‘Don’t answer your phone’: Health experts feared Cuomo’s intervention at pandemic’s height
While Cuomo projected calm during his daily public briefings, with thousands dying as the virus ravaged New York City, public health officials were forced to find ways to work around him.
ALBANY, N.Y. — No one dared tell Andrew Cuomo how terrible they thought his idea was.
In the summer of 2020, with Cuomo at the height of his pandemic-inflated fame, the then-governor of New York suggested that the state health department deploy half its roughly 5,000 employees to check restaurants for their compliance with the state's mask-wearing and capacity limit rules. Cuomo wanted to tout the number of tickets issued for noncompliance during his nationally televised news briefings, according to a former administration official who was on a call when the governor floated the idea.
“He was like, ‘You could use them like an army,’” said the official, who worked on the state’s pandemic response and requested anonymity to speak freely.
The governor's proposal — “an impossible request” — baffled the official, whose account was confirmed by another person familiar with the plan. But, the official said, "the call ended and no one said ‘no’ to him ... No one could explain to him how bad the idea was."
Cuomo, who resigned in August, is facing renewed scrutiny over his response to the pandemic, including allegations that he downplayed Covid deaths while writing a pandemic memoir that netted him more than $5 million. New POLITICO interviews with several former state Department of Health officials, along with a trove of government documents released this month, suggest the former governor’s behavior behind closed doors was in direct contrast to the science-first, hyper-competent image Cuomo presented in his Emmy-winning 2020 press conferences.
The interviews, combined with a legislative impeachment investigation report and transcripts made public by state Attorney General Tish James’ office, paint a picture of an administration in chaos at the height of the emergency, with political appointees and public health professionals frequently at war over decisions and messaging. As Cuomo projected calm during his daily public briefings, with thousands dying as the virus ravaged New York City, public health officials were forced to find ways to work around him.
In the case of the health department’s "army," top officials quickly formed a plan they hoped would placate the mercurial governor until he moved on to some other idea. The official said he told department leaders on the call to "sign up" about 50 agency staffers and "send out pictures" of their enforcement actions on their Twitter accounts.
It worked, and became just one of several subterfuges state health officials concocted to deal with demands from the governor’s office they believed to be based in politics, not science. That continuous pressure from Cuomo's office contributed to dozens of high-level staff departures in the months after New York became the global epicenter for the viral outbreak, according to several people who worked on the state’s Covid response. And it left a state health department with a potentially long road to recovery after being ravaged by both the pandemic and an iron-fisted executive.
“That’s why a lot of people left,” Democratic Assemblymember Richard Gottfried, the chair of the Assembly Health Committee and the longest-serving state legislator, said in an interview. “It’s not that they felt overworked. It’s that they felt that they were not being allowed to do their jobs in a professional manner.”
In a statement to POLITICO, a spokesperson for the former governor, Rich Azzopardi, defended the administration's pandemic response and was dismissive of the Assembly and attorney general’s inquiries, saying one key source offered “second- or third-hand interpretations.” Cuomo, the spokesperson said, “pushed back against the bureaucracy.”
Inside the Covid war room
While Cuomo’s reputation as a micromanager was well known, the extent to which he wielded power at the state Department of Health when it was under siege still is not fully appreciated, former state officials said.
They described a frantic environment where public health experts were not just overruled, but constantly responding to Cuomo's “ridiculous demands” that were expected to take precedence.
“There were times when [Cuomo] was on the warpath, and I would text people over there [at DOH] and be like, just don't answer your phone,” said the official who described Cuomo‘s “army” plan. “If it's coming from a number you don’t know, don’t answer it for the next eight hours. And he would forget about it and move on to the next.”
One of several former Health Department staffers who confirmed that account said it was just one example where the agency was “being asked to do too much.”
That former staffer, who is familiar with the conversations about nursing home policy, said they decided to leave the agency because “the working conditions were so bad.” They said they were routinely working from early morning until midnight, all the while dealing with mounting deaths and severely strained resources, which further hurt morale.
Elizabeth Dufort, a former medical director for the Division of Epidemiology who was identified as “State Entity Employee #2” in one of the transcripts released by the attorney general’s office, told investigators that working conditions had gotten so bad at the Department of Health that some employees had asked the Public Employees Federation, one of the state's largest unions, if they had any legal recourse when it came to things like unpaid overtime. (They were reportedly advised that it was “not illegal during a public health emergency.”) The union did not respond to requests for comment.
Despite their expertise and long hours, several former staffers said, decisions that should have come from DOH experts — such as where to send personal protective equipment — were often routed through Cuomo’s inner circle.
For example, the department would conduct daily surveys of nursing homes and other facilities to see what PPE was needed and assemble packages to be sent from the state’s warehouse. At one point, Larry Schwartz — a longtime Cuomo ally and former secretary to the governor who was, at the time, a C-suite executive at airport vendor OTG — had to sign off on those requests and at times questioned the need for them, the former staffer said. Schwartz and other former aides had returned during the pandemic to work in a “volunteer capacity.”
That system of direct approval was initially intended to override bureaucratic delays and manage inventory during the early days of the pandemic, said former Cuomo administration officials. But it evolved to reinforce an image of tightly concentrated power held only by the individuals Cuomo trusted.
“He would push back and say, ‘How accurate do you think this is? … Do you think they’re trying to not buy that themselves, trying to get us to supply it?’ I remember he asked that question a couple of times, and I was like, ‘Listen, Larry, they need it,’” the former Department of Health staffer said. “The warehouse couldn’t distribute the stuff until they had [governor’s office] sign off.”
Two former administration officials defended the roles Cuomo’s office staff and inner circle played in the pandemic response, saying that they were never intended to replace public health experts, but rather to work as liaisons, organizers and managers on behalf of the governor. They were regularly conversing with state and local health officials when Cuomo was not, they said. The inquiries about personal protective equipment were made to properly gauge supply and demand, not to hold up any deliveries, they said.
In her interview with the attorney general's office, Dufort described “a toxic work environment” in which state Health Department staff were not allowed to collaborate with their counterparts in the New York City Department of Health and Mental Hygiene or other local health departments. The governor’s office would also arbitrarily override certain metrics, like which regions qualified for various Covid “zones,” which Cuomo used to delineate the level of reopening restrictions in certain regions of the state. And the office had ordered Department of Health staff to share incomplete data on Hydroxychloroquine with the White House. Both things, Dufort said, raised ethical concerns at the department.
“Data was not ready to be shared in a manner that would be ethical or appropriate,” she told investigators of the Hydroxychloroquine request. But the governor’s office insisted the department share the incomplete data, Dufort said. She said she was prepared to resign rather than hand over the information.
Numerous former Department of Health staffers said that the governor’s office had to approve every communication coming out of the department — at times holding up press statements and directives over things like grammar. Dufort said the approval process held up the release of nursing home data and even a flier on isolation and quarantine for use by local health departments.
“It’s just crazy the amount of time they spent on that, instead of coming up with ‘what are we going to do next week, two weeks, three weeks, a month, three months, five months from now,” the former staffer familiar with nursing home policy discussions said. “No, they weren’t really forward thinking, they were just reactionary.”
Feeding the beast
That obsession with controlling the public narrative around all things related to Covid-19 took center stage in Cuomo’s pandemic news conferences. The daily briefings — known for being part fireside chat, part bluster — made Cuomo a national figure as the country looked for an alternative leader to then-President Donald Trump in the early days of the pandemic.
The televised address, often delivered at 11:30 a.m. from the Capitol’s Red Room, initially played a key role in communicating important public health information and calming public unease as the virus took hold of New York. But, by the time the “Cuomo Show” had reached national syndication, it consumed much of the administration’s pandemic response as public health officials turned their attention to supporting the daily briefings, several former state officials said.
The endeavor “diverted people’s attention to service the press conference instead of servicing the running of the state,” the former Department of Health staffer said. “It became more about the press conference and about the issue that he was talking about at the press conference.”
Aides to the governor (and sometimes agency staff) would typically begin work on the day’s news conference early in the morning — at times finishing the final slides in the powerpoints that became a hallmark of the governor’s musings only after Cuomo had already begun presenting — former staffers told POLITICO.
“The governor would make a powerpoint by hand, others would type it up, he’d go over it, and then sometimes, on the way out the door, he’d say ‘OK, now add all these other slides,’” a former Cuomo aide familiar with the briefing operations said. “Just, on his way to the briefing.”
After the show ended, they would regroup and start planning the next day’s briefing and topic du jour, including announcements that sometimes caught state and local health officials off guard.
“The governor would announce something, and then we would implement; or sometimes we would find out in advance we need to do this and then it would be announced. It went either way,” Dufort told the attorney general’s investigators. “I got the sense like they didn't fully understand the public health system to understand what our role is in it.”
A member of the governor's Covid task force conceded that Cuomo "was managing by press release, by press conference. If he saw a bad story he pivoted, and we reacted to it, the policies reacted to it. Everyone who worked with him put up with it. But he got a lot of kudos."
Dufort, who was summoned to perform a Covid-19 test on Cuomo at a May 2020 briefing, said the department had raised concerns that the nasal swab demonstration would be at odds with federal Centers for Disease Control and Prevention guidance that such tests be done without an audience. After several “back and forth discussions” — including suggestions that the test be performed in a room with a camera but no reporters or having Cuomo get tested at a drive-thru site — officials decided to go ahead with the on-air swab.
“They were not interested in the other alternatives … They said they wanted to do [it] in a press event, and they felt it would look better,” she said, later adding: “We were saying that is not an OK reason if it is not following CDC protocol.”
She further told investigators that she had planned to swab the governor while he was seated, as is protocol. But the governor had insisted on standing for the demonstration because he felt “it looks better,” Dufort said.
The doctor said she wasn’t comfortable with the demonstration, but understood the value in the public understanding the process and approached it as a medical professional.
A new report from the state Assembly’s Judiciary Committee suggests not only that Cuomo used staff employees to work on his pandemic memoir, “American Crisis: Leadership Lessons from the COVID-19 Pandemic,” but that the effort took priority over other important tasks. The disclosure raises new questions about whether the work on the book influenced the state’s Covid-19 response or its messaging on deaths linked to nursing homes, a full accounting of which the state had avoided disclosing publicly.
According to the Assembly report, a literary agent representing Cuomo had been in talks with Penguin Random House as early as March 2020 about a book. On July 1, 2020 the agent told a Penguin Random House representative that the governor had been working on a book on his experience and leadership during the first six months of the Covid-19 pandemic.
Cuomo and a senior official took part in a meeting with Penguin Random House on July 6 — the day on which the Department of Health released a now infamous report on Covid-19 in nursing homes, which defended the administration from claims that a nursing home admission policy led to thousands of deaths at long-term care facilities. On July 10, Penguin Random House won a bidding war for Cuomo's book, for which he received a $5.2 million payout.
Senior aides in the governor’s office and members of Cuomo’s Covid task force “spent significant time working on the book” — all while Covid continued to take a toll in New York, the Assembly report found. That work included the drafting and editing of a chapter on nursing homes during the pandemic.
The report noted that one senior state official “complained in a text message to a colleague that work on the Book was compromising his ability to work on other COVID-related matters.” And another “noted that the State’s response to COVID-19 involved nonstop work for senior members of the Executive Chamber — including during July and August 2020, a period during which the Book continued to be drafted and revised.”
A former state official, who also asked for anonymity to speak freely, told POLITICO that state health Commissioner Howard Zucker had no idea the governor was writing a book until it was announced publicly. "He was just as surprised as I think anybody was," the official said.
The nurse home deaths
Witnesses told state lawmakers that the same senior Cuomo aide who was the point person for the book made decisions about the reporting of Covid deaths in nursing homes in the July 6 Department of Health report. That document, the Assembly concluded, was intended to “combat criticisms” of the state’s early-pandemic nursing home admission policy that allowed hospitals to discharge Covid-19 patients to such facilities. That staffer was not explicitly named, but it is clearly Melissa DeRosa, who served as Cuomo's top aide.
Cuomo also “reviewed and edited the draft DOH Report on multiple occasions, and made edits to strengthen the defense of the March 25 Directive,” the report stated.
The result, according to the Assembly’s findings, was that the nursing home report “was accurate in its disclosures,” but “not fully transparent regarding the total number of nursing home residents who died as a result of COVID-19.”
The intentional underreporting of the deaths “was the subject of multiple discussions involving employees of the Executive Chamber, members of the Task Force and others in April and/or May 2020” who were reluctant “to admit error when it was discovered and to correct the published numbers immediately.” In one of those conversations, the report states, a task force member asked, “Do you want me to admit that we’ve been reporting deaths incorrectly?”
As the state prepared the nursing home report, officials argued over whether to include data from a draft scientific paper that covered deaths for all nursing home facility residents — about 10,000 deaths — or a figure that included just those that occurred within nursing home facilities — about 6,500 deaths.
The nursing home report initially cited the 10,000 death figure, but after a late-June call with members of the governor’s office and his task force, all subsequent drafts included the 6,500 figure.
State health officials who worked on the report “expressed a number of concerns regarding drafts of the report,” according to the Assembly’s findings, including “that the DOH Report was directed by the Executive Chamber and Task Force and was not in fact a scientific or medical report.”
Health Department officials interviewed by the Assembly complained that "the former governor’s COVID-19 response team was largely comprised of non-medical experts and felt that as a result, decisions were not always made based on scientific or medical advice.”
The only health care professional on the Covid-19 task force — Zucker, the health commissioner — “did not have regular meetings with the former Governor during the pandemic and found it difficult to speak directly with the former Governor, as senior Executive Chamber employees guarded access to the former Governor," the Assembly report said. It did not name Zucker but referred instead to a "senior DOH official."
And when they did converse, Zucker did not feel he could speak freely, “as advice that was contrary to the Chamber’s views was often rejected,” according to the Assembly report.
“The senior DOH official felt that speaking up could result in an even more limited ability to provide advice going forward,” the Assembly report said.
Even when Zucker was called upon to testify remotely during an August 2020 hearing on Covid-19 in nursing homes, he was joined by the governor’s office — a “senior executive chamber official” was giving instructions to him via whiteboard, according to the Assembly report. At one point during questioning, that individual wrote that Zucker should “testify in effect that the March 25 Directive was authored by DOH and that the Executive Chamber was not involved.”
He did not: “This statement was not true, and the senior DOH official did not make such a statement in the testimony,” the Assembly report concluded.
Zucker that same month prepared a letter to the Legislature reporting the full nursing home death numbers and provided it to the executive chamber for approval. To his knowledge, the report found, the chamber never authorized its release.
Former DOH officials confirmed these accounts. Zucker announced in late September that he will resign as state health commissioner, as Cuomo's successor as governor, Kathy Hochul, faced pressure to clear out Cuomo administration holdovers. Former New York City health Commissioner Mary Bassett will officially take the reins from Zucker on Dec. 1.
The Department of Health did not respond to multiple requests for comment on the alleged culture inside the agency during the pandemic, and Zucker declined to comment.
Azzopardi, Cuomo’s spokesperson, provided a statement to POLITICO in which he defended the former governor’s pandemic response and dismissed the criticisms as politically motivated.
“These are second or third hand interpretations from an employee whose only interaction with the Governor or his top staff was during a live COVID briefing and the fact that this line of questioning was even pursued in this unrelated matter speaks volumes about how this entire situation was politicized and weaponized,” Azzopardi said.
"This pandemic was unprecedented, there was zero support from the federal government and — as was the case with many other governors — it required a centralized all-hands-on-deck response,” he added. “We listened to the evolving science, but pushed back against the bureaucracy and the bureaucracy has been trying to get even every day since.”