New York State Crafting "Fall Action Plan" For Back-To-School and Seasonal Pandemic Surges

RFP Released for Independent After-Action Review of State Response to The COVID-19 Pandemic

Governor Hochul: "This pandemic and COVID has taught us, preparations are the key to literally survival. And when I came into office last fall, we rolled out a plan to deal with schools and a smooth plan to have schools reopen I wanted to sit down with my team now and develop two plans. One is in the short term. That is our fall action plan to prepare for fall and winter this year. And for the long term, what we are calling our pandemic after action review."

Hochul: "We're going to have a pandemic after-action review. We're not required to do it. It's not mandated by law, but it is something I feel is important because New Yorkers deserve the best from their governmentno state has done this. We'll be the first in the nation, and we do hope that this can be a blueprint for others to follow."

Earlier today, Governor Kathy Hochul announced new COVID-19 preparedness initiatives to protect public health and support New York State's ongoing response to the pandemic. Governor Hochul announced the State is working closely with public health experts to craft a Fall Action Plan to address the potential for seasonal COVID-19 surges later this year, as well as strategies to allow students to return safely to school this fall. Governor Hochul also announced a Request for Proposals has been released for an independent After-Action Review to assess the State's COVID-19 response, identify what worked and what did not, and serve as a guide for all local governments planning emergency response efforts.

VIDEO of the event is available on YouTube here and in TV quality (h.264, mp4) format here . 

AUDIO of the event is available here .

PHOTOS of the event will be available on the Governor's Flickr page . 

A rush transcript of the Governor's remarks is available below :

Good morning. Great to see everyone here. I'm joined by our Health Commissioner Dr. Mary Bassett, Jackie Bray, our Commissioner of Division of Homeland Security and Emergency Services, and Kathryn Garcia, our Director of State Operations. And I'm here to give an update on COVID. There's a lot of news to talk about, but also I first quickly want to touch on Monkeypox. According to this,  New York State, the city, has also confirmed us 679 cases. 639 of which are in New York City.

Due to our continuous pressure, we know that we need to secure more doses of the vaccine. So we have over 60,000 to date, that includes New York State and New York City. And I want to thank President Biden and his administration for being responsive. We also have a recent round from the feds being distributed as we speak. And we're also reallocating over 2,000 doses from other parts of the state at this time. So just to give a snapshot of where we are and some thoughts on how to contain Monkeypox, I'm going to turn it over to Dr. Bassett first.

Dr. Bassett: Thank you very much, Governor. And let me just say, I would like to thank the Governor for all of her partnership on health related issues, on COVID, on reproductive rights, and so many contemporary public health issues.

I'm going to talk about monkeypox because it's a growing concern for all of us. It's just been about two and a half months since the current outbreak began and it's already extended to over 60 countries around the world. And since mid-May, it has arrived in the United States and been diagnosed in individuals across the country and virtually every state. But our state, New York State, has the highest numbers by far in the nation. And it is these numbers that drive our sense of urgency. Your Health Department, and its incredible professional staff have been working tirelessly.

There are three aspects of the current outbreak that make it unusual and concerning.

The first, we are seeing monkeypox ongoing transmission in countries where it has not previously been seen. Second, the clinical presentation is not classical. It's not what you'll see if you Google “Monkeypox”. And overwhelmingly the people who've been diagnosed are people who identify as gay, bisexual, or men who have sex with men.

Anyone can get monkeypox. But right now this virus is spreading through the social networks of men who have sex with men.

So, as ever, the Department is providing information to the public, reaching out to advocates and activists in the LGBTQ community, with which we have longstanding and highly valued collaborative relationships. Healthcare providers are receiving information from us, so that they're aware of and can diagnose and test for suspected cases. We've been developing clinical guidance, expanding test capacity, initially from our public health labs, now to commercial labs, partnering with the federal government, as the Governor has said ,and revitalizing our network of local health departments, which remain such a key part of our public health infrastructure in this state, as the entity that will be distributing vaccines. And of course, educating the public.

We're doing all of this with real attention to the importance of dignity and respect, without stigma, and with equity, always, at the center of our work. So, you can see the case update on the slide. Already, the CDC has reported something over 2,100 cases as of yesterday nationwide. The actual number is 2,108. New York State has 69 of those cases, 639 in this city. Almost all of the other cases diagnosed in the state, 40 of them are located in the downstate area. But yesterday we had a case diagnosed in Tompkins and in Albany counties. So, we expect the number of cases to increase. This reflects both increased diagnostic and ascertainment, and it reflects ongoing transmission within communities.

I'm going to take a moment just to remind everybody about monkeypox as a clinical syndrome. It is rarely fatal, but it is extremely unpleasant, and the lesions can be severely painful. And also they're scarring lesions as they heal, they will leave scars. So this is something that nobody wants to get, but there have been no deaths reported in the United States. The other thing to be aware of is that we have to await the rash to make a definitive diagnosis. So once the rash emerges, and that pustule forms, we can do a swab and test it for virus. At this time, there is no other way to diagnose Monkeypox, save swabbing a pustule. But people may feel symptoms, and feel unwell before the rash appears. And we want people to be alert to flu-like symptoms, swollen lymph nodes. And of course, if you get a rash, you should seek, attention if you're concerned about monkeypox.

In this outbreak, rashes have not always been generalized, as they are classically. They've occurred on or in the mouth, in the genital area, in the perianal area. So they have been more localized than we've seen. Once you have symptoms, these can last for two to four weeks. As long as you have heal a healing rash, you are contagious. You have to wait until all of the pustules have scabbed, the scab peeled off, with healthy skin beneath before we can be confident, this can take two to four weeks.

All right, let me just say again. That anyone can get monkeypox, but in the current outbreak, monkeypox is primarily spreading through the social networks of gay, bisexual, men who have sex with men. And it spreads through prolonged skin-to-skin, face-to-face contact, the kind of contact that people have during sex or other intimate activities. It's important for New Yorkers to protect themselves. The people they love, their friends, their community, and it's important to ask sexual partners whether they have a rash or symptoms that are consistent with monkeypox, and to avoid skin-to-skin, face to face contact.

If you have a rash, or if you are having intimate relations with somebody who has a rash, consider the level of risk in clubs, raves, saunas, parties, other places where people are having contact with multiple individuals and consider these to be high risk situations. Again, consult a healthcare provider and follow provider recommendations for testing. I'll reiterate that the testing does depend on a lesion. All of us wish that there were rapid tests as there are for COVID, but there is no test like that at this time. We have, in this state, two outstanding public health labs, the Wadsworth Center is able to process about 240 specimens a day.

We continue to have capacity. We have no backlog of untested specimens. And as I've mentioned, we now have commercial labs bringing onboard - the same people who are responding to monkeypox are also working hard on COVID, which we'll turn to in a moment.

I also just want to say a word about treatment. Treatment, there are antivirals available for treatment. But for most people, the treatment will be symptomatic. It's aimed at reducing symptoms - keeping that rash, clean, dry, protecting against additional possibly bacterial infections, avoiding sun exposure, taking time to go to a healthcare provider to talk, over-the-counter remedies like calamine lotion, and other topical aspects that can help with the itch of the rash and also things like lidocaine jelly that can help with the pain of the rash. Over-the-counter stool softeners may help with the pain in the anal area.

The vaccines are the next thing that I'll turn to now. Because of a limited supply, our eligibility criteria continue to be based on people at the highest risk of exposure or people who have been exposed to Monkeypox, and that includes individuals who've been exposed in the last 14 days and those at risk of recent exposure to Monkeypox. That includes members of the gay, bisexual, transgender, gender-nonconforming communities and other communities of men who have sex with men.

The window for contact is the last 14 days and people who've had skin-to-skin contact in a network where monkeypox transmission is ongoing are also eligible. We are distributing this supply through local health departments, who are using a variety of strategies to ensure the vaccine is made available and that it is made available in an equitable fashion.

We do not at this time, have a vaccine to provide a vaccination to everybody who wants or needs a vaccine. We continue to advocate for more vaccines from the federal government. And in this, we have active support of our Governor on the web, on the slide here, you can see the website where you can get more information about Monkeypox and we have a texting program that people can enroll in either in an English or in Spanish. And can see the text number is Monkeypox to 81336. So with that, let me thank you. And back to you, Governor.

Governor Hochul: Thank you, Dr. Bassett for the very thorough, as expected, but necessary conversation about the reality of what Monkeypox is all about and how it's spreading. The numbers are continuing to go up and we need to be transparent and communicate as openly as possible with the public about how it's transmitted, what the remedies are and how we're working really hard to be able to secure more doses to protect everyone. 

At this point, I'd like to bring in someone who's been in regular communication with us. And I want to thank Dr. Ashish Jha, who is the White House Coordinator on COVID. We also have been having many conversations about what you are doing on the Monkeypox distribution. We've talked about our numbers and our cases in New York. And I really just want to thank you for your willingness to look at the normal distribution based on population, but also recognizing that we have at least a quarter up, and if not, a third of the cases in the country here in New York State. So, Dr. Jha, thank you very much for joining us today .

Dr. Jha: Governor Hochul, thank you. And thank you for your extraordinary leadership and partnership here. Always a pleasure to also follow Dr. Bassett, who is one of our nation's preeminent public health experts. You’ve got a great team and I think this has been a really good partnership on our end. We are just grateful for that.

I'm going to take just 2-3 minutes. I will spend a minute talking about COVID because it’s still with us. We have a set of challenges that all have to manage. And then I will talk about monkeypox. Both recap some of what we're seeing at the national level as well as what expect in the next days and weeks ahead. In terms of COVID, as many of you might have heard me talk about it, right now, the challenge that is facing us is BA.5. This is a subvariant of Omicron. It is now the dominant variant in the United States. About 70-80 percent of all cases are BA.5. And the reason it has us concerned is because it's incredibly immune evasive. People who were infected 3 months ago, we’re seeing high levels of reinfections. People who have not been boosted for a while, who have not gotten the vaccine, we’re seeing a lot of breakthrough infections.

But the key message that I want to make sure everybody understands is that the key tools that we have developed over the last 18 months - vaccines, treatments, our diagnostic tests, they continue to work against BA.5. And probably the most important message on COVID that I want to get across today is if you are over 50 years of age and if you have not gotten a COVID shot this year, if you've not got vaccine this year in the year 2022, you need to go out and get one now. It will offer a very high degree of protection, keep you out of the hospital and will get you through the rest of the summer into fall. And we do expect in the fall, we will have a new generation of vaccines, that are Omicron-specific. Getting vaccinated right now will not make you ineligible for that. Very, very important, everyone over 50, if you have not gotten the shot in the last six months, please go out and get one.

The other part is our treatments are continuing to work. If you're over 50, if any high-risk conditions, if you have a breakthrough infection, get treated. New York has been one of the national leaders on setting up easy access to treatments through Test to Treat sites, whole set of ways that New York is really leading the county. But the goal is in partnership, the federal government, your state government, working very closely to make treatments as easily available and as widely available as possible. So those are my key messages on COVID.

Let me now turn to Monkeypox. And again Governor, this has been, as these things always are, a very close partnership. And I really appreciate your leadership, Mayor Adams, in both advocating for New York as well as making sure that we're all aligned and focused on trying to get the limited supply of vaccines we have to the people who need it most.

So, I just want to talk a little bit about vaccinations and where that is. Just a couple of weeks ago, there were about 10,000 doses out into the community. That number has gone grown exponentially where over 100,000 doses have been administered just last week as the Governor said that number has gone grown expedition where over 100,000 doses have been administered. Just last week as the Governor said, we announced another 131,000 doses allocated. Of that, New York State got about 33,000 doses, a little more than 25% and appropriately so. As you heard, the outbreak, it's happening in many places across the country, but certainly New York has a substantial share of the outbreak, a substantial number of cases, and New York absolutely needs and deserves those doses.

And right now, based on all the allocations, we have given out a total of about 65,000 doses of vaccines allocated to New York so far. That, by the way, just to give you a perspective, that's enough vaccines for the first shot for about 50% of the population at risk. We’re talking about people living with HIV, we're talking about men who have sex with men who are eligible for PrEP, and so that's progress. Not enough. We've got to keep going, and we've got to keep doing more.

So, let me just talk little bit about what people should be expecting in the days and weeks ahead. There are about 800,000, I think a little less, I think about seven or 800,000 doses that were filled and finished in Denmark. FDA inspectors went and did inspections in Denmark, are back. Those doses are coming over to the United States. We expect about half of those doses to be in the United States this week over the next few days. The rest of it coming next week. FDA inspectors, FDA scientists are running some integrity checks, making sure the vaccines are in good shape. You know, everybody wants to move very quickly on this. FDA really is the gold standard. We want to ensure safety of these vaccines. They are moving about as fast as possible to get all of that kind of safety checks, and we're expecting early next to get a thumbs up from the FDA, assuming everything goes well, and I don’t want to prejudge that. But assuming everything goes well, that means another 760,000 doses nationally become available.

My hope is over the next few days we’ll be able to make allocations, again disproportionately getting vaccines to places where the outbreaks are the biggest. But in the days and weeks ahead, you're going to just see more and more vaccines become available. And obviously after those 760,000 doses, we're not going to be done. We're going continue to work with the one company in the world that makes the JYNNEOS vaccine to try to more vaccines produced both there and in the United States and with the goal of more and more vaccines becoming available.

Let me just finish the last point. Vaccines are only one part of the three-part attempt here. We've got also make sure diagnostic tests are becoming easier to use. We heard from Doctor Bassett that great, great state labs, among the best state labs in the country are in New York. We're also making commercial labs available, making sure that that's easy to access. And we're doing a lot to make sure the treatments are also becoming easier for doctors to get. So, this is, you know, a three-pronged approach, but one thing that has always been very clear to us is there’s only so much we can do here in the federal government. Public health works best in America when it's a tight partnership between states and the federal government. And we could not be happier here in the White House with the partnership we have with Governor Hochul, with Doctor Bassett, Mayor Adams, Dr. Prasad, the entire New York team. So, thank you for that. and thanks for letting me spend a few minutes here.

Governor Hochul: Dr. Jha, thank you so much, we appreciate the attention you've been giving us after we've had many conversations and I know you know our concerns and that help is on the way. Have a great day . All right, now for the topic of the day, COVID. There's so much going on. We have a lot to cover, but you know, it's another chance to take a look at what we talked about, the emergence of BA.5, and so I wanted to give New Yorkers an update of where we're at and as much as it's phenomenally hot outside - and in fact, before we're done today, I'll give you a heat update, a weather update - fall is rapidly approaching. And as we've seen from past trends, this is now our third season heading into fall after seeing numbers decline late spring and in the summertime. The fall's quickly approaching we're watching the numbers, but people start heading indoors. It gets colder. And kids are heading back to school. So, we've been doing intensely, having many, many meetings internally to prepare for the future, but the future is right around the corner starting this fall.  

So, like I said, we've seen cases before. Look at the numbers of - this is the history. This is what we're very cognizant of in what happened in 2020, in 2021, and what could be happening now. The number of cases that start spiking up this time of year, so that means it's time to be prepared. We need to make sure that we look at the cases. You can see our spike that went up because of Omicron in the wintertime. We got through that, but if you look at June 20th, July 16th, trending upwards a little bit we're at 37 cases per a hundred thousand. Last week was 35, and a month ago was 24. So, not a serious spike, but when compared to Omicron,  we're at 37, we were at 381 cases per hundred thousand at that time, but we've seen the past can become the present if we don't take the steps necessary now. 

Again, look at the July 16th number, just a little creep up there, New York City being one of the highest right now. Hospitalizations, this is what we watch like a hawk. We lost 22 New Yorkers yesterday. Individuals who succumbed to this illness. So, it is still real. It is still dangerous.  

We are looking at hospitalizations trending upwards. A month ago it was about nine per hundred thousand, today it's 12, almost 13, per hundred thousand. Omicron was 62 per hundred thousand. So we're not there, we need to be cognizant of what could be our future. So, these are our hospitalizations, our trends you see at the bottom. They are absolutely trending upward.  

So, vaccinations are the key. We've talked about this a lot. We still are proud that we're number one in the nation for having adults fully vaccinated. Number one for teenagers fully vaccinated, and number two in the nation for children five to 11 fully vaccinated, but we can do better.  These are numbers I want to put in front of the public once again to say, where are you? It's time. They're readily available. No scarcity, no lines, no hassles. There is no excuse.  

Dr. Jha also talked about the importance of boosters, as did Dr. Bassett, we talk about this often. The booster right now, the second booster, is only approved for people who are 50 and over and 12 years old who have a weakened immune system. We are pushing the federal government to expand this. We think we're going to get some information soon because we believe that this should happen. New York State stands ready to get the additional boosters out the door. And again, there's no shortage, we're just waiting for the law to catch up with what we're dealing with here. So, those are our numbers. Over 9 million people have received boosters, but we have more to do as well.  

So, let's talk about the future. That's where we are today. If anything, this pandemic and COVID has taught us, preparations are the key to literally survival. And when I came into office last fall, we rolled out a plan to deal with schools and a smooth plan to have schools reopen. And then all of a sudden, we got slammed with Omicron and we saw a very serious crisis at the time. So, I wanted to sit down with my team now and develop two plans. 

One is in the short term. That is our fall action plan to prepare for fall and winter this year. And for the long term, what we are calling our pandemic after action review. So let me start with the fall planning, which is now underway. Yes, this looks like a military operation. This is what we operate under with our very, very regular meetings to talk about all the points that we need to be assessing and examining. Our response and our preparation, it is militaristic in how we do this, but if we're serious. We're very serious and intentional about how we're going to deal with this pandemic because it is trending upward, and we expect it to continue to increase. 

So, that's sort of our map, but let me walk you through some of those elements of it. Unlike a year ago, we have far more tools at our disposal between the availability of tests and vaccines and treatments, the boosters. Again, our goal here is to remove any barriers to people receiving these. Make sure they know the availability, make sure the doctor's offices know, and also looking at the overall strategy. We will be talking about our return to school strategy, getting more New Yorkers vaccinated and boosted testing, early testing, offering more access to treatment and therapeutics. Also stockpiling. Yes, once again, having a stockpile, PPE. Strengthening our hospital systems that really were under such stress. And I'll talk about what we're doing there as well as coordinating with our partners.  

Something else, I wanted to hear directly from New Yorkers and how they're feeling about what's going on and how they're adapting to the new normal. So, we listened to them. We conducted a survey just last month and I just want to highlight some of the key findings and most New Yorkers feel things have gotten better. They currently feel safe about the state of COVID; about 90 percent feel somewhere between neutral to very safe. About 75 percent still believe in the ability that vaccines prevent transmission. That's important to us. People know about antivirals, but they don't know how to access them. You know, 70 percent know that the antivirals are available.

And also 80 to 90 percent of New Yorkers have said that they have no trouble accessing at-home tests and PCR tests, but people who are uninsured, we knew this could happen, are having a hard time accessing the PCR test. About 40 percent think they don't have them available to them. So, we have provided more information about eligibility and effectiveness around people over 65.

They're willing to do so if they're provided more information. So we're focusing on, you know, that place where we are to sort of a snapshot in time of what it's been like after two years, but let's talk about our return-to-school strategy and how that is critically important, because as we started venturing into back-to-school shopping and getting supplies and thinking about that return, I know it's only midsummer, but we have the luxury now of time to prepare for the inevitability, which is parents and teachers being anxious about going back into the classroom again.

So, parents, we have a return-to-school strategy once again. We're going to make sure kids are safe and protected. So, here's what we're proposing. We are now distributing at this as we speak over 3 million test kits to school districts, to make sure that every student and member of their staff can test before the first day, we encourage everybody to take advantage of this.

We did this last year. I was only in office starting August 24. The start of school was literally the next week. So, we had an emergency crisis where we were trying very, very hard to protect kids in schools and getting information and vaccines and everything out there. But we're in a different place this year.

We have the time to say, okay, what has to happen? Direct communication with our school districts is key, telling them these are coming. We are making sure that we can have the tests available to schools, which is why we've been, amassing so many test kits. Right now, everybody's going to ask about are our kids going to need tests or masks in schools.

This was a big issue last year. Right now, we are saying they don't. That we don't currently based on today's numbers, anticipate the need for masks in classrooms, but I'm going to reserve the right to return to this policy. If the numbers change, the circumstances change, and the severity of the illnesses changes.

So, God forbid there is a variant that affects kids more severely, you know, we've seen a lot through this crisis. Feel like we've seen everything, but maybe we haven't. And that's what we're preparing for. My number one job is to protect the health of New Yorkers, especially our vulnerable children.

And if we learned anything, we know that kids need to be in school. One of the biggest takeaways that we'll be talking about in our analysis, the effect on children not being in a cool school setting and we're still dealing with the aftermath today. So, it is our objective to ensure the safety of our students, but that they be in the classroom for in-person learning this fall once again.  

Next part of the strategy is more vaccinations and boosters. 99 percent of residents live within a drivable distance of a vaccine provider. That's extraordinary, you know, a year ago, we would've just thought that's never going to happen or even six months ago. I mean, so a lot of work has been behind this. We have a provider network that can, we can take care of boosting all residents over 65 in a short time.

We know how to do this. We know how to do these operations now. And, you know, we're just assessing our overall infrastructure. Are there shortcomings, is there power to the state? Are there buildings and congregate settings in places where people have vulnerabilities? We also know we can stand up mass vax sites like this if we have to. We know what to do, and that gives us some comfort and we're prepared, you know, if we see the numbers, something changes. And again, we don't always know that we can count on the federal government. You know, send in the cavalry.   We don't know that they'll be there with the money that they had been in the past. We don't know that they'll be there with the resources. So, this is ensuring that we can be independent and take care of our residents. Also, a part of our strategy is to continue with the testing and what we did.  

And I'll never forget these dates because it was November 26th, we're doing a lot of holiday briefings around Thanksgiving and Christmas Eve and New Year's Eve, I think a lot of you may recall that.  

We saw that the spike in Omicron went from being just named on November 26th, our first case around December, first or second in New York. And all of a sudden, the numbers were off the charts. And that was right when we were talking about kids being home for the holidays, gathering with all their relatives, super spreader events around the holidays, and then kids returning to school shortly thereafter.

So, what we did, in a very intense way, really, I'm in a crisis situation, we had to amass as many test kits as we could, because if we didn't have them, we are not going to be able to send kids back to schools. So, we were so aggressive in this, and I'm proud of what we did. We talked about this at all of our briefings, our daily meetings, how we could amass over 100 million test kits so we could open schools and keep our prisons safe, our nursing homes safe and make sure that there was no shortage of test kits once they became available.  

And we had more than any state. I think that at one time we probably had more than the federal government because people were calling us. Other states were calling us asking if they could borrow some because we jumped on this immediately to make sure that we could never have to say no to anyone who needed tests done here in the State of New York.

So right now, we have a remaining stockpile of about 20 million and that's dedicated toward our fall effort to protect kids in schools, there are 2.6 million children in schools, plus support staff and teachers. So, we're going to get the three million out right away, but then we'll have enough. But also, we had that emergency situation. We had to do a lot of ordering, in a short timeframe, but now because we have the benefit of time and analysis and projected trends, we have an RFP out in the field right now to help ensure the continuous supply of tests. 

So we have enough, but we also have to anticipate a challenging fall once again. And the tests have been extraordinary. The availability of them, I guarantee has stopped the spread when so many people can just test early, myself included, to make sure that we adapt our behaviors. We stay home if you test positive at home. We also have massive capacity in our labs so that we can do over 500,000 PCR tests every single day, if necessary. We're working with our local health departments in a way that they know that we count on them as real allies. So, if we need to reactivate any local test sites, we'll be able to pull this off as well. 

Access to treatment and therapeutics, that's our next step. We have 44 test to treat sites. But also, as I mentioned, a lot of people know there are therapeutics out there. They don't know how to get them which is why we put forth this treatment hotline. Literally, you can call this number, speak to a practitioner and be able to get treatment. That was not the case before we put up this phone number. So we want people to take advantage of that. About 40 percent of our pharmacies receive a direct supply of therapeutics from the federal government. So that's an important part of what we're doing. 

This hotline we just literally launched about a week ago. I just want to give you some numbers from our one-week-old hotline to call for treatments. We've had 275 calls. We had 198 clinical assessments and we had 131 doses of antivirals prescribed, again to people who did not have access to their own practitioner. So please call for help if you need anything. We're here to help and make sure that you are not left without the treatments you may need.

And also we cannot forget the effects of long COVID. There are still people hit so early during the pandemic who have that loss of energy and feel that their senses are not what they used to be. It affects everybody so differently. Earlier this year at the Department of Health,  we talked about engaging a discussion with researchers, clinicians, and scientists and how we deal with long COVID and help advance research toward a treatment. And just to have people take this seriously and recognize that these are real and it's a huge source of anxiety for people who are dealing with this. But they need to know, we hear them. We understand what they're going through and we're going to be there to help them as we approach the future. 

I mentioned stockpiling, didn't think we'd have to do it, but I'm not going to be caught off-guard here in the State of New York. We're going to make sure that we have over 60 days' worth. As I mentioned, 20 million at-home tests, but also our PPE is going to be there heading into the fall. Strengthen our hospital systems, this is a topic, another whole conversation. It is a fact that our hospital systems, many places were overwhelmed. 

We had different spikes in different parts of the state, even as late as this spring when you were sending in the National Guard. This seems like a long time ago. This winter and in the spring, we had the National Guard going into hospitals and nursing homes to help with the shortage of workers to help people heal and get better from, not just COVID, but from whatever they're in the hospital for. So huge lesson we learned was to make sure that we have enough beds and resources available. And so we're continuing to keep our Surge Operations Center open, where we can deploy people to different parts of the state.

We don't want to shut this down. We don't want to remove any authority we need to make these institutions. We don't want to take our foot off the pedal because we know from the slide you saw earlier that the trend is that the numbers will go up. So, that's what this has been all about. And on top of that, we investing over $20 billion to help our healthcare economy overall. Raise the workers' pay, get them to stop leaving, improving infrastructure and incentives for more people to want to join the workforce. And as I mentioned, continuing our surge operations. We have staffing contracts that we're going to keep in place so that we can reactivate people with five days' notice. That is a  tremendous savings of time when you're in an emergency situation and you want to be able to take advantage of it.

So we need that flexibility. We still have that flexibility. We are seeding that flexibility as long as we're still in this environment. And I look forward to the day when we don't need to have those concerns, but also I coordinated with our federal partners. We have a deep relationship with the White House which is great. Dr. Jha and others who are continuing to work closely with us. So those conversations are ongoing. So, that's our fall plan. A lot of time and energy going into all the different buckets, so everybody should have their own fall action plan. 

Stay updated on your vaccine and booster doses and test often. I keep test kits by my bed just in case. When I was off to see my grandbaby, I was going to be tested before I went and saw her. Everything's good. If you test positive, talk to your healthcare provider or call our hotline and we'll be able to help you out there as well. So, as I mentioned, those are the current operations. That's very much underway.

Let's talk about the aftermath of what we've been going through already. As much as I'd love to stay, I thought we'd be able to launch this when the pandemic is gone. It is becoming clear to me that it's not gone, so we're not going to wait any longer to start some analysis. So since March, we've been talking about this in anticipation of a day this is beyond us, but I want to start moving ahead right now. So we're going to have a pandemic after-action review. We're not required to do it. It's not mandated by law, but it is something I feel is important because New Yorkers deserve the best from their government. 

And I believe it cannot just be a guide for future leaders in the State of New York, but also for other states as we respond to not just COVID but to future emergencies, because we had to deploy all the resources of State Government. We have been doing so continuously, and how is that going to function under different circumstances, different emergencies, and best practices and also decisions that you would not want to make again in the future. So, no state has done this. We'll be the first in the nation, and we do hope that this can be a blueprint for others to follow. So, today I'm pleased to announce we're posting a Request for Proposals, RFPs, to continue moving this after-action review forward, specifically to review our COVID response, identify strengths, best practices, as well as deficiencies, provide key recommendations, and prepare a planning guide for the State to use in future emergencies.

So, this is going to be an important resource for us. It's not going to be done overnight, it's going to take a fair amount of time, but we're going to get it right. We're going to be covering policies related to medical procedures, and hospitals, and patient facilities, the transfer of individuals, vulnerable populations in congregate settings, homeless shelters, group homes, nursing homes, jails, prisons, and how efficient the infection controls were in those settings. That's very important to us, as well as the impact on early childhood and school-age children, and special ed, and post-education programs, and talk about the shutdown and the reopening of schools, and how to handle that in the future as well as the shutting down of the economy. We had a lot of areas affected. And so, I want to make sure we are very intentional about this. That we have a broad scope to what we're doing, but also to have a real blueprint that is useful to us, it doesn't sit on the shelf, but it can be something that we employ day after day as we deal with the day to day crises but also going forward.

And also look at what some of the benefits are based on what we saw people rise up and do. You know, the whole future of remote work, and areas, telehealth services — there were a lot of good things that came as a result of the pandemic. We're going to determine also factors that were used to determine which businesses and industries are considered essential and for what purposes, as well as how we secure essential goods and services to meet New Yorkers. The food supply that was disrupted, the supply of PPE and protection needed for workers. We're going to also talk about the coordination between the federal government and other localities, counties and cities and making sure that communication is always tight. Communication with the public is important, how data was shared, and all the staffing and expertise required to implement these emergency procedures.

So, this will be a one-year contract. I've asked for initial findings in six months to make sure everything's on track, and we expect to be able to present the review within a year. Because this is going to be thorough, this is for the ages, this is something that we're going to continue to rely upon through other crises to make sure that we are operating at the top of our game, in a sense, that there are no areas we would leave untapped or areas that need remedy, that are not fixed going forward. So, these are some of the areas we're going to be focused on. And again, it's not going to conflict with other ongoing reviews, that's important, but what I want to do is look at -- not interfere with other inquiries that are going on, but look at what I have the authority to do and in my capacity as the state's top executive. So, I authorized a look back for us to examine what happened in the past, but the whole purpose is to loo with an eye toward the future and how we prepare for that and making sure that we are independently running this.

So, to oversee this process I'm going to announce that Jackie Bray, our Commissioner of Homeland Security and Emergency Services, will be involved. She was a key member of the team starting right around when Omicron started, around that time, so she's brilliant in her execution of what we had to do. She's responsible for finding the way that we got those 100 million tests when we needed them. I want to thank her for that effort, but it's also going to be important to me that independent entities are selected. The RFP specifically says that any consulting firm that was involved in advising during the pandemic would be not included, because we want to make sure that there's complete independence as well here. So, that's what we're working on. We're very much looking forward to starting that process. I believe it's an important one. Again, we had thought it would start when the pandemic was completely in the rearview mirror, but that's not going to happen anytime soon. So, now's the right time to go forth with those preparations.

But, before we wrap up we cannot ignore the fact that we're going through extreme heat, a heat wave, and so that's what we're looking at. This is the State of New York as of hours ago. Jackie Bray, when she's not worrying about COVID response and now managing the comprehensive scale of our after-action report, she gets these on her desk about every few minutes or so. They keep updating it. So, we're going to have extreme heat throughout the state, possibly going into over 100 degrees. And so, just to let you know what we're focused on, we are working with DHSES, Jackie's agency, to monitor weather conditions, coordinating our response. We are also, and this is really important, in constant communication with utilities. Can they handle the capacity? What this is going to do for the effect on the loads, and making sure they're able to manage the need for increased capacity as people continue to keep their air conditioners running and try to escape the heat. Also, we're monitoring air quality. We're going to continue, if necessary, issuing air quality advisories if we need to. So, again, we'll do what we can on the state end, but avoid going out in the peak hours. Stay out of it, stay hydrated, keep your pets inside, check on your neighbors, and be aware of any other induced illnesses. So, just look out for everybody. But if you have anybody who needs help make sure you get hold of our office of temporary assistance and also keep track of our local weather forecasts.

So, that was a lot today, a lot going on, but it's important. Communication with the public through the media, and I appreciate those of you who came through the heat. I guarantee it's going to be a little hotter when you leave the room since this went on a long time, but I appreciate you being here. It's really important that we have this two-way communication. 

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