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New York, the onetime center of the pandemic, faced a growing crisis on Monday over the lagging pace of coronavirus vaccinations, as deaths continue to rise in the second wave and Gov. Andrew M. Cuomo came under mounting pressure to overhaul the process.

The small number of vaccine recipients is particularly striking in New York City, where roughly 110,000 people — in a city of more than eight million — have received the first of two doses necessary to help prevent serious cases of the disease. That is about a quarter of the total number received by the city.

Mayor Bill de Blasio called on the Cuomo administration to allow the city to inoculate a broad array of essential workers and New Yorkers who are 75 and older. The vaccinations are currently limited to health care workers and those living and working at nursing homes.

“There’s lots more we can do if we have both those categories approved,” Mr. de Blasio said at a news conference on Monday.

Shortly after the mayor spoke, Mr. Cuomo rejected any notion that his administration was at fault, asserting that the problem was a local issue, and urging Mr. de Blasio and other local leaders who oversee public hospital systems to take “personal responsibility” for their performance.

“They have to move the vaccine,” the governor said in Albany. “And they have to move the vaccine faster.”

The governor threatened to fine hospitals up to $100,000 — and redirect future vaccines to other hospitals — if they did not rapidly increase the pace of vaccination. He also named the slower-performing hospital systems in a slide show, something he said he did not do “to embarrass” them but to make sure they are “held accountable.”

“We want those vaccines in people’s arms,” Mr. Cuomo said, adding, “This is a very serious public health issue.”

But efforts to speed up vaccinations may prove to be at odds with the strenuous task of making sure to prioritize the right people.

In one possible example, the state has advised clinics and other facilities to rank each employee using a matrix that takes into account age, comorbidities, occupation and the section of the facility where the person works.

Mr. Cuomo said he would propose legislation that would impose criminal charges for facilities or health care providers that did not follow guidelines on who is eligible for the vaccine. “This vaccine can be like gold to some people,” the governor said.

Asked about whether his threat of fines for hospitals — already warned that they will face penalties if they break state mandates on who gets the vaccine — could be slowing down the process, Mr. Cuomo said no.

“I want to get needles in the arms and I want to get that done quickly as possible,” he said. “If there are some hospitals that are better at doing that, then they should be doing that.”

The governor estimated that about 300,000 people had received the vaccine in New York, but offered no single reason for the slow pace of vaccination. “There is no one cause,” he said, noting that he had spoken to dozens of hospitals about the issue.

He did suggest, however, that “management capacity and efficiency” were causing problems, saying there was a lack of “urgency” at some hospitals.

“It’s bureaucracy,” he said.

Mr. de Blasio acknowledged that the city’s rollout had been slow, blaming the logistical challenges of dealing with a new vaccine, and said the city took a cautious approach as it laid the groundwork for more widespread distribution.

“Now it’s time to sprint,” Mr. de Blasio said.

Avery Cohen, a spokeswoman for the mayor, said that Mr. de Blasio has stressed to the city’s public hospital system — NYC Health and Hospitalsthat they should “get as many vaccines in arms as possible.” But she questioned the logic of Mr. Cuomo’s pledge to cut off hospitals that are not fast enough for his taste.

“Threatening to revoke the privilege of vaccination from the city’s public hospital system is punitive and unnecessary,” Ms. Cohen said.

Other elected officials in the city have been urging a more aggressive plan of attack, with round-the-clock operations. On Monday, the mayor seemed to agree, promising three new “vaccination hubs” would open on Sunday in Brooklyn, Queens and the Bronx, and pledging to offer shots of the vaccine seven days a week and 24 hours a day when possible. The city also hoped to double the number of locations offering vaccination to 250 sites by the end of the month.

The mayor repeated his pledge to reach a rate of 400,000 doses per week by the end of the month, with a goal of one million doses — safeguarding at least a half-million residents — by February.

Mr. de Blasio and Mr. Cuomo have long had a difficult relationship, but they have tried to show a united front in recent weeks as the state and city face a second wave of the virus. Mr. de Blasio was careful on Monday not to directly criticize Mr. Cuomo, but called on “the state” several times to alter its approach.

The mayor showed no such restraint when it came to the federal government, suggesting in a slide show that the “feds” needed to “PICK UP THE PACE” on distributing the vaccine.

Mr. Cuomo, a third-term Democrat, has touted his own response to the coronavirus crisis and the state’s vaccination plan in recent months, though statistics continue to bear troubling news: On Monday, more than 8,200 residents in the state were hospitalized with the coronavirus, levels not seen since early May, as deaths have topped 100 a day for several weeks. On Monday, the governor reported 170 deaths, the highest daily count since the dark days of the spring.

Over the past week, the state has seen more than 10,000 new cases per day, as the statewide rate of positive test results has also jumped alarmingly, even before an expected increase tied to holiday travel and gatherings. New York continues to be the hardest hit state in the nation, with more than 38,000 deaths.

Mr. Cuomo said on Monday that “there have been issues with the delivery of the vaccine,” laying that blame with federal officials whom he has regularly criticized for their handling of the crisis.

He said that the state would expedite delivery and injection of the vaccine to nursing homes — where thousands of New Yorkers have died — aiming to get 85 percent of residents vaccinated by the end of this week.

“The federal program has not worked as quickly as we would have liked,” Mr. Cuomo said.





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