Trump Writ Small

I am referring, of course to Andrew "Rat-Faced Andy" Cuomo, the Governor of the great state of New York, who thinks that he is smarter than public health experts, which, among other things, has led to vaccines being thrown out because of fears of draconian fines under Cuomo's directives:

The deputy commissioner for public health at the New York State Health Department resigned in late summer. Soon after, the director of its bureau of communicable disease control also stepped down. So did the medical director for epidemiology. Last month, the state epidemiologist said she, too, would be leaving.

The drumbeat of high-level departures in the middle of the pandemic came as morale plunged in the Health Department and senior health officials expressed alarm to one another over being sidelined and treated disrespectfully, according to five people with direct experience inside the department.

Their concern had an almost singular focus: Gov. Andrew M. Cuomo.

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

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

I'm wondering if there are any major Cuomo donors at the "Large Hospital Systems."

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

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

How very Trumpian.

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In Albany, tensions worsened in recent months as state health officials said they often found out about major changes in pandemic policy only after Mr. Cuomo announced them at news conferences — and then asked them to match their health guidance to the announcements.

That was what happened with the vaccine plan, when state health officials were blindsided by the news that the rollout would be coordinated locally by hospitals.

But it also occurred earlier with revisions in a host of state rules from the fate of indoor dining and businesses like gyms to capacity limits on social gatherings, according to a person with direct experience inside the department.

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But at least nine senior state health officials have left the department, resigned or retired in recent months. They include Dr. Elizabeth Dufort, the medical director in the division of epidemiology; Dr. Jill Taylor, the head of the renowned Wadsworth laboratory — which has been central to the state’s efforts to detect virus variants — and the executive in charge of health data, according to state records.

Additionally, the Health Department’s No. 2 official left for another job in state government, and another official, who helped oversee contact tracing, is expected to leave the department, also for another state government job.

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Mr. Cuomo’s handling of the pandemic has come under criticism in recent days after the state attorney general, Letitia James, said his administration had undercounted the tally of Covid-19 deaths of nursing home residents by not publicly disclosing deaths of those residents that occurred at hospitals.

Given just how much of a control freak hizzoner is, this was not an accident.

This is Cuomo playing politics with the numbers, because he went to bat for his nursing home donors to get them immunity from their own malfeasance.

He knows that the horrific death numbers from New York nursing homes, if reported accurately, will be a source of criticism for any future elections.

Current and former health officials agreed to be interviewed about the crisis inside the public health bureaucracy only on condition of anonymity, saying that they feared retaliation for speaking out against the governor.

Also, he's a vindictive son of a bitch, and managing through fear does not work.

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The departures came as the state prepared for and then stumbled through the early weeks of its vaccine campaign, in which experts said speed was paramount because of the threat posed by more contagious variants of the coronavirus.

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Mr. Cuomo said his approach had delivered results in New York, including a positivity rate that has been declining after a peak in early January and better vaccination rates. New York saw the worst of the pandemic in the spring, and roughly 43,000 have died, more than in any other state.

………

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

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But elements of the state’s approach hindered the rollout, New York City officials contended.

“Extensive red tape and unnecessary rigidity over who we could vaccinate and when — all with the looming threat of millions of dollars in punitive fines — made an extraordinarily difficult task all the more challenging in those first initial weeks of the rollout,” said Avery Cohen, a spokeswoman for Mayor de Blasio.

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

Again, I gotta figure that the hospital systems are major Cuomo donors.

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

Ka-ching!

The approach included narrow eligibility rules and suffered from a lack of urgency by some hospitals. That led to fewer doses being administered in the early weeks, followed by abrupt shifts in policy that created a kind of free-for-all among those searching for vaccine appointments, according to interviews with more than two dozen current and former health officials, county leaders, vaccination experts and elected officials.

“The governor’s approach in the beginning seemed to go against the grain in terms of what the philosophy was about how to do this,” said Dr. Isaac Weisfuse, a former deputy commissioner at New York City’s Health Department who often served as an incident commander during emergencies. “It did seem to negate 15 to 20 years of work.”

Sounds like the Donald, doesn't it?

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For help in planning the vaccination campaign, the governor turned to consultants from Deloitte and Boston Consulting Group. The in-house lobbyist for New York’s largest hospital system, Northwell Health, had direct involvement in the rollout.

For about a month, starting in mid-October, the Northwell lobbyist, Dennis Whalen, worked from an office inside the State Health Department and helped shape the state’s approach. Mr. Whalen had worked previously as the department’s No. 2 official.

Yeah, Cuomo was rat-f%$#ing the vaccine roll-out to accommodate lobbyists.  Hoocoodanode?

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Still, Dr. Denis Nash, a professor of epidemiology at the City University of New York and a former senior city health official, said that giving such a large share of doses directly to hospitals meant that the government lost control of the pace of vaccinations during the program’s first month.

“That was the bottleneck,” Dr. Nash said. “To put hospitals in charge of a public health initiative — for which they have no public health mandate, or the skills, experience or perspective to manage one — was a huge mistake, and I have no doubt that’s what introduced the delays.”

This is Cuomo considering his donors, and his ego, before the well being of the people of New York.

I am wrong.  That does not sound like Donald Trump at all.