Healthcare Heroes: Fighting AIDS & COVID-19.

New York State Governor Andrew M. Cuomo’s fierce and focused fight to find enough hospital beds to combat the Corona Virus pandemic ripping through NYC and State, is not the first time a Governor of NY named Cuomo became a healthcare hero, grappling with a great public health crisis.

“I don’t want the hallways of hospitals to be overflowing with COVID-19 patients on gurneys,” Andrew Cuomo said, at an Albany press briefing last week, describing the nightmare medical scenario we experienced with AIDS patients in the 1980’s when his father, Mario Cuomo was NY’s Governor.

With the HIV virus that caused AIDS being discovered only four years earlier, I walked the hallways of public hospitals in NYC with Mario Cuomo and his State Health Commissioner Dr. David Axelrod in 1985, to see first hand just how bad things were. Gurney after gurney was gridlocked, one behind the other like shopping carts waiting for Costco to open during these days of COVID-19. Each portable hospital bed on wheels was occupied by a gaunt, gay man, curled in a fetal position, bedsheet pulled tightly under his chin. When a nurse or doctor came through, we had to move sideways to create enough space for all of us.

Dr. Axelrod, a Harvard-educated infectious disease scientist who worked at the National Institutes of Health before coming to NYS’ Health Department in 1968 to head the State’s Infectious Disease Center, led us down toward a special section of the Pediatrics floor. There, babies who were born HIV-positive were kept, apart from their mothers. In the days before anti-retroviral drugs could be given to pregnant HIV positive woman to prevent the passage of the virus onto the newborn, these were the Children of the Epidemic, born prematurely, many to drug-addicted mothers infected by using a dirty hypodermic needle. The babies’ emaciated bodies were so tiny, they could fit into Mario Cuomo’s large hands.

We left the hospital and headed out into the waiting, unmarked State Police car, with Dr. Axelrod and me climbing into the backseat. Mario Cuomo was silent for several minutes, numbed by what we just witnessed. Finally, he turned around from the front passenger seat, and looked at his Health Commissioner, whom he affectionately referred to as “The People’s Doctor.”

“These hospitals don’t have enough beds, David,” Mario Cuomo said. “We’ve got to get those patients out of the hallways, off those gurneys and into a room where they can get properly cared for. Where do we find more beds?” The corridors of carnage we just came out of had shaken Cuomo.

“Well, Governor, “ said Axelrod, the son and grandson of Orthodox rabbis, “ the only places where there are empty hospital beds are in the Catholic Hospitals.”

The Governor grimaced. A devout Catholic, but not a favorite of the Catholic Church’s hierarchy in New York because of his Notre Dame speech on Abortion the previous year, Cuomo followed the French Jesuit theologian Teilhard de Chardin’s prescription for service to others as defined in The Divine Milieu (Harper & Row, English translation, 1960). It was a deep spirituality, anchored in concrete acts, and the Governor was determined and bound by a powerful sense of practical and moral duty to do more.

Catholic hospitals and their Church, in denial of the issues of sex and sexuality, and unaccepting of gay men, were, just like Ronald Reagan, silent on the matter of HIV/AIDS. If it was happening in a community they didn’t recognize existed, then it wasn’t happening at all. Following the lead of their new and imperious Cardinal John J. O’Connor, New York’s Catholic hospitals resisted accepting AIDS patients, most of whom, at the time, were young, gay men. O’Connor was an outspoken opponent of homosexuality and impervious to the enormous suffering being inflicted upon NYC’s gay community by the HIV/AIDS epidemic.

Dr. Axelrod reminded the Governor that the Catholic Church had vast tax-exempt landholdings throughout New York City and State.

“All you have to do, Governor, is remind Cardinal O’Connor of that, “ Axelrod smiled impishly, “and tell him of the State’s critical needs for more hospital beds for people with advanced AIDS-related illnesses.”

Cuomo’s eyes twinkled with delight. There was no one in public life Mario Cuomo admired more than Dr. Axelrod, whom he also dubbed “Dr. Disaster,” making him Chairman of the Governor’s Commission on Disaster Preparedness, essentially the State’s Czar in dealing with matters of public health or safety.

As New York State’s Public Health Commissioner under two Governors, Axelrod was one of the few public officials in the nation who immediately grasped the immensity of the AIDS Epidemic. Over the next 35 years, 675,000 Americans would die from AIDS-related illnesses, 100,000 of them New Yorkers.

The first wave of illnesses and deaths crashed into New York during Mario Cuomo’s first term as Governor, and Axelrod wasted no time in responding, organizing the NYS AIDS Institute and AIDS Advisory Council, just months after Cuomo took office in 1983. Dr. Axelrod instituted a full-court press against the AIDS epidemic: immediately supporting widespread testing and public education; pushing confidentiality protections for people with HIV and legal protections against Insurance or workplace discrimination; and advancing universal precautions against the transmission of infection.

But for now, the issue of the most urgency was the availability of hospital beds — the same critical issue which Andrew Cuomo instinctively knew he had to quickly resolve when the Corona Virus walloped New York 35 years later.

Mario Cuomo seized upon the solution offered by his Health Commissioner and the message was communicated to Cardinal O’Conner that the Catholic Church could best serve the interests of public health, and the Church’s own, by opening up their hundreds of hospital beds to people with AIDS.

Miraculously, within days, O’Connor announced to great fanfare that the City’s Catholic hospitals would be opening their doors to all AIDS patients. The Cardinal, crowing about his humanitarian “decision,” reminded anyone who would listen that the Church could embrace the sinner, but not the sin.

New York State’s first Governor Cuomo and his extraordinary Health Commissioner Dr. David Axelrod — who would propose universal health care for all New Yorkers in 1989 — were fearless in forcing open hundreds of unused hospital beds, scoring a life and death victory for public heath and HIV/AIDS care in the teeth of a terrifying new plague, as well as an epidemic of ignorance and discrimination.

A full generation later, as the Corona Virus pandemic spreads like wildfire, another Governor Cuomo from New York has teamed up with top public health professionals like his own Health Commissioner Dr. Howard A, Zucker, and Northwell Health System’s CEO Michael J. Dowling, in a relentless hunt for hospital beds, ventilators, Personal Protective Equipment, and more healthcare workers to battle this new terror around the clock.

Like their superb predecessors in public service in the 1980’s, and the activists who battled the AIDS epidemic, these public health warriors will not rest until testing is widespread, patient care is under control, work on a treatment for COVID-19 patients is underway, and a vaccine is available to save lives. For these healthcare heroes and thousands like them, there is no other option.

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