We called the plan “Surge & Flex.” Not the most artful name, but it was descriptive. We would have to operate the individual hospitals as if they were one health-care system and work to manage the surge of patients and the increased demand. Patient load would increase exponentially, but the surge needed to be balanced throughout the system. As patients came in, we would monitor the numbers and direct them to hospitals that had vacancies and capacity. If patients needed to be moved from one facility to another, we would provide transportation.
The system would also have a “flex” capacity. No hospital had significant inventory of ventilators and PPE. We would flex resources as necessary among the hospitals and develop a central supply of materials. All hospitals throughout the state would work together in purchasing supplies. Rather than having separate hospitals competing against one another, we would cooperate.
The flex concept would also apply to staff. If one hospital had a shortage, we would identify staff from other hospitals who could be moved. This would all be coordinated through a daily reporting system where each hospital reported its capacity, vacancy rate, ICU bed availability, PPE, ventilators, and so forth. Every night there would be a coordinating call run by the state with all the hospitals in that region which would allocate and adjust the load across the system. This would be an extraordinary and unprecedented management exercise, but it had to be implemented tomorrow. Like everything else, it seemed, what was impossible yesterday was a necessity today.
We set up a meeting at the Javits Center with all the major downstate hospital administrators to go through our new Surge & Flex plan. It was a large group, and Javits had the space for a socially distanced meeting. This physical setting at the Javits Center drove home the urgency of our situation, without my saying a word. The seemingly endless row of hospital beds and sea of green uniforms took your breath away. They were frightened. We went through the details, and everyone was shocked and dubious, but they were on board to try.
Of course, we received concerning news right after the meeting. Par for the course. One of the hospital executives who was there, Lee Perlman, from the Greater New York Hospital Association, tested positive the next day. I spent time at the meeting in proximity to Lee, as had many of the other hospital executives.
It would be one thing if I got sick. I understood the risk; more troubling would be if it spread to my senior team and the others at that meeting, which included all the key hospital administrators who were running the entire system. Lee’s infection reminded all of us of the power of the virus and how quickly our situation could get even worse.
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THE NEXT PERSON close to me to contract COVID was very close: my brother, Christopher. He spoke openly about battling the virus on his nightly show: the teeth-rattling chills, how he lost more than ten pounds. What people were seeing in our exchanges wasn’t much different from how we were in private. I was nervous for Chris; he’s my little brother, and I’ve always been there for him. He was staying at home with his three kids and wife, confined to the basement, and he couldn’t see anyone else. It felt unnatural for me not to be able to see him and help him. But that was the curse of COVID.
Chris is relatively young and healthy and not in a vulnerable category, but COVID is frightening nonetheless. He was fortunate to have the best doctors available and all the help he needed. Dr. Fauci also spoke to him. Dr. Fauci is from Brooklyn. I knew him from the 1980s when he worked on the HIV/AIDS crisis. I was talking to him a couple of times a week as it was. He was the best mind on the science.
Chris’s broadcasts and my briefings were the most comprehensive and intimate communications people were receiving about this crisis, and now he was giving people a front-row seat to the disease’s devastating symptoms—even for those who were young and healthy before. Chris recovered after about two weeks, so people saw someone battle the virus from start to finish. They also watched me experiencing it with Chris, so they knew once again that I understood the crisis on a deeply personal level. They were right.
APRIL 4 | 10,841 NEW CASES | 15,905 HOSPITALIZED | 630 DEATHS
“If we don’t stop the spread, then it’s going to burn down our country.”
NONE OF MY TASKS EVER seemed to be finished. They just kept going. It was hard for me to deal with. I am a “closer.” I find comfort in completion. The doctors kept telling me hospital beds without ventilators would be virtually useless. We would need about forty thousand ventilators at a minimum, at the projected apex. That would at least give every ICU bed a ventilator. We had about four thousand to start, and ordered about seventeen thousand, of which about three thousand had arrived, for a total of seven thousand on hand, and the search for more was a daily undertaking.
China remained a major supplier of ventilators. Who could help in China? I contacted Bob Rubin, former secretary of the Treasury, chairman emeritus of the Council on Foreign Relations, and a colleague from the Clinton administration. His partner Blair Effron is an old friend and a wise, trusted investment banker. They were pursuing every contact they had. I also spoke to Elizabeth Jennings at the Asia Society, who has extensive contacts and is indefatigable. They were great and had many good ideas that we pursued together for weeks. In this exercise of manic networking, a gentleman named
