President Trump cited a Gateway Pundit report during a COVID-19 Chinese coronavirus town hall on the Fox News Channel Tuesday that was posted on March 22 at The Gateway Pundit website.
In 2015 New York Governor Andrew Cuomo rejected a recommendation by a study group that New York state needed 16,000 more ventilators than the several thousand they had in stock to deal with a pandemic on the scale of the 1918 Spanish flu.
Cuomo opted instead to set up “triage officers” and even lotteries to determine who would get a ventilator should the hospital system get overwhelmed during a pandemic and who would be left to die with palliative care, with the young getting preferential treatment.
Without naming TGP, Trump read the Gateway Pundit article headline to Fox News anchor Bill Hemmer, “NY Gov. Cuomo Rejected Buying Recommended 16,000 Ventilators in 2015 for Pandemic, Established Death Panels and Lottery Instead”
FNC YouTube video cued to President Trump citing TGP article:
And Twitter video clip posted by the Trump campaign:
— Team Trump (Text TRUMP to 88022) (@TeamTrump) March 24, 2020
The TGP report was based on a column published this month by former New York Lieutenant Governor Betsy McCaughey (who served under Governor George Pataki), a February report by the New York Times and a 2015 press release by the Cuomo administration.
This has become an issue because Cuomo has become panic-stricken as the coronavirus pandemic ravages his state, particularly New York City, and he has taken to criticizing the Trump administration for not getting ventilators to his state fast enough.
Cuomo expresses outrage at FEMA for sending New York 400 ventilators when it needs at least 30,000: "You pick the 26,000 people who are going to die because you only sent 400 ventilators." https://t.co/hmODbKuv4b pic.twitter.com/vsbEX1dny8
— CBS News (@CBSNews) March 24, 2020
Vice President Mike Pence announced on FOX during Tuesday’s town hall before President Trump joined the discussion that the Trump administration was sending 2,000 ventilators to New York today and 2,000 more Wednesday.
— Team Trump (Text TRUMP to 88022) (@TeamTrump) March 24, 2020
…After learning that the state’s stockpile of medical equipment had 16,000 fewer ventilators than New Yorkers would need in a severe pandemic, Gov. Andrew Cuomo came to a fork in the road in 2015. He could have chosen to buy more ventilators. Instead, he asked his health commissioner, Howard Zucker to assemble a task force and draft rules for rationing the ventilators they already had.
That task force came up with rules that will be imposed when ventilators run short. Patients assigned a red code will have the highest access, and other patients will be assigned green, yellow or blue (the worst) depending on a “triage officer’s” decision. In truth, a death officer. Let’s not sugarcoat it. It won’t be up to your own doctor.
Cuomo could have purchased the additional 16,000 needed ventilators for $36,000 apiece or a total of $576 million in 2015. It’s a lot of money but less than the $750 million he threw away on a boondoggle “Buffalo Billion” solar panel factory. When it comes to state budget priorities, spending half a percent of the budget on ventilators is a no brainer.
Now the pandemic is actually here. Cuomo’s grim reaper rules will be applied. New York City’s deputy commissioner for disease control Demetre Daskalakis is anticipating “some very serious difficult decisions.” So far, in New York City, 1 out of every 4 people with a confirmed case has been hospitalized, and 44% of them have needed a ventilator.
The task force claimed there was no point in buying ventilators because there’s also a shortage of doctors and nurses trained to use them. Five years ago, that problem could have been fixed, too. Even now, the National Disaster Medical System can send staff to hot spots like New York…
Across New York, there were 7,241 ventilators in acute care settings, and another 1,750 stockpiled for use in an emergency, according to a 2015 state report. The report noted that the supply of ventilators would be inadequate for a pandemic on the scale of the 1918 flu outbreak.
The task force that issued the report devised a formula, relying partially on medical criteria, to help hospitals decide who would get ventilators and who would not. It also envisioned a lottery system in some instances. And age could play a role, with children being given preference over adults.
Excerpt from Cuomo administration press release November 25, 2015 that mentions the triage officers.
New York State Department of Health and New York State Task Force on Life and the Law Update Ventilator Allocation Guidelines
ALBANY, N.Y. (November 25, 2015) – The New York State Department of Health and the New York State Task Force on Life and the Law released updated guidelines for allocating ventilators during an influenza pandemic in New York State.
“Pandemic influenza is a foreseeable threat, and New York has a responsibility to plan now,” said Commissioner of Health Dr. Howard Zucker. “These guidelines provide an ethical, clinical, and legal framework to help health care providers and the general public make difficult decisions in the event of an influenza pandemic.”
The guidelines provide direction for the distribution of ventilators in the event ofa severe pandemic, when there are insufficient ventilators to treat everyone who needs them. The guidelines balance the goal of saving the most lives with important societal values, such as protecting vulnerable populations. The guidelines are non-binding and designed with sufficient flexibility to adjust to changing clinical information.
The guidelines consist of four parts: Adult Guidelines, Pediatric Guidelines, Neonatal Guidelines, and Legal Consideration when Implementing the Guidelines. New York is the first state to develop innovative clinical protocols that address special considerations in treating children and neonates. The adult clinical protocol was updated and revised from the 2007 draft guidelines.
The guidelines were developed with input from experts in the fields of medicine, ethics, law, and policy as well as members of the public. Key points include:
The guidelines provide an evidence-based clinical framework that support the goal of saving the most lives in an influenza pandemic in which there are a limited number of available ventilators.
All patients in need of a ventilator are subject to one of the three clinical protocols, using objective, universally-applied clinical criteria to evaluate a patient’s likelihood of survival. Patients who have the highest likelihood of survival with ventilator therapy receive priority. Factors such as race, ethnicity, sexual orientation, socio-economic status, advanced age, perceived quality of life, ability to pay, role in the community, or other subjective criteria will never be part of the evaluation in determining who receives ventilator therapy.
To ensure that patients receive the best possible care in a pandemic, the guidelines call for a triage officer or triage committee to determine who receives or continues to receive ventilator therapy. To prevent a conflict of interest, these decision-makers are not the patients’ attending physicians. The decision regarding whether to use a triage officer or committee is up to each hospital, given the different resources at each site.
The guidelines apply only to patients at hospitals and not to ventilator-dependent chronic care patients at long-term care facilities, such as nursing homes. However, if such a patient requires hospital care, the patient is then subject to the clinical protocol.
Patients not receiving ventilator therapy should receive alternative forms of medical intervention. Palliative care will be provided to all patients to manage patient discomfort.
During a pandemic the guidelines will be modified as new information is obtained. Data collection and analysis of the pandemic viral strain, as well as symptoms, disease course, treatments, and survival, will be taken into consideration, so that patients receive the best care possible.
Additional public outreach efforts will be conducted regarding the guidelines and the public will have opportunities to comment on them.
“The guidelines were written to reflect the values of New Yorkers, and extensive efforts were made to obtain public input during their development,” said Susie Han, Deputy Director of the New York State Task Force on Life and the Law and project chair of the guidelines. “The guidelines are a living document, intended to be updated and revised in line with advances in clinical knowledge and societal norms.”
Established in 1985, the New York State Task Force on Life and the Law is the State’s bioethics commission and consists of approximately 23 Governor-appointed experts who volunteer their time to assist the State in developing public policy on issues arising at the interface of medicine, law, and ethics. Chaired by New York State’s Commissioner of Health, the Task Force is comprised of leaders in the fields of religion, philosophy, law, medicine, nursing, and bioethics. The Task Force has produced influential reports on cutting-edge bioethics issues, including the withholding and withdrawing of life-sustaining treatment, assisted reproductive technologies, organ transplantation, dietary supplements, surrogate decision-making, genetic testing, and research involving adults who lack capacity to consent.
The 272 page Ventilator Allocation Guidelines in PDF format can be read at this link.