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CDC Changes Guidelines to Allows Healthcare Providers to Continue to Work after Being Exposed to Coronavirus Provided They Wear Masks; Shortages in Medical Equipment Including Masks Prompts CDC to Recommend Healthcare Providers Use Bandannas or Scarves; Schools Closed in 39 States Due to Coronavirus; CDC: Consider Allowing Exposed Doctors to Continue to Work. Aired 8-8:30a ET
Aired March 19, 2020 - 08:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JOHN BERMAN, CNN ANCHOR: An emergency room physician will join us in just a moment to talk about this.
President Trump has invoked a wartime law to increase production of supplies including ventilators. He signed an emergency funding measure overnight and is discussing some details of a $1 trillion economic package that could be finalized by early next week.
How about this -- two members of Congress have tested positive for coronavirus. Both these members were voting on the floor and mingling with other members as recently as Saturday morning. The entire Georgia legislature and lieutenant governor have now been told to self- quarantine because of reported cases there. One hopeful sign now from China, a potential milestone, if it is to be believed. For first time, China is reporting no new cases from inside the country. It will be some time, though, before we get there in the United States.
Joining us now is Dr. Sanjay Gupta, CNN chief medical correspondent. And Sanjay, I want to get to some new information right away. You are reporting or you have seen that the CDC is changing its guidelines for doctors and medical workers?
SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes, this is quite striking. We have been talking about obviously the need to keep healthcare workers safe, the need to have personal protective equipment. What we're not seeing on the CDC's guidelines is they're saying consider allowing people who've had exposure to someone with the coronavirus, a healthcare worker who has had exposure, allow them -- consider allowing them to continue working as long as they wear a face mask.
Remember John, just as of a couple of days ago, what people were being told -- if you have exposure to a people known to carry the coronavirus, you should then quarantine yourself for up to 14 days. But I think given the concern about lack of healthcare workers, people who are going into quarantine, thus no longer being in the workforce, they're now saying, hey, maybe we need to loosen this and allow them to continue to work. Obviously, a huge concern, John, because this is how you potentially increase the spread, or at least not slow down the spread.
BERMAN: Feels like a big move, Sanjay. Just to reiterate this, they're saying that healthcare workers who have been potentially exposed to coronavirus keep on working if you're wearing masks, and the reason is because if they took them out of the system, they wouldn't have enough healthcare workers?
GUPTA: Right. That's basically it. And, John, let me add on to that. So they say, look, you can consider working, even if you've been exposed, as long as you have a mask. And, by the way, we don't necessarily have enough masks, so within those guidelines as well, they say bandannas and scarves could potentially be considered to be used as well. We know that they're not personal protective equipment that's been approved in any way, but, hey, look, we're at a situation now where we don't have enough of this, we don't have enough of the personal protective equipment, and we don't have enough healthcare providers. So we need to start making accommodations for what we think is going to be necessary here.
So obviously talking to a lot of my colleagues who are healthcare workers, this is concerning to them. They are then going home to their own families, trying to figure out how to keep them safe, a lot of times isolating themselves within their own home if they're even going home. So this is a reality even at the early stages of what healthcare providers may be facing in some hospitals. I'm not saying this is being adopted in all hospitals, but you can go to the CDC's website, and that's where they're listing some of these new guidelines.
ALISYN CAMEROTA, CNN ANCHOR: Sanjay, John and I have so many questions about this, so let's start at the beginning. They're obviously doing a cost-risk analysis, where by if one doctor has been exposed but may not test positive, they are deciding that it is more advantageous for that doctor who will come into contact with dozens of people, right, so as you say, potentially spreading it, but they need that doctor to stay working. Is that -- is that what we are to understand, that we're in such short supply of doctors that they're willing to take that risk?
GUPTA: Yes, I think you're exactly right. I don't want to overstate it like you, Alisyn. But that's the real time metrics that is happening within hospitals right now. The hospital where I worked yesterday, I'll give you an example, two days ago now, there was a patient who came in, it was unclear whether the patient had coronavirus. By the time the person was tested and confirmed to have coronavirus, two medical students, six resident doctors, and one attending physician had been exposed. OK, so that's seven doctors and two medical students exposed.
Now, what has happened to them is that they're basically told, OK, you now -- known exposure, you need to quarantine yourself for 14 days. Not only do you not need to come in contact with patients or other physicians or healthcare providers, you need to not come into contact with anybody as much as you can.
As of a couple of days ago now, within the last day or so, this has changed. They're now saying, look, if you have come in contact with somebody, as long as you wear a mask, you can still continue to take care of patients if you don't have symptoms.
And by the way, if you don't have masks, bandannas or scarves may have to do for the time being. That's what healthcare providers are hearing, and I think that's part of the reason as the interviews you're doing with people, the people I'm hearing, that's part of the reason I think you're hearing this concern among them even a little bit of panic.
GUPTA: If you can't get a mask, wear a bandanna, how am I supposed to feel about that, Sanjay, as a public health strategy?
CAMEROTA: Does that work?
GUPTA: There is no -- look, the personal protective equipment, these N95 masks, they're supposed to be fit tested, those are the types of masks that can actually help keep these viral particles out of your nose, out of your mouth. A bandanna or scarf is obviously, obviously not approved for that sort of thing. But you get the sense that what we're hearing is, look, we need to throw everything against the wall that we can possibly think of because we know, we recognize, even though we have been hearing about this for months, and we know that there was going to be a short fall, we're getting to the point -- the break point where we're not sure we have enough over the next few days.
There is another hospital in Georgia that says they have essentially gone through a few months of personal protective equipment within a few days. Every time a patient shows up in the emergency room with any kind of symptoms, the way that that person should be treated, is the healthcare providers put on personal protective equipment to examine that patient, because they don't know, does this person have COVID-19, have this coronavirus, or not? You kind of have to assume they do.
At the same time, what are we hearing? We're hearing that according to some of the early data in China, four out of five people who were subsequently diagnosed with coronavirus acquired that infection from someone who didn't know they had it. OK, let me just repeat that. Four out of five people who got a positive coronavirus infection acquired it from someone who didn't know they had it. So we don't know. You have to assume anyone possibly has it. That's why we're social distancing in our lives. In the hospital, you don't have that option. You've got to take care of a patient, which means you need personal protective equipment. They don't have it. So now you're hearing this loosening of the guidelines, which is very concerning, I can tell you, to a lot of frontline healthcare workers.
CAMEROTA: Sanjay, stand by, if you would. We have more questions for you, but we do want to bring somebody in who is on the front lines at a hospital in Tennessee. This is Dr. Darria Long. She's an emergency room physician. She's been treating coronavirus patients. Dr. Long, so let's just go with the breaking news. You've been treating coronavirus patients. Are you in self-quarantine right now?
DR. DARRIA LONG, EMERGENCY ROOM PHYSICIAN: Alisyn, thank you for having me. This is a tough call. I did four shifts just in the last week alone, extra shifts because we had some physicians call out. So I'm trying to isolate as much as possible. I have a young family. And then I have to go back to the hospital. And I think we can't forget, if I have been exposed to coronavirus, I still have other patients who don't have coronavirus. Patients are still coming in with strokes and cancer and heart attack, I can't be passing along coronavirus to them.
BERMAN: You also say you have already been told that you need to take care of your own protective gear, in some cases buy your own protective gear. Is that right?
LONG: Several of my colleagues nationwide have been told they should buy their own protective gear. We have gotten emails, some of us have gotten emails that you should put your masks in a paper bag between patients. Somebody else said maybe put your mask in a Ziploc bag after a shift. Sanjay, I don't know about you, what am I supposed to do with these ziplocked bags of masks when I get them? I just put it in my trunk? It is not a good way to keep our physicians safe, and most importantly, then, our patients.
GUPTA: Look, it's really frightening, Darria. And I know that you have to consider your own family as well. I'm hearing about doctors who essentially have one of these N95 masks. They're treating it like it is gold. They're told oftentimes for a couple of weeks that's the only mask they may have. Typically, maybe we overused a lot of this personal protective equipment in the past. There was always masks and gloves, everything sitting outside the various patient areas whenever I needed them in the past.
That's not the case anymore. They're under lock and key. And, look, as we're hearing, the people who are taking care of these patients can't necessarily count on being able to have that equipment right now. I think we have a graphic, let me show you quickly, just the mask, we talked so much about ventilators, but how many masks are projected to be necessary is around 3.5 billion of these face masks. And the country generally makes about 1.5 billion a year. So significant shortfall. They're trying to up the production of these masks. But there it is. But we're not there.
And, look, again, I just want to modulate myself a little bit here as we talk about this, but I think part of the reason people are really frustrated is, a, they don't have the masks, b, we knew this was coming. We have known this was coming for two-and-a-half months at least. There was certain things that could have been done.
You take out healthcare workers, and the system is going to have a very hard time continuing to run, and the idea that healthcare workers, even after they have been exposed, should continue to work, possibly becoming sick themselves and infecting others, that can't be a long-term strategy. That just can't work.
CAMEROTA: But Sanjay, isn't Dr. Long in that category? There are coronavirus patients that you -- Dr. Long, correct me if I'm wrong, you've come in contact with that are being treated at her hospital, and she's going to work every day. Isn't she already in that category?
LONG: Yes, you are. And the problem is all the testing also takes three to five or more days. So there is really no way if I was exposed Monday or Tuesday during a shift to know actually if I really truly was exposed and infected by it. And I have other colleagues across the country who are emergency room physicians who are -- have symptoms of coronavirus. They're not sick enough to be admitted, so their hospitals are telling them, since we don't have enough tests, just go home until you're asymptomatic for 72 hours.
BERMAN: And Dr. Long, and Sanjay, as we digest this news, and I think we're all trying to figure out exactly that this means, because this seems like a big change, and I'm not trying to make it sound scarier than it is, but it does raise your eyebrows. But, Dr. Long, while we have you here, just tell us what it has been like for you the last few days. What have you seen in terms of the number of patients and the age range of the patients you're treating?
LONG: You know, John, I'm glad you're asking this, because we are seeing -- yes, of course, we are seeing people who are older having respiratory problems, but we're seeing a lot of people in their 30s and 40s and younger who are coming in, their oxygen levels are a little low, their heart rates are up, they're sick and some of them are being admitted, and across the country we're seeing people in their 40s on ventilators for prolonged periods of time. That's unheard of. We don't normally see that.
CAMEROTA: There is just no way that that's not scary, Sanjay. You're trying to modulate, so are we, so is everyone. But there is just no way that what emergency room doctors are seeing across the country is alarming.
LONG: Yes, and let me just be clear, Alisyn, to your last point, because I think it's an important one. Here is the scenario -- patient comes in, you don't know they have coronavirus, they come in for something -- maybe just some basic symptoms. What would be ideal in an ideal scenario is any physician, any healthcare provider who is going to examine this patient has personal protective equipment, right? Right away they can put that on and go see the patient because the patient is basically an unknown at this point. But given how much coronavirus is circulating, you have to assume that maybe they could have coronavirus.
Because there is not enough personal protective equipment, doctors, residents, nurses, whoever may examine this patient, then subsequently find out the patient has coronavirus. That's what happened at the hospital. Seven physicians, that happened to them.
The question at that point is what should happen to those physicians, nurses, whoever? What should happen, as Dr. Long was talking about, they should be able to quarantine for 72 hours. Instead now what they're being told is you had an exposure. You didn't have personal protective equipment on at the time, you've had an exposure. If you're not symptomatic, go ahead and continue to work. But you have to wear a facemask. Problem is, for the same problem in the first place, they didn't have a face mask. So they can't wear a facemask, so you know what, maybe you can wear a bandanna or scarf. I've just laid out a scenario of events that is happening in hospitals all over the country.
CAMEROTA: Dr. Long, Dr. Sanjay Gupta, we really appreciate you helping us understand this breaking news. Obviously, we're getting developments throughout the program. The CDC has just updated their website, Sanjay, as you told us. Thank you both. And Dr. Long, thank you very much for what you're doing for all of your patients there and for talking to us.
Also join Sanjay and Anderson Cooper for a new CNN global town hall, "Coronavirus, Facts and Fears," this is in partnership with Facebook Live, this is tonight at 8:00 eastern.
BERMAN: I've got to say what Sanjay was saying too, we knew this was coming.
We have a developing story this morning. Georgia's entire state legislature, staffs and lieutenant governor, under self-quarantine for 14 days after a state senator tested positive for coronavirus. CNN's Amara Walker live in Atlanta with these developments. What are you learning?
AMARA WALKER, CNN CORRESPONDENT: Hi, there, good morning, John. Yes, Senate leader are also asking the general public who frequent the capital building here behind me to use their judgment on whether or not they should be self-quarantining as well. But as you said, the lieutenant governor of Georgia, Jeff Duncan, along with all members of the Senate, Georgia Senate and House, are being asked to self- quarantine for the next 14 days.
As you said, this is because a state senator, Brandon Beach, tested positive for coronavirus. Apparently, he was experiencing symptoms on March 10th. The concerning thing here and the question is, then why did he show up on Monday, just a few days go, to the Georgia state legislature for a special session? In fact, one of his colleagues, a House representative, Scot Turner, angrily vented on Facebook, and this is what he said last night.
I'm shaking with rage. We were told if we had symptoms to refrain from going to the Capitol on Monday. I have an elderly hospice patient at home. He irresponsibly stayed all day at the Capitol on Monday after being tested on Saturday and exposed all of us.
CNN has also reached out to the governor of Georgia, Brian Kemp, to find out whether or not he is self-quarantining as well.
John, Alisyn, back to you.
ALISYN CAMEROTA, CNN ANCHOR: Thank you very much for that breaking news. We're having a lot of developing stories throughout the program.
There are more than 42 million kids home from school again today. So we'll speak with former Education Secretary Arne Duncan about the impact of what does this mean for all of these kids. Will they advance to the next grade level next year?
We have so many questions. That's next.
CAMEROTA: Schools across the country are closed or closing to try to stop the spread of the coronavirus. "Education Week" says 39 states have closed public schools. That's 92,000 schools affecting more than 42 million students.
Joining us now is Arne Duncan. He's the former education secretary in the Obama administration, now the managing partner of the Emerson Collective.
Arne, great to see you this morning.
Are kids going back to school this year?
ARNE DUNCAN, FORMER SECRETARY OF EDUCATION: Good morning, Alisyn.
I think the short answer is none of us know if kids are going back. We all desperately want kids to go back to school this year. Obviously, it's very important that kids in school.
Right now, we're trying to save lives, and the best thing we can do to keep kids safe, keep teachers safe, keep our students' families safe is to have kids home. Frankly by next week I assume all the schools in the nation will be closed and probably should be closed. And the faster we shut this down, the faster we stop the spread of the virus, the better the chance we have of going back to school down the road.
CAMEROTA: And what is the upshot? Let's imagine for the moment the worst case and that's they're not going back to school this year, and what's the upshot of millions and millions of kids missing three to four months of school? Will they advance to the next grade level in September?
DUNCAN: Yes, this is a new world, and we're figuring this out as we go. Again, the first thing now is it keep children safe, teachers safe, administrators safe, families safe. We have to keep kids fed, schools aren't just schools, they're amazing social safety nets, and over 30 million students rely on schools for their meals.
And so, we have places like here in Chicago giving out 100,000 meals, you have in L.A. distribution centers around the city where they're feeding kids. We're now working on the learning part and you're seeing some very different things, you're seeing high tech and low tech in places like Cleveland, you're seeing it on bus routes, the people dropping off both food and homework.
You're seeing in places like Miami, where every child has a device in their -- a little bit farther ahead, some very good blended learning going on there. You're seeing school districts from Indiana to Utah where there isn't access to Wi-Fi, Wi-Fi enabled buses being parked in those neighborhoods to close that digital divide.
So you're seeing amazing creativity, you're seeing people working really hard. Will students advance to the next grade? Yes, I think they will and they'll continue to learn at home, we have to figure this out together and people work extraordinarily hard to keep kids safe, to feed them, and, yes, absolutely to keep that learning going.
CAMEROTA: I mean, obviously, this is a life altering event for everyone in this country. Obviously, there is learning to be done outside of, you know, math work sheets. I'm talking about just sort of life lessons. This is at best a character building moment for kids.
And so, you know, if everybody is in it together, that's the priority and we're going to get through that. But that said, have you heard enough from Education Secretary Betsy DeVos about what the plan and vision is?
DUNCAN: Well, I can't even answer that, we haven't heard anything, and, you know, where you have a lack of credibility, you know, a lack of honesty, it is not real helpful.
What we're seeing is great, great leadership, not at the federal level, but at the local and state level and we're in constant contact with state superintendents and superintendents of big districts. We're doing a conference call with a number of them tomorrow afternoon, just to check in, so people can learn from each other, replicate successes, shut down things that aren't working.
So the real leadership now is coming at the state and local level and I'm so proud of that.
Larger point is a good one. This is a time where we need tremendous compassion, this say time for students learn to take care of each other and be part of a team. And so, I'm truly inspired, this say really hard time,
I hate we're here as a nation, I hate that we're here as a planet, but what we're seeing from adult leaders, from students really gives me great hope that we will get through this, and we'll get through it together.
CAMEROTA: Former Education Secretary Arne Duncan, thank you very much for your time and words.
DUNCAN: Thank you.
JOHN BERMAN, CNN ANCHOR: All right, the breaking news we just heard from Dr. Sanjay Gupta, the CDC has changed its guidelines for doctors and medical workers, now saying they can treat patients even if they have been exposed to the coronavirus. What does this mean for the growing crisis? We'll talk to the governor of New York, next.
[08:28:05] BERMAN: Developing overnight, hospitals and healthcare workers bracing for an onslaught of coronavirus patients. At this hour, there are nearly 9,000 confirmed cases nationwide, although the number is surely more, we're going to learn more as we get more testing. It's a 45 percent increase since yesterday, 149 Americans have died.
New data from the CDC shows nearly 40 percent of the first patients in the U.S. were sick enough to be hospitalized. They were between the ages of 20 and 54 -- so, younger than we had thought.
A member of the coronavirus task force is pleading with millennials to take the outbreak seriously and stop socializing.
Overnight, the president signed a multibillion dollar emergency aid package that provides paid sick leave for some Americans and free coronavirus testing. It comes as Congress works out the details of a $1 trillion economic stimulus package that could be finalized by early next week.
CAMEROTA: OK, John, we have been hearing from healthcare workers about a shortage of protective gear in hospitals. They don't have enough face masks. They don't have enough gloves. They don't have enough gowns. For patients, they don't have enough respirators.
Dr. Sanjay Gupta just reported here moments ago on our air there is breaking news the CDC has new guidelines that now tell healthcare workers they can use homemade masks as a last resort and they can continue working even if they believe they have been exposed.
Joining us now is New York Governor Andrew Cuomo.
Governor, we appreciate you coming on. There are so many developments every morning.
What about that? I mean, this is just -- Dr. Sanjay Gupta just reported two new guidelines on the CDC website that say healthcare workers who are asymptomatic, but who have been exposed to a patient with coronavirus can continue to work if they wear a face mask and, by the way, here is the other new guidance, if you don't have a proper face mask, you can consider using homemade masks like bandannas and scarves.
Will this -- will we see this in New York hospitals?