“Current and former administration officials said the conflict” with his own top health official stemmed from the leader’s “apparent distrust of experts and his dissatisfaction with public health recommendations, which are often based on scientific analysis of imperfect and at times incomplete information” while the leader “prizes certainty, decisiveness and directness.”
Actually, that’s New York City’s mayor, as described in the New York Times’ story, He Saw ‘No Proof’ Closures Would Curb Virus. Now He Has De Blasio’s Trust. The article details how Bill de Blasio shoved away the city Health Department—with more than a century of highly regarded experience in tracking and suppressing outbreaks from the Spanish flu to HIV/AIDS to Ebola—and its commissioner, Oxiris Barbot—whom he’d praised wildly earlier in the pandemic but said on Friday he hadn’t even spoken to in days—and swapped in the city’s public hospital system run by Mitchell Katz, who told the mayor what he wanted to hear about how there wasn’t a need to shut things down and even argued in March that herd immunity would deal with the virus for us.
It turns out that Trump, for all of his gifts at seriously and literally sucking up all the oxygen in the room, isn’t the only leader more concerned with controlling the message than with controlling the virus, as ProPublica laid out in a superb piece detailing how the mayor and his frenemy, Gov. Andrew Cuomo, fell short, including with state health officials cutting their city counterparts out of the loop.
After de Blasio finally, belatedly told New Yorkers to prepare to shelter in place, Cuomo shot that idea down before declaring his own “pause” three days later that took effect two days after that. As the mayor and the governor acted out the rules of teenage dating (if he calls it first, you have to wait at least three days), thousands of New Yorkers died— and the city and the state can’t even agree on the number of deaths and infections.
Meantime, both men are separately boasting about seeing New York through the worst of this, and their success in “flattening the curve.” But who let the curve get so fat in the first place?
One issue was de Blasio’s insistence, as the virus spread, that it wasn’t spreading very far and couldn’t spread very easily—and that we had the Health Department’s handful of “disease detectives” on the case to help ensure that it would not.
He had Barbot next to him vouching for that approach at press conferences where he always gets the first and last word and commissioners lace their answers with phrases like I want to amplify what the mayor said and the mayor got this exactly right even after she’d started to privately warn him that community transmission meant that the moment for tracing and containment had passed.
Starting in late January and continuing up until the week that New York finally closed, de Blasio kept promoting the detectives–even claiming that they had acquired New York-specific information showing that COVID-19 wasn’t easily transmitted even as other health authorities warned that it could be. That kept the mayor from having to account for the absurdity of having 50 such detectives (the number he eventually said they were, after weeks of avoiding that number were followed by loose promises about how more would be added soon) tracking down every person on every train car that someone with the virus had been on.
Then he abruptly stopped talking about the detectives altogether, except to explain how they differed from the new Test and Trace Corps he announced last week and that the hospital system is supposed to be ramping up now.
Repeating an approach he’s used with other women in his administration, de Blasio now appears to be keeping Barbot at the Health Department, but cutting her out of the loop, to try and maintain control over what she says about the mess we’re in and how we got into it.
Here’s a look back at just some of his disease detective hype as we got here:
March 2 (one confirmed case in NYC)
We have been down this road as a city, as a state many times before. We have disease detectives at the New York City Department of Health. The New York City Health Department is renowned all over the world, one of the great public health agencies on Earth. Disease detectives who literally track back everyone’s interactions if they contract a disease, do the work to figure out who they’ve come in contact with.
March 6 (four cases, 2,773 people in self-quarantine)
Everything we know about this kind of disease, because it is part of a family of diseases is you're never going to have a situation where it becomes an airborne disease. Meaning it hangs in the air like measles does, like some other diseases do and can be contracted hours later after its presence in a room, for example. That is not coronavirus…
We believe in a strategy that focuses on identification and testing. We believe deeply in the work of the disease detectives and we will be introducing you to some of them soon so you can get to see the real human beings who do this important work.
March 7 (12 cases)
When we started dealing with this crisis, we were dependent on information from the World Health Organization and the Center for Disease Control and the broader medical literature. Now over these last days, we've started to get direct information from our own disease detectives and they have every day more and more information to work from.
March 9 (20 cases)
If you are traveling by subway and the train that comes up is all packed and you can possibly wait for the next train in the hopes that it might be less packed, please do…
I want to emphasize this, we are getting our own direct information. Our Department of Health, our disease detectives doing this work with real life cases here in New York City conditions. We're learning some things that are, you know, somewhat different than what some of the going assumptions are in the global medical community. What we're seeing is, you know, very clearly, again, you need that direct transmission…
Even in the case of a positive (test result at a public school), we have what we call disease detectives, our Department of Health is renowned for this, who tracks specific contacts. If a child really only had close contact with a handful of adults or kids in the school, like really close contact, that's where your concern is. It's not the kids on the other grades – they had no, they didn't in any way, shape or form interact with. It doesn't – again, it doesn't hang in air. In fact our doctors made clear here in New York City, only minutes. On a surface, this virus only lives for a few minutes. So we are clear about the fact that we need to be pinpoint. I don't want to see mass closures. I want a pinpoint response…
It has to go from someone who is infected to another person directly into their mouth, their nose, or their eyes. How does that happen? A sneeze that gets right on you. A cough that gets right on you. Someone's talking right up close to you and inadvertently spits a little bit while they're talking and then it has to get right into your mouth, nose, or eyes, not it got on your arm. That's not an issue. Not it was in the air over here. It has to get right into you. It is true, if somehow you get it immediately on your hand and you immediately take your hand to your mouth or your nose, your eyes, that is a way it can be transmitted, but a fact that our disease detectives are seeing is that this disease does not last long on surfaces, literally a matter of minutes. So there's understandably a lot of concern and we want to answer the concern, but there's also some mythology out there that's making the disease something it's not. This just takes a certain amount of intimacy and closeness, if you will, for it to be transmitted.
March 10 (the same day that Katz wrote de Blasio’s top aides that there was “no proof that closures will help stop the spread” but that they would hurt the economy and spread fear)
Related to our disease detectives, we are working right now to double the number of disease detectives. One element of that will be training all school nurses to do this work, to do the initial screening. We'll have an update shortly on the exact timeline on the doubling and the protocols we'll use, going forward. But the – one of the most immediate things we'll do is get all of these very effective school nurses into this work immediately. That's going to help us speed up the process.
March 12 (the same day that Barbot reportedly told business executives at a closed-door meeting in City Hall that up to 70 percent of the city could become infected)
The disease detectives from the Department of Health have been deployed to figure out any close contacts, as we said would be the case in any potential temporary school closure. We have checked the school and we'll keep double checking, but, as of now, there are no children in the school who reach what we call a tier one level of preexisting medical conditions – so, children who would be particularly vulnerable. We're double checking that. But as of this point, we do not have an indication of any children in the school having those particular preexisting conditions.
March 13 (154 cases)
As of this morning we had one confirmed case of a positive coronavirus test that was in Staten Island. The student in this case was at the Richard Hungerford School, co-located within the New Dorp High School campus. For the record, there are a couple of other or several other Hungerford schools in other locations in Staten Island. The only one that was affected here was the one at New Dorp High School.… So the entire school building was closed. Cleaning and disinfecting went on today. There'll be an evaluation of the building over the weekend. Disease detectives are talking to the student and their family. The plan right now is to reopen Monday…
Look, we have a serious number but we also have 8.6 million people… I can't say the proof is in the pudding in some perfect way. I can say it is very meaningful to me that we are at this advanced a point in the trajectory, starting from Wuhan until now in a city of 8.6 million people and we're clocking in at 154 cases. You could have easily said for something that started in December, you should be at a much, much more advanced place. And that doesn't mean we aren't going someplace tough, but I think some of these things really did help.
March 14 (183 cases)
As this outbreak matures, the work of the disease detectives then becomes even more important for those individuals that are very sick in the hospital. And that's where, you know, we're going to start seeing a pivot to focus on those that are very sick and especially protecting our health care workers.
That was the day that New York City had its first coronavirus death, and the last time for a long time de Blasio talked about disease detectives, who’d been very much part of his daily messaging until then. The next day, March 15th, he announced the public schools would close.
On March 17, he brought up the idea of a “shelter in place” shutdown order, only for Cuomo to shoot it down.
On March 20, with the city reporting 5,683 cases and 43 deaths, Cuomo signed his “New York Pause” shutdown order, which took effect on March 22nd.
De Blasio’s next mention of disease detectives, except for one evasive answer to a question about what happened to them, didn’t come until last week, on May 9th, when he said he hoped they would be part of the “final phase” after community spread has been halted and that he said could come at the end of the summer.
More than 20,000 deaths and 200,000 cases later, de Blasio has shunted the Health Department to the side and substituted the hospital system’s new and untested Testing and Tracing Corps that’s supposed to have 2,500 “public health foot soldiers” by the end of June to track the contacts of every infected person. Sound familiar?
When Barbot was asked last Sunday to clear up the “confusion” between what her agency had been tasked with doing and what the hospitals system is doing now, and between the disease detectives and the testing army, de Blasio jumped in to answer:
“I just have to say, it's America, anyone can ask a question the way they want, but I don't honestly think the word confusion is right.”