Andrew Cuomo: Activate the Army to fight coronavirus

Dear Mr. President,

The coronavirus pandemic is now upon us, and data from other countries shows us clearly where we are headed.

Every country affected by this crisis has handled it on a national basis. The United States has not. State and local governments alone simply do not have the capacity or resources to do what is necessary, and we don’t want a patchwork quilt of policies.

There is now only one question your team must answer for you: Can we slow the spread of the disease to a rate that our state health care systems can handle? The answer increasingly looks like no.

But that does not mean we should not try. There are fewer options available at this late date, but the federal government should move to implement them swiftly. There are three clear imperatives we need to address:

Testing

Slowing the spread of coronavirus is a function of testing and reducing the density of public gatherings. So first, Mr. President, you must stop the Food and Drug Administration and Centers for Disease Control and Prevention from overregulating the testing process, and authorize states to certify a wider array of testing labs and methods.

On Friday, you said that your administration had agreed to allow New York State’s public health department to authorize local labs to perform the state’s approved coronavirus test — a good first step. Your administration also approved high-volume automated testing by the Swiss diagnostics maker Roche.

But these moves are insufficient. Because of the high demand for testing kits nationwide, many labs with Roche machines will be unable to obtain enough of the company’s testing kits for weeks or even months. There are other labs that can do high-volume coronavirus tests that do not use Roche kits. But these machines cannot be used without further F.D.A. approvals, of the sort Roche received on Friday.

That means that while New York is conducting thousands of tests a day, we are still below our full testing capacity because many labs still rely on low-volume manual testing.

Mr. Trump, don’t let bureaucracy get in the way of fighting this virus. Break the logjam, let states fully take over testing so they can unleash hundreds of labs tomorrow and bring testing to scale. It is the only way we will have a chance of keeping up with the rapid spread of this contagion.

Closings

Second, the closing of schools and businesses has federal implications, even if these are state or local decisions. When one state unilaterally closes businesses, people typically cross state lines to look for open businesses elsewhere. If the purpose is to keep our citizens home and out of crowded spaces, such inconsistency in state policies is counterproductive. There should be a uniform federal standard for when cities and states should shut down commerce and schools, or cancel events.

All of this disruption will have immense financial and economic impact, and federal assistance will be needed to soften the blow. When schools close, localities will need help to provide meal programs to students and child-care programs to parents. Unemployment will skyrocket, as will insurance, health care and education costs.

The federal government must not only make aid available, it must also ensure that its assistance is distributed in clear, uniform ways. No state should be penalized for doing the right thing in trying to protect its residents during this crisis.

Risk to hospitals

Third, you must anticipate that, without immediate action, the imminent failure of hospital systems is all but certain. According to one projection, as many as 214 million people in our country could be infected over the course of the epidemic. Of those, as many as 21 million people could require hospitalization.

This would crush the nation’s medical system. New York State has just 53,470 hospital beds, only 3,186 of which are intensive-care beds. Our country as a whole has fewer than one million staffed hospital beds, fewer proportionately than China, South Korea or Italy.

Ask your experts, how many intensive-care beds do we need for our vulnerable populations, and how many do we have now? The scarcity portends a greater failing and a worse situation than what we are seeing in Italy, where lives are being lost because the country doesn’t have the health care capacity.

States cannot build more hospitals, acquire ventilators or modify facilities quickly enough. At this point, our best hope is to utilize the Army Corps of Engineers to leverage its expertise, equipment and people power to retrofit and equip existing facilities — like military bases or college dormitories — to serve as temporary medical centers. Then we can designate existing hospital beds for the acutely ill.

We believe the use of active duty Army Corps personnel would not violate federal law because this is a national disaster. Doing so still won’t provide enough intensive care beds, but it is our best hope.

In short: Localize testing, federalize shutdowns and task the Army Corps of Engineers to expand hospital capacity.

I make these suggestions not as a Democrat but as one of the nation’s most senior governors and a former cabinet secretary who knows the capacity of the federal government.

We have had disagreements about your actions against New York, which we can pursue at another time. Today, let’s work together as Americans. Time is short.

Andrew Cuomo is the governor of New York.