last call.
Question: Do they each get one? Do we know? We don't know?
Deputy Mayor Perea-Henze: They're working with the FDA to actually allow them to get their own reagents and their own testing, so they don't have to go back and get kits from CDC.
Question: And we get more test kits, so public health laboratories can do more testing? What is the –
Deputy Mayor Perea-Henze: We are getting more kits from CDC. But the honest truth is that our public health lab is set up for more research now that the commercial labs and HHC and all the other voluntaries are open. The expansion is where a lot of the tests are going to be.
Mayor: But, but still hindered by the lack of the automation, which is what we're waiting on the FDA for. Anna.
Question: So I apologize if this has come up previously, but is there any indication that this can be sexually transmitted other than like the close facial contact? It might happen during a sex act?
Commissioner Barbot: I haven't seen any scientific studies that are looking at whether you can find it in semen or in vaginal fluids. But I suspect that with time that will become available. But certainly as you alluded to, the close contact that one would have would clearly be an increased risk.
Mayor: Can you, while you're there, talk about, because this came up. I mentioned that people –we are talking to each other all day long and coming up with all sorts of interesting questions. So
In food, in your soup, in your entree, in the water, in the beer, just talk about whether any of those things are transmission vehicles?
Commissioner Barbot: So this virus, if ingested the acidity of the stomach will denature it. And that's sort of the most succinct answer.
Mayor: Yes, that's a no?
Commissioner Barbot: That's a no.
Mayor: Last, very last call. Erin, two more. You – Erin and then you.
Question: Just a technical point. For the preexisting conditions, are you classifying asthma as a lung disease that should cause people to be extra concerned?
Mayor: Severe asthma, you can clarify it. Severe asthma is more of an issue. But what is your definition?
Commissioner Barbot: Typically when we say chronic lung disease, and Dr. Katz can help me out. We're talking about things like emphysema.
President Katz: Emphysema, chronic bronchitis.
Question: So that's a no?
Mayor: But can I ask a clarifying –
Commissioner Barbot: Although I will add –
Mayor: Yeah, let's, can we do everything you put in that category, but what you do feel about severe asthma interplay with this? If anything.
Commissioner Barbot: And again, Dr. Katz, if someone has severe asthma that they have had for a long time and they need to take steroids for it or they may have other complicating, you know, conditions. Those are the kinds of factors that a clinician would take into consideration when evaluating their individual patients.
President Katz: I would agree that asthma is a highly variable disease. So sometimes what it means is a young person where the bronchioles or the breathing tubes are just more reactive. But many times if people have had asthma for a very long time, it accompanies by that time some harm within the lungs. And so –
Mayor: Just list, Mitch, the lung diseases that would categorize here.
President Katz: So certainly emphysema, chronic bronchitis, people who have rheumatological diseases that are associated with restrictive lung function, which means that the lungs don't expand normally. As well as people who have obstructive disease, which means that the air does not move in smoothly. People who have suffered from exposures. So we do very much worry about people from the World Trade Center incidents. This is New York right? Where we have a number of people who may be suffering from lung dysfunction due to their exposure. So, it's basically that people, when your lung function and structure are not normal, your risk is greater.
Mayor: Okay, last call.
Question: I know last week you mentioned an increase in the number of disease detectives and added resources. At this point, do you know how many, in terms of number, disease detectives you've added, how much more personnel there is to handle this?
Mayor: I think we will have that firm number tomorrow. We're still doing a little bit of work on that. I think we'll have that tomorrow. Thanks everyone. Go ahead, Marcia. Yeah.
Question: Are there any conditions under which you would consider closing New York City?
Mayor: Again, what I said earlier and I'm going to just need people to not take me out of context. We're going to look at any scenario, but that's not a scenario I could see happening anytime soon. Our goal here is to keep the city running. Our goal is to make sure that kids go to school, people go to work, while supporting the folks who do need a health care. That's what's happening right now. I want to see us do that for a long time. Meanwhile, a lot of very smart people led by our Emergency Management Commissioner are playing out and scenarioing, war gaming all sorts of scenarios. But none of those are over the horizon right now.