The New York Times
Cuomo Aides rewrote the nursing home report to hide the highest number of deaths
Governor Andrew Cuomo’s top advisers were alarmed: a report by state health officials had just arrived and included a count of how many nursing home residents in New York died in the pandemic. The number – more than 9,000 up to that point in June – was not public, and the governor’s senior advisers wanted to keep it that way. They rewrote the report to remove it, according to interviews and documents reviewed by The New York Times. The extraordinary intervention, which occurred when Cuomo was beginning to write a book about his pandemic achievements, was the first known act in what critics called a month-long effort by the governor and his aides to obscure the full scope of deaths in nursing homes. elderly. Subscribe to the New York Times newsletter The Morning After the state attorney general revealed this year that thousands of deaths in nursing home residents were underestimated, Cuomo finally released the full data, saying he had omitted them because he feared that the Trump administration can carry out a politically motivated investigation into how the state is dealing with the outbreak in nursing homes. But Cuomo and his aides actually started hiding the numbers months earlier, while their aides were battling their own senior health officials, and long before federal authorities’ requests for data arrived, according to documents and interviews with six people. with direct knowledge of the discussions, who asked for anonymity to describe the debates behind closed doors. The central role played by the governor’s top advisers reflected the extent to which Cuomo had reached the middle of a deadly pandemic to control data, put aside public health knowledge and reinforce his position as a national leader in the fight against the coronavirus. While the nursing home report was being written, data from the New York State Department of Health – contained in a graph revised by The Times that was included in a draft – put the death toll about 50% higher than that number then publicly quoted by the Cuomo administration. The Department of Health worked on the report with McKinsey, a consulting firm hired by Cuomo to help respond to the pandemic. The graph they created compared deaths in nursing homes in New York with other states. The total of 9,250 deaths in New York far exceeded that of the next state, New Jersey, which had 6,150 at the time. The changes sought by the governor’s advisers fueled bitter conversations with the health officials who worked on the report. The conflict punctuated an already tense and involutive relationship between Cuomo and his Department of Health, which would generate an exodus from the state’s top public health officials. Last week, Cuomo’s previously unshakable control was hit by a wave of scandals. Three women accused the governor of inappropriate conduct, including sexual harassment in the workplace. On Wednesday, he publicly apologized for his actions, which will soon be subject to an independent investigation overseen by the state attorney general. The crisis over Cuomo’s behavior with women came at a time when his government was dealing with political turmoil over nursing homes. Lawmakers acted to remove him from the emergency powers granted to him during the pandemic, and federal prosecutors in Brooklyn opened a separate investigation. An outside lawyer hired by the state began interviewing officials on how to deal with asylums during the pandemic, according to a person familiar with the discussions. Advisers involved in changing the report included Melissa DeRosa, the governor’s principal advisor; Linda Lacewell, head of the state’s Department of Financial Services; and Jim Malatras, a former Cuomo advisor who returned to work in the pandemic. None had public health experience. In response to a detailed list of questions from The Times sent on Tuesday, the governor’s office responded with a statement Thursday night from Beth Garvey, a special adviser, who said that “the data from outside the facilities was omitted after DOH has not been confirmed has been properly verified. ”She added that the additional data did not alter the report’s conclusion. The tension over the death toll dated back to the early weeks of the pandemic, when Cuomo issued an order preventing nursing homes from refusing people who were discharged from the hospital after being treated with COVID-19. The order was similar to those issued in other states in order to prevent hospitals from becoming overloaded. But in late spring, Republicans suggested that the order had caused a deadly spread of the virus in nursing homes. Cuomo contested that it did. Still, critics and others clung to the way the state was publicly reporting deaths: unlike other states, New York excluded residents who were transferred to hospitals and died there, effectively hiding how many nursing home residents died from COVID-19. The 33-page report, published in July by the state Department of Health, concluded that the governor’s policies were not to blame, but it became a turning point in Albany’s debate over the governor’s policies. The day after publication, lawmakers began to convene hearings and request complete data. Public health officials have criticized his approach. A think tank started looking for data the following month, as did the Department of Justice. Health officials, nursing home operators and even some of Cuomo’s aides expressed perplexity at the governor’s apparent insistence on delaying the release of data for so long, as none of the information released so far has changed the total number of deaths from COVID-19 in New York – now more than 47,000, including more than 15,000 nursing home residents. But the July report allowed Cuomo to treat the nursing home issue as resolved last year, paving the way for him to focus on publicizing New York’s success in controlling the virus. “Now I’m thinking of writing a book about what we’ve been through,” said Cuomo four days after the report was released, his first public comments on a possible book. By this time, he was already seeking formal approval from a state ethics agency to obtain outside income from the sale of books, according to a person who knew his planning at the time. The governor’s policy of directing nursing homes to accept and readmit patients with a positive test for coronavirus remains a subject of intense debate. An investigation by the attorney general’s office, released in January, said Cuomo’s memo to nursing homes was consistent with federal guidance, but “may have put residents at greater risk of damage to some facilities.” Garvey said in his statement that the governor’s order did not cause deaths in nursing homes, a conclusion that was also reached in the Department of Health report. At the time, when the report was being prepared, Cuomo, a third-term Democrat, still he enjoyed widespread popularity for his news briefings on television. For its report, the Department of Health relied on data presented by more than 600 state nursing homes, which were particularly hard hit in March and early April, when New York became a global epicenter. “For us, it was clear: that you have to report cases and deaths across all categories – case in nursing home, case in hospital,” said Stuart Almer, chief executive of the Gurwin Health Care System, which manages a 460 bed long-bed nursing clinic on Long Island that recorded 65 deaths of COVID-19 residents. “We have always had confidence, and we still have it, in our numbers.” State health officials could see from the data that a significant number of residents died after being transferred to hospitals. State health commissioner Dr. Howard Zucker has known since June that officials in his department believed the data was good enough to be included in the report, according to two people familiar with the discussions. But Zucker testified to lawmakers in early August that the department was still auditing the figures and could not release them. State senator Gustavo Rivera, chairman of the health commission, suggested during the hearing that the data was being hidden to improve the governor’s image. “This is a problem, bro,” Rivera told Zucker. “It seems, sir, that in this case, you are choosing to define it differently so that it can look better.” In a statement released on Thursday, Health Department spokesman Gary Holmes echoed Garvey’s words, contesting that the figures were ready in time for the report and saying that, regardless, they would not have changed his conclusions. Dr. Eleanor Adams was the leader of the Department of Health in the report, but her draft was substantially rewritten by Malatras, now dean of the New York State University system. He was among several officials and former advisers temporarily recruited by Cuomo to help respond to the pandemic. The comings and goings went well beyond the usual process in the governor’s office to suggest edits to an agency report and at times became “intense”, according to two people familiar with the discussions. Health officials felt that the governor’s office, whose opinion was conveyed by Malatras, wanted to oversimplify. They feared it was no longer a true scientific report, but they feared for their jobs if they did not agree. Even so, an edited version prepared by Malatras did not remove the largest number of dead. This occurred later, after DeRosa and Lacewell became aware of their inclusion. It was withdrawn shortly afterwards. This article was originally published in The New York Times. © 2021 The New York Times Company