Over the next several weeks, the true scale of the virus’s spread in the state and region became apparent as hospitals filled up and hundreds of people died each day. Thousands died in nursing homes, despite Cuomo’s assurances, as thousands died in nursing homes elsewhere in the country.
As the months passed, questions rose about how New York was reporting the number of people who died of covid-19, the disease caused by the virus. Reporting on deaths in nursing homes varies by state, and some states don’t report the figures at all. But in states that do, the reported death toll has generally been of nursing home residents who contract the virus and then die of covid-19. In New York, the number was constrained only to those who died in nursing homes.
In the abstract, this is not a crucially important distinction: a death counted inside a nursing home is no more tragic than one outside of it. But subsequent reporting, including from the New York Times on Thursday, has shed light both on how Cuomo aimed to mask the scale of the death toll in nursing homes and how he tried to leverage the low reported toll for his political benefit.
Below, a timeline of the past year focused on Cuomo’s approach to the pandemic broadly and nursing-home deaths specifically. Particularly significant developments are highlighted.
March 1, 2020: The first case in New York is reported. The patient was a Manhattan woman who had traveled to Iran.
There’s no question that the virus was much more widespread at this point than simply one person. Testing capacity was limited nationally, however, and the virus was still new enough that now familiar symptoms and spreading mechanisms weren’t as well understood. One estimate suggests that nearly 500,000 New Yorkers were infected by March 10.
March 2: Cuomo holds his first briefing with New York Mayor Bill de Blasio.
“When you’re saying what happened in other countries vs. what happened here, we don’t even think it’s going to be as bad as it was in other countries,” Cuomo says in a statement that would come back to haunt him. “We are fully coordinated, we are fully mobilized; this is all about mobilization of a public health system.”
“Getting the testing done, getting the information out and then having the health care resources to treat people who are going to need help,” he continued. “Again, that is going to be primarily senior citizens, people who are debilitated. And we’re going to have a special effort for our nursing homes, et cetera, congregate facilities where senior citizens are being treated.”
March 4: In another briefing, Cuomo says that what he’s worried about most is “undue fear and anxiety” — as well as “nursing homes, senior care facilities, any senior congregate setting.”
March 6: A cluster of cases is reported in New Rochelle, just north of New York City.
March 7: Cuomo restricts movement in the area around the cluster, including introducing limits on visits to nursing homes in the area.
March 9: Cuomo announces that the state will begin mass-producing hand sanitizer under a state brand, given shortages.
March 12: The state limits visits to nursing homes in every county.
March 14: New York records its first coronavirus-related deaths.
March 25: As cases and deaths begin to mount, Cuomo issues a controversial executive order. To avoid overloading hospitals, the state mandates that nursing homes accept patients cleared for discharge from hospitals, even if they might be covid-positive.
“No resident shall be denied readmission or admission to [a nursing home] solely based on a confirmed or suspected diagnosis of COVID-19,” the order reads. Homes “are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for the coronavirus prior to admission or readmission.”
More than 6,000 covid-19 patients were moved back into nursing homes under this policy.
March 30: Siena College polling puts Cuomo’s favorability rating at 71 percent, up from 44 percent the month prior.
April 8: Cuomo appears on his brother Chris Cuomo’s CNN show. Chris Cuomo teases the governor about his popularity, calling him “the love guv.”
“I’m a cool dude in a loose mood,” Andrew M. Cuomo replies. “You know that. I just say let it go. Just go with the flow, baby.”
The governor would appear on the show regularly during this period.
April 14: Cuomo specifically addresses concerns about the death toll from nursing homes, saying that “the number of deaths in nursing homes and the nursing homes have been an increasing issue.”
Late April: A graph published only in the past month shows how the number of patients returned to nursing homes compared with the peak in facility deaths.
This data was not public at the time.
April 15: The governor orders nursing homes to inform patients’ families within 24 hours of a patient’s infection.
April 19: In a briefing, Cuomo again asserts that “nursing homes are still our number one concern.”
“Vulnerable people in a congregant facility, in a congregant setting where it can just spread like fire through dry grass,” he says. “We have had really disturbing situations in nursing homes, and we’re still most concerned about the nursing homes.”
Among those who died of the virus in a nursing home in April was the uncle of Assembly member Ron Kim, a Democrat from the New York City borough of Queens.
April 22: “We’ve tried everything to keep it out of a nursing home, but it’s virtually impossible,” Cuomo says during a briefing. “Now is not the best time to put your mother in a nursing home.”
April 24: In an interview on MSNBC, Cuomo gives a broad sense of the toll the virus has taken in New York.
“We have about 15,000 people who have died in New York. That is hospitalizations and nursing homes,” he says. “That does not count the actual deaths which we still have to calculate.”
April 27: Siena puts Cuomo’s favorability rating at 77 percent.
May 10: The executive order mandating that nursing homes accept covid patients is rescinded.
May 22: The Associated Press reports that more than 4,500 covid-19 patients were sent to nursing homes under the policy.
May 24: In response, top Cuomo aide Melissa DeRosa points at the federal government’s policies.
“I just want to reiterate once again that the policy that the Department of Health put out was in line directly with the March 13 directive put out by [the Centers for Disease Control and Prevention] and [the Centers for Medicare and Medicaid Services] that read, and I quote, ‘Nursing homes should admit any individuals from hospitals where covid is present,'” DeRosa says during a briefing.
May 27: Cuomo’s favorability slips to 66 percent.
May 29: Seema Verma, then-administrator for the Centers for Medicare and Medicaid Services, responds to DeRosa.
“The issue the governor is bringing up — which I disagree with — is that somehow federal guidance said you should put people who are covid-positive in the nursing home,” Verma says during a Fox News interview.
June: In part to tamp down questions about whether that order spurred new infections and deaths in nursing homes, the New York Department of Health begins drafting a report titled, “Factors Associated with Nursing Home Infections and Fatalities in New York State During the COVID-19 Global Health Crisis.”
On Thursday, the New York Times reported that senior officials within the Cuomo administration directly intervened to prevent the document from including the total number of coronavirus deaths associated with nursing home patients and staff instead of the figure the state had been using publicly — just deaths that occurred in the facilities themselves.
“As the nursing home report was being written, the New York State Health Department’s data — contained in a chart reviewed by The Times that was included in a draft — put the death toll roughly 50 percent higher than the figure then being cited publicly by the Cuomo administration,” J. David Goodman and Danny Hakim reported. “ … The changes sought by the governor’s aides fueled bitter exchanges with health officials working on the report.”
The timing is important, as Goodman and Hakim note that the intervention from the governor’s office came “just as Mr. Cuomo was starting to write a book on his pandemic achievements.”
June 28: In an appearance on NBC News’s “Meet the Press,” Cuomo makes clear the political utility of the state’s underreported nursing home death toll.
“In New York we’re number 46 in the nation in terms of percentage of deaths at nursing homes compared to the total percentage,” Cuomo said. “By the New York Times, we’re number 46. So it’s been unfortunate in every state, and we have to do more. We have to figure it out, but if they want to point fingers, not at New York. We’re number 46. You have 45 other states to point fingers at first.”
The Times reports that a chart originally included in the draft Department of Health report had vastly different numbers.
“New York’s total of 9,250 deaths far exceeded that of the next-highest state, New Jersey, which had 6,150 at the time,” Goodman and Hakim report.
June 29: During a briefing, Cuomo unveils a large foam mountain meant to represent the surge of the virus in the state and New York’s descent down the other side.
June 30: Siena has Cuomo’s favorability rating steady at 66 percent.
July 6: The report is released. It includes obvious efforts to spin the state’s handling of the pandemic. At one point, for example, it states that:
“Of the 310 nursing homes that admitted COVID-19 patients, 252 of them already had a suspected or confirmed COVID-positive resident, COVID-related confirmed or presumed fatality, or worker infected prior to admission of a single COVID-positive patient — meaning the admission of a covid patient did not introduce covid into the nursing home as it was already present.”
The distinction between “did not introduce the virus to the nursing home” and “did not cause new infections” is an important one. The chart above, included in a later version of this same report, suggests that the transfer of patients to nursing homes did occur after the peak in nursing home-related deaths, but that by itself doesn’t eliminate any causal link from the policy to potential deaths.
Perhaps more revealing was a table included in the original report. Appendix B shows the number of deaths in nursing homes relative to the number of deaths overall in each state using Times data. At the bottom is New York, which is reported to have seen only 21 percent of its death toll occurring in nursing homes.
If the Times report that came out on Thursday is accurate, the administration knew that this table was incorrect and misleading. When complete data on the death toll associated with nursing homes was released last month, the percentage of New York covid-related or covid-suspected deaths that occurred in nursing homes jumped from about a quarter of the total to almost 40 percent.
The state is still in about the middle of the pack on that metric, but Cuomo was instead hyping its unusual success.
Reviews of the report were not glowing.
“It seems like the Department of Health is trying to justify what was an untenable policy,” one expert said that month.
July 10: In an interview, Cuomo first hints that he’s thinking of writing a book about how well he and New York handled the pandemic.
July 14: Cuomo announces the production of a poster extending the “mountain” metaphor of the previous month, but including various in-jokes about his briefings and handling of the pandemic.
July 20: The Department of Health report is revised to include more detailed analysis of the question about whether the March 25 order caused additional deaths. It updated the earlier estimate that 252 nursing homes already had known cases to 304 homes that had cases before the reintroduction of patients.
That left six facilities where cases may have stemmed from the reintroduction of patients, a figure winnowed to two once the timelines of those reintroductions were compared with subsequent new cases.
“[I]n all but two cases,” it concludes, “it is highly unlikely that the hospital admission caused infection or fatality.”
Aug. 3: During a hearing in Albany, New York Health Commissioner Howard Zucker is pressed for accurate data on nursing home deaths. He indicated that the data needed to be double-checked for accuracy — the same argument used this week by the Cuomo administration to rationalize its handling of the draft report.
Aug. 11: The Associated Press reports on the gap between the publicly stated nursing home death toll and the true figure.
Aug. 17: Cuomo gives a speech included in the virtual Democratic convention.
“New Yorkers were Ground Zero for the covid virus and have gone from one of the highest infection rates on the globe to one of the lowest,” he said. “We climbed the impossible mountain, and right now we are on the other side.”
“Government can tell the truth and can build trust,” he adds later, in an effort to undercut then-President Donald Trump’s handling of the pandemic.
Before the governor’s speech, Trump administration official Michael Caputo attacks Cuomo on Twitter: “Does the #DemConvention know [Cuomo] forced nursing homes across NY to take in covid positive patients and planted the seeds of infection that killed thousands of grandmothers and grandfathers?”
Aug. 18. The book is formally announced.
Aug. 19. In a radio interview, Cuomo defends the distinction that the state was drawing in reporting nursing-home deaths.
“If you die in the nursing home, it’s a nursing home death. If you die in the hospital, it’s called a hospital death,” Cuomo said. “It doesn’t say where were you before.”
He later argued that nursing home operators were also arguing that they shouldn’t be accountable for a death that occurred in a hospital, since “if the hospital did a better job, they wouldn’t have died.”
Aug. 26: The Justice Department announces that it was requesting “COVID-19 data from the governors of states that issued orders which may have resulted in the deaths of thousands of elderly nursing home residents.”
New York is among the Democratic-run states targeted, with the department’s news release specifically pointing to the March 25 order.
Sept. 30: Asked at a briefing what he would say to families who lost loved ones in nursing homes after the order, Cuomo lashes out.
“Do you know what number we are by percentage before you made that statement, which number? Forty-six out of 50 states,” he says. “So — and we had the worst problem. And we’re 46 in terms of percentage of deaths in nursing homes.”
This is an obviously misleading defense.
Oct. 2: Siena puts Cuomo’s favorability rating at 59 percent.
Oct. 13: Cuomo’s book is released. When the idea of the book first came up, the Times reported on Thursday, the governor had asked the state ethics agency to approve his ability to generate income from royalties on the sale of the book.
Nov. 20: The Emmy Awards announce that Cuomo will win an award for his briefings.
Dec. 14: Vaccinations begin in New York. The week before, Cuomo says in an interview that “our prioritization are nursing homes [and] nursing home staff, which will be conducted by the federal government.”
Jan. 28, 2021: New York Attorney General Letitia James for the first time releases complete data on the number of nursing home-related deaths seen in New York during the pandemic.
“[A] larger number of nursing home residents died of COVID-19 than the New York State Department of Health’s (DOH) published nursing home data reflected and may have been undercounted by as much as 50 percent,” a news release states. “The investigations also revealed that nursing homes’ lack of compliance with infection control protocols put residents at increased risk of harm, and facilities that had lower pre-pandemic staffing ratings had higher COVID-19 fatality rates.”
Feb. 10: In a briefing with state legislators, Cuomo aide DeRosa reportedly says that the administration “froze” when the Justice Department asked for data, which is why Cuomo’s team didn’t provided accurate data to state elected officials.
“We were in a position where we weren’t sure if what we were going to give to the Department of Justice, or what we give to you guys, what we start saying, was going to be used against us while we weren’t sure if there was going to be an investigation,” DeRosa said, according to the New York Post. “That played a very large role into this.”
This doesn’t match the timeline, particularly given the Times report about the edits made to the report in June. It also doesn’t explain why Cuomo repeatedly touted the lower numbers as proof of success.
Ron Kim, the assembly member whose uncle died in a nursing home, told the Post that DeRosa’s comments sounded like “they admitted that they were trying to dodge having any incriminating evidence that might put the administration or the [Health Department] in further trouble with the Department of Justice.”
A few days later, Kim reports that Cuomo called and berated him for this quote, a claim Cuomo’s team denied.
Feb. 11: The Department of Health report is again amended, including the graph shown in April above. The new addendum reaches a familiar conclusion: “when considering the entire data set and new information since the Report’s issuance, the Report’s conclusions are reconfirmed.”
Feb. 16: Siena College has Cuomo’s favorability at 56 percent.
Feb. 24: Former Cuomo aide Lindsey Boylan accuses him of having sexually harassed her. Over the next week, two other women would make similar claims.