COVID-19 Update April 30, 2019

New York State COVID-19 Stats

NYSDOH COVID-19 Tracker –

Notes from Governor Cuomo’s COVID-19 Briefing:

  • Hospitalizations and new cases are down.-306 new deaths yesterday – 287 in hospitals / 19 in nursing homes.
  • DATA:– Gov stressed two points about reopening:- Closely monitor the rate of transmission, keep it below 1.1.- Maintain 30% or more available hospital capacity.- The state has collaborated with the federal government to increase testing to 30,000 tests per day. The goal is 40,000.
  • TRANSIT:– NYC Subway conditions have rapidly deteriorated as a result of corvid-19.- MTA employees and NYPD officers are sick, so there are less people available to maintain the subway.- There are less people to provide outreach for homeless people.- The MTA has been cleaning the trains and buses every 72 hours.- Unfortunately, the virus can remain on surfaces for days.- Gov said that trains and buses should be disinfected every 24- The scale of work is unprecedented, but it must be done.

    – The MTA will also disinfect the Metro North and LIRR without

    service disruptions.

    – Overall ridership is down 92%.

    – The slowest hours are from 1:00 a.m. to 5:00 a.m.

    – When you get a positive case of COVID-19, you must trace by identifying who they have been in contact within the last 14 days.- Yesterday, there were 4,681 positive cases.- There are too many people to contact at once.- The state needs help tracing people- The state will collaborate with city and county health departments to find tracers- The state is also collaborating with former NYC Mayor- Bloomberg: we must use contact tracing as we relax socialdistancing protocols.

    – He announced partnerships with Johns Hopkins University,

    Vital Strategies, and Resolve to Save Lives, staffing

    organizations, and SUNY/CUNY.

    – These organizations will help with tracing training,

    recruitment, guidance, and app development.

    – Guidelines will be publicly available to provide a model for

    others and spread best practices.

    – There must be 30 contact tracers for every 100,000 cases.

    – Statewide, we will need about 6,000 tracers

    – There will be a tri-state collaboration for contact tracing.

    – Zucker: COVID-19 infects the lining of blood vessels and lungs.
    – Some kids are having strange, adverse effects to this.
    – Camps are set to open at the end of May.
    – Gov says that the federal government is not providing
    enough funding for schools, rental assistance, etc.

Physicians Offices Should Continue to Submit Requests for PPE through Local Office of Emergency Management (OEM)
Physicians’ offices should continue to submit requests for Personal Protection Equipment (PPE) through their local Office of Emergency Management. Physicians generally need to call the local Department of Health first.  Upon providing their license number and practice address they will be given the private OEM phone number or website address for requesting PPE supplies.   Physicians will need to provide information to the local OEM regarding the amount of PPE needed, license number, and practice location.  In some cases, we have been able to eliminate one step.  IT’S OFTEN A TWO-STEP PROCESS TO REQUEST PPE.

  • Here are contacts for this region:
  • In NYC, EMAIL the OEM   Make sure you include doctor’s name, complete contact information, and the request.
  • In Nassau, you can go directly to the OEM website (OEM phone number is 516 573-9600)
  • In Suffolk, you can go directly to this website.
  • In Westchester, call the DOH at 1-866-588-0195, Option 2.  A DOH expert will take the request and provide the next step for reaching the OEM

New York State continues to fulfill requests for PPE and provides supplies to the local OEM when there is a request. If your practice is unable to obtain PPE through vendors and local Offices of Emergency Management fail, please let MSSNY know.  MSSNY will need the information that was provided to the local OEM so that we can provide that information back to the state.  MSSNY is in continuous contact with the NYS Department of Health to help address such situations.

For general guidance on the use of PPE in healthcare settings, please refer to CDC guidance entitled “Healthcare Supply of Personal Protective Equipment”.

MSSNY is engaging our county societies statewide to assess the level of difficulty physicians may be encountering in obtaining PPE, to determine if problems being reported are local in nature, or more widespread.

2)  Guidance on steps to take in reopening physician practices is being finalized and will be circulated shortly. 

3)  We are engaged with the Dept of Health and the OPMC on legal changes needed to support confidential peer-to-peer support for physicians during the pandemic and beyond.  Meetings are occurring this week.

HHS: FAQs Posted Regarding Second Tranche
The Department of Health and Human Services (HHS) has posted new Frequently Asked Questions regarding the second tranche of disbursement of the CARES Act Provider Relief Fund. Regarding second Tranche Please note there is conflicting information about whether a provider who has not previously received money from the first round of funding can apply for this round.  The AMA is trying to clarify this and other questions with HHS.

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Paycheck Protection Program (PPP) Update
Have you applied for the PPP small business forgivable loan program yet?  According to as of 5:00 PM yesterday more than 960,000 loans had been approved totaling greater than $90 billion. The total number of lenders involved in processing these transactions has been 5,300 so far. Last week Congress approved an additional $310 billion for the program.

Yesterday, the SBA notified borrowers and lenders that certain provisions would be put in place to favor lending from smaller institutions. The text of the notice:

Paycheck Protection Program (PPP) Lending Operations Update – Wednesday, April 29, 2020

SBA and Treasury value all lenders and their small business customers.

To ensure access to the PPP loan program for the smallest lenders and their small business customers, starting at 4 p.m. yesterday EDT through 11:59 p.m. EDT, SBA systems will only accept loans from lending institutions with asset sizes less than $1 billion.

Please note, lending institutions with asset sizes less than $1 billion will still be able to submit PPP loans outside of this time frame. Please also note that lenders with asset sizes greater than $1 billion will be able to submit loans outside of today’s 4:00 PM -11:59 PM EDT reserved processing time.

Today this reserved processing time applies to April 29, 2020. SBA and Treasury will evaluate whether to create a similar reserved time again in the future.

SBA and Treasury continue to monitor loan system performance and will continue to provide frequent updates to the lending community.

Governor Issues Executive Order to Resume Elective Surgery in 35 Counties, but Only in Hospitals
The Governor issued an Executive Order on April 29 to lift the prohibition on elective surgery in 35 upstate counties based upon meeting certain criteria, but only for hospitals in those counties.  There was an arbitrary exclusion of Ambulatory Surgery Centers and Office-Based surgery locations in these counties from resuming elective surgery.  With many patients facing significant health care issues including pain that require surgical intervention, there is no good reason to exclude these care facilities from the resumption of these elective procedures.  For the benefit of patients, physicians are urged to contact the Governor to lift this restriction by sending a letter from here.

The counties in which hospitals are now eligible are: Allegany, Broome, Cattaraugus, Chautauqua, Chenango, Delaware, Dutchess, Essex, Franklin, Fulton, Genesee, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Niagara, Oneida, Onondaga, Ontario, Orleans, Oswego, Putnam, Saratoga, Schoharie, Schuyler, St. Lawrence, Steuben, Sullivan, Tompkins, Ulster, Wayne, Wyoming and Yates.

NIH Announces $1.5 billion, ‘Shark Tank’-like Initiative to Accelerate Covid-19 testing
The NIH yesterday announced a $1.5 billion initiative aimed at speeding up the availability of diagnostics for Covid-19. The hope is that this endeavor will lead to “millions of tests” being deployed per week by late summer or fall. The initiative will rely on a “national Covid-19 testing challenge,” in which researchers and inventors across the country will compete for a share of $500 million in a “Shark Tank”-style competition to move their proposed inventions forward. The National Institute of Biomedical Imaging and Bioengineering’s director Bruce Tromberg tells STAT’s Lev Facher that the agency, which will be coordinating the initiative, expects to select roughly five winners who will be paired with manufacturers who will mass-produce the new diagnostics.

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NIH: Critical Study of COVID-19 Drug Shows Patients Respond to Treatment
Preliminary data released yesterday from a closely watched, government-run trial of Gilead’s remdesivir showed it was effective in Covid-19 patients. Those who were given remdesivir recovered four days faster than those who were given placebo. The decrease in mortality rate compared to placebo was not statistically significant. Anthony Fauci, the director of NIAID, which is conducting the study, said the data are a “very important proof of concept,” but cautioned they were not a “knockout.”

The preliminary results come after days of conflicting results on remdesivir’s efficacy against Covid-19: While early results from Gilead’s separate trial of the drug in severe Covid-19 patients showed promise, data from a trial in China showed no added benefit. NIAID’s trial results are critical because the drug was tested in a large number of patients and neither the patients nor physicians knew who was getting the drug, which controlled for any unconscious biases. And following NIAID’s preliminary data, the FDA is exploring an emergency use authorization for remdesivir, according to The Wall Street Journal.



COVID-19 Update April 29, 2020

New York State COVID-19 Stats

NYSDOH COVID-19 Tracker –

Deaths: Individual NYS Nursing Homes

Gov. Cuomo Press Conference: What You Need to Know


  • Schools and nonessential businesses will stay closed through May 15th.
  • Governor Cuomo issued executive orders 17 and 202.18 requiring all people in New York to wear masks or face coverings in public, including when taking public or private transportation or riding in for-hire vehicles.
  • Governor Cuomo outlined a phased plan to re-open New York starting with construction and manufacturing, implemented in phases based on regional analysis and determinations.
  • 35 counties without a significant risk of a COVID-19 surge in the near term have been approved to resume elective outpatient treatments.
  • Preliminary Phase II results of Antibody Testing Study show 14.9% of the population have COVID-19 antibodies. Find more information and FAQs on antibody testing.
  • New York State is expanding diagnostic testing criteria to allow all FDNY and NYPD officers, first responders, health care workers, transit workers and essential employees to be tested for COVID-19 even if they are not symptomatic.
  • Preliminary results of the FDNY and NYPD antibody testing survey show 17.1% of FDNY officers and EMTs have COVID-19 antibodies, and 10.5% of NYPD officers have COVID-19 antibodies.
  • 1,000 transit workers will be tested for antibodies to further determine the spread of infections among frontline workers.
  • New York State is now conducting 30,000 diagnostic tests for COVID-19 per day.
  • The MTA has been directed to issue a full plan by April 30th, on how it will clean and disinfect trains in response to reported deteriorations of conditions in subways.
  • New Yorkers without health insurance can apply through NY State of Health through May 15, 2020; must apply within 60 days of losing coverage.
  • New Yorkers can call the COVID-19 Emotional Support Hotline at 1-844-863-9314 for mental health counseling.
  • Testing is free for all eligible New Yorkers as ordered by a health care provider.

Gov. Announces 35 NY Counties That Can Resume Outpatient Treatment
Governor Cuomo today announced the 35 counties have been approved to resume elective outpatient treatment, as a follow up to his previous announcement that the state will allow elective outpatient treatments to resume in counties and hospitals without significant risk of COVID-19 surge in the near term.

These counties include: Allegany, Broome, Cattaraugus, Chautauqua, Chenango, Delaware, Dutchess, Essex, Franklin, Fulton, Genesee, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Niagara, Oneida, Onondaga, Ontario, Orleans, Oswego, Putnam, Saratoga, Schoharie, Schuyler, St. Lawrence,  Steuben, Sullivan, Tompkins, Ulster, Wayne, Wyoming and Yates.

Dr. Fauci Touts Clinical Trial of COVID drug as “Quite Good News”
Dr. Anthony Fauci, a key member of the White House coronavirus task force, said results from a COVID-19 clinical trial of a drug for treating the disease showed “quite good news.” Data from a study of remdesivir showed patients recovered quicker when taking the drug, Fauci told reporters at the White House Wednesday, alongside President Trump and Vice President Pence. Remdesivir patients saw a 31 percent improvement over placebo patients, Fauci said.

Although a 31 percent improvement does not seem like a knockout 100 percent, it is a very important proof of concept,” Fauci said. “What it has proven is that a drug can block this virus.”

He added the drug will be “the standard of care.”Remdesivir patients also saw an 8 percent mortality rate, which is slightly lower, but not statistically significant, from the 11.6 percent mortality rate of placebo patients, Fauci said. The drug’s impact on the COVID-19 mortality rate needs further analysis, he said.

The clinical trial, which began in February, evaluated the safety and efficacy of remdesivir, an experimental drug developed by Gilead Sciences, in 1,063 hospitalized adults with COVID-19. The trial was the first in the U.S. to evaluate an experimental treatment for COVID-19.

“We think it’s really opening the door to the fact that we now have the capability of treating [COVID-19],” Fauci said of the results. He said he can “guarantee” the drug will improve as more people, companies and investigators get involved. The study has not yet been published or peer reviewed.

Scientists have had high hopes for remdesivir as a potential COVID-19 treatment. The drug originally developed as a potential treatment for Ebola but was found to be ineffective.

However, the drug has shown promise against coronaviruses in experiments.

Scott Gottlieb, former Food and Drug Administration commissioner under President Trump, said on CNBC Wednesday he thinks the drug is probably not a “home run” treatment for COVID-19, but it could help people avoid worse outcomes. The Hill

Updated at 1:30 p.m.

MSSNY: Community Doctors Should Be Part of Testing Efforts
The Medical Society of the State of New York applauded Gov. Andrew Cuomo’s efforts to increase Covid-19 testing but said community physicians should be at the forefront. The group expressed concern over a new executive order to allow pharmacies to become collection sites for tests.

“In particular, we are concerned that there has not been any specification for how such test results will be shared with the patient’s primary physician or physicians to help explain to the patient what the results mean … as well as what the patient should do,” said Dr. Art Fougner, president of the medical society, in a statement.

The group also questioned the lack of effort to involve community physicians in any statewide testing program and to help them obtain the supplies and personal protective equipment needed to provide Covid-19 tests.

“Not only are community physicians an integral part of New York’s health care system, but many of them have been—unaware to many—working tirelessly to keep the surge of patients from becoming a tsunami, which would have overwhelmed our hospitals,” Fougner said.

People place trust in community physicians, he said, adding that the medical society is urging Cuomo to enlist them to fully expand the state’s testing capacity, which is critical to reopening businesses. ((April 29 Crain’s New York)

Physician Advocacy Orgs Object to Suspension of Medicare Advance Payment
As reported in Med Page, the AMA and other national physician societies joined MSSNY in expressing strong concerns with the decision of the Center for Medicare & Medicaid Services to suspend its program to give physicians and hospitals advance Medicare payments to help them keep their practices open in the wake of COVID-19, suggesting that the program is no longer necessary.

The program had provided nearly $500 million in advance payments to New York Part B providers including physicians and $8.3 billion to Part B providers across the country overall.  It also distributed over $90 billion to Part A providers.

According to a press release issued Sunday, “The agency made this announcement following the successful payment of over $100 billion to healthcare providers and suppliers through these programs and in light of the $175 billion recently appropriated for healthcare provider relief payments,”

In a fact sheet update accompanying the announcement, CMS explained that “beginning on April 26, 2020, CMS will not be accepting any new applications for the Advance Payment Program, and CMS will be reevaluating all pending and new applications for Accelerated Payments in light of historical direct payments made available through HHS’s Provider Relief Fund. Significant additional funding will continue to be available to hospitals and other healthcare providers through other programs.” The agency noted that the Department of Health and Human Services has already given $30 billion to providers through the CARES Act Provider Relief Fund.

While MSSNY, the AMA and other physician groups had previously taken issue with some of the terms of the Advance Payment program, the program was urged to be continued under more favorable terms. MSSNY is urging the New York Congressional delegation to continue the program in the next stimulus bill to be taken up by Congress.

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Targeted Allocation for Treating the Uninsured
For any physicians who may have treated uninsured patients during this COVID-19 Pandemic,  please review the following link for how you may seek financial help from the Targeted Allocation of the CARES ACT.

HHS: FAQs Posted Regarding Second Tranche
The Department of Health and Human Services (HHS) has posted new Frequently Asked Questions regarding the second tranche of disbursement of the CARES Act Provider Relief Fund. Regarding the second Tranche Please note there is conflicting information about whether a provider who has not previously received money from the first round of funding can apply for this round.  The AMA is trying to clarify this and other questions with HHS.

Gov. Cuomo Orders All NYC Subway Cars Cleaned Every Night
New York Gov. Cuomo on Wednesday ordered that all New York City subway cars be cleaned every night by Metropolitan Transportation Authority (MTA) workers to ensure the safety of essential personnel during the coronavirus pandemic.

“Any essential worker who shows up and gets on a train should know that that train was disinfected the night before,” Cuomo told reporters at his daily coronavirus press briefing.

“Letting them endanger their own life and endanger the lives of others is not helping anyone,” Cuomo said. The governor said that he wants MTA to present to him a plan for the nightly cleanings by Thursday. “It’s realistic. It is essential. How realistic is it? What’s the alternative?” Cuomo said when asked if the state would provide funding to the MTA for the cleaning.

He also commented on reports of the deteriorating state of subway cars during the crisis as the city has allowed homeless people to stay on the cars with their belongings. “No one wants to live their lives on a subway train,” Cuomo said. “We have a higher obligation as a society than to say ‘OK, you can sleep in a subway car.'”

He also announced that starting Wednesday, the state of New York would be offering antibody testing for transit workers to determine if they have contracted or been exposed to COVID-19 and developed the antibodies to fight it. A positive antibody test does not guarantee immunity from the virus, but it does signal that someone may have added protection against the virus moving forward. The Hill 4/29