It is a provable proposition and it should be proven. Accountability matters. If you don’t want to be accountable, you shouldn’t be in a government position. The people pay your salary. What did they get in return?
Operational capacity is also a metric for political validity. If we want politics to get beyond the empty rhetoric and “advocacy in action” betrayal, then government must be able to make an actual difference. If government can’t make a difference for one reason or another, then stop deceiving people. At some point, politicians have to stop making excuses and accept responsibility.
An official is elected to make a difference. Either they can or they can’t. During COVID, this became true on steroids. The timeline is short, progress or failure is evident, and the consequences could not be more dramatic.
While I spent a great deal of time working on my relationship with the people in briefings, communication, and follow-up, I put as much energy into the management of government. It’s all about the details and making the bureaucracy work.
From the beginning, we understood that setting up a testing system would be the top priority. The federal government had no interest in enacting a national testing strategy, and without testing we were flying blind. After my first conversations with the Department of Health and my own team, I knew how hard it would be to bring testing to mass scale in just weeks—but there were no options but to tackle it head-on.
To set up a testing organization required several large steps, some of which I have already described. But to review, first, the laboratories in the state capable of the highest production needed to be brought up to speed and equipped. The state lab at Wadsworth, the Northwell Health system lab, the Mount Sinai lab, the NYU Langone lab, the University of Rochester Medical Center lab, the Columbia-Presbyterian lab—with the right equipment operating seven days per week, these facilities could conduct several thousand tests per day.
The second step was to somehow mobilize the state’s smaller private laboratories into one system. New York State licenses about three hundred private labs to do clinical diagnostic testing. Each lab had to be brought online and incorporated into the system. We had to find out what equipment they had, what equipment they needed, and what supplies and reagents were needed, and we had to work with them to create a seven-day-a-week operation. As of this writing, about 250 of these labs conduct testing each day for New York State—an increase of 249 from when the FDA gave the state approval to test on February 29!
Third, we contacted the major out-of-state “reference” labs, which were national labs that did businesses across the country, such as LabCorp and Quest. These labs had enormous capacity—more than 100,000 tests per day—but were relied on by all fifty states.
Fourth, we had to locate and construct public testing sites where people would actually go to have the test taken—normally a nasal swab. Proximity was important, as were the practical logistics of a suitable site to manage the COVID challenges—long waiting lines where people congregate could end up resulting in more viral spread.
We took a multifaceted approach. We set up outdoor drive-through testing sites all across the state, using the National Guard to erect temporary tent structures, and brought in health-care providers to do the tests. For urban communities where fewer residents had cars, we set up mostly outdoor walk-in sites, but we made them appointment-only to avoid lines where the virus could spread. In addition, we partnered with Northwell Health and SOMOS Community Care to set up additional testing sites in hot-spot zip codes, including at churches and community centers, where people would feel comfortable coming to get their noses swabbed. I also signed an executive order to allow pharmacies to become test sites. Tom Feeney, a competent and hardworking staff member who is an expert at advance planning and operations, was instrumental in this effort; in July, as part of the New York delegation, he traveled to states such as Florida, Georgia, and Texas to help them set up testing sites. When all was said and done, we had more than 850 sites across the state where New Yorkers could go get a test.
Fifth, we had to convince people to go to take tests. By May 17, we had both a good and a bad problem. The good problem was that while we were doing about forty thousand tests per day, our labs and testing sites were running under capacity. The bad problem was that New Yorkers didn’t want to get tested. People were not showing up to appointments, and many still thought testing was scarce—and possibly painful! We needed to be creative. We used advertising campaigns to communicate how important testing was. We also had to ease the fear of testing. Everyone wanted to know if it would hurt.
I had the idea of getting tested at a briefing to show the public how fast and easy and painless it was. It was a good idea in concept. I had taken the test before, and having a long swab put in your nose isn’t pleasant. It can make your eyes tear and make you cough or sneeze. Normally you have a few minutes to recover afterward, and normally you don’t have a camera in your face broadcasting it on live TV.
My team said that if I did the test on TV and had a bad reaction, it would set the progress made on testing back months. I told them I was sure that I could do it. Really, I wasn’t so sure. The day of the test, I was about to go out to the briefing and I met the nurse who was going to perform the test. She seemed a little tense and was not accustomed to performing tests on national TV, for obvious reasons.
We chitchatted, and I was trying to put her at ease with my cool-dude-in-a-loose-mood banter. At
