Why Isn't New York Vaccinating More People?

Andrew Cuomo hasn't done much right related to COVID-19

Elite failure has long been a feature of American society.

While the vast reaches of the working class must always live life on some kind of brink—one mistake is a lost job, a police record, or a lifetime trapped in incriminating Google searches—the very rich and well-connected are allowed to smash up as much as they’d like. Millionaire executives get golden parachutes, billionaire corporations get government bailouts, and money-losing tech giants can always secure more venture capital welfare.

In politics and media, the dynamic is not so different. Former supporters of the Iraq War—the most disastrous foreign policy engagement of the last half century—hold sinecures at America’s largest publications or, like George W. Bush himself, have rebranded themselves as kinder, gentler men of integrity. Donald Trump, of course, was a failure many times over, and his reward was the most powerful elected office in world history.

In New York, Governor Andrew Cuomo has come to embody this concept. For many months, he was praised in all corners of media for how his state government contended with coronavirus. He graced the covers of national magazines. His approval rating at one time rose to nearly 80 percent. There were people who deemed themselves “Cuomosexuals” and those who hawked Cuomo-themed merchandise on Etsy. If the fevered Cuomo adoration of 2020 has died down, the narrative remains fairly hardened. Ask any conventional news consumer about government and coronavirus, and they will rightly tell you Trump and Mayor Bill de Blasio responded disastrously. Cuomo would be regarded as the exception, a man who stood between twin poles of ineptitude.

Yet more than 38,000 people have died of coronavirus in New York. In raw numbers this is, by far, the highest death toll in America. Per capita, it ranks second to New Jersey, which likely suffered for its close proximity to New York. In New York City alone, more than 25,000 have died from COVID-19. Cuomo failed utterly to contain the virus and lock down the city in early March when COVID-19 was first spreading. He kept comparing coronavirus to the flu and proclaimed the fear of the virus was worse than the virus itself.

“The facts here,” Cuomo said on March 11th, when coronavirus was rapidly infecting thousands, “actually reduce the anxiety.”

“How many people died in the United States from the flu last year? Roughly 80,000 from the flu. So, again, perspective.”

Later that day, for some perspective, the NBA postponed their season and Trump banned travel from Europe.

Cuomo rejected the idea of a shelter in place order for the city as late as March 17th, even though San Francisco had already implemented one. He apparently was annoyed de Blasio, his long-running punching bag, suggested it first. Renamed PAUSE, shelter in place came for New York City on March 22nd. By any objective estimation, this delay likely cost tens of thousands of lives.

After the lockdown order, Cuomo ordered nursing homes to accept coronavirus patients, refused to give their staff proper personal protective equipment, and handed them sweeping legal immunity. Refusing to include nursing home residents who died in hospitals as part of the state’s nursing home tally, Cuomo very likely undercounted the deaths in these homes by many thousands.

The curve was flattened, as Cuomo always reminded us in his heralded press conferences, but it came with mass death. There is no way, in any conventional or rational sense, to describe New York’s response to coronavirus as a success. California, by this point, has endured at least three waves of the virus, as Governor Gavin Newsom has drawn criticism from the left and right. New York still manages to have, in total, more than 10,000 deaths. California is double New York’s size.

Vaccination cannot offer redemption for New York, just as the dead can’t be brought back to life. But it can provide hope for 2021. With the city’s economy in freefall, an aggressive, coordinated vaccination effort is needed to kickstart an actual comeback. So far, New York is lagging. While it roughly matches California’s rate of vaccination—California has vaccinated more than 4,700 per 100,000 people, compared to New York’s 4,605—there are other states racing ahead of New York. West Virginia has managed to vaccinate almost 7,000 per 100,000 people. Florida, Vermont, Washington, and Wyoming are above 5,000. New York is not exceptionally behind—the vaccination rate is on par with other northeastern states—but it does not lead. It is not exceptional.

This is a problem. It’s not that these other states didn’t grapple with coronavirus and don’t face a serious threat today. It’s that their futures won’t be defined by how quickly they recover. Since their death tolls weren’t so extraordinarily high to begin with, their local economies were not as devastated. Several of New York City’s major industries have been crippled over the last year. Tourism has all but vanished. Hotels are shutting down. Restaurants are facing a winter of extinction. Broadway is closed and museums are operating at limited capacity. The commercial real estate industry, predicated on inflated rents in the midtown and downtown corridors, will probably never be the same, as more companies decide they can save money with smaller offices and telework. The city will return to its former glory eventually—the fiscal crisis, 9/11, and Hurricane Sandy were all endured—but the longer the recovery is delayed, the more the aftereffects of coronavirus will linger. A slow 2021 can beget a 2022 that is weaker than it should be.

Bill de Blasio has promised a million vaccinations for his city in January. To date, only about 110,000 people have been given shots. But he can do little without the state’s assistance and approval. The process has been centralized—a good thing, theoretically—and this has meant Cuomo entirely controls who receives a vaccine, where it’s provided, and when. Right now, thanks to Cuomo’s extremely cautious approach, only healthcare workers, group homes residents, and nursing home staff have been given vaccines. County health departments will have little say over the matter, shoved to the side in favor of large hospitals Cuomo has designated to administer the vaccine. In Albany County, according to the Albany Times Union, officials believe they could vaccinate the population of the southern half of the county in a few days if they were given the coronavirus vaccines and allowed to mobilize their own plan.

“County officials interviewed for this story have said that if their mass vaccination plans were activated, and if they receive enough doses, they could vaccinate the residents of their counties in a much shorter time frame,” the Times Union reported.

Overall, counties will probably not be able use their own computer systems to track who received their shots.

Last week, Cuomo threatened healthcare providers that commit “coronavirus vaccine fraud” with up to $1 million in fines. The fines will apply to doctors, nurses, pharmacists, and any licensed healthcare professional.

Cuomo’s executive order came as ParCare, a healthcare network with centers in New York City, is being investigated for possibly obtaining the vaccine fraudulently. On December 16, ParCare said it had been authorized to distribute the COVID-19 vaccine for the elderly, those at high risk and people with underlying conditions. A flyer said limited doses would be available on a first come, first serve basis.

The New York State Police logged reports that ParCare had received the vaccine and was administering it to the general public. This was a problem, because Cuomo had deemed the vaccine only available to some essential workers, including healthcare workers and nursing home residents.

“We want to send a clear signal to the providers,” said Cuomo. “If you violate the laws on these vaccinations, we will find out and you will be prosecuted.”

The debate over who should receive a vaccine is fraught with a variety scientific and ethical dimensions. Should it be the communities hit hardest, particularly those of color? The workers most at risk? The elderly most likely to die? The real problem with Cuomo dangling million dollar fines over providers for administering a vaccine to anyone who does not meet the state’s strict priority guidelines is that it will discourage mass vaccinations at a time when New York desperately needs them. This is dangerous, considering vaccines stored in deep freezers can expire when unused. Cuomo’s million-dollar hammer is one more manifestation of his authoritarian instincts.

It’s worth considering how halting Cuomo’s approach to vaccination has been, how his move toward total control has not even led to increased efficiency. Israel, a country with a population not much larger than New York City’s, has managed to vaccinate a large share of their population by focusing on elderly citizens. Their neglect of the Palestinians, of course, is both shameful and predictable. Due to the dramatic age-skew of disease, vaccinating the small number of very old people has a remarkable impact on mortality risk. “By late January, the country will probably have reduced its fatality risk from the disease about tenfold,” wrote New York Magazine’s David Wallace-Wells.

New York, like all states, is in a race against time. A new variant of coronavirus has reached the state and is considered much more contagious, though not necessarily more deadly. The first priority should be to set up as many vaccination sites as possible everywhere, open them at all hours, and begin a program for true mass vaccination. Whatever supply is had must be released immediately. New York can take a similar approach to Israel—mass vaccinate the elderly—and set up easily accessible sites. Sports stadiums and others large venues can host vaccine events. Anyone who shows up should get a shot.

“In Britain and Canada, for example, officials are planning to deploy all of their current vaccine supply immediately, rather than reserve half of it so those who get a first shot can quickly get their booster,” the Times editorial board noted recently. “Modeling has suggested that this approach could avert some 42 percent of symptomatic cases.”

Vaccination is the last chance for New York to be a national leader, to set a standard it has not come close to reaching throughout this crisis. If America is regarded, by so many liberals, as a failed state, then what is New York? The death toll hasn’t stopped climbing.