state of the state
Apr. 7th, 2020 08:29 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
dragonlady7via https://ift.tt/2Xk1TN9
I did manage to find a news story about this, but I haven’t seen much discussion of it. Still, here: https://13wham.com/news/local/urmc-chief-medical-officer-governor-listening-to-upstate-concerns-on-ventilator-order
The long and short of it is: New York is a big state. While the coronavirus has hit NYC hard, it’s been slower to spread to the rest of the state. Behind the cut, partly for posterity and partly in case anyone is curious, here’s a summary of what’s up in New York, from the perspective of the rest of New York. (Mostly, tl;dr, fuck you, Cuomo, but there’s some analysis before I get to that conclusion. Really, though, fuck that guy. Maybe he’s competent but that’s a low fucking bar.)
Demographically speaking, about 50% of the state’s population lives in or around the City, with another hefty percentage of the population living in the City’s immediate surroundings (Long Island, and the counties just north, including Yonkers– Rockland and Westchester). The rest of the state’s population is spread across the entire quite large expanse of the state; the second-largest city, Buffalo, is 400 miles northwest of NYC, and has about 2.5 million people in its metro area. (Third-largest is Rochester, 60 miles east of Buffalo, trailed by Syracuse, in the middle of the state, and Albany, 150 miles north of NYC, where the state’s capital is housed.)
Image description/caption: Persons Tested Positive By County. A screenshot of a map of NYS, showing the different counties shaded in different colors, in a spectrum from yellow for less than 100 confirmed COVID-19 cases, to medium orange for less than 10,000 cases, to dark red for 20,000+.
The dark red counties are the counties that make up NYC, down in the lower right. Long Island is dark orange, as are the southernmost counties of the state. Much of the state is yellow, but the more populous counties of the rest of the state are showing shades of orange, including Erie Co on the far left, Monroe Co in the top left, and a cluster of pale orange around the Albany area north of NYC. (There is pale orange near Syracuse as well.) (If you click through there’s more information; that’s a screenshot to show the data as of April 6th.)
So New York City’s hospitals are overwhelmed, and the hospitals in the rest of the state have cleared out space in advance of the epidemic, cancelling elective surgeries and sending anyone they possibly can home. Only one hospital has received transferred patients– Albany Medical Center had a specific pre-existing relationship with a hospital downstate and took in a number of critical patients to free up space, but generally the NY policy has not been to move infected patients around. (For many reasons, among them contagion but also the simple fact that by the time a patient is critical, transport is iffy at best.)
In the article above, URMC refers to the University of Rochester Medical Center, which includes Strong Memorial Hospital and a smaller teaching hospital, Highland, as well as other facilities. (There are other unaffiliated hospitals in Rochester as well, including a large one called Rochester General Hospital.) Rochester, in Monroe County, seems to have been largely spared the epidemic thusfar– they have patients, and have had some fatalities, but they are trailing far behind, statistically. Erie Co, which is where Buffalo is located, has far more patients per capita.
And so most of their ventilators are not being used. They have a few patients on them, as is unavoidable– they are the trauma center for an enormous region of the state, geographically speaking. But they have several dozen standing idle, waiting. And they have a stockpile (not a large one, but) of personal protective equipment waiting for them to use to keep their own doctors safe, while the doctors downstate make do with rinsed handkerchiefs and cut-up napkins or whatever the current thing is.
The governor signed an executive order with much fanfare: ventilators and masks from “upstate” were going to be requisitioned and sent to NYC, with the National Guard doing the transporting. Perhaps unsurprisingly, the rumor had begun to spread by the next day in Erie County that the National Guard had come to ECMC, Buffalo’s largest hospital, and taken away several of their ventilators by force. The county executive had to actually hold a press conference to dispel the rumors.
There’s so much fear here. I’ve heard it confirmed that seven ventilators are being taken from URMC (Rochester) after all. And it’s not that, collectively, the rest of the state doesn’t want to help. The sensible among us are well aware that without the City, the rest of us would be a glorified rural red state of no particular interest to anyone else, and we certainly wouldn’t be wealthy. But there’s an ongoing feeling that the City has no reciprocal awareness of the rest of the state, and it’s often justified. The state government being in Albany doesn’t really win much consideration, and the state governor, being a native of the city himself, is often referred to up here with an eyeroll as the Governor of New York City. (I am not aware of a single time he’s visited Buffalo. I’m sure he has, but it hasn’t been often. It does not endear him to us that he refers singularly to the entirety of the rest of the state as “upstate” with no apparent awareness that Western NY is a distinct region with different concerns.)
And so the fear, which is quite reasonable, is that we will give all our extra ventilators and all our extra doctors and all our PPE to go and fight the epidemic in NYC, and then the peak will hit us, and it will overwhelm us and since they’ll still be swamped, there will be no help to give us, and then afterward there will be no return of the things we gave away, and it will be forgotten how many of the vulnerable of Buffalo and Rochester and Albany and Syracuse and the littler places nobody in Queens has ever heard of like Utica and Canandaigua and Greenwich and Canton died for want of the ventilators that were saving the vulnerable of Queens and Brooklyn.
Personally, I’m afraid, but I’m more afraid that the epidemic will peak and pass and we will have had those ventilators sitting idle the entire time because the warnings that were too late for the City came to us in time, the measures they waited too long to implement in the City were in time for us, and our facilities will never be overwhelmed. And we’ll come out of this epidemic with spare boxes of masks and gowns, idle ventilators, underused doctors sitting on their hands and pacing as they waited and were never called.
And that will be blood on our hands.
I have a lot of family down there, so maybe I don’t feel the us vs them resentment as strongly. An uncle, aunts, cousins and so on. They’re my people and I want to help them. But just the nameless millions in Queens are enough to move me, even absent those direct ties. I want to help. I want them to be okay. I’m afraid but I’m willing to accept that our own readiness should take a hit to help them in their current emergency. Of course I am. People don’t deserve to die just because they live in too populous a county. (However, they also don’t deserve to die just because they live in an underserved rural county without much of a tax base, I don’t feel like that’s controversial either.)
But Andrew God-King Cuomo issuing executive orders without any understanding for how frightened we all are does nothing to inspire me. I’m fucking sick of people talking about him being presidential. I would vote for a fucking slug before I voted for that asshole. Like, I’m glad he’s capable of stringing together a sentence, and has enough invested in the structures of government that he largely understands how to use them, but fuck that guy. This was the absolute worst way he could have handled this. All he ever wants to do is to be seen to be powerful, he blocked progressive legislation for years in the state so he could play both sides, and was furious when the 2018 midterms swept his party into undeniable power because there was no longer any way for him to claim credit. And in the midst of this crisis, instead of doing any kind of coalition-building, instead of reminding us of our familial relationship, instead of doing literally fucking anything else, he decided the way to deal with this was to call in the fucking National Guard.
Christ, what an asshole. Because we don’t have enough to worry about. People are fucking dying, Andy, could you have it not be about you for a goddamn second???
No, we can’t vote him out; nobody will run against him because he’s so fucking petty he has ruined the lives of anyone who dares speak out against him from any place of prominence, so we’re fucking stuck with him until he sets his sights on something higher, God fucking forbid.
I did manage to find a news story about this, but I haven’t seen much discussion of it. Still, here: https://13wham.com/news/local/urmc-chief-medical-officer-governor-listening-to-upstate-concerns-on-ventilator-order
The long and short of it is: New York is a big state. While the coronavirus has hit NYC hard, it’s been slower to spread to the rest of the state. Behind the cut, partly for posterity and partly in case anyone is curious, here’s a summary of what’s up in New York, from the perspective of the rest of New York. (Mostly, tl;dr, fuck you, Cuomo, but there’s some analysis before I get to that conclusion. Really, though, fuck that guy. Maybe he’s competent but that’s a low fucking bar.)
Demographically speaking, about 50% of the state’s population lives in or around the City, with another hefty percentage of the population living in the City’s immediate surroundings (Long Island, and the counties just north, including Yonkers– Rockland and Westchester). The rest of the state’s population is spread across the entire quite large expanse of the state; the second-largest city, Buffalo, is 400 miles northwest of NYC, and has about 2.5 million people in its metro area. (Third-largest is Rochester, 60 miles east of Buffalo, trailed by Syracuse, in the middle of the state, and Albany, 150 miles north of NYC, where the state’s capital is housed.)
Image description/caption: Persons Tested Positive By County. A screenshot of a map of NYS, showing the different counties shaded in different colors, in a spectrum from yellow for less than 100 confirmed COVID-19 cases, to medium orange for less than 10,000 cases, to dark red for 20,000+.
The dark red counties are the counties that make up NYC, down in the lower right. Long Island is dark orange, as are the southernmost counties of the state. Much of the state is yellow, but the more populous counties of the rest of the state are showing shades of orange, including Erie Co on the far left, Monroe Co in the top left, and a cluster of pale orange around the Albany area north of NYC. (There is pale orange near Syracuse as well.) (If you click through there’s more information; that’s a screenshot to show the data as of April 6th.)
So New York City’s hospitals are overwhelmed, and the hospitals in the rest of the state have cleared out space in advance of the epidemic, cancelling elective surgeries and sending anyone they possibly can home. Only one hospital has received transferred patients– Albany Medical Center had a specific pre-existing relationship with a hospital downstate and took in a number of critical patients to free up space, but generally the NY policy has not been to move infected patients around. (For many reasons, among them contagion but also the simple fact that by the time a patient is critical, transport is iffy at best.)
In the article above, URMC refers to the University of Rochester Medical Center, which includes Strong Memorial Hospital and a smaller teaching hospital, Highland, as well as other facilities. (There are other unaffiliated hospitals in Rochester as well, including a large one called Rochester General Hospital.) Rochester, in Monroe County, seems to have been largely spared the epidemic thusfar– they have patients, and have had some fatalities, but they are trailing far behind, statistically. Erie Co, which is where Buffalo is located, has far more patients per capita.
And so most of their ventilators are not being used. They have a few patients on them, as is unavoidable– they are the trauma center for an enormous region of the state, geographically speaking. But they have several dozen standing idle, waiting. And they have a stockpile (not a large one, but) of personal protective equipment waiting for them to use to keep their own doctors safe, while the doctors downstate make do with rinsed handkerchiefs and cut-up napkins or whatever the current thing is.
The governor signed an executive order with much fanfare: ventilators and masks from “upstate” were going to be requisitioned and sent to NYC, with the National Guard doing the transporting. Perhaps unsurprisingly, the rumor had begun to spread by the next day in Erie County that the National Guard had come to ECMC, Buffalo’s largest hospital, and taken away several of their ventilators by force. The county executive had to actually hold a press conference to dispel the rumors.
There’s so much fear here. I’ve heard it confirmed that seven ventilators are being taken from URMC (Rochester) after all. And it’s not that, collectively, the rest of the state doesn’t want to help. The sensible among us are well aware that without the City, the rest of us would be a glorified rural red state of no particular interest to anyone else, and we certainly wouldn’t be wealthy. But there’s an ongoing feeling that the City has no reciprocal awareness of the rest of the state, and it’s often justified. The state government being in Albany doesn’t really win much consideration, and the state governor, being a native of the city himself, is often referred to up here with an eyeroll as the Governor of New York City. (I am not aware of a single time he’s visited Buffalo. I’m sure he has, but it hasn’t been often. It does not endear him to us that he refers singularly to the entirety of the rest of the state as “upstate” with no apparent awareness that Western NY is a distinct region with different concerns.)
And so the fear, which is quite reasonable, is that we will give all our extra ventilators and all our extra doctors and all our PPE to go and fight the epidemic in NYC, and then the peak will hit us, and it will overwhelm us and since they’ll still be swamped, there will be no help to give us, and then afterward there will be no return of the things we gave away, and it will be forgotten how many of the vulnerable of Buffalo and Rochester and Albany and Syracuse and the littler places nobody in Queens has ever heard of like Utica and Canandaigua and Greenwich and Canton died for want of the ventilators that were saving the vulnerable of Queens and Brooklyn.
Personally, I’m afraid, but I’m more afraid that the epidemic will peak and pass and we will have had those ventilators sitting idle the entire time because the warnings that were too late for the City came to us in time, the measures they waited too long to implement in the City were in time for us, and our facilities will never be overwhelmed. And we’ll come out of this epidemic with spare boxes of masks and gowns, idle ventilators, underused doctors sitting on their hands and pacing as they waited and were never called.
And that will be blood on our hands.
I have a lot of family down there, so maybe I don’t feel the us vs them resentment as strongly. An uncle, aunts, cousins and so on. They’re my people and I want to help them. But just the nameless millions in Queens are enough to move me, even absent those direct ties. I want to help. I want them to be okay. I’m afraid but I’m willing to accept that our own readiness should take a hit to help them in their current emergency. Of course I am. People don’t deserve to die just because they live in too populous a county. (However, they also don’t deserve to die just because they live in an underserved rural county without much of a tax base, I don’t feel like that’s controversial either.)
But Andrew God-King Cuomo issuing executive orders without any understanding for how frightened we all are does nothing to inspire me. I’m fucking sick of people talking about him being presidential. I would vote for a fucking slug before I voted for that asshole. Like, I’m glad he’s capable of stringing together a sentence, and has enough invested in the structures of government that he largely understands how to use them, but fuck that guy. This was the absolute worst way he could have handled this. All he ever wants to do is to be seen to be powerful, he blocked progressive legislation for years in the state so he could play both sides, and was furious when the 2018 midterms swept his party into undeniable power because there was no longer any way for him to claim credit. And in the midst of this crisis, instead of doing any kind of coalition-building, instead of reminding us of our familial relationship, instead of doing literally fucking anything else, he decided the way to deal with this was to call in the fucking National Guard.
Christ, what an asshole. Because we don’t have enough to worry about. People are fucking dying, Andy, could you have it not be about you for a goddamn second???
No, we can’t vote him out; nobody will run against him because he’s so fucking petty he has ruined the lives of anyone who dares speak out against him from any place of prominence, so we’re fucking stuck with him until he sets his sights on something higher, God fucking forbid.
no subject
Date: 2020-04-08 03:16 am (UTC)I even had to talk my Dad down from the ledge of "He should run for President."
It makes perfect sense that him being a city boy would make him poisonous to the rest of the state, I just hadn't heard the statement before.
no subject
Date: 2020-04-08 11:31 am (UTC)I mean, nobody hates him like Albany, don't get me wrong; people out here are slightly more neutral because we've basically never met him and don't know him, but Albany's fucking sick of his personal unpleasantness.
He spent YEARS backing up that weird coalition of conservative Democrats that caucused with the Republicans to keep us from getting, say, guaranteed abortion protection or universal health care in the state constitution, and then when the 2018 blue sweep happened he was so mad when all those things he'd been blocking were all going through at once, he did his best to slow them down and try to let them through one at a time and try to somehow make it so he was allowing it-- he has been trying to avoid letting the government govern at all, because he wants accomplishments to happen only if he gets credit. He's also stolen literally millions of dollars through various cronies, and most of them have gone to jail but never him. He's ruined the life of anyone who's spoken out about him, it's fucking horrifying.
So it's great that he knows how the government works, but only because he's avoided letting it do so for so long. And here he is instilling actual panic in a part of the state that he'll only ever refer to as "upstate", as if there's only one "rest of everything" outside of the City, which I suppose is at least honest of him; the only different parts that matter are the five boroughs and the rest of it's all just sort of over there somewhere, just like that New Yorker cartoon my grandma had framed on her wall. And it's galling, because of course we want to help but he could at least acknowledge that we do have needs and aren't just stockpiling supplies to keep them away from the really important people. The National Guard! How fucking tone-deaf!
But, just like the incompetent asshole he's getting so much credit for opposing, he doesn't really need to worry about the areas that aren't going to vote for him anyway.