ALBANY (TNS) — In early April, at the height of the coronavirus pandemic in New York, Gov. Andrew M. Cuomo warned that the state may need 40,000 ventilators and up to 150,000 hospital beds — projections that would prove to be far beyond the state’s actual needs.
In response to those initial concerns, his administration began spending hundreds of millions of dollars to purchase thousands of ventilators, mobile X-ray machines and “BiPAP” breathing-assistance devices, most of which were never used.
Although the inventory of the state’s medical stockpiles is arguably a matter of public record, the governor’s office declined to provide details on how much medical and personal protective equipment are now in its reserves — much of it stored at large industrial warehouses in Guilderland, at Oriskany, Oneida County, and a facility in the New York City region.
The office did, however, promptly provide a breakdown of its expenditures during the pandemic, including listing $278 million to purchase more than 8,800 ventilators; $94.4 million to buy 1,179 mobile X-ray machines; and $60.7 million for more than 17,000 “oxygen concentrators” — a category the administration said encompasses the BiPAP devices.
On April 7, as the governor appeared on MSNBC to report that New York had logged a pandemic-high 800 deaths during the previous 24 hours, he said that hospitals were “over capacity” and facing a critical shortage of the ventilators used to treat critically ill coronavirus patients.
“We have been scrambling with ventilators. We move them all over the state like pieces on a chess board, literally whatever hospital has the greatest inflow (of patients) that night, we move ventilators around the state,” he said. “We have also used other machines that have a ventilating capacity, something called the BiPAP machine.”
BiPAPs are bi-level airway pressure machines that push air into a person’s lungs. Under the state’s plan, Cuomo had said, they were to be fitted with a special part that could make them function like a ventilator.
The state scrambled to acquire those machines as Cuomo cited health experts’ worst-case scenarios for hospitalizations and patients who may need to be intubated. On April 2, he announced the state had 750 BiPAPs in reserve and had purchased another 3,000 from a Pittsburgh medical supply company.
Six days later, Cuomo said a Florida company, Mercury Medical, had donated another 2,400 BiPAP machines that were being flown to New York for free by JetBlue.
But despite the governor’s assertions in April that the BiPAP machines were being “used” to treat patients, they were never put into operation.
“BiPAPs, luckily, were not needed,” Richard Azzopardi, an adviser and spokesman for Cuomo, acknowledged. He added: “As a matter of policy we do not comment on our stockpiled supplies.”
Azzopardi said the purchases were necessary at a time when the state — facing a $6.1 billion deficit before the pandemic struck — was planning for the worst, despite pushback from the White House that the governor was overstating his needs.
That discrepancy emerged in mid-April, when Cuomo and President Donald J. Trump repeatedly sparred over the levels of response as the governor cited earlier Centers for Disease Control estimates indicating there could be up to 2 million U.S. fatalities, and that New York’s 56,000 available hospital beds would fall far short of its needs.
But those estimates apparently did not factor in the reduction of infection rates due to economic shutdowns, social distancing mandates and the wearing of masks by millions of people.
The president retorted that New York would not need the number of hospital beds and ventilators that Cuomo had called for, and he also criticized the state for failing to keep an adequate stockpile of ventilators.
“Cuomo ridiculously wanted ‘40 thousand Ventilators.’ We gave him a small fraction of that number, and it was plenty,” Trump tweeted on April 17, as the two government leaders clashed. “State should have had them in stockpile! ... We built you thousands of hospital beds that you didn’t need or use, gave large numbers of ventilators that you should have had, and helped you with testing that you should be doing.”
Cuomo, who countered that the federal stockpile had just 10,000 ventilators, insisted that his estimates were based on scientific projections offered by federal and other medical experts and, if they were wrong, Trump should blame them.
The president’s remark about New York’s hospital beds referred, in part, to a 4,000-bed field hospital the federal government swiftly built at the Jacob K. Javits Convention Center in Manhattan, which never had more than 10% capacity and on most days was virtually empty. It was one of several field hospitals that Cuomo’s administration had scrambled to assemble in April that saw little use.
Azzopardi, the governor’s spokesman, said it was those field hospitals and potentially many more that were never built that had prompted the state to purchase more than 1,000 X-ray machines.
“These were procured at a time when the state was preparing for an apex projected to require 150,000 hospital beds and we planned on building several field hospitals — which needed to be fully equipped,” he said. “As we now know, New Yorkers crushed the curve of the virus and, thankfully, we never had to build the hospitals.”
Cuomo continued to push for more ventilators and increased hospital capacity after New York and nearly all other states implemented stay-at-home orders — including closing businesses and schools — that sharply flattened the rate of infections and deaths in New York.
It was during that period that Cuomo’s administration scrambled to purchase personal protective equipment, ventilators and the mobile X-ray machines, which cost an estimated $125,000 or more apiece, according to medical industry equipment suppliers.
Other expenditures included $35 million for gloves, $168 million for respirators and $4 million worth of soap. The governor’s office did not provide an exact dollar figure or quantity of the unused BiPAP machines.
“While New York was climbing the apex and projections showed we would need upwards of 150,000 hospital beds and 40,000 ventilators, Northwell Health developed a way to add a readily available part to the BiPAP that would effectively convert it into an emergency use ventilator,” Azzopardi said. “This type of conversion would only be necessary in an emergency situation and if hospitals and the state ran out of ventilators.”
He added “for context” that the number of people hospitalized in New York for COVID-19 symptoms only reached a little more than 18,000 at the height of the pandemic here, and that the state “never ran out of ventilators.”
With a now-ample supply of medical and protective equipment, the nation’s hardest-hit state from the coronavirus is now, in Cuomo’s words, returning favors to states that he said had helped New York, including sending “volunteer” health care workers here. But those volunteers were compensated, including many at pay rates far above what New York nurses and other front-line workers here were paid.
So far, Cuomo has authorized a multitude of donations from New York’s stockpiles of personal protective equipment to Houston, Atlanta, Savannah, Ga., and St. Petersburg, Fla. Those gifts include 22,500 face shields, 26,500 gloves, 22,500 N95 masks, 3,750 gallons of sanitizer, 124,000 surgical masks and 22,500 test kits.
“I know I speak for all New Yorkers when I say we will always be grateful for that help that came to us, and we are paying back the favor today by sending PPE to St. Petersburg, where we’ve worked together to establish a community testing site,” Cuomo said Wednesday, adding that New York would equip a testing site in Pinellas County, Fla. “We will continue to return the favor and lend help to whoever needs it.”
Azzopardi said New York’s purchases and stockpiling of medical equipment came as the pandemic’s grip on the world was peaking and it was unclear how many people may die or need hospitalization, including in intensive care units. Many states sent ventilators and workers to New York as its cases soared.
“New York was hit the hardest and had to contend with a worldwide shortage of protective equipment, but when we needed it the most 30,000 front-line workers from other states stepped up and volunteered to help us through one of our darkest moments,” he said. “We never forgot that and are proud to return the favor in any way we can, while also making sure we have the resources and the PPE available to brace for a second wave.”
Assembly Minority Leader William A. Barclay, a Republican from Oswego, said New York lawmakers should receive more information about how much equipment is in the state’s stockpiles, and why some of it is being shipped to other states.
“If taxpayer dollars are paying for equipment that is now collecting dust or being shipped to other states, then we have questions that demand answers,” Barclay said, adding that upcoming legislative hearings regarding New York’s response to the pandemic “may just be the right forum.”