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Dr. Celine Gounder Answers Viewers' Coronavirus Questions; Washington State Officially Bans Events Larger Than 250 People; Coronavirus "Tsunami" Pushing Italy's Hospitals To Brink; St. Joseph Hospital's Dr. Charles Bailey Discusses Worldwide Coronavirus Outbreaks & Hospitals At Breaking Point; How Governors Are Making Life & Death Decisions Amid Outbreak. Aired 1:30-2p ET

Aired March 11, 2020 - 13:30   ET



DR. CELINE GOUNDER, INFECTIOUS DISEASE SPECIALIST & HOST, "IN SICKNESS AND IN HEALTH" PODCAST: Well, on that one, I have to agree 100 percent with Dr. Fauci. I personally have never taken a cruise, never plan to take a cruise. They're known to be petri dishes. We have seen over the years many norovirus outbreaks.


GOUNDER: Norovirus causes vomiting, diarrhea. I personally do not want to put myself in that situation.

And I think, as we've observed, you know, if you do have a case of coronavirus on a cruise ship, the chances of that propagating and spreading through everybody else, and then you're also at risk of being quarantined.

And if you're older, especially people 70 and above -- although the risk increases after the age of 50 -- you know, you're more likely to suffer the more severe forms of the illness.

KEILAR: OK, so for now, no cruises until this is obviously subsides, is what you're saying? That's just the smart -- if you want to be careful, that's what you would do, right?

GOUNDER: That would be my advice, yes.

KEILAR: OK. Does the military -- does the U.S. military have the current trained staff and appropriate PPE, the personal protective equipment, and ventilators that they need to serve as surge capacity in hotspots?

GOUNDER: I do think military health care providers are a potential source of extra help to the civilian world in terms of dealing with this surge.

And as you mentioned, the PPE, the ventilators -- this is precisely what we're really worried we're not going to have enough to go around if we see a big spike in cases in the coming weeks.

KEILAR: When do you think this epidemic of the coronavirus will end?

GOUNDER: Yes, gosh, I don't know on that one. I think, you know, at the far end, it would, you know, take a vaccine, which is 18 months or more. But I'm really hopeful that it won't take a vaccine to put this to an end.

A lot of people said with Ebola, oh, we need a vaccine, then everything will be fine. And the fact is, actually, that wasn't what brought the West African epidemic to an end. It was just more traditional epidemiologic measures. And so, contact tracing and isolation and quarantine and so on.

And, frankly, that's probably going to be a similar story with this, with the social distancing. And I think the social distancing is key to prevent a big spike in cases. We want to -- we know it's going to spread, but if we can slow it down --


KEILAR: OK, so, tell us that. Just walk us through this really quickly. You're going to the grocery store. You're dealing with your kids. Maybe you have little -- I have little kids, right? They're very snotty. That's just what happens. How are you incorporating this into your life? Social distancing.

GOUNDER: Yes, so, in terms of the social distancing specifically? I mean, I don't know if it's the same down in D.C. where you guys are, but in New York, frankly, the streets are pretty spartan. There's not a lot of people around. There's not a lot of people on the subway.

I haven't been to the grocery store yet in the last day or two, but I suspect it's the same.

So, you know, I would say avoid rush hour. You know, try to minimize the amount of time you're in a place like that. And really, with droplets spread, two meters is the distance that we think about, so try to keep a two-meter distance from other people.

KEILAR: All right. Dr. Gounder, thank you for answering our questions. We appreciate it.

GOUNDER: My pleasure.

KEILAR: Washington State officially banning large gatherings of 250 people or more. We'll take you there live.

Plus, hear from one man with coronavirus who is quarantined inside a Georgia hospital. Hear what happened when he showed up there.



UNIDENTIFIED HOSPITALIZED PATIENT: Well, I feel like I'm in prison, because you know, nobody can come see me. I can't even walk out of the room. (END VIDEO CLIP)



KEILAR: Washington State has the largest number of coronavirus cases and deaths in the U.S. Just moments ago, Governor Jay Inslee announced a drastic new measure aimed at stopping the spread of the coronavirus.

We have our Omar Jimenez in Seattle.

Omar, tell us what the governor announced here.

OMAR JIMENEZ, CNN CORRESPONDENT: Yes, Brianna, Governor Jay Inslee is just finishing up a press conference right now at the moment. And he just announced that they would be prohibiting events that included more than 250 people in three counties here in the Seattle area, including, of course, Seattle itself.

It was a decision he said he did not take lightly. And while he has been satisfied with the response of the state so far, he felt that they needed to take a more vigorous approach to stop the spread of the coronavirus here in the state.

As you know, this state has been hardest hit throughout this entire country. More than 200 cases. We have now seen over 20 deaths, at least 19 stemming from one single facility. We know the elderly and those with underlying health conditions have been the most vulnerable in this.

And today's announcement comes right on the heels of an announcement he made yesterday limiting the number of visitors that could go to nursing facilities and trying to make sure that those at nursing facilities get screened after every shift.

Because, while I mentioned those deaths, we are now seeing positive coronavirus cases at, at least, 10 long-term living facilities just in the Seattle area alone -- Brianna?

KEILAR: Ten in the Seattle area alone. It does highlight the risk there.

Omar, thank you so much for that, live from Seattle.


In Italy, coronavirus has killed more than 630 people. The entire country as of now is under lockdown. And that means that movement is restricted, schools are closed, large public events are canceled.

And as cases continue to rise, so do the number of patients at hospitals, which are really need their breaking point here.

CNN's Ben Wedeman has more from Bologna, Italy. BEN WEDEMAN, CNN SENIOR INTERNATIONAL CORRESPONDENT: Brianna, multiple

Italian medical officials have told CNN that the public health system in this country, in the north of the country, which has one of the best health systems in the world, is steps away from collapse, that they are receiving, in their words, "a tsunami" of new patients.

And complicating this situation is the fact that around 12 percent of the total number of cases, which is now more than 10,000 in this country, are medical personnel, doctors and nurses, who are desperately needed in the fight against coronavirus -- Brianna?

KEILAR: All right, Ben Wedeman, thank you so much.

And my next guest is Dr. Charles Bailey. He is the medical director for infection prevention at St. Joseph's Hospital in Orange County, California.

Doctor, thank you so much for joining us today and sharing this information that's so important here.

We're keeping this eye on Italy because we see what's happening. And the health system there is -- you heard it there -- it's on the brink.


KEILAR: Hospitals are overwhelmed. Do you think that's where the United States is heading?

BAILEY: Certainly, we don't know what to expect exactly, but I would be confident that the domestic public health infrastructure and hospital system can manage the cases that we would anticipate getting here in the United States.

KEILAR: OK. So, just walk us through what happens if your hospital receives a coronavirus patient. And also what you do to try to minimize the risk of, from the moment that person walks in the hospital until they are at least considered to be suspected coronavirus.

BAILEY: Sure. Well, since the outbreak first originated, hospitals have taken the precautions of screening patients coming into their emergency department by asking them about their travel history as well as their symptoMs.

Those that have fever with respiratory symptoms and a history of travel to the countries of concern, which at this point include China, Italy, Iran, South Korea, and Japan, they are -- a mask is placed on the patient and then they are further questioned with the health care worker donning protective equipment.

So, this has been recognized from the beginning. And that's an attempt to minimize the risk of exposure to the health care worker, because, obviously, we need them to carry on with caring for ill patients, not only with coronavirus, but everything else that comes into the hospital. KEILAR: And even with precautions, that repeated exposure that

hospital workers have makes them more susceptible for coming down with the coronavirus. Do you think there's going to be a shortage of hospital workers here as the outbreak grows?

BAILEY: There certainly will be some health care workers that have to be furloughed from work because of exposure or because of developing symptoms. But repeated exposures or repeated opportunities to be exposed shouldn't be a risk if they're employing appropriate protective equipment.

KEILAR: OK. And so, what do hospitals do if they reach capacity?

BAILEY: Well, we've been preparing for things like this for decades, so-called epidemic or pandemic situations, pandemic flu, even prior to the 2009 swine flu, and then more recently with the SARS back in 2003 and then the Middle East Respiratory Syndrome. So, plans are in place and they are escalated as necessary.

Certainly, there's the possibility that a given hospital, or perhaps a few hospitals in a given area that was highly impacted, might meet their capacity, in which case they would have to enlist the help of adjacent facilities.

In the case of Orange County, if that were to happen, the Orange County Health Department could step in, help coordinate shunting patients to other facilities that weren't as severely impacted.

KEILAR: Dr. Bailey, thank you so much. Dr. Charles Bailey, joining us from St. Joseph's Hospital. We really appreciate your information there.

BAILEY: I appreciate the opportunity, Brianna. Thank you very much.

KEILAR: World health officials just moments ago saying they're seeing an alarming level of inaction around the world. Is the U.S. behind on slowing this outbreak here?


Plus, I'll be speaking live with a former governor on what it takes to make a life-and-death decision on whether to lock down a city. Stand by for that.



KEILAR: Just in, San Francisco is halting large gatherings of more than a thousand people. And this includes NBA games. The Golden State Warriors play there. And as of now, the order going to last for two weeks.

We are seeing massive shutdowns around the world over the coronavirus. And here in the U.S., governors are having to start making tough decisions over just how far they need to go in order to keep people safe.

Here's New York Governor Andrew Cuomo.


ANDREW CUOMO, (D), NEW YORK GOVERNOR: Like it or not, we're going to have to make some tough decisions and we're going to have to start to act united to reduce the density. More testing, more testing, more testing. That's the only way we reduce the spread.


KEILAR: Right now, there's close to 200 known cases in New York State that we're aware of.

I want to bring in former Ohio Governor, John Kasich.

And I wonder, you've been a governor dealing with situations of public health, with considerable issues. What do states need to do? Is there any place where you feel like they need to open their eyes and maybe confront something or think they're doing a good job here?

JOHN KASICH, CNN POLITICAL COMMENTATOR: Brianna, I think what has to happen is every governor has to assemble the best people they can get. And you don't want to have political people in there. You want to have the experts in there.

And you want to reach inside of your state from some of the major hospital systems that are in your state, from the university researchers. And frankly, I would have the CDC on speed dial and ask them to have somebody assigned.

Now, I went through this when we had an Ebola threat. And the key is you want to really, in a sense, overprepare. What you don't want to do is to worry about the criticism, you know, for example, why are they cancelling these games, why can't we get in, what about the impact.

You can't worry about those things. You are -- think about it. You are either the mother or the father of your entire state. The same way you think about your family, the same way you think about your children or grandchildren is the same way you need to think about the residents inside of a state. And then try to be as consistent as you can.

And I think as a leader, you want to be out front. You want to have your medical people out there. You want to have them speak. But at the end, you are the one in charge.

And I think the ability to communicate all the things that you're doing -- and it should be on a regular basis. I mean, you need to be out there all the time trying to tell people what is going on.

Now, you're going to have people who are going to complain, and that's OK. I mean, that's just part of being a leader.

So the most important thing, be consistent, gather information, make sure you don't have people in that room who are afraid to tell you the truth.

That's another thing. You have to hear the truth. And then you have to act. You act decisively. And you remain consistent. And you remain strong. And you communicate to the public. And ultimately, you'll be rewarded. That's what you have to do.

KEILAR: You can't keep everyone happy but maybe you can do your best to keep as many people safe as possible.

That bring me to another question that I have. We've been watching these campaign rallies that these candidates are having. And Joe Biden's cancelled his rallies. Bernie Sanders cancelled. The president has -- is still going to go ahead with his rally,

And I wonder if that's your state, and you are governor, what do you think of that? Do you think he should be cancelling that if his --


KEILAR: -- social distancing.

KASICH: Well, first of all, I am talking to epidemiologists and many doctors. I am convinced that it is very important to try to isolate or to have social distance. And, you know, I think that's an important part of it.

So I would be very clear about the fact that at this point in time for the next several weeks that I'm going to do everything I can to make sure that people are not in close contact in large numbers. And this is what we're going to have to do.

And if we can do that, then I think we can see -- particularly, if we can believe what we see in China -- that the ability to separate people, to maintain that clear distance seems to be working. And that's what we need to do.

Now, there will be political pressure and economic pressure. The other thing that a governor can do is to begin to think about the economic impact.

Are there some things that can be done to help small businesses? Are there some things that you can do dipping into some perhaps of your emergency funds, which would be, I think, appropriate at this point? Are there some tax things that you can do so that people can understand, once this is over, there's going to be an opportunity to gain some of this back?

But we're all in this together. So the key is to be informed, be consistent, constantly stay on top of it, constantly communicate, explain the seriousness of the situation. But make it clear that we're going to get through this, because we are going to get through this as a society. It's going to happen.

Then we need to learn from it. Brianna, we need to learn from it. When we have drugs critical in the treatment of medicine and 163 critical drugs being manufactured in China and India and not here, that's a big issue for our country.



KASICH: There's many, many things we have to think about after. But in the process of dealing with this crisis, be strong, be firm, be knowledgeable and don't guess. Do not guess.


KASICH: And again, it's better to be safer than not.

KEILAR: Yes, very, very good advice.

Governor John Kasich, thank you so much.

KASICH: OK, Brianna, thank you.

New today, one of the president's task force doctors said the coronavirus is 10 times more lethal than the seasonal flu. What you should be doing to prepare for this pandemic.