ALBANY COUNTY — Governor Andrew Cuomo today directed the state’s health department to begin the surge-and-flex protocol that will have all hospitals expand their bed capacity by 25 percent to handle surges of COVID-19.

“We can issue up to 50 percent,” said Cuomo in a press conference, noting that the state starts with 54,000 beds.

“Roughly 35,000 of those beds are now occupied,” he said. “If you cancel elective surgery, we estimate that you reduce the number of occupied beds by about half. That takes us to a total system capacity of about 58,000 beds for COVID patients. Today, we have 4,600 hospitalized, so that gives you a range of the capacity for the system.”

Cuomo also noted that about 5,000 field hospital beds could be added.

The governor also issued a call to retired doctors and nurses across the state, asking them to return to service and promising their registration will be renewed at no cost to them.

“We believe we can get about another 20,000 nurses and doctors from this mechanism,” he said.

Having announced a winter plan last week for battling COVID-19 that still uses micro-cluster zones to control outbreaks of the virus, Cuomo announced today that regions reaching critical hospital capacity will be named as red zones.

The former metrics were based on infection rates.

Under the new plan, if a region’s seven-day average hospitalization growth rate shows that the region will reach 90 percent within three weeks, it will be named a red zone.

Also, citing new guidance from the Centers for Disease Control and Prevention, Cuomo said that, if a region’s hospitalization rate does not stabilize within five days, more restrictions will be applied to indoor dining.

For New York City, indoor dining will be suspended. For the rest of the state, restaurant capacity restrictions will be reduced to 25 percent.

In the Capital Region, of which Albany County is a part, 220 patients are currently hospitalized with COVID-19, which is .02 percent of the region’s population, leaving 26 percent of the region’s hospital beds available, according to data released by the governor’s office.

Also, the Capital Region has 324 beds in intensive-care units of which 167 are now occupied, leaving 44 percent available.

“Bottom line for us: I see it as hospital capacity versus vaccination critical mass,” said Cuomo. “I think that's the ultimate bottom line. Can your hospitals handle the increase until you start to see a reduction from the vaccinations?”

Fauci chat

Much of Cuomo’s press conference today was a cordial exchange with Anthony Fauci, the nation’s top infectious-disease specialist.

“He’s given me great advice and great guidance,” said Cuomo.

Cuomo asked Fauci when New York should expect the peak spread of COVID-19 from holiday visits.

Fauci said the peak from Thanksgiving will lead right into the Christmas season. “So you have a surge upon surge,” he said, as people travel for Christmas and gather with family and friends.

“So, if those two things happen and we don’t mitigate well and we don’t listen to the public-health measures that we need to follow, then we could start seeing things get really bad in the middle of January,” said Fauci.

Cuomo then asked about “living-room spread” and the restriction of no more than 10 people gathering in a home, noting, “Compliance is very low on that.”

Fauci called the 10-person limit “a very sound rule,” adding, “I feel 10 may even be a bit too much.”

He also said, “Make sure that, when people come in, that they’re not people who have no idea where they’ve been or who they’ve been exposed to.”

On vaccinations, Cuomo asked Fauci when it was likely the needed 75 to 80 percent of the population would have gotten shots.

“When you have 75 to 80 percent of the people vaccinated, you have an umbrella of protection over the community that the level of community spread will be really, really very low,” said Fauci, anticipating that won’t be until the end of next summer.

Fauci said he was originally surprised that the COVID-19 infection rates in schools were so low because he had anticipated it would look more like the influenza model. The best strategy, he said, would be to subsidize bar and restaurant owners so they could close their businesses without crashing while keeping schools open.

He commiserated on New York being “hit with a sucker punch right from the beginning” as COVID-19 cases flew in from Europe. “You guys got really slammed and then you rebounded,” Fauci said.

He went on, “And you rebounded in a way that you kept your test positivity low because you did the prudent things that you need to do. I was following it from here in Washington and I was seeing that whenever it looked like things were getting a little out of hand, you’d tighten the rope a little bit and then when things went back, you eased up a little bit. “

Cuomo proposed that the two of them take vaccinations in a television ad. “We’re like the modern-day DeNiro and Pacino. You can be whichever one you want,” he said.

“I love them both. I don’t want to insult one or the other. If I say one, I don’t want to hurt the feelings of the other, so either one,” answered Fauci.

 “Yeah. Who’s the politician?” responded Cuomo.

Finally, Cuomo asked Fauci, a New York native, what he’d like for Christmas.

“Whenever I need some comfort food and I dream back on my days in the Bensonhurst section of Brooklyn,” said Fauci, “the thing that comes to my mind are two things: a nice Nathan’s hot dog and a really steaming pastrami sandwich. That would be really great.”

Newest numbers

Statewide, the positivity rate, based on Sunday’s test results, was 4.79 percent, Cuomo announced. The Capital Region had a rate of 4.60 percent. 

Of the state’s 10 regions, the Southern Tier continued to have the lowest rate at 2.09 percent while Western New York continued to have the highest rate at 7.34 percent.

As of Monday morning, Albany County has 6,736 confirmed cases of COVID-19, with 108 new cases since yesterday, according to a release from Albany County executive Daniel McCoy’s Office.

Of the new cases, 17 had close contact with someone infected with the disease, 87 did not have a clear source of infection identified at this time, and four are health-care workers or residents of congregate settings.

The five-day average for new daily positives decreased to 150 from 161.8. There are now 1,300 active cases in the county, up from 1,254 on Sunday. The number of people under mandatory quarantine increased to 2,396 from 2,345.

So far, 25,741 county residents have completed quarantine. Of those, 5,436 had tested positive and recovered.

There were six new hospitalizations reported overnight, and there are 85 county residents currently hospitalized from the virus — a net increase of one. Thirteen patients are in intensive-care units, one fewer than on Sunday. The county’s hospitalization rate remains at 1.26 percent.

Another county resident succumbed to COVID-19, bringing the county’s death toll to 169. The patient who died was a man in his eighties who did not live in a nursing home.