
Elective surgeries can restart in Suffolk as the focus sharpens on reopening NY

This story was reported by John Asbury, Matthew Chayes, Matt Clark, David Olson, David Reich-Hale, Craig Schneider and Dandan Zou, with AP. It was written by Olson.
Elective surgeries can begin again in Suffolk County, and racetracks like Belmont Park can start hosting horse races without fans on June 1, Gov. Andrew M. Cuomo said Saturday, as the state takes more steps toward reopening amid improving COVID-19 numbers.
Cuomo halted elective surgeries statewide in mid-March to ensure there were enough hospital beds and medical staff available to handle the surge in COVID-19 cases.
“We are past that period,” he said.
The governor's office later Saturday said the surgeries in Suffolk and Westchester counties can resume "now."
Nassau County Executive Laura Curran said she is talking to the governor and hospital officials about resuming elective surgeries "as soon as possible."
“There are health risks if people don’t get certain procedures and we want to make sure we’re doing all we can to prevent a slow-motion health crisis for people not getting the care they need," she said.
Asked why Nassau cannot yet restart elective surgeries, a state Health Department spokesman did not respond directly but sent an April 29 directive on the criteria for resuming surgeries. The directive includes factors such as the percentage of available hospital beds overall in the county and the percentage available in intensive care, and the change in the number of COVID-19 patients in the 10 previous days.
'Welcome news' for hospitals
Northwell Health said the governor's lifting of the elective surgery ban for Suffolk and Westchester was "welcome news."
"Northwell alone has had a backlog of well over 10,000 urgent and elective surgeries that were postponed because of the COVID-19 epidemic, many of them in Suffolk and Westchester," said Terry Lynam, a spokesman for the largest health care system in the state. "About two weeks ago, Northwell hospitals resumed so-called urgent surgeries and other procedures that if delayed more than two or three months could result in long-term negative health implications for patients."
Lynam said New Hyde Park-based Northwell will test all patients for COVID-19 prior to a surgery.
Catholic Health Services has delayed nearly 1,000 elective procedures since the ban was imposed, said Dr. Patrick O'Shaughnessy, executive vice president and chief clinical officer at CHS, which operates six hospitals on Long Island, three in Suffolk County.

"You can only delay the care for so long before the patient begins to deteriorate," O'Shaughnessy said. "Elective procedures include colonoscopies, joint replacements and breast biopsies. These need to get done."
He said CHS hospitals have about half the number of patients they generally have.
Suffolk County Executive Steve Bellone said the resumption of elective surgeries “is indicative of opening up and getting back to a more normal place.”
Hospital officials in Nassau County said they could restart elective surgeries and still be able to quickly open up beds if the number of COVID-19 cases spikes.
Dr. Joseph Greco, chief of operations at NYU Winthrop Hospital in Mineola, in Nassau County, said the term “elective” is a misnomer, because “when somebody’s having surgery they’re coming in for a reason, because of pain, because of cancer, or the chance of a diagnosis, because it interferes with their lives. To put that off further is doing an injustice to the patient.”

Gov. Cuomo at his daily briefing Saturday. Credit: Office of the Governor
Postponements of elective procedures can turn a routine surgery into an urgent one that is necessary to save the patient’s life, if the delays cause complications, said Dr. Adhi Sharma, chief medical officer at Mount Sinai South Nassau hospital in Oceanside.
“The delay can result in decompensation to the point where a simple procedure becomes a complex procedure,” he said.
Sharma said South Nassau on Saturday was at 57% capacity, well below its typical 70% to 90% capacity pre-COVID-19, because of the lack of elective surgeries and because some people continue to have a fear of going to hospitals, even though COVID-19 and non-COVID-19 patients are separated.
“We have tremendous capacity to bring on elective surgery safely,” he said.
NYU Winthrop is at 75% capacity, above the state’s metric that hospitals countywide should be at a capacity of less than 70%, Greco said.
But, he said, if there was a resurgence of COVID-19 cases, “all we’d have to do is to stop doing the [elective] surgeries and we would empty out our hospital pretty quickly, just as we did the first time around. … We did it once and it worked.”
The lack of elective surgeries is causing huge financial losses, hospital executives have said, because insurers typically pay much more for them than for treatment of COVID-19 patients.
On April 22, Cuomo ended the ban for some areas upstate with relatively low numbers of coronavirus cases. Elective surgeries are now permitted in 49 of the state's 62 counties, the governor's office said.
Tracks to reopen without fans
The governor said the state would be issuing regulations in the coming week on how horse racing tracks can operate safely.
“There will be guidelines for the actual participants, but no crowds, no fans,” he said. “But for the industry itself, for the televised viewers, that can still work.”
State Sen. Todd Kaminsky (D-Long Beach), whose district includes Belmont Park, released a statement Saturday afternoon thanking Cuomo. Kaminsky called Belmont "a crown jewel in Nassau which, even without fans in the stands, will generate economic activity. There is also little risk here since most employees are already on the grounds."
On Tuesday, Kaminsky and five other legislators representing Nassau and Queens wrote a letter to Cuomo asking the governor to allow racing without fans at Belmont.
Dave O’Rourke, CEO and president of the New York Racing Association, which operates Belmont, also applauded the move.
“This is a reasoned and responsible decision by Governor Cuomo that will enable horse racing to resume in a way that prioritizes health and safety while recognizing that NYRA is the cornerstone of an industry responsible for 19,000 jobs and $3 billion in annual economic impact,” he said in a statement.
O’Rourke said the association will announce race dates and a stakes schedule “in the very near future.”

The association already has developed a comprehensive plan in response to the pandemic that “includes extensive protocols to keep our community safe,” he said.
Cuomo said that Watkins Glen International, a car-racing track upstate, can also reopen without fans.
A 'stubborn' leveling out
The announcement on elective surgeries and racetracks came during a daily coronavirus briefing in which Cuomo said the number of deaths from COVID-19 statewide jumped to 157 from 132. Cuomo expressed frustration with the “stubborn” leveling out in what had generally been a steady drop in deaths since the peak of more than 700 daily fatalities in early April.
There was a decline in new COVID-19 hospitalizations, to 400 from 431, after three days of slight increases, he said. In early April, more than 3,000 COVID-19 patients were admitted daily to hospitals statewide.
Total hospitalizations continued to slowly fall, the governor said.

Beachgoers Saturday at Jones Beach. Credit: Howard Schnapp
“It’s interesting to look at the curve, how fast we went up and how relatively slow the decline has been," he said. "That shows you the problem of having a spike. A spike happens quickly but resolves slowly.”
Five of 10 regions in New York State began reopening their economies Friday. Long Island, New York City and three other regions remain fully under a "pause" order that Cuomo has extended until May 28. Nonessential businesses remain closed until the regions meet benchmarks set by the state.
Cuomo said that as the state begins to reopen, “We expect to see an increase in numbers. But you don’t want to see a spike."
Whether there is a large increase in cases depends on New Yorkers’ behavior, including if they wear masks and use hand sanitizer, he said.
“Will we have a higher infection rate?” he asked. “It depends on what we do. How you act will determine what happens to you, literally.”
Bellone said he understands people’s desire to reopen, but he said it must be done safely.
“We still have over 500 hospitalizations, 200 people a day testing positive, and another 24 people who died in the past 24 hours,” he said. “Those numbers are very high.”
Inaccurate numbers on state website
Long Island has met five of the seven metrics for reopening, falling short again on two, according to data posted online Saturday. They are failure to see a 14-day decline in three-day averages of hospital deaths from COVID-19, and a hospitalization rate well above the maximum level of two per 100,000 residents.
Yet that state website set up for the public to track how well each region is meeting the various metrics, which Cuomo has encouraged New Yorkers to check daily, has been reporting inaccurate numbers for several days.
Among other errors, the state's monitoring website has reported for several days that there was an increase of 425 hospitalizations on Long Island in one of the last three days. But the same website also shows — as does other state data — that there has been nothing but hospitalization declines on Long Island each day for more than a month.
The state's website also has been reporting that there were 99 deaths in Long Island hospitals during one of the last three days, even though other data suggests that is unlikely.
Suffolk has reported no more than 20 deaths in hospitals on any day of the last week. As a result, Nassau, which does not publish hospital death data, would need to have had 79 hospital deaths in a single day in the last week for the state website's number to be accurate.
LI state parks reach limit, close
A day after Cuomo announced that all state and local beaches could open this coming Friday, with 50% capacity and other restrictions, Nassau County and Long Beach officials said they were working to prepare beaches for the beginning of the Memorial Day weekend.
Curran said Nassau County is working to reopen Nickerson Beach by Friday and is partnering with town beaches.
Long Beach officials said opening next weekend will require hiring several hundred seasonal workers, including lifeguards, ticket takers and special summer police officers being trained this weekend.
The city’s boardwalk has been closed since March. The beach can still be accessed off streets on opposite ends of the boardwalk.
Cuomo’s order allows counties and municipalities to keep beaches closed and impose more restrictions than the state’s.
Meanwhile, with temperatures in the 70s Saturday, Long Islanders flocked to parks.
By midafternoon, seven Long Island state parks were at 50% of normal capacity and closed to new visitors: Sunken Meadow, Wildwood, Orient Beach, Hempstead Lake, Amsterdam Beach, Democrat Point (Robert Moses) and Montauk Point East Overlook.
Jones Beach Field 6 also was closed, state parks spokesman Dan Keefe said.
Hempstead closed Lido West beach after crowds reached 50% capacity.
In New York City, where Mayor Bill de Blasio announced Friday that the NYPD would limit its enforcement of social-distancing measures, 30 trucks were out playing public-service announcements promoting social distancing and face coverings.
In addition, said Olivia Lapeyrolerie, a de Blasio spokeswoman, “over 1,000 social distancing ambassadors are out today across all five boroughs distributing masks and reminding New Yorkers on why it’s important to wear a face covering and practice social distancing.”
Also Saturday, New York reported another 2,419 cases of the coronavirus, bringing the total to 348,232 confirmed cases.
Nassau had an additional 169 cases, for a total of 39,033, and Suffolk had 223 more, and 37,942 in total.
In national news, former President Barack Obama on Saturday criticized U.S. leaders overseeing the nation's response to the virus.
“More than anything, this pandemic has fully, finally torn back the curtain on the idea that so many of the folks in charge know what they’re doing,” he said in an online address to students graduating from historically black colleges and universities. Many officials, he said, "aren’t even pretending to be in charge.”
Obama did not name President Donald Trump or any other federal or state officials in his comments.