Trump: Cuomo Opted for Death Panels, Lotteries Instead of Buying Ventilators

Melanie Arter | March 24, 2020 | 4:00pm EDT
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(Photo by BRYAN R. SMITH/AFP via Getty Images)
(Photo by BRYAN R. SMITH/AFP via Getty Images)

(Correction: Fixes attribution in first paragraph.)

( - New York Gov. Andrew Cuomo had a chance to order 16,000 ventilators five years ago for a discount, but he opted for death panels and lotteries instead, President Donald Trump said Tuesday. 

During his press conference on Tuesday, Cuomo complained that the federal government only sent 400 ventilators, when they needed 30,000.


“FEMA says we're sending 400 ventilators. Really? What am I going to do with 400 ventilators when I need 30,000? You pick the 26,000 people who are going to die because you only sent 400 ventilators,” the governor said.

During Fox News’ virtual town hall, Trump responded to Cuomo’s remarks, saying, “I watched Governor Cuomo, and he was very nice. We’re building him hospitals. We’re building him medical centers, and he was complaining -- we are doing definitely more than anybody else. He was talking about the ventilators, but he should have ordered the ventilators, and he had a choice. 

“He had a chance, because right here, I just got this out that he refused to order 15,000 ventilators. I will show this to Bill,” the president said, handing the paper he was holding to Fox News host Bill Hemmer, who co-hosted the virtual town hall in the Rose Garden of the White House.

“Take a look at that, Bill. What does that say?” Trump asked.

“Is this social distancing here?” Hemmer asked.

“It says New York Governor Cuomo rejected buying recommended 16,000 ventilators in 2015 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, but he shouldn't be talking about us,” the president said.

“He's supposed to be buying his own ventilators. We are going to help, but if you think about it, Governor Cuomo, we are building him four hospitals. We are building him four medical centers. We are working very, very hard for the people of New York. We are working a lot with him, and then I watch him on this show complaining. He had 16,000 ventilators he could have had a great price and he didn't buy them,” Trump said.

Trump was referring to an op-ed by former New York Lt. Gov. Betsy McCaughey published March 19, 2020 by the New York Post:

Hospitals in New York are running short. To his credit, Gov. Andrew Cuomo is doing his best, but he admits “you can’t find available ventilators no matter how much you’re willing to pay right now, because there is literally a global run on ventilators.”

It’s a little late. Several years ago, after learning that the Empire State’s stockpile of medical equipment had 16,000 fewer ventilators than the 18,000 New Yorkers would need in a severe pandemic, state public-health leaders came to a fork in the road.

They could have chosen to buy more ventilators to back up the supplies hospitals maintain. ­Instead, the health commissioner, Howard Zucker, assembled a task force for rationing the ventilators they already had.

In 2015, that task force came up with rules that will be imposed when ventilators run short. ­Patients assigned a red code will have 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 sugar-coat it. It won’t be up to your own doctor.

In 2015, the state could have purchased the additional 16,000 needed ventilators for $36,000 apiece, or a total of $576 million. It’s a lot of money, but in hindsight, spending half a percent of the budget to prepare for pandemic was the right thing to do.

Ventilator Allocation Guidelines, released in November 2015 by the New York State Task Force on Life and the Law New York State Department of Health, warned that “a severe influenza pandemic on the scale of the 1918 influenza outbreak will significantly strain medical resources, including ventilators.”

The guidelines warned that “a severe influenza pandemic on the scale of the 1918 influenza outbreak will significantly strain medical resources, including ventilators.”

In such a case, “89,610 influenza patients will require ventilators in New York State and there will not be enough ventilators in the State to meet the demand” in the case of “a severe 6-week outbreak.”

“A clinical ventilator allocation protocol will need to be implemented to ensure that ventilators are allocated in the most efficient manner to support the goal of saving the greatest number of lives,” the report said.

The 2015 report outlines what protocols will be used to determine ventilator allocation:

In 2007, the New York State Task Force on Life and the Law (the Task Force) and the New York State Department of Health (the Department of Health) released draft ventilator allocation guidelines for adults. New York’s innovative guidelines were among the first of their kind to be released in the United States and have been widely cited and followed by other states. Since then, the Department of Health and the Task Force have made extensive public education and outreach efforts and have solicited comments from various stakeholders and the Task Force reexamined and revised the adult guidelines (Adult Guidelines). 

The primary goal of the Guidelines is to save the most lives in an influenza pandemic where there are a limited number of available ventilators. To accomplish this goal, patients for whom ventilator therapy would most likely be lifesaving are prioritized. The Guidelines define survival by examining a patient’s short-term likelihood of surviving the acute medical episode and not by focusing on whether the patient may survive a given illness or disease in the longterm (e.g., years after the pandemic). Patients with the highest likelihood of survival without medical intervention, along with patients with the smallest likelihood of survival with medical intervention, have the lowest level of access to ventilator therapy. Thus, patients who are most likely to survive without the ventilator, together with patients who will most likely survive with ventilator therapy, increase the overall number of survivors. 

There are five components of the ethical framework that underlie the Adult Guidelines. The duty to care is the fundamental obligation for providers to care for patients. The duty to steward resources is the need to responsibly manage resources during periods of true scarcity. The duty to plan is the responsibility of government to plan for a foreseeable crisis. Distributive justice requires that an allocation system is applied broadly and consistently to be fair to all. Transparency ensures that the process of developing a clinical ventilator allocation protocol is open to feedback and revision, which helps promote public trust in the Adult Guidelines. 

In order to maintain a clinician’s duty to care, a patient’s attending physician does not determine whether his/her patient receives (or continues) with ventilator therapy; instead a triage officer or triage committee makes the decision. While the attending physician interacts with and conducts the clinical evaluation of a patient, a triage officer or triage committee does not have any direct contact with the patient. Instead, a triage officer or triage committee examines the data provided by the attending physician and makes the decision about a patient’s level of access to a ventilator. The decision to use a triage officer or committee is left to each acute care facility (i.e., hospital) because available resources will differ at each site. 



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