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A 2015 New York state report said that in the case of a “severe” pandemic, the state would be short about 16,000 ventilators during the peak week. But the report did not recommend buying 16,000 ventilators, and did not indicate whether the state was at a fiscal position to purchase them.
The state did not plan to increase its ventilator stockpile because it anticipated that in the event of a severe crisis, there would be shortage of trained staff to operate them and demand would outweigh any emergency stockpile.
The report said the state had to balance the likely ventilator shortage with the need for adequate funding for current and ongoing health care expenses.
President Donald Trump didn’t like that New York Gov. Andrew Cuomo said on TV that the federal government should provide the state stockpiled ventilators to help New Yorkers battling the coronavirus pandemic.
Trump said his administration was helping Cuomo, and Cuomo "shouldn't be talking about us, he’s supposed to be buying his own ventilators."
Trump used a moment in his Fox News town hall to say Cuomo had the chance a few years ago.
"Right here, I just got this out," Trump said March 24, shuffling through papers. "This says New York Governor Cuomo rejected buying recommended 16,000 ventilators in 2015 for the pandemic, for a pandemic, established death panels and lotteries instead. So, he had a chance to buy, in 2015, 16,000 ventilators at a very low price and he turned it down. I’m not blaming him or anything else."
New York is, as of March 25, the worst-hit spot in the United States, with more than 25,000 people diagnosed with COVID-19, the disease caused by the new coronavirus. Cuomo has repeatedly said New York needs thousands more ventilators and that the federal government should lend ventilators it has in its reserves.
PolitiFact wondered if Trump was right that Cuomo a few years ago rejected buying ventilators, and "established death panels and lotteries instead."
The White House did not reply to our requests for evidence backing Trump’s claim.
But Trump appeared to be reading, word-for-word, a March 22 headline on the Gateway Pundit, a conservative website. The website linked to a March 18 post on creators.com, by Betsy McCaughey, a Republican who served as lieutenant governor of New York in the 1990s.
McCaughey’s post said that Cuomo in 2015 "could have chosen to buy more ventilators" after learning that the state’s stockpile had 16,000 fewer ventilators than needed in case of a "severe" pandemic.
Instead, a task force drafted rules for rationing the ventilators they already had, McCaughey wrote. "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," she wrote.
Cuomo, a Democrat, has been New York’s governor since 2011. New York’s health department in 2015, as part of its emergency preparedness plans, issued a report on ventilator allocation guidelines the state could follow if it had to deal with an influenza pandemic. It modeled data to examine scenarios under a "moderate" pandemic (1957 and 1968 flu pandemics characteristics) and a "severe" pandemic (similar to the 1918 pandemic).
A task force estimated that under a severe scenario, more than 800,000 people would be hospitalized, and during peak week demand, around 18,600 ventilators would be needed. During that peak week, the state would likely be short about 16,000 ventilators, the report said. (Under a moderate scenario, the state would have a surplus during the peak week.)
The state had "no current plans" to buy enough ventilators for the most severe scenario, the report said.
"The state’s current approach to stockpiling a limited number of ventilators balances the need to prepare for a potential pandemic against the need to maintain adequate funding for current and ongoing health care expenses," the report said.
Buying ventilators beyond a threshold would not save more lives because there wouldn’t be enough trained staff to operate them anyway, the report said. And if the health care system became overwhelmed, the state wouldn’t have enough ventilators despite an emergency stockpile.
The report does not indicate that the state had the funds to buy 16,000 additional ventilators "at a very low price," as Trump said. It also does not say that the task force recommended to the governor buying 16,000, or that he turned down that suggestion.
Cuomo’s communications director told PolitiFact that Trump "obviously didn’t read the document he’s citing."
"This was a five-year-old advisory task force report, which never recommended the state procure ventilators — it merely referenced that New York wouldn't be equipped with enough ventilators for a 1918 flu pandemic. No one is, including Mr. Trump," said Cuomo spokesperson Dani Lever.
The phrase "death panels" dates back to 2009, when former Alaska Gov. Sarah Palin used it to argue against President Barack Obama’s healthcare proposal. She argued that the government would ration medical care and that the elderly and disabled would suffer under such a plan.
Trump and the Gateway Pundit article he appears to have quoted do not give a complete picture of the state’s findings. The state did acknowledge that in case of ventilator shortage, hospitals would need to make difficult decisions about what patients would get access to the available ventilators in order to save the most lives. It outlined protocols for adults, children, and infants less than 28 days old.
Top priority would be given to patients with the highest likelihood of survival with ventilator therapy. Lower priority would be patients with the highest likelihood of survival without medical intervention, and patients with the smallest likelihood of survival with medical intervention.
The report said hospitals had the option to designate a triage officer or triage committee to make these decisions. A patient’s attending physician would provide all clinical data to the officer or committee so that they could then determine the patient’s level of access to a ventilator.
The state in 2015 said that race, ethnicity, sexual orientation, socio-economic status, advanced age, perceived quality of life, ability to pay, role in the community, or other subjective criteria would never be part of the evaluation in determining who receives ventilator therapy.
The task force also explored non-clinical approaches, including a lottery system that randomly allocated ventilators. But the report said those non-clinical approaches should not be used as the primary method because they could be subjective and/or not support the goal of saving the most lives.
The report also didn’t say its guidelines were final rules to follow. It said the guidelines were a "living document, intended to be updated and revised" based on new clinical information, societal norms, and feedback from clinicians and the public.
Trump said Cuomo "rejected buying recommended 16,000 ventilators in 2015 for the pandemic, for a pandemic, established death panels and lotteries instead. So, he had a chance to buy, in 2015, 16,000 ventilators at a very low price and he turned it down."
A 2015 state report said that in the case of a "severe" pandemic, the state would be short about 16,000 ventilators during peak week. But the report did not recommend buying 16,000 ventilators, and did not indicate whether the state was at a fiscal position to purchase them.
The state did not plan to increase its stockpile because it anticipated that in the event of a severe crisis, there would be shortage of trained staff to operate them and demand would outweigh any emergency stockpile. The report said the state had to balance the likely ventilator shortage with the need for adequate funding for current and ongoing health care expenses.
The report issued guidelines on ventilator allocation if there weren’t enough for everyone and suggested that hospitals designate a triage officer or committee. It explored a lottery system, but did not recommend it as the primary option. Cuomo did not establish one.
Trump’s statement is inaccurate. We rate it False.
Gateway Pundit, NY Gov. Cuomo Rejected Buying Recommended 16,000 Ventilators in 2015 for Pandemic, Established Death Panels and Lottery Instead, March 22, 2020
Creators.com, New York's Ventilator Rationing Plan, March 18, 2020
Emailed statement from New York Governor’s press office, March 24, 2020
New York Health Department report on ventilator allocation guidelines, November 2015; New York State Department of Health and New York State Task Force on Life and the Law Update Ventilator Allocation Guidelines, Nov. 25, 2015; FAQ on ventilator allocation
Twitter, @TeamTrump tweet, March 24, 2020
Twitter, @NYGovCuomo tweet, March 24, 2020
NY government website on number of COVID-19 cases in New York, accessed March 24, 2020
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