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Confirmed Coronavirus Cases in U.S. Increases; Health Care Providers Express Concern Treating Coronavirus Cases May Overwhelm Current U.S. Health Care System; Ohio Postpones Primary Over "Health Emergency". Aired 8-8:30a ET

Aired March 17, 2020 - 08:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[08:00:00]

ALISYN CAMEROTA, CNN ANCHOR: It is Tuesday, March 17th, 8:00 now in the east.

The global coronavirus pandemic is getting worse. There are now 4,477 confirmed cases in the U.S. U.S. with 87 people dead. That's nearly 1,000 new cases in just 24 hours, or at least new cases reported. Breaking overnight, polls are closed this morning in Ohio, the governor there postponing today's primary because of this public health emergency. President Trump is advising Americans to avoid social gatherings of more than 10 people. That is a notable difference from the CDC guidelines that put the number at 50 people just 24 hours earlier.

JOHN BERMAN, CNN ANCHOR: The most sweeping restrictions in this country right now, the San Francisco area, 7 million people there are being ordered to shelter in place and not leave their homes except to go to the store to buy food.

And breaking news, at this moment, this morning, we're getting a real time account of the surge of new cases at hospitals in the United States. So want to go right to CNN's chief medical correspondent Dr. Sanjay Gupta, who has been working the phones all morning. Sanjay?

SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes. And I'm about to let you in on a conversation I've been having with some of my colleagues here in Atlanta, at the Emory hospitals. I want to preface by saying, look, what you're hearing, obviously, over the last 24 hours, 48 hours, is pretty concerning, alarming. We're going to get through this pandemic. We're going to get through this. It is going to take time, but we thought we'd give you some idea of what doctors are facing in hospitals now.

So I would like to bring in my colleague Dr. Carlos Del Rio, who is the Dean of Emory at Grady Hospital. We have been colleagues for a long time, we've traveled around the world together. Carlos, good morning. You and I were emailing throughout the night as well, and I thought I might just start off by sharing a little bit. There's certain things I can't share, but some of the emails came in last night. Guys, this is happening. We are now seeing droves of patients being admitted with COVID-19, the novel coronavirus, nine doctors now sick with 20 more expected tomorrow. The nine doctors who are sick tested positive for the coronavirus. The advice that the doctors were giving to the colleagues, to us, Carlos, tell your friends to hunker down and take this quarantine very seriously. You replied, this is happening fast and furious.

Look, we have been talking about this for a long time, the anticipation of these patients coming to the hospitals. Dr. Del Rio, what are you seeing?

DR. CARLOS DEL RIO, PROFESSOR, EMORY UNIVERSITY SCHOOL OF MEDICINE: We're seeing throughout the city and the different hospitals is the number of people coming in with what we call -- with symptoms, we call them persons under investigation, is going up very, very rapidly. And they're coming in at a very quick pace.

And part of the reason we have -- you will see in many hospitals, we have 100 patients, persons under investigation, and we may only have five or six confirmed cases, part of that is because there is still a big bottleneck in testing at the state. And I'm very happy to know that Emory Healthcare University Hospital stood up their first test yesterday, started running tests in house, and they were able to run 60 tests, which is, fantastic, because that is as many as the state is able to run right. So we need to start having more tests, because we have more testing, we will have a lot more ability to diagnose who is really a patient -- a person under investigation and who is not and who is really a true case.

So the number of cases are going to go up. I'm not surprised, because they're so backed up in cases that as we get more testing, we'll be looking at the cases that already exist. But I want to emphasize that patients are coming in, and two issues that come up, Sanjay. Number one is our E.R.'s, our health care system is beginning to get crowded, and it's going to get even worse over the coming weeks in the ICUus and the floors. And number two, health care providers are at risk. They're at risk in the hospital of getting infected, in the clinics. But they're at risk in the community.

So we really -- I'm really worried about having sick health care providers and therefore having the worst possible combination, too many patients, too low a number of doctors, nurses, midlevel best practice provider, et cetera. So that's a bad combination, too many patients, too little people to take care of them.

So I want to emphasize to people, you have it take this seriously, you have to stay home, do whatever you can not to get infected, because the reality is if we don't do our job, this is going to get really bad.

GUPTA: No question. And I want to talk about the best guidance for individuals, even aside from when we're hearing from the federal government. But again, I was really struck by this, Carlos, nine physicians, nine doctors sick, tested positive, 20 more currently under investigation. That's a huge problem. I know my colleagues. I know the system. If that's already happening this early on, are we going to have enough healthcare providers to take care of these patients? DEL RIO: I think that's exactly a concern. But you have to remember

that every place we have seen this virus we have seen this. China had close to 2,000 infected healthcare providers. Italy seeing that, Korea seeing that.

[08:05:07]

And I think part of the reason is you have somebody come in with very little symptoms. What we learn with this disease is not everybody is very ill. People frequently come in with very mild symptoms. So you may have them in the clinic and they have a little cough or a little fever or a little something, and they look no different than anybody else. And you get exposed. So I think that's a concern.

We, as doctors, as you well know, we get pretty close to patients. When we're examining them, we're looking inside their mouth, we have them say "ah," we do all sorts of things that's actually -- it is hard to do social distancing as you're taking care of a patient. You really are not. You're really intimately close and touching the patient. So we as healthcare providers are -- we're doing a very rapid scale-up of training everybody on how to use personal protective equipment, how to do that, how to use it appropriately.

Part of the problem that we're having as a country, and Atlanta is no different, is there is a real shortage of masks, of gowns, of gloves. So our recommendation for people, please don't buy masks. We need them in healthcare. Do not go out there and buy your own masks, we need them in healthcare. We have a big shortage of personal protective equipment, and that's something that we have been telling the federal government that we really need. We need a big purchase of personal protective equipment.

GUPTA: I have had colleagues who are telling me that they come home at the end of the day and they're essentially living and sleeping in their garage because they don't want to come and possibly infect their spouse, they don't want to infect their children. This is real.

Carlos, I want to bring in my colleagues John and Alisyn here, as well, but let me just ask you one more thing. You're hearing in San Francisco that people should shelter in place. Hearing from the federal government no more mass gatherings of 10 or more people. Based on what you're seeing now, what would be your advice to people out there, to the community at large? What should they be doing?

DEL RIO: My advice to the community and my advice to others, and I've talked to this to many people is stay home. Do not leave. I really think we need to basically quasi shut down the country. We have to close restaurants. We have to close bars. We have to close shopping. We have to close business. The economic pain is going to be significant, but we can stand it as a nation. We can do that for a month and stand it. But the economic pain of not doing it is going to be much higher because simply we're going to have incredible costs, and the human cost is going to be huge. We're going to have many deaths and we're going to have much suffering.

So please take this seriously. This is not a time to take it lightly. And I was still quite surprised yesterday as I was driving through city seeing places with parking lots full and people being there shopping and doing other things. Stay home for a month. Really, if you don't do that, you're putting everybody at risk.

GUPTA: OK, well, Dr. Del Rio, thank you for all you're doing.

Alisyn, John, it is a little bit of an insight into what doctors are seeing, and then the recommendations based on that, because this is happening real time. Carlos and I were talking about this last night through the night by email and text. Real conversations right now.

CAMEROTA: We really appreciate you bringing that conversation public. I know that he didn't have to do that, but that's something that we need to know. So our thanks to Dr. Del Rio. And let's bring in now Dr. Vivek Murthy. He's the former U.S. surgeon general a member of Joe Biden's public health advisory committee. Dr. Murthy, it's very alarming when we hear people -- doctors on the front lines say that it is starting, that patients are coming in, quote, fast and furious. This is what we had feared. This is what you all predicted. And so what do you hear from colleagues, what did you hear from Dr. Del Rio there?

DR. VIVEK MURTHY, FORMER U.S. SURGEON GENERAL: Unfortunately, what we're hearing from Dr. Del Rio is being echoed by doctors all over the country. There are private Facebook groups of thousands of doctors who are all reporting very similar things. They're seeing their E.R.s fill up. They're seeing patients come in with symptoms consistent with COVID-19 infection. They're struggling to get them tested, and now increasingly the doctors themselves are beginning to get sick.

This is, sadly, not surprising because, number one, we knew this is a very contagious virus, much more so than the flu. But also because we know many of these doctors are working without the protective equipment that they need, including masks.

Now, as this progresses, what we're going to see is not only the hospitals fill up, but we're going to see our workforce be strained as nurses and doctors get ill. And what we need to do is to mobilize healthcare providers who are retired, who are part time, and who may be able to come in and provide some of that additional surge capacity. We need to do that in a way that allows them to work across state lines.

But we also have a medical reserve corps in this country of 200,000 healthcare workers who have volunteered to serve during times of emergency, and we have to effectively mobilize that group as well.

[08:10:00]

And finally, something that few people know about is we have a United States Public Health Service Commission Corps, which has 6,600 medical and public health officers of various disciplines. We need to stand up a reserve corps there as well so that we have retired public health officers and others who can stand at the ready and be deployed during times of emergency. We could use them right now. GUPTA: Sanjay, what I thought was most interesting and helpful, I

think, for our viewers to see is that it is on. That was a real time assessment of what the leading hospitals around the country are seeing, which is that people are coming in fast and furious. So when we put up on the screen numbers that 4,400 people have tested positive for coronavirus, that doesn't tell the story. That only tells the story about the people we know who have been tested now. There are some studies that suggest it could be 10 times that many people who have it or are carrying it already, which brings me to the study we know got before the president over the last few days. And you suggest you see numbers like this for a-long time, which is that if extreme measures are not taken to stem the tide here, that more than 2 million people in this country could be killed. This is a study out of England.

GUPTA: Yes, look, we have seen these numbers as well. And this is a balance between being very factual and very honest about the worse- case scenarios and what needs to be done. So I think we focused on, OK, here's what needs to be done. But there is no question, look, John, and we have talked about this -- 40 percent to 60 percent of the country potentially, according to some projections, could be exposed to this virus, could become infected. You can do the math here. We're talking 150 or so million people. And we know the fatality ratio we that have been talking about, around two percent. So, again, I want to be careful, I want to be cautious, because I still think there are things that can be done here, but this is serious. It has been serious for a long time. We have been talking about on this program for, a couple of months now, and I think what you're now seeing, what was anticipated for a long time, these patients would start to show up. They are going to need care. As Alisyn pointed out, we're not sure that we have all the things that we can need to care for them.

And as Dr. Del Rio is saying, look, even basic things like the masks, so nine healthcare workers yesterday at Emory, my institution, were diagnosed with this infection, nine. If that -- we're just starting off. If that sort of thing continues, it calls into question how are we going to be able to care for these patients.

CAMEROTA: Dr. Murthy, I know that doctors, like all of you, are on the front lines, but why does this virus seem to be hitting doctors in a more dangerous way? Why are they more seriously ill than some other people? Or am I just imagining that?

MURTHY: I don't think you're imagining this. This has been remarked upon in scientific papers and in newspapers around the world that we see a number of doctors being impacted quite seriously, even though they're of younger age. And we don't fully understand why that is. And it also emphasizes the point that there is a lot about this virus that we are still learning.

And if you put all this together, a virus that we are just beginning to understand, that we know has a high fatality rate, that's very contagious, this makes the case for why it is so essential that we act right now. Some people are wondering, are we overreacting by having people stay at home if they can and by shutting down so much of the normal operations in society? But I don't think that we are. I think this is exactly what we need to do.

And if you want to see what happens when we take aggressive mitigation measures, just look halfway across the world at China, at South Korea, and what you see is that China after putting aggressive measures in place now just closed down the 16 hospitals that had opened. Apple has opened up stores there, and South Korea is seeing cases -- new cases continue to fall. That's what we have to do here in this country, be aggressive about mitigation.

BERMAN: Dr. Murthy, Sanjay, thank you very much for that. Such an important window into what is happening at this moment around the country, we appreciate it.

In the meantime, there is breaking news, Ohio's governor has postponed today's primary elections in that state over coronavirus fears. What about that move? Why haven't other states taken that measure? We'll discuss next.

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[08:18:04]

JOHN BERMAN, CNN ANCHOR: To the breaking news, Ohio not voting this morning. The governor there called off today's primary just hours before the polls were scheduled to open.

Florida, Illinois and Arizona have moved forward with their primary elections despite the coronavirus concerns.

Joining us now, Ron Klain, who coordinated the White House response to Ebola under President Obama, and John Kasich, former Republican governor of Ohio, and a CNN senior political commentator.

So, Governor, let me just start with you, the news coming from your home state calling off the primary election. What do you think of that decision?

JOHN KASICH, CNN SENIOR POLITICAL COMMENTATOR: It was a great decision and the right decision. I had to actually have conversations with the secretary of state's office yesterday. Frank LaRose, about, you know, this they were trying to decide what to do. I said, just go for it. They made good decisions and the governor has been out in front.

And, John, look, we're on a war footing. There is no -- there is no surprise here. We actually are fighting a war. And there is some things that I think can be done. First of all, I do believe that Donald Trump in terms of discussing with his son how serious this was was a step forward.

But you got to think about Winston Churchill and the way he got people to be in -- under ground and to come out and sweep the streets, he didn't do that by forcing them, he did it by inspiring them. And I think we need more of that from the president. We need Pelosi and Schumer to be right next to him. We need a sort of war cabinet to be able to convince people how important this is. And those are the kind of things that I think can make a big difference. And we have the weapons, by the way, to win the war and that involves washing our hands, of staying away from other people at a reasonable distance, and at the same time not touching our face. These are the weapons that all of us employ them, we can win.

BERMAN: We'll get more to the administration response in a second. But I want to stick with Ohio for one second.

Ron, just so people know, many people already know this, you're advising Joe Biden, but I'm asking you as a matter of public health, also an area of your expertise, Ron, the decision in Ohio, how reasonable do you think it was to call off the election there, particularly when they didn't make the same decision in Florida, Arizona and Illinois?

[08:20:08]

RON KLAIN, COORDINATED WHITE HOUSE RESPONSE TO EBOLA UNDER PRESIDENT OBAMA: Look, I have been generally praiseworthy of what Governor DeWine has done. He's one of the leading governors on this. Along with Governor Cuomo, Governor Hogan, it is not a partisan issue.

I'm a little worried it was done in a defiance of the court order and the state didn't pursue this through the courts, as it should have. I understand why Governor DeWine did what he did. But we can have public health and democracy. And Governor Kasich said, you know, this is like World War II, well, people voted during World War II also.

And so, I just think we have to make sure we're doing things the right way, here, the fact that the court ordered him not to do this and he didn't appeal that order is a little concerning. Again, overall, I think what Governor DeWine has done in this -- in the effort against coronavirus has been very admirable. I wish this was handled differently.

BERMAN: Governors have been the leading edge of the coronavirus response, in some cases by necessity over the last several weeks if not months, Ron. There was a conference call that the president had with the nation's governor yesterday. And in this call, some of the governors interpreted the president as saying, in terms of getting equipment, that is needed, including ventilators and ICU beds, you should go out and try to do this yourselves.

KLAIN: Yes.

BERMAN: Now, the president later explained what he was saying, he would cut through some of the federal government bureaucracy, but some of the nation's governors took this to mean go out and fend for yourself. And New Mexico governor, Democrat Michelle Lujan Grisham responded, you know, if one state doesn't get the resources and materials they need, the entire nation continues to be at risk.

So, what do you think of that perceived message?

KLAIN: Well, you know, here's where I respectfully disagree with something Governor Kasich said a minute ago, which is that we don't have the weapons we need. Washing hands is a great thing. Not touching your face is a great thing. But we need real weapons, medical equipment for our hospitals.

And the problem with the president's message is every state for its own, it's only just kind of the way that sounds. It's very contrary to what Governor Kasich was saying a minute ago about we need to pull together. I agree with that a thousand percent.

But there is logistical problem with it too. During the Ebola response, we managed supply chains very directly from the White House to make sure that the key supplies were getting to the most urgent places. If we have just a 50-state dervish to collect all this stuff, it is not going to wind up where it is needed. And so, we need leadership from the White House and saying, hey, we need masks over here, we need ventilators over there, we need PPE over here.

And just kind of letting everyone kind of do it for themselves not only abandons people, but it's going to wind up with these stories we'll see it a couple of days of a lot of supplies in a place that doesn't need them and not enough supplies in a place that does need them.

BERMAN: Governor?

KASICH: Well, look, first of all, let me be clear here in Ohio, we're not canceling the election. We're just delaying it. And part of the problem is you have a lot of our senior citizens who feel a civic obligation to participate and God bless them. But I think it was the right decision, to delay, but not cancel.

Secondly, look, I really believe that we need to hear consistently and we're starting to hear it from the president, along with Pelosi and Schumer, this idea of a war cabinet, the ability to speak to the whole country, to get everyone in the country understand how serious this is, because there are still swaths of our country and groups in our country that aren't taking this as seriously as we can.

If you go back to this whole "Washington Post" simulation that shows that if we can get people to do this voluntarily, it is going to have a much greater effect and that's why there needs to be an inspiration and for people to understand that you are part of the army to win this war.

In terms of what Ron said about equipment and, by the way, I was here when we went through Ebola, I was governor at the time, I don't think what they're saying, maybe they need to be clear about this, you know, you're kind of on your own. What I think they're trying to say is we want to give you maximum latitude because each state has its own situation. And what we don't want to do is be trapped up by -- trapped in silly roles and regulations that are outdated because we face a new normal, we face a new future.

I agree with Ron on the need to help all those places that don't have this equipment and that involves businesses and calling on businesses to do things that are dramatically different, to be able to produce things that are desperately needed in this country.

But that all comes, you know, it is not just top down it bottom up, but I just want to say to people that you are the warriors to defeat this disease, and there should be a lot of people helping you, but bottom line is, you -- you have the weapons.

BERMAN: Ron?

KLAIN: I agree with almost everything the governor just said. I do think -- each one of us has a responsibility, that responsibility includes taking care of ourselves, socially distancing and staying home, all those things. I completely agree with everything the governor said on that.

But there is an important role for federal leadership. And I agree it's not bureaucracy --

(CROSSTALK)

KASICH: Absolutely.

KLAIN: And it is repurposing some of these industries, it is president has authority and the Defense Production Act to try to stimulate the production of ventilators.

[08:25:06]

Story yesterday this are companies that can make five times more ventilators, they just haven't been tasked to do this.

I think, look, I want to say this, I think we heard better words out of the White House yesterday. We need now actions to match the words on testing, on ramping up hospital capacity. The story you had a minute ago with Dr. Gupta and the doctor from Atlanta, it's just a warning sign that things people have been saying for several weeks, we need to have emergency hospital capacity.

Governor Cuomo has been pushing very hard on this. Again, so have Republican governors, this isn't a Democrat, Republican thing. We need to ramp up those hospital capacities and we need to get protective gear it our healthcare workers.

We want to prevent the kinds of things you were talking about in the last segment, we need to really get that protective gear to the front lines where healthcare workers confront this disease.

BERMAN: Governor Kasich -- we got to run.

KASICH: Yes, war council will work and people like Ron should be on that council. It should be bipartisan, America first.

BERMAN: Governor Kasich, Ron Klain, I thank you both for being with us. Thank you both for your leadership, because what I'm interested in is what's going to save lives, not tone from one place, one day to the next, but what is the tone that will save lives. And that's the one people need to stick to. So, thanks for being with us. KLAIN: Thank you.

BERMAN: Alisyn?

ALISYN CAMEROTA, CNN ANCHOR: John, if all of this is causing you anxiety, and not just you, everyone, stick around. We have tips to help you manage stress and anxiety during this outbreak. We will also share stories of people helping other people through this challenging time, what are they doing?

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