The face of the country's coronavirus pandemic response ignored expert advice, deflected blame amid skyrocketing infections, lashed out at journalists who tried to hold him accountable, feuded with Democratic mayors and touted hydroxychloroquine while presiding over one of the deadliest outbreaks in the world. But it wasn't Donald Trump.
New York Gov. Andrew Cuomo's national profile quickly rose amid the massive early outbreak in his state, earning him worldwide praise. But new reports show that his actions may have hampered the state's response and sparked a mass exodus of health experts.
Cuomo emerged as an early pandemic hero as he took the reins in his daily news briefings while Trump repeatedly sought to downplay the virus in a futile attempt to convince stock traders the threat wasn't real. By contrast, Cuomo took the threat seriously, closed schools and businesses, and generally behaved like an adult, offering the public data and copious charts to track the spread of the outbreak. While Trump ultimately banished medical experts from his briefings, Cuomo sat daily flanked by his top public health officials providing a sober and reassuring voice during a time of peak panic. While Trump suggested that perhaps people should drink bleach, Cuomo affably recounted his own personal experiences dealing with the unprecedented social distancing restrictions with his daughters.
Cuomo "earned respect from the public, the media did not grant him some kind of mantle of sainthood," Rosemary Armao, an investigative reporter and journalism professor at the University of Albany, said in an email to Salon. "His earnest, honest, homey talks every day were such a huge contrast to Donald Trump's briefings and pronouncements on the virus that you could not help but notice him. He was FDR at the Fireside, telling us the hard truths, showing empathy for victims, showering praise on front-line medical and other workers, organizing, calming."
Cuomo's briefings were aired nationally and sometimes even overseas, serving as the ultimate media foil to Trump's incessant efforts to gaslight the public about the threat. Nationwide plaudits earned the governor an Emmy award, a book deal to write about his "leadership lessons from the COVID-19 pandemic," and the adoration of countless "Cuomosexuals" — an actual name that his legions of online supporters eagerly, if regrettably, embraced. Never mind that Cuomo has now presided over one of the deadliest outbreaks in any state for nearly a year.
Cuomo's decision to write a book in the middle of a pandemic that was far from over was "disturbing," Armao observed. "It seemed premature with thousands still dying and new surges still highly possible. Where did he have the time to write a book if he was indeed leading so well?"
Armao noted that CNN host Chris Cuomo often hosted his brother for interviews that she now cites in her journalism ethics classes, expressing mixed views on their friendly cable news exchanges. Though CNN largely limited the discussions to public health issues, she said, the network and the governor "both profited from them."
"Are they a blatant conflict of interest? Yep," she said. "Were they widely and warmly received? Also yep."
Steven Thrasher, a journalism professor at Northwestern University and a former reporter for the Village Voice, described Andrew Cuomo's Emmy as "outrageous" and said the relationship between CNN and the governor was "ridiculous" and served as a sort of "manufactured consent" to establish him as a pandemic hero.
"He personifies a kind of liberal calmness and order that was very appealing as the opposite of Trump," Thrasher said. But Cuomo's decision-making led to "lots of things that made the pandemic worse," he said, adding that it was "really disgusting that he wrote this book praising himself."
Through it all, Cuomo has dismissed most criticism as partisan attacks and blamed Trump for many of the failings in New York's state-level response. Mainstream media outlets seized on his criticism of Trump, ignoring critical decisions that contributed to the skyrocketing number of cases in the state last spring. By the summer, Cuomo brought out a giant foam mountain sculpture to celebrate that New York "went up the mountain, we curved the mountain, we came down the other side." But recent reports suggest that Cuomo's decisions made that climb more perilous than it had to be, and his latest directives risk a return to its apex.
At least nine New York health officials, including the state's deputy commissioner for public health and top epidemiologists and disease control experts, have quit since the summer after they were "sidelined or treated disrespectfully" by Cuomo, who "has all but declared war on his own public health bureaucracy," The New York Times reported last month.
Cuomo has not tried to conceal his disdain for health officials.
"When I say 'experts' in air quotes, it sounds like I'm saying I don't really trust the experts," he said in a January news conference. "Because I don't."
Cuomo defended his administration after officials said morale at the state's health agency had plunged to a new low, arguing that health officials were overwhelmed by the scale of the pandemic.
"It's the Mike Tyson line: 'Everybody has a plan until I punch them in the face,'" he told the Times.
State health officials said they were not even consulted on major decisions, however, and only found out about them while watching Cuomo's televised briefings, according to the report.
A state official told Salon that Cuomo was simply describing the reality that there are no real experts COVID-19, since the virus has only been in the U.S. for about a year. Expert advice has frequently changed as new data came in.
New York State Health Commissioner Dr. Howard Zucker told Salon that his agency has faced "an intense period of extraordinary stress and pressure and a different job than some signed onto."
"The Times' point is several staff left; true and many others joined the agency with the talents necessary to confront this new challenge," Zucker said in a statement. "What was the result? It is factual and inarguable that the 4,500 DOH employees faced a challenge greater than any other state and went from the highest infection rate in the nation to one of the lowest when we had more cases in this state than any country on the globe; the proof is in the performance numbers."
Cuomo's disdain for medical experts rivaled his enmity toward journalists, with whom he has sparred for months about his decision to require nursing homes to accept recovering coronavirus patients.
"He has a very authoritarian approach to dealing with the media," Thrasher said. "He can be very condescending. … He doesn't like to be questioned, and if you look at the state of the pandemic there's a lot to be answered for."
New York Attorney General Letitia James, a fellow Democrat who is generally seen as a Cuomo ally, said in a report last month that his nursing home directive "may have put residents at increased risk of harm in some facilities." The report revealed that Cuomo's administration had undercounted nursing home deaths by more than 40%, bolstering allegations that the state "may have intentionally played down the number of those deaths to avoid blame" by not disclosing deaths of residents that occurred at hospitals, The New York Times reported. The state's Department of Health updated its nursing home death total to reflect the findings hours later, though it insisted there was no evidence the policy had "resulted in additional fatalities in nursing homes." In typical fashion, Cuomo blamed the Trump administration and "federal guidance" for the policy.
Though the state severely undercounted nursing home deaths, Zucker said that the report "is clear that there was no undercount of the total death toll," that the policy was in line with the Trump administration's guidance, and that the investigation "found no evidence that any nursing home lacked the ability to care for patients admitted from hospitals." He went on to criticize the Trump administration's "complete abdication" of its duty to manage the pandemic and oversee the reporting of data.
"There is no satisfaction in pointing out inaccuracies; every death to this terrible disease is tragic, and New York was hit hardest and earliest of any state as a direct result of the federal government's negligence," he said.
State Assembly Health Committee chairman Richard Gottfried, a Manhattan Democrat, said in a statement that the attorney general's findings were "shocking and unconscionable but not surprising" and criticized the state's health department for refusing for months to release the number of nursing home patients who died at hospitals.
"The budget cuts proposed by Gov. Cuomo will make this situation even worse," he warned.
Thrasher said his friend and mentor Ward Harkavy, a former editor at the Village Voice, died in March because "he was sent to a nursing home to recover" from a coronavirus infection.
"If Donald Trump were the governor, a lot of people in the media would be very critical of the record here because so many people have died," he said. "But [Cuomo] is very close to people in the media and represents a sort of return to Clinton-Obama liberal politics, without acknowledging that those politics are a reason we had so much death," he added, pointing to Cuomo's cuts to hospitals and Medicaid before the pandemic.
The attorney general's report also took issue with a waiver that Cuomo quietly snuck into the state's budget last spring — at the urging of industry lobbyists — that granted nursing homes, as well as hospitals and other health care facilities, legal immunity over their failure to protect residents from the virus. U.S. Senate Republican Leader Mitch McConnell later tried to copy the language in Cuomo's waiver verbatim while unsuccessfully pushing for a federal version of the liability protections. Many New York legislators did not even realize that the provision was added until after they voted to approve the budget. Furious lawmakers who felt blindsided by the provision partially rolled back the immunity protection so it only applies to coronavirus patients.
"These provisions were enacted by the legislature as part of the budget process," Jack Sterne, a spokesperson for Cuomo's administration, told Salon.
James' office found that some nursing homes did not screen staff members for the virus, allowed coronavirus-positive patients to mingle with healthy residents, maintained dangerously low staffing levels, and forced some sick employees to come to work.
Despite the "disturbing and potentially unlawful findings" in the investigation into nursing home deaths, James said last month, "it remains unclear to what extent facilities or individuals can be held accountable if found to have failed to appropriately protect the residents in their care."
Zucker said the findings were consistent with his department's own investigation and policies.
"These failures are in direct violation of Public Health Law and DOH guidance that every nursing home operator was aware of," he said. "Violations of these protocols is inexcusable and operators will be held accountable. In fact, DOH has already issued 140 infection control citations and more than a dozen immediate jeopardy citations."
Zucker said his office would review the recommendations in the report amid the ongoing crisis.
"All of this confirms that many nursing home operators made grave mistakes and were not adequately prepared for this pandemic, and that reforms are needed, which is why we proposed radical reforms to oversight of nursing home facilities in this year's State Budget," he said. "We will do everything in our power to enact those reforms this year."
State Assembly Aging Committee chairman Ron Kim, a Democrat who had immediately called for the entire provision to be repealed, told Salon that the attorney general's report validates his months of warnings and reports highlighting the negative impact of granting legal immunity at the peak of the pandemic and the "profit motives that led to unnecessary deaths."
Kim, who introduced a bill in response to James' report to scrap the liability shield and allow families to sue retroactively, said that Cuomo must acknowledge the problem in order to adequately address it.
"There must be full accountability and transparency moving forward," he said in an email. "The legislature and the public need to review the full data on fatalities and transmission patterns. We also need full honesty on who drove these policies and why they chose to only follow the advice of hospital and nursing home lobbyists."
A state official said Cuomo's office would review the bill if it passes the legislature but stopped short of saying he would sign it.
Cuomo also sided with industry lobbyists when he threw out decades of planning by public health officials to roll out his own vaccination plan that relied on private hospital systems with the help of consultants from Deloitte and Boston Consulting Group and the top lobbyist for the hospital giant Northwell Health, according to the Times. He previously relied on consulting firm McKinsey to craft the state's "Trump-proof" reopening plan. The latest move appeared to "negate 15 to 20 years of work," former top New York City health official Dr. Isaac Weisfuse told the Times.
Cuomo argued that state and local health officials, who had worked on a mass-scale vaccination plan since the 9/11 attacks nearly 20 years ago, "had no understanding of how to conduct a real-world, large-scale operation like vaccinations," according to the report. Cuomo did not even inform health officials of his new plan until they learned about it during a briefing.
"The state is gathering, organizing and analyzing unprecedented levels of data 24/7 as a result of this once-in-a-century public health emergency. We are taking an all-hands-on-deck approach and these consultants complement the Department of Health's data management infrastructure," Sterne, the governor's spokesperson, told Salon.
Sterne disputed that the administration had scrapped its existing plans and relied exclusively on private hospitals.
"This is an apples and oranges comparison: The COVID vaccine supply is extremely limited, there's prioritization guidance, it requires ultra-cold storage, and is a two-shot regimen, so we could not solely rely on past planning," he said. "The state picked the most relevant elements of prior plans that made sense here — like mass vaccination sites used during H1N1, targeted distribution to health care facilities to serve their workforce, and scalable parts of the annual flu vaccination effort such as pharmacies — and operationalized them to fit the unique requirements of COVID. As we expanded eligibility, we've expanded our partners."
New York struggled early on with vaccine access, though its rate of vaccination has improved in recent weeks. Some of the difficulties were caused by restrictive eligibility and Cuomo's threat of fines. While medical workers around the country have drawn praise for improvising when their vaccine doses neared expiration by immunizing anyone in the vicinity, Cuomo threatened $1 million fines if anyone got a vaccine before they were eligible, 10 times more than the fine he imposed on hospitals that fail to use all their allotted doses.
Dr. Celine Gounder, an infectious disease specialist at the NYU Langone medical school and an adviser to President Joe Biden, argued last week that the vaccine rollout has been slow because Cuomo "made the process too restrictive and punitive."
"He entrusted the job to private healthcare systems, not public health," she wrote. "Private healthcare systems don't know how to do public health, like mass vaccination."
A state official told Salon that the focus when the fines were announced was on vaccinating hospital employees before the winter holidays, and fines were seen as necessary to ensure sufficient availability of doses for health workers while preventing ineligible people from jumping the line. Though the state will expand eligibility to about two-thirds of New York residents by next week, the directive to issue fines remains in effect. Since there are more people eligible to be vaccinated, it is unlikely that states will have to throw out vaccines, the official said, and vaccination centers have standby lists for vaccines in case they have unused doses.
Though the state has taken steps to address its slow rollout, it still faces challenges in equitable distribution. Data released by New York City's health department last month shows that just 11% of vaccinations went to Black residents and 15% went to Latinos, even though they make up 24% and 29% of the city's population, respectively. Elderly Black and Latino residents have also received disproportionately fewer vaccinations than white residents statewide as well.
"Extensive red tape and unnecessary rigidity over who we could vaccinate and when — all with the looming threat of millions of dollars in punitive fines — made an extraordinarily difficult task all the more challenging in those first initial weeks of the rollout," Avery Cohen, a spokesperson for New York City Mayor Bill de Blasio, told the Times.
Sterne said that Cuomo has been working to address this issue since last year.
"For months, Gov. Cuomo has been highlighting the intolerable reality that New Yorkers of color are dying at higher rates than white New Yorkers — and he has been working to ensure vaccine distribution is equitable," he said. "In a matter of weeks, we've deployed pop-up vaccination kits to over 70 public housing developments and churches statewide, which have administered shots to over 30,000 New Yorkers in communities of color, and have launched a mass vaccination site specifically for Bronx residents at Yankee Stadium. Dozens more are planned for coming weeks, along with major vaccine hubs for hard-hit communities, and we plan to stand up over 300 vaccine sites in communities of color as supply continues to increase under the Biden administration."
Dr. Denis Nash, an epidemiologist at the City University of New York and former city health official, said a key reason for the discrepancies is the design of the state's online-based scheduling program.
"I am very disappointed that the city and state developed a vaccine scheduling system that appears designed to prevent prioritization of those at greatest risk and those neighborhoods with the highest burden, even among those who are currently eligible," he said in an email. "When you have limited vaccine and while community transmission is still very high, you need a plan that gives adequate attention to equity so that the program does not perpetuate or more likely worsen the existing health inequities we are seeing."
Nash said these racial disparities should have been anticipated and built into the rollout plan instead of setting goals for total number of vaccinations.
"The system has no guard rails to prevent the very unfair early differences," he said, adding that "it is not too late to fix it."
More recently, medical officials have warned that additional restrictions may be required to contain the spread of new coronavirus variants coming from overseas. Despite the warning, Cuomo announced last month that indoor dining in New York City would reopen in a limited capacity by Valentine's Day and weddings could resume with 50% capacity and "up to 150" guests by March, citing the "current trajectory" of infections. But The New York Times noted that the rate of cases in the city was 64% higher, and the rate of hospitalizations was 60% higher, when he made this latest announcement than they were in December when he shut down indoor dining. Cuomo defended the decision by displaying a chart at a briefing showing a 30% drop in positivity rates, but the numbers he used were "the highest and lowest daily numbers in January to that point, extremes that did not exactly reflect the overall trend," the Times reported, adding that the drop in average positivity rates was about half as large as Cuomo's numbers.
"He's not a fighter for the people of NY," Gounder tweeted. "He's a fighter for his friends and monied special interests."
A state official said that the situation remains fluid and scheduled reopenings could be rolled back in the event of a spike. The official cited a recent Buffalo Bills NFL playoff game — attended by about 6,700 people in a 70,000-seat stadium — as evidence that testing and other safety measures can be used to safely allow larger events. The official also took issue with the Times' analysis, arguing that positivity rates are currently down 21% from early January and hospitalizations have been steady for 16 consecutive days.
Nash is highly skeptical of Cuomo's plans to permit indoor dining and large group events. "I think this is very ill-advised," he said. "We have a high prevalence at the moment, which pretty much guarantees indoor dining will contribute to community transmission and put restaurant employees at greater risk."
The state official argued that this logic would have prevented the state from reopening in the first place last May, when the number of new infections was still around the same rate as they were when the state closed down but trends showed that rates were clearly dropping.
Cuomo's aversion to lockdowns, which have been shown to significantly reduce the spread of infections, has been criticized since the pandemic hit. Cuomo, who initially compared the coronavirus to the flu, quarreled with de Blasio last March over the mayor's call to issue a "shelter-in-place" order and feuded with the mayor over who had the power to shut down the city's schools and businesses, before ultimately deciding to impose a lockdown after days of bickering anyway.
By the time Cuomo made that announcement, the number of new cases in the state was doubling every three to four days. Medical experts from the Imperial College in London and the University of California, Berkeley, have estimated that the state could have cut its death toll in half if they had acted a week or two sooner.
"Days earlier & so many deaths could have been prevented," tweeted Dr. Tom Frieden, former head of both the Centers for Disease Control and Prevention and New York City's Health Department.
After the early squabbles, Cuomo's team effectively cut de Blasio and city officials out of the decision-making process, ProPublica reported last year.
While Cuomo pushed aside local officials and experts in favor of lobbyists and private interests, he frequently channeled Trump in style, if not in substance. He touted hydroxycholoroquine, the ineffective malarial drug heavily hyped by Trump, as "promising" and pushed for the federal government to approve clinical trials before buying 70,000 doses of the drug that medical providers later stopped using after it was shown to have no effect on coronavirus patients while potentially causing significant side effects.
A state official told Salon that the governor was acting on data suggesting that the drug could be effective, but that the state stopped using the medication once clinical trials showed it was not useful.
Cuomo has at times also echoed Trump's claim that the number of infections was increasing because the state was conducting more tests, even though testing simply identifies infections that already exist.
"The facts do not merit the level of anxiety we are seeing," Cuomo said in a March briefing. "The number will increase because it is math. The more people you test, the more positives you are going to find. I'm a little perturbed about the daily angst when the number comes out and the number is higher. Perturbed meaning, I'm perturbed that people get anxious every time the number goes up. The number has to go up if you continue to test."
Armao made a damning comparison that might outrage the governor's fans: "Cuomo is Trump-like in many ways."
"He's a bully, kind of scary-mean, and he's secretive and he wants to be in charge. Hubris is the word that comes to mind," she said. "So he hides the real number of nursing home deaths and has his health department people tell journalists they are working on getting the numbers. He stalls so long the Democratic AG comes out with a damning report that has all the statistics. Then it turns out the health department has lost some key personnel because they can't work under Cuomo's directives, and when asked about this he retorts that he doesn't trust the experts. This is a line out of Trump's script."
She concluded with a rhetorical question: "Listening to the experts, heeding the science, telling the unvarnished truth, fair treatment for all state residents, admitting to shortcomings — aren't these the very leadership qualities the governor wrote a book about?"