Gotham Gazette

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City Says Medical Supply Stockpile Nearly Complete; Healthcare Workers Wonder If It'll Be Enough

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Supplies arrive at a hospital (photo: Michael Appleton/Mayoral Photography Office)

New York City is a "few weeks" away from securing a 90-day stockpile of medical personal protective equipment (PPE) and ventilators, according to Mayor Bill de Blasio’s administration, a project the mayor announced in April as part of a vow to be better prepared for a potential second wave of COVID-19 and other emergencies. But some elected officials and the New York nurses union are questioning the formula behind the 90-day supply benchmarks and whether the stockpile will be adequate for hospitals in the event the current uptick in cases and hospitalizations gains enough momentum to approach crisis levels.

De Blasio said the stockpile, known as the "NYC Strategic Reserve," would be ready by the end of the year and should be able to support public and private health-care facilities citywide for a three-month period based on the city's PPE usage at the height of the pandemic -- a time when hospitals were overrun and doctors, nurses, and support staff were forced to reuse disposable gear for days. According to the mayor’s office, the city is close to amassing thousands of ventilators and hundreds of millions of units of PPE, including 13.5 million N95 masks, 185 million nitrile gloves, gowns, face shields, and dozens of other categories of gear.

"We'll purchase what we need and create a stockpile so we will never be in a situation where we turn to those who are supposed to supply this and they say, sorry, we're all out," de Blasio said in April when he made the announcement.

"At the Mayor’s direction, we established a Medical PPE Service Center that could supply the New York City healthcare sector with peak volumes of PPE from the Spring for a full 90 days and meet any ventilation needs we might have," wrote Avery Cohen, a spokesperson for de Blasio, in an email at the end of October.

As part of the Strategic Reserve plan, de Blasio promised to acquire 4,000 ventilators, to be stored and regularly serviced until needed. "We are building up our City-owned ventilator fleet, in combination with resources at hospitals and ongoing support from the Strategic National Stockpile," wrote Cohen, who would not say whether 4,000 was still the goal, or if the maintenance program was underway.

The discussion has taken on more urgency in recent days with hospital admissions leaping upward and the seven-day positivity rate averaging over 2%. City Council Member Mark Levine, who chairs the Council’s health committee, says the figures mean the city is already experiencing a second wave. Governor Andrew Cuomo announced new statewide restrictions on Wednesday.

People on the ground in hospitals and elsewhere are skeptical that there will be enough PPE for a full resurgence of COVID-19 and, in terms of ventilators, city and state public health agencies have never before considered New York to be prepared for a serious pandemic influenza. Highest among the concerns is that the PPE burn rate at the peak of the pandemic should have been much higher, if supplies had been available, and that the city is calibrating to a time when hospital conditions were likened to war zones.

"At that time the way that we were using these supplies were [through] these contingency and crisis guidelines and, really, many places weren't even hitting the crisis guidelines," said Pat Kane, executive director of the New York State Nurses Association, which represents roughly 20,000 registered nurses in the five boroughs alone, of whom 8,500 work in the city's public hospital network.

"Shortly after the pandemic hit, the CDC changed a lot of its positions on what the proper equipment was. They changed their guidance based on supply," Kane told Gotham Gazette.

"When there is a crisis in the supply chain...that's OK to do, but when that becomes the ceiling and the norm it's a problem," she added.

In the spring, nurses in hospitals were being asked by administrators to reuse the same N95 mask for five days or more, keeping them in paper bags and, when they got damaged, mending them with staples and rubber turnequits, Kane told Gotham Gazette. Hospital staff -- including non-clinical personnel -- at times resorted to other makeshift methods, like wearing plastic garbage bags as a protective layer.

"We are still using conservation methods for N95s in many places. We're still not using N95s the way we were before covid," Kane said, when nurses were able to follow "proper infection control."

"They don't have all the PPEs they deserve," de Blasio said at an April 3 press briefing, acknowledging the emergency measures strayed from traditional guidance. "We've been now for weeks and weeks on a crisis footing and the CDC recognizes this, that there's one standard, if you will, for peacetime, there's another standard for wartime and we have to make tough, tough choices and get by with less in wartime.”

City Council Member Ben Kallos, a Manhattan Democrat who chairs the Council’s contracts committee, said he has been seeking information on the peak PPE burn rate and the formula behind the city's stockpile figures without success, most recently at an oversight hearing in October. The mayor's office did not respond to a separate Gotham Gazette inquiry for the same information.

"The administration still hasn't shared how they came to this number and whether or not these numbers are accurate," Kallos said in a phone interview.

"We do know from common sense, common knowledge, anecdotes, and testimony at the hearing, that the numbers of PPE that we need are deflated because of people being instructed or choosing to recycle PPE that they shouldn't," he said, adding, "I am incredibly fearful that this 90-day stockpile is not the right number."

Kane said she is optimistic that any resurgence of the virus would not be as bad as in the spring because of the increase in testing, mask-wearing, and overall awareness of the virus. "I think it's great that the city put out some information, but it all comes down to: how are we going to be using the equipment," Kane said. Experts are exploring reusable alternatives to disposable PPE, like elastomeric masks -- a kind of gasmask-style face covering with removable filters -- which they say are safer and cheaper over longer periods of time, and are urging public health officials to consider.

"The good news from the hearing is that the administration said they were open to buying these elastomeric masks, but we have not heard from the city and whether they are going to add them," Kallos said.

Months after the first peak in COVID-19 cases and deaths in New York, the state is again seeing a rise in cases, hospitalization, and deaths. On Monday the mayor called a second wave "dangerously close" as the city's slate of COVID-19 indicators reached their highest point since spring, approaching or surpassing thresholds set by public health officials that indicate when action is needed. Since August, several coronavirus hotspots have emerged that the city and state have taken action to try to supress, including more testing, pushing mask use, cracking down on gatherings, and closing down schools and non-essential businesses.

It's unclear exactly what a second wave will look like but de Blasio is now saying he views the combination of a "sustained" 3% positivity rate of the tested population, a seven-day average of new reported daily cases above 550, and daily hospitalizations over 200 as constituting a resurgence of the virus. On Tuesday, the seven-day average positivity rate was 2.3% and covid hospital admissions in the city increased from 71 to 92. New reported cases surged to 795, per the mayor’s Tuesday report, alarming public health officials. The mayor has said the entire school system will move to all-remote learning if the seven-day rolling positivity average hits 3%.

These are still far from the levels the city saw in March, April, and May, but the recent memory of how quickly things can escalate has raised serious concerns in the city, which has lost over 24,000 residents to COVID-19, approximately 1 in every 350 New Yorkers.

The city's Department of Health and Mental Hygiene (DOHMH) said it has 37 million Level 3 isolation gowns, 54 million 3-ply surgical masks, 900,000 goggles, and 6 million face shields, on top of the N95 masks and gloves. Without more information on the city's peak data and modeling it is hard to gauge exactly what these numbers mean relative to a potential second wave of mass hospitalizations. Spokespeople for the department did not provide a full list of the items in the Strategic Reserve or respond to questions about stockpiling other non-PPE surgical and medical supplies -- things like intubation drugs, sedatives, and IV extension tubing -- that hospitals burned through at high levels this spring.

While New York public health officials have not historically considered stockpiling ventilators a viable option in a severe pandemic, representatives from the mayor's office expressed confidence that the city's ventilator reserves are enough to handle a second wave.

The city's "Pandemic Influenza Preparedness Response Plan," crafted by the DOHMH in 2006 under Mayor Michael Bloomberg, projected a citywide shortfall of between roughly 2,000 and 9,500 ventilators in the case of pandemic on the scale of 1918. The Department recommended a pilot program with a small number of ventilators because of the "large endeavor" of purchasing and storing the machines. The plan served as the basis for future estimates and was cited in a July report on hospital preparedness from City Comptroller Scott Stringer, which states the city later stockpiled a few hundred but "understandably" sold them when they became too expensive to maintain.

In April, de Blasio and the city's Economic Development Corporation (EDC) announced a partnership with local manufacturers to design and build 3,000 bridge ventilators -- a less powerful version of a full-service ventilator, designed for more minor cases -- though it is unclear if these are part of the 4,000 promised in the Strategic Reserve or if they would be going directly to hospitals. "The City produced 3,000 bridge ventilators to support local hospitals and to shore up the New York City Strategic Reserve, a stockpile of medical devices that will be ready for any future crisis," wrote Shavone Williams, an EDC spokesperson, in an email echoing the language of the mayor's original pledge.

Pre-coronavirus pandemic state guidelines appear to view ventilator stockpiling as a lost cause. In protocols developed by a task force chaired by Health Commissioner Howard Zucker in 2015, a question-and-answer supplement says stockpiling ventilators for a “severe pandemic” is futile: "Even if New York State purchases additional ventilators, the demand would quickly outpace supply in a severe pandemic."

At the time, the state had a stockpile of 1,750 ventilators on top of roughly 7,000 in use in hospitals. In response to questions about the state's current stockpiling, Jonah Bruno, a Health Department spokesperson, wrote, "We do not comment on our stockpiled supplies." 

He did note there are "multiple warehouse sites located strategically throughout the state" with PPE and other medical supplies, which the state distributes through the Division of Homeland Security and Emergency Services.

In July, Governor Andrew Cuomo issued emergency regulations mandating all healthcare facilities maintain their own 90-day PPE supply and nursing homes, a 60-day supply. Cuomo, through his executive powers, laid the framework for the state to coordinate resources among all public and private hospitals statewide. At the time he announced the public-private partnership on March 31, he said the state would take the lead in "coordinating State-City stockpiles and individual hospital stockpiles." It's not clear exactly what is in the state's stockpiles and how they were used.

According to the Health Department, the state's supply goals are based on the average daily PPE burn rate between April 19 and 27.

"PPE supply numbers understandably fluctuate as facilities have regular need of the equipment, in addition to continuing to use it in their responses to localized COVID-19 outbreaks, while also preparing for a second wave," Bruno wrote in a separate email. "Recognizing that there continues to be supply chain challenges, the Department, in its role as regulator, continues to work with all facilities to achieve sufficient PPE and will track that process through our continued communication and daily HERDS reporting,” he wrote, referring to the Health Electronic Response Data System, the state's database of hospital capacity and resources.

Cohen, the de Blasio spokesperson, said the mayor's office has "worked with the [city] Health Department to set allocations for each and every provider in the city based on usage data from the Spring peak and scientific modeling, making sure that providers servicing vulnerable populations and neighborhoods in need are prioritized."

The Greater New York Hospital Association, a network of over 160 institutions in the region, did not provide an update on supplies in its facilities after multiple Gotham Gazette inquiries.

by Ethan Geringer-Sameth, reporter, Gotham Gazette

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Kevin Parker Launches Campaign for New York City Comptroller

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State Senator Kevin Parker (photo: Parker campaign)

State Senator Kevin Parker, a Democrat from Brooklyn, officially announced his campaign for New York City Comptroller on Wednesday evening in an interview on NY1. He joins three other Democrats who have already jumped into the race to replace Comptroller Scott Stringer, a Democrat who is term-limited next year and is running for mayor.

In a phone interview prior to his announcement, Parker touted his long record in government, including the more than five dozen laws he has sponsored, and his background in finance as what he believes qualify him for the job of comptroller, the city’s chief fiscal officer, and make him the best candidate for the job.

Parker, who was just reelected this month to the Senate, has served in the Legislature’s upper chamber for more than 17 years, representing a Brooklyn district that covers the neighborhoods of Flatbush, Midwood, Park Slope, Kensington, Ditmas Park, and Windsor Terrace. He currently chairs the Senate’s Committee on Energy and Telecommunications and over the years has served on a range of committees including finance, banking, insurance, higher education, alcoholism and drug abuse, cultural affairs, tourism, and parks and recreation. He is currently the Senate majority whip.

Prior to being elected to the Senate, his experience includes serving as a special assistant to former State Comptroller H. Carl McCall, as project manager for the state Urban Development Corporation, and working on municipal finance in the chairman’s office of UBS PaineWebber, the global financial services firm.

Parker has on several occasions been a figure of controversy, with a history of angry outbursts and incidents that have landed him in legal or ethical trouble.

In the Democratic primary for the citywide post, Parker is competing with Brooklyn City Council Member Brad Lander, Manhattan State Senator Brian Benjamin, and Queens Assemblymember David Weprin. Other candidates could still enter the race. There are no Republicans running for comptroller at this time. The primaries will be in June 2021, and will include the city’s new ranked-choice voting system, which will apply to special elections and party primaries for city government positions starting next year.

“I think that I have a superior vision than my colleagues, and understand how we need to really, truly invest in our communities and young people,” Parker said in the interview with Gotham Gazette, “to do things like make sure our seniors are protected, make sure that we are addressing the needs of people who are homeless, and make sure that everyone in the city feels safe, while simultaneously making sure that there's an equitable distribution in economic opportunities.”

The comptroller is the city’s top fiscal officer and the office’s duties include monitoring city spending and revenue, auditing city agencies, reviewing city contracts, enforcing prevailing and living wage laws, and overseeing the city’s public pension funds that hold more than $228 billion in assets. Those who’ve held the office also typically issue a variety of reports and policy recommendations, and often weigh in on a wide range of issues that are not directly under the comptroller’s purview but relate to the health of the city.

The comptroller cannot make decisions, only recommendations, about the city budget, but offers an important voice and perspective in such matters, especially given that the office has a large staff of professionals who carry out analyses and audits.

The fact that New York City is currently in the throes of a major economic recession and government fiscal crisis because of the coronavirus pandemic makes the 2021 race for comptroller all the more important.

With billions in lost revenues, there is a massive budget deficit that Mayor Bill de Blasio’s administration has not yet resolved for the current and next fiscal years, even as the mayor continues to seek the authority from the state Legislature to borrow billions for operational spending. The next comptroller will inherit the office at a time when oversight of fiscal management has arguably never been more important. A great deal of the city’s fiscal health will be determined by what relief package may or may not come out of Washington, D.C. and decisions made at the state government level.

“You need somebody who is going to bring practical solutions to the table and these are solutions that not just help individual communities but also get our entire city back on track,” Parker said. He pledged that he would create a task force on day one to examine the impact of COVID-19 on the city and propose solutions to it. The task force would be composed of business, labor, nonprofit, community, and clergy leaders. “We need some more intricate data...and more conversation about looking at where the opportunities are to advance our economy,” he said.

“When you talk about economic opportunity, creating full-time jobs and living wage benefits is job one, and it’s job two, and I think it’s probably job three. I think if you boost jobs, then revenue will follow,” he said. “I don't think you need to do anything exotic around revenue if you're creating jobs and putting people back to work. New Yorkers don't want a handout, they want a hand up.”

On NY1, Parker cited his record on police reform, including several recently-passed laws, and said that as comptroller he would prioritize examining the NYPD budget, stressing that while he is not part of the "defund the NYPD" movement he does think New Yorkers can get more bang for the buck from police spending.

He also said he would continue to play a strong legislative role. “I expect to have a person in Albany, have a person at City Hall, working with the City Council and the state Legislature to pass legislation that is important for the fiscal health of our city, and in all types of issues that are critically important,” Parker told Gotham Gazette.

Parker seemed to dismiss any potential criticism he may face over announcing a run for another office right after being reelected to his current position. “It's been a great opportunity,” he said of serving in the Senate. “But I also see our city at a crossroads and [understand] that I have both the leadership experience, the legislative experience, and the vision to fill this gap in leadership that we're going to have because of term limits.”

What’s likely to hound Parker on the campaign trail is his history of controversy. Infamously ill-tempered, Parker has made several headlines for all the wrong reasons though he has repeatedly seemed to avoid real consequences. In 2005, he was arrested for punching a traffic agent and avoided criminal charges by agreeing to anger management classes. In 2010, he was convicted on two charges of misdemeanor criminal mischief for a 2009 incident where he attacked a news photographer and damaged his camera. In 2018, he tweeted “Kill yourself!” to Senate Republican spokesperson Candice Giove, who had called him out for parking placard abuse, before deleting the tweet and apologizing. The following year, he reportedly got into a shouting match with the newly elected State Senate Alessandra Biaggi in a closed door meeting of the Senate Democratic conference where the tweet was discussed. He wound up facing no formal consequences from the Senate majority he is part of.

“The reality is that I've been serving for 18 years, and I think I have a tremendous record of service. Everything I've done hasn't been perfect. I think that no one is perfect,” Parker said on Wednesday. “But I think I've grown professionally and I've grown personally in this job. Would  have done everything...that I've done in the past the same way, looking back? No.”

He added, “Anything that you think you don't like about me, you have to balance against the work that I've done.”

As a somewhat late entrant into the race, Parker is behind the other candidates in fundraising for his campaign. As of July 11, the last campaign finance deadline, Parker had only $3,255 in his comptroller campaign account. He also has just over $77,000 in his state campaign account that he could potentially transfer to his city account. Meanwhile, as of July, State Senator Benjamin had a campaign balance of roughly $386,000, Council Member Lander had about $351,000, and Assemblymember Weprin had about $144,000.

by Samar Khurshid, senior reporter, Gotham Gazette

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Max & Murphy Podcast: Zach Iscol is Running for Mayor

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Zach Iscol (photo: Iscol campaign)

November 11, 2020 - Max & Murphy Podcast: Zach Iscol is Running for Mayor

Military veteran Zach Iscol is running in the Democratic primary for mayor set to take place in June 2021. He joined the show do discuss his resume, why he's running for mayor, and his vision for the city.

Listen to the conversation and let us know what you think -- we're on Twitter @TweetBenMax and @JarrettMurphy. You can listen to the show through the embedded audio below or download the episode wherever you get your podcasts, under "Max & Murphy," and listen to Max & Murphy live on Wednesdays at 5 p.m. on WBAI radio, 99.5FM or

by Ben Max, Gotham Gazette

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