Cuomo said at today’s press conference that the two systems, which include the greater New York private voluntary hospitals and the public hospitals, need to work together to transfer and distribute the overload. 

“I just had a meeting with the entire statewide healthcare establishment, Cuomo said. “And the entire healthcare system will coordinate to work as one for the first time in decades.”

 Cuomo pleaded for a national response to help with New York State’s coronavirus crisis by undertaking a balancing strategy within the healthcare system. He said such action of distributing the load among public hospitals will be done “immediately, on a daily basis.”

“Anyone who says this situation is a ‘New York City only situation’ is in a state of denial. You see this virus move across the state, you see this virus move across the nation, there is no American who is immune to this virus,” he said. 

New York has been hit the worst. The outbreak has infected more than 60,000 people in the state as of Monday. Among them, at least 1,218 people have died, over 9000 people are currently hospitalized and 2352 ICU patients. 

Earlier today, Cuomo welcomed the arrival of The USNS Comfort Navy hospital ship that will help New York hospitals with the soaring numbers of coronavirus patients. 

Cuomo said that the hospital will provide roughly 1,000 beds and 1,200 personnel to New York and will be used to treat patients that don’t have COVID-19.

NYC also built an emergency field hospital in Central Park as the death toll climbs to over 1,000.

As New York approaches the apex of the crisis, Cuomo said that states should be building up stockpiles.

He also responded to President Trump’s accusation of supplies “going out the back door”, in New York City hospitals, stating that there was no evidence of this and that New York has been building up stockpiles in a warehouse in New Jersey.

“If you are not preparing for the apex, you are missing the entire point of the operation,” he said. “We’ve been behind this virus from day one”.

New York is still scrambling to obtain medical supplies, especially with the prices of ventilators rose to over $50,000, he said. 

Cuomo also agreed with President Trump and said, “this is a war.”

“The front-line battle is our health care system,” Cuomo said. “And our soldiers are our health professionals.”

“Whether it’s Detroit, it’s New Orleans, it will work its way across the country,” he said.

Catarina Lamelas Moura contributed to this report

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A debate over life and death is being waged in New York.

As of 2018, New York has been considered one of the top battleground states for the medical aid in dying debate, centering around the legalization of prescriptions for lethal drugs for patients at the end of their lives. In the two hearings held on the issue this year, many who testified shed tears while telling emotional tales of the end of a loved one’s life.

The New York State Assembly and New York State Senate introduced identical Medical Aid in Dying bills, but neither progressed to a vote. Following the midterm elections, supporters have higher hopes for 2019, but the fight for legislation continues to be slow-moving due to deep divisions within several key groups.

“I would say that there are obviously people on both sides of the issue with every segment of society,” said Diane Coleman, disabilities rights activist and founder of Not Dead Yet, an anti-medical aid in dying organization.

Current legislation under consideration in New York, called the Medical Aid in Dying Act, mirrors legislation in Oregon and other states where the practice is legal. Medical aid in dying prescriptions are only available to terminally ill patients with a six-month prognosis, who must complete two oral and written requests in addition to being approved by two doctors. They must be residents in the state and both mentally competent of making the decision and physically able to self-administer the medication.

According to a poll conducted by Quinnipiac University, 63 percent of New Yorkers support Medical Aid in Dying. At hearings for the New York bills in 2018, advocates and opponents alike testified with emotional, moving personal stories.

One of these stories was that of Amanda Cavanaugh and her partner of five years, New York State correctional officer Chrissy Connery. After being diagnosed only a year after meeting Cavanaugh, 26-year-old Connery fought for three years against her cancer, exhausting every option available to her.

“I took a special interest in [this issue] because my partner Chrissy was coming to the end of her journey with stage four adenocarcinoma cancer,” said Cavanaugh, who is also the  campaign organizer for Compassion & Choices in New York and New Jersey.

Connery and Cavanaugh’s tale is one that too many families have also lived. Around 111,000 New Yorkers each year are diagnosed with cancer, with more than 35,000 not surviving. In fact, some opponents of Medical Aid in Dying legislation have heart-wrenching stories just like Cavanaugh’s, despite ending up with opposite perspectives.

This is the case for Lynda Holler of Brewster, NY. Eight months after marrying in New York City, she and her husband Kenneth Holler received devastating news: he was diagnosed with oral cancer at 39 years old.

Over the next 21 years until he passed, the Hollers had two sons together and learned to adjust to a “new normal.” Kenneth Holler battled through 11 surgeries and eventually lost his ability to speak and eat, but despite the pain he refused to let the cancer dominate his life. He remained an involved father to his two sons, cheering them on at every game, and never once wishing for medical aid in dying.

Their journey was what inspired Lynda Holler to become a passionate opponent of such legislation in the state.

“He made such an enormous impact on people and people are living their lives better because they saw how Kenny lived,” said Lynda Holler. “So, I really realized I needed to be involved in this movement because we have to treasure life, and we have to appreciate that there’s still value that comes out of suffering.”

Like Cavanaugh, Lynda Holler’s personal story drove her to get involved with the medical aid in dying debate. For people on both sides, medical aid in dying is a deeply personal issue.

Doctors remain on both sides of the issue

There is not a clear divide on this issue even within affiliated groups. The medical community remains one of the most divided. Though the majority of physician groups used to be opposed, several have recently switched their stance to neutral, including the American Academy of Family Physicians. Others, such as the New York State Academy of Family Physicians, have announced their direct support.

“I don’t think the medical community is monolithic,” said Katharine Deiss, a practicing physician in medical pediatrics at the University of Rochester Medical Center. “I think they have a split view like everybody else does.”

David Kim, an attending physician in Staten Island, is worried about the ethical burden it would place on physicians themselves, forcing them to be the “judge, jury, and executioner.” Other concerns he voiced include risks to the doctor-patient relationship and violations of some medical codes of ethics, in addition to fears that this would a “cop out” to fixing current care inadequacies.

“Assisted suicide really risks, and probably does, erode trust in the doctor-patient relationship,” said Kim. “We’re talking about death or suicide as a medical treatment to be prescribed by the physician, in order to alleviate suffering or pain by the patient, and that has never been a part of any mainstream code of ethics than any physicians follow.”

While Kim is one of many physicians who firmly believe in literal definition of “do no harm,” other doctors believe that medical aid in dying would in fact help them uphold that oath to patients. Regardless, under the proposed legislation, doctors who do not believe in the practice can opt out.

Concern from marginalized communities

Another group in the discussion is the disabled community. For them, there is fear about how the legislation might put unequal pressure to utilize medical aid in dying. An able-bodied person might define quality of life in a completely different way than someone who is disabled and some in the community fear that such legislation would target or discriminate against disabled New Yorkers.

“If you look at the reasons that people give, that doctors are writing down for why people want assisted suicide, the top five reasons are not related to being terminal — they’re related to being disabled,” said Coleman, who has been disabled for most of her life, which was her motivation for starting Not Dead Yet.

Oregon was the first state to legalize the practice, with seven other states and Washington D.C. following suit. According to data from Oregon in 2017, the top five reasons were decreasing ability to participate in activities, loss of autonomy, loss of dignity, burden on caregivers, and losing control of bodily functions. These traits are felt by both the disabled community and the terminally ill. In Oregon, most patients who used medical aid in dying in 2017 had cancer, followed by ALS, and heart/circulatory disease.

In Oregon, 94.4 percent of patients who used this option in 2017 were white, and most were described as “well-educated.”. Only 5.6 percent of patients in the state who utilized medical aid in dying did so partly due to the financial burdens.

“From these data, and in the absence of verified reports of coercion or exploitation of people with disabilities or other vulnerable groups, analysis has concluded that there is simply no evidence of coercion of people with disabilities or other vulnerable groups, despite predictions to the contrary,” said Alicia Ouellette in her Barriers to Physician Aid in Dying for People with Disabilities paper.

Also preventing any hints of coercion is legislation stating that doctors and insurance companies are not supposed to offer this as an option. Rather, patients must be the ones to ask for it and seek it out, and still over one third of people opt not to use their prescriptions in the end.

“I don’t know, you know you never know, if someone is going to use it or not,” said Cavanaugh. “People sometimes don’t, but knowing that the option is available is a huge, huge benefit. And so, I think if [Chrissy] had the control should she want it, it would’ve helped her live longer.”

Supporters look to renew their push for legislation in 2019

Hearings for the proposed New York bills lasted more than 14 hours combined. Despite neither bill making it to vote in 2018, proponents viewed the year as an overall success. Cavanaugh spoke of 2018 as a “foundation-building year,” and was happy with how far the movement had come since she first got involved. Supporters are hopeful since the democrats gained control of the New York State senate.

Compassion & Choices  supporters sport the organization’s t-shirt at the April hearing before the New York State Legislature in Albany. Photo courtesy of Compassion and Care.

“The bill that was in the assembly now has even more co-sponsors, legislators who have now signed onto it,” said Bonnie Edelstein, founder of Death with Dignity Albany. “It’s been adjusted and redrafted, somewhat, for this next legislative session, to include even more safeguards and to allay fears of some people who are in opposition.”

On Nov. 14, New York State Senator democrat Neil Breslin held a fireside chat in conjunction with Death with Dignity Albany. Though he expressed mixed support, Senator Breslin seemed unsure of whether or not the bill would progress in 2019.

“With 15 new democrats — and really there’s only about eight or 10 long-term serving democrats, I’m not sure — it certainly will be much better than under the Republicans,” said Senator Breslin. “There’s, to me, a lot of discussion it still needs.”

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In recognition of National Suicide Prevention Week, physicians clad in white coats held roses and pictures of departed colleagues who battled mental illnesses. They marched silently yesterday, past Mount Sinai West Hospital in Midtown to a spot just blocks away from the hospital where one of their own tragically ended her life.

“We are here to honor our brothers and sisters that felt like they had no choice, but to take their lives,” said Dr. Lisa Goldman, of Tucson, Arizona. “We want to just let them know we still think about them and miss them.”

Lisa Goldman, M.D., holds up a picture of her friend Nehal Shah, M.D., who tragically took her life on the day the two were suppose to go to Guatemala for a graduation celebration. Photo by Levar Alonzo

Members of the group who came from across the country also held signs that read “Do No Harm to Patients, Do No Harm to Doctors.” “Do no harm” is significant to a doctor, as it is part of the Hippocratic oath to protect those they serve. These doctors said they want the same pledge to be extended to them.   

The high rates of doctor suicide they believe are increasing because hospital systems severely overwork their physicians, which lead to medical errors, and there is no outlet to release stress. Doctors are fearful to go to their bosses with their issues because it makes them look unfit to perform.

According to Dr. Deepika Tanwar of the Harlem Hospital Center who has studied physician suicides over the past 10 years, 300 to 400 doctors a year take their lives, which is higher than the suicide rate of the general population.  

Dr. John Danyi of Virginia attempted suicide over a year ago. He said that he had no way or time to get his frustrations out.

“This is not an issue that is confined to physicians alone, but it’s worst in us because there are more stresses and fewer outlets for those stresses,” he said. “The most common way to deal with the stresses and despair you see is to just soldier on. That’s what we are taught.”

Danyi added that since his attempt to take his life he has not been able to return to practicing medicine.

“It’s like I’m blackballed,” he said. “The Physicians Monitoring Program won’t let me start practicing again. You’re punished more if you try to harm yourself than if you try to harm a patient.”

According to the American Foundation for Suicide Prevention, factors that drive doctors to suicide are workload, work inefficiency, lack of autonomy and meaning in work, and work-home conflict.

Doctors silently march towards Mount Sinai West Hospital in midtown holding hands roses and pictures of their friends  who committed suicide. The doctors want to bring awareness of the increasing number of doctor suicides. Photo by Levar Alonso

Dr. Pamela Wible of Eugene, Oregon, who organized the event, said she has been speaking with her peers about their issues for six years. She set up an anonymous hotline and has collected 1,000 accounts of doctor suicides.

“We are not protected by labor laws or confidentiality laws,” she said. “If you go to a doctor they can look up your file and judge your ability to work on what troubles you. The post-traumatic stress disorder that these doctors deal with daily, from having to see your patients died or tell a family they lost a loved one takes a toll on one’s psyche.”

The problems faced by these doctors start at times when they are in medical school.

Danny Lee, 27, a medical student at Virginia Commonwealth University, said that a recent survey in his class of 200 revealed about 10 percent were suicidal.

“It’s the whole culture of medicine that has to change as much as they give us counseling and social activities,” he said. “The culture of medicine is toxic, it really has to change from a systemwide level and just how it’s taught.”

Wible wants patients to also try to understand that as much as society views doctors as superhumans, they are simply humans underneath.  

“Be nice to your doctors,” she said. “They are humans. They might be dealing with a traumatic situation, just in the room before they come to see you and smile with you,” she said. “Nothing hurts to just have a conversation with your doctor.”

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In front of the Fox News building on Avenue of the Americas this evening, a band of mostly medical students in white coats, huddled together and protested against the repeal of the Affordable Care Act as cars zoomed by next to them, some honking in agreement.

“We believe that it’s important to protect people’s healthcare,” said Alex Gomez, a fourth-year medical student. “And protecting the ACA is the first step to doing that.”

It was beginning to turn dark as another large group of medical students crossed the streets to join the crowd already in place. Their signs were colorful and creative, some quoted Dr. Martin Luther King, but the most common sign had a simple message: do no harm.

“I went into medicine so I could help people who are in pain and who needed help,” Gomez, 31, said. “We as doctors can prescribe medications, give appointment, we can perform surgery but unless we work on changing the laws we can’t be sure out patients stay healthy.”

Trump has made it his initiative to repeal the ACA, or Obamacare, since his presidential campaign. This protest comes after Trump signed an executive order to “minimize the unwarranted economic and regulatory burdens of the Act.”  Many people believe this is the first step in completely repealing the ACA, leaving millions uninsured.

Gomez said that while the ACA is not perfect, it is still more comprehensive than anything be proposed to replace it. He said he would like to see it reformed, not repealed.

Toby Cohen, a third-year medical student, said that the repercussions of repealing Obamacare would affect his sister who is self-employed. Without the ACA, his sister’s insurance rate would be much more expensive than that of an employee of a large organization.

Toby Cohen, 29, keeps his sister in mind as he protests the repeal of Obamacare. She is self-employed and would have a more expensive insurance rate without the ACA. Photo By Sophie Herbut

“Insurance premiums are cheaper when you buy in bulk,” Cohen, 29, said. “It is expensive for a lot of people but the other options are much more expensive.”

The other options would either be in purchasing insurance individually or going without it and paying for hospital bills.

“People without insurance don’t see their doctors regularly,” said Cohen. “They can end up in the emergency room and end up bankrupt paying those bills.”

Many have predicted tragedies that could happen if the ACA is repealed and it is not unreasonable to think the worst when someone’s life is at risk.

“There is literature that says that if the ACA is repealed 43,000 people will die,” Gomez said.

That statistic is what inspired the protesters to drop on the sidewalk suddenly, lie down and stay quiet for a few minutes, feigning death.

Protestors fall to the floor to symbolize the “43,000 people [who] will die” if the ACA is repealed. Photo By Sophie Herbut

“If they don’t have the ACA, the hospitals will eat the cost and the people will go bankrupt,” Donna Templeton, 69, said.

She works as a nurse practitioner in Lake Hopatcong, New Jersey in the mental health and addiction department. Templeton said many of her patients receive Medicaid and without it the entire department would probably be in danger.

“If the mental health patients lose their insurance they don’t get their medicine,” she said.

Templeton said that if they get rid of the pre-existing conditions clause of the ACA, her wife, Sandra Powers, might be in trouble.

“I got back problems, I have an eye condition,” Powers, 58, said. “Where am I going to go?”

Powers said she’s disagreed with politicians in the past but it’s never been this divisive before but she says that she continues to protest and fight for her grandkids.

“I feel like they’re systematically trying to get rid of human rights,” she said.

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