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Pandemic Worsens In U.S, Hospitals Desperate For Supplies; Senate Democrats Block $2 Trillion Stimulus Plan. Aired 7-7:30a ET

Aired March 23, 2020 - 07:00   ET




Erica Hill joins me this morning. Alisyn is in a long planned day off.

This morning, the nation's largest cities warning of being overwhelmed by the coronavirus pandemic, a wave of new cases, a shortage of supplies. There are now more than 34,000 cases in the United States. More than 400 Americans have died.

This morning, New York is the epicenter of the outbreak in the United States with roughly 5 percent of the world's total cases. President Trump announced he's activating the National Guard in three of the hardest hit states, New York, California and Washington State. The federal government is sending medical supplies and directing FEMA to set up medical stations to increase the number of available beds. More than 100 million Americans waking up this morning under stay-at-home orders.

And, overnight, there was this remarkable interview with the nation's top infectious disease doctor, Dr. Anthony Fauci. He seemed to show frustration with the president grasp the facts, telling Science Magazine, quote, I can't jump in front of the microphone and push him down.

ERICA HILL, CNN NEW DAY: Also overnight, the Senate failing to reach an agreement on a historic $1.8 trillion stimulus bill. Democrats arguing the Republican measure puts corporate interests above the needs of American workers. The vote is now expected around 1:00 P.M. That's after Democrats blocked Senate Majority Leader McConnell's efforts to force a vote this morning. McConnell wanted to hold that vote just minutes after opening bell on Wall Street.

The Republican effort also hampered by the absence of five GOP senators are now quarantined, including Senator Rand Paul, who has tested positive for coronavirus.

The Senate dysfunction comes at a time when millions are waiting anxiously for help and for answers. They have rents, mortgages, bills to pay. They are losing their jobs, having their paychecks cut.

And just a few hours ago, the president issued a statement that is raising new questions about whether he's perhaps losing patience with the mandated social distancing, tweeting, we cannot let the cure be worse than the problem.

Let's begin with CNN's Chief Medical Correspondent, Dr. Sanjay Gupta. Sanjay, as we look at that, a lot of people scratching their heads this morning over what the president may mean. We can't know. We're not inside his head. But it does leave you wondering if perhaps in another week, we are going to hear that we no longer need to worry about social distancing. That would seem a rather dangerous message at this point.

SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes. Look, I mean, we're not, by any means, there yet. I think that's pretty clear. I think even when this was first proposed, they said we're going to do it for two weeks and then we're going to reassess.

There's a couple of things to keep in mind. First of all, the amount of -- when you're testing patients, you're really getting a lag time. It takes several days for someone after the time of exposure to the time that they develop symptoms and then two to three days to get the test. So by the time you're actually testing people, it's about two weeks after they've been exposed already, Erica. So if you take that into account, you'd have to add at least another two weeks from this time period now.

So if you look at countries around the world, that's pretty clear that you've had to actually enact social distancing measures for a period of time for them to have the impact. I've been talking to public health officials both on and off the record. And they say the goal was always to try and do this for two weeks, reassess, but the belief was that at that point we might have actually to get more stringent, not actually reverse course.

BERMAN: Yes. You can't find any medical professional out there, Sanjay, who says that we're any -- we're near the peak yet in terms of case. And that may not just be the testing. It may be because the disease is still being passed around at a very quick rate.

You have some new reporting, Sanjay, on these drugs that the president has been talking about. And one of the studies cited for success in terms of these drugs. There are New questions about that. Explain.

GUPTA: Look, I think this is a really big deal. I think there's a lot of enthusiasm around these medications. And, look, everybody should be hopeful. Everybody on the planet is hopeful that maybe we'll come up with some of new therapeutic.

But I want to be clear on this study that has garnered so much enthusiasm, some 26 patients originally in the study. It wasn't randomized, meaning, patients weren't put into one group or the other, and it wasn't blinded either, meaning, the patients knew if they were getting the treatment or they weren't.

But here is the critical point. If you follow these 26 patients, what you'll also find is that six of the patients were actually excluded from the study. It's curious why. So as we started to do a little digging, we found that three of the patients were actually transferred to the intensive care unit. One patient died. And two patients stopped the therapy altogether because they could not tolerate the side effects.

Now, when you do the math, I'll do the quick math for you, that puts the mortality rate for the study around 4 percent and it puts the critical care rate around 15 percent. So that's actually higher than the general population that we've been hearing right now.


Now, granted it's a small study, so you really can't read into it either way, is it successful or not. But the idea that it's being presented as a sort of panacea, everyone sort of was treated successfully is simply not true.

It's also worth pointing out that they only followed these patients for six days, John and Erica. I mean, we just talked about the fact that it can be two weeks at least before patients actually start to have recovery of symptoms, we don't really know what happened to those other patients that stayed in the study. This really has to be vetted out. It should be vetted out. We need to do the trials. But that's why you do the science.

So far, there may be promise but it's important to have the full data there.

HILL: Always important to have all of the facts.

The other thing that stood out, and I know you were tweeting about this yesterday, Sanjay, are different symptoms that we're now hearing about from doctors. So you were tweeting out about loss of appetite actually being the most common. But there's also new information out of the EMT U.K., an organization in the U.K., about loss of smell and loss of taste, and that that can sometimes be an indicator.

GUPTA: Yes. This is fascinating. So they go back and they look at these patients. Obviously, many of them in China, trying to figure out how exactly did their courses progress, were there other symptoms.

You may remember, initially, there was a thought that that wasn't really much in the way of digestive symptoms. But the study of about 200 patients out of China showed that, in fact, not only were there digestive symptoms presents in about half the patients, oftentimes, it was the first symptom, loss of appetite, about 84 percent of the time, diarrhea, abdominal pain, vomiting, those types of symptoms.

So it's a little bit of a heads up for people to say, maybe this doesn't always start with a fever or dry cough or shortness of breath. It can start about half the time with digestive symptoms.

And, as you mentioned, just overnight, Erica, what's called anosmia, which basically means loss of smell, seems to be another symptom that many of these patients often develop. They don't know if it's related to the upper respiratory virus part of this or what. But anosmia may be linked to loss of taste, maybe linked to loss of appetite. We're not entirely sure, but it's clearly something to look out for.

Sometimes the early symptoms aren't these classic symptoms. BERMAN: There are so many things you can look out for now in terms of wondering if you might have it, Sanjay. But you have instructions for Americans about when they should actually go to the hospital with these symptoms.

GUPTA: Yes. You know, this is a tough one. I mean, and I get that this is a new virus so people are understandably concerned. But I think a good way to look at this even in the midst of this coronavirus outbreak is to just rewind our clock back to last year and say, okay, here are my symptoms right now. Last year, would I have gone to the doctor, would I have gone to the hospital with these symptoms? If the answer is no, then I think the answer can still say no this year as well.

Keep in mind, hospitals that you're hearing, you guys have been reporting all morning, they're starting to get very crowded. Oftentimes, that is where sick patients are. So even if you don't have the virus, you're may be more likely to contract the virus if you go to the hospital. So go only if you need to and call ahead as well. So that if you get there, you can be isolated.

Most people, as you guys know, aren't going to need to go to the hospital. The vast majority aren't going to need any additional treatment. If you do, obviously, go and make sure you just check those boxes first.

HILL: Sanjay, always appreciate the insight. And we'll continue to check on you, of course, throughout the rest of the morning. Thank you.

Millions of Americans meantime are also looking to Congress for relief. Congress though really isn't any closer to delivering that much needed help. Why? Because of a stalemate in the Senate, over roughly $2 trillion stimulus plan, and that stalemate comes as one fed official is now predicting unemployment in this country could reach as high as 30 percent.

Joining us now with more on that, CNN International Anchor Julia Chatterley.

Julia, as we look at this, I know you've said this package is so important because, in your words, it is an investment in survival. What does this mean for the American economy and for the American worker most importantly?

JULIA CHATTERLEY, CNN ANCHOR: And they are the most important thing to think about here. The statistic for me, 40 percent of U.S. households can't cut a $500 check at this moment in an emergency. There are millions of people who work and live paycheck to paycheck. So this stimulus package is, as you quite rightly reminded us all, an investment in survival.

So the $2 trillion is important. But what we have to keep coming back to is every minute, every day's delay here means one less -- one more delay in getting those checks out to individuals that need this for the next two to three months. [07:10:00]

What I'm hearing is it's coming down to the money that's going to be given or at least in forms of loans to big corporations in this country. And if you look at the ratio of money for corporations to the money that's going to be allocated to individuals, it's almost double the size. So you get the sensitivities here.

But the biggest problem is, apparently, Nancy Pelosi is trying to demand that in order to get the loans for big corporations, Congress gets a say in executive pay for the next ten years. And my problem with that is, and I appreciate there are lots of issues and the differences between how much executives get paid and how much workers get paid, but we can't fix the problems for the next ten years. We need to focus on survival for individuals in the next two to three months. And that has to be the focus. So have to put the party politics aside here, unite and get this deal done.

HILL: There's also the concern, and you just touched on this, but there is this Democratic concern that it is tilted too far, especially when it comes in terms of oversight or lack of oversight for the $500 billion for corporations. What is the concern there? That this money will, in fact, go to companies that we won't know anything about and perhaps companies could benefit, perhaps the president said -- he was asked about it yesterday, whether his companies could benefit?

CHATTERLEY: The problem here is that they need to focus this money and know what this money is going towards. So what they're already talking about is saying, look, if you take this money, you have to retain the vast portion of your workers. It's preventing those wades of people Becoming unemployed. They were also looking at limiting companies buying their own stock back here too. But, again, these things are being talked about and will happen.

The problem here is, Erica, you can't have just about every big company in every sector in the United States threatened with bankruptcy, because that is having a multiplier effect, a financial crisis effect. That will accelerate us towards the numbers, the issues that we're talking about here, economic depression. And if we head to an economic depression, the most vulnerable, the most weak people in this society, financially, are the ones that get crushed most. And that's what we need to prevent. It all comes back to protecting the people.

HILL: In terms of protecting people, we also have this stunning number out over the weekend from the St. Louis Federal Reserve. The president of the Fed there saying that there's a potential jobless rate of 30 percent due to the ripple effects of the coronavirus. What do you make of that number? Do you agree with that?

CHATTERLEY: I think all these numbers are possible if we don't provide support to prevent small or medium-sized businesses making incredibly tough decisions in the next weeks, the next one, two weeks, to let go of their workers. But it's happening in all layers here.

So these numbers are not -- they're not so incredible to me. I think this is what we're risking. It brings it back to what's going on in D.C. We need to take measures now. We need to get money out. And we need to make sure that big businesses aren't firing people. None of this, none of this matters more than getting money to people short- term, getting money to businesses and just stabilizing everything for the next two to three months.

I don't think the economy can survive more than that, to be honest.

HILL: It is sobering to put it mildly, especially for the many Americans who are struggling this morning. Julia, thank you.


HILL John?

BERMAN: Talking about risk, doctors and medical workers risking their own health, their own lives to treat coronavirus patients. Two emergency physicians give us the latest from the frontlines, next.



BERMAN: Medical workers on the frontlines continue to warn about shortages in supplies, critical items like masks and respirators running out.

Dr. Sanjay Gupta back with us. Also joining us now, Dr. Rodrigo Kong, an emergency physician at Staten Island University Hospital in New York City, and Dr. Megan Ranney, an emergency physician in Rhode Island.

Dr. Ranney, I want to start with you, because you have said that medical workers across the country, in some cases, feel forgotten right now, which is hard. Because I think we all have so much gratitude for what you're doing and admiration for the courage you're showing. But I think at this point, I think you want more than admiration and more than gratitude. You just want supplies. Explain.

DR. MEGAN RANNEY, EMERGENCY PHYSICIAN, LIFESPAN/BROWN UNIVERSITY: That's absolutely right. Across the country, healthcare workers are feeling anxious and frustrated. They're scared to go to work. They're making videos for their kids in case they get infected and die.

Workers are -- my colleagues, doctors, nurses are emailing each other, we're on Facebook, we're on Twitter trying to share tips and tricks. We've set up our own website, get us PPE, to try to match the need for PPE with people who are offering donations. We are waiting for the federal government to step up.

Now, President Trump talked yesterday about activating supplies in three states and we're thrilled by that. But I hope that they get out beyond New York, California and Washington, because, honestly, it's healthcare workers across the country who feel at ricks.

BERMAN: And, Dr. Kong, one of the things that the president announced yesterday was these medical stations that are going to be activated and manned by federal workers in three states. And the numbers, there are four large medical stations with a thousand beds each in New York, eight large medical stations with 2,000 beds in California, three large and four small federal medical stations with a thousand beds in Washington.

So, Dr. Kong, New York City is going to get a bunch of those. You are going -- you work in New York City. How will that help your situation here?

DR. RODRIGO KONG, EMERGENCY MEDICINE, STATEN ISLAND UNIVERSITY HOSPITAL: This will actually be enormously helpful. Right now, in hospitals in New York City, separate ICUs for COVID patients have been created, including in my hospital, and wards for these patients.


And that's good for the COVID patients, but that will soon -- those units will soon be full.

So the other question becomes not just for the COVID patients, but what about for all the other patients that ordinarily would come to the hospital. Many of these patients are actually avoiding the hospital right now with the fear of contracting COVID. What happens to all those other patients, the heart attack patients, the stroke patients, the colon infection patients? They need places to go and they need areas to be treated.

So adding additional space is not just good for the COVID Patients but it's good for all the care that needs to be delivered to all the patients that are coming to the hospital. It will definitely help.

BERMAN: Yes. Because, Sanjay, the fact is, I mean, people aren't going to stop having heart attacks just because there's a pandemic here. People aren't going to stop having health problems just because there's a pandemic here. So what does it mean and what do people need to know when they hear that hospitals around the country are no longer doing elective surgeries? What does that mean exactly?

GUPTA: Well, you know, I mean, elective versus urgent or emergent is not always a bright line. You can't always tell the difference between things and something that is elective now may become urgent later on down the line. So it has to be a continuous conversation with their physicians, their healthcare team. And it's challenging. I mean, you know, they're going to have to sort of figure out, can we delay this, how long can we delay this, are there treatment options in the interim.

And also, keep in mind, John, one of the things that really strikes me, and I think Dr. Ranney sort of mentioned this, is that any patient that comes in could potentially be a COVID patients, even if they're not coming in for infectious disease issues. And so the doctors, the nurses really has to treat them as if they could potentially be carrying the coronavirus, and that means personal protective equipment for every patient. You're hearing hospitals now making that more of a policy. But I think that that's been the case sort of at least informally in many hospitals around the country, which is, again, why the personal protective equipment is running out and why people should really heed this idea that unless they need to go to the hospital, stay at home for now. Just think about it. Would I have gone to the hospital last year for this? If not, don't go to the hospital at this point either.

BERMAN: Dr. Ranney, President Trump wrote just a few hours ago in a statement on Twitter. He says, we cannot let the cure be worse than the problem itself. At the end of the 15-day period, we'll make a decision as to which way we want to go. I wonder what you make of that statement and how close you think America is or Rhode Island is to being able to go back to life as usual.

RANNEY: So, in Rhode Island, just as across the United States, we are seeing cases are grow exponentially day by day. And that's despite not having adequate testing, right? When I work a shift in the emergency department right now, I test almost none of the patients that I'm seeing because most of them go home and we simply don't have enough tests to use for people that are going home from the hospital. So I think the numbers are actually far higher than we're currently reporting.

Now, as Dr. Gupta mentioned earlier, there's about a two-week incubation period. So two weeks from now, we may start to see a slowdown. And, indeed, San Francisco is starting to report a decrease in the number of severe cases.

But I don't know that two weeks is going to be enough. I would hope and pray that it will. Goodness, I've got two kids at home. I'd love for them to go back to school. But I worry that if we lift these restrictions in two weeks, that we're just going to see a huge spike in infections, and we're going to be right back where we started.

We've seen in other countries that we've needed to maintain the social distancing for four, five, six weeks for it to be truly effective. And, again, my priority is my patients and my community as well as making sure that we in healthcare have enough resources to take care of all of you.

BERMAN: The priority is saving lives here. And it may be best not to think in terms of days and weeks at this point.

Dr. Kong, there is some new information, and Sanjay was talking about it before, about new studies which talk about the symptoms that people may have before developing COVID. Stomach issues, Sanjay was saying, stomach issues are maybe more prevalent than we thought and then there's this new story overnight that a loss of sense of smell might be something that people experienced. But you're seeing patients day in and day out and you still say the breathing issue, shortness of breath is the most prevalent case that brings people into the hospital, correct?

KONG: This is correct. I think shortness of breath, fever, cough, a picture that looks like a bad flu or pneumonia or frank respiratory failure or distress, these are the cases wherein patients use to bring themselves, so the reasons why patients usually bring themselves to the hospital.

But what we're finding even among many other patients that we're seeing, patients who have malaise or fatigue or other non-specific symptoms, once they're admitted and tested, because just as Dr. Ranney said, for the patients that we discharge, most of these patients are not getting tested.


And for the ones that we are admitting, those patients with non- specific symptoms, what we're finding is many of them often have the coronavirus as well.

BERMAN: Many of the patients who are coming in for any number of things have it because people can be asymptomatic.

Dr. Kong, just a point on shortness of breath and breathing issues, can you explain what that feels like for people. At what point should they be concerned if shortness breath? It's not just like walking up a set of stairs, is it?

KONG: I think that's correct. Shortness, I have not experienced the coronavirus, so I can't speak to the way the coronavirus would make one feel short of breath. But, in general, if I could empathetically kind of understand what my patients are going through when I look at their shortness of breath, the shortness of breath that would be concerning enough to bring them to the hospital would be one in which they have difficulty doing their common daily activities that they once could do easily or well.

That doesn't mean going up a flight of stairs, of course, because I get short of breath if I go up a flight of stairs. But if you're doing your typical daily activities and you find I'm getting short of breath doing this and I shouldn't, that should raise some concern for you.

BERMAN: And this gets us something you were talking about, Sanjay, which is what should actually get you to the hospital isn't necessarily a runny nose or scratchy throat. That wouldn't have taken you to the hospital a year ago. It's got to be something more than that. Because at the hospital, they need the space to deal with the severe cases of coronavirus.

Sanjay, you were home over the weekend although you were working because you work 36 hours every day. But you were watching the efforts in social distancing that are still hard for some people, and you still have a message for people to stay vigilant. What is that message?

GUPTA: Well, look, I mean, we're in it together right now. There's no question. And, I mean, I think the country is doing a much better job. I think when you think about these social distancing mechanisms and think about why they might work, you realize that you have to be very diligent about this at this point. And there's plenty of evidence from around the world right now and throughout history that this can work. Again, John, as we are talking about, everybody wants a therapeutic. I would love to have an anti-viral that people can start using and be confident it's going to help people. But in the meantime, staying home as much as possible. I'm home now. A lot of people are staying home. It's going to make a difference. And I think we can start to see through the other side of this, as we have in other places around the world.

BERMAN: Dr. Ranney, just so you can clarify, even if these drugs work, and let's hope they all do, it's not a vaccine, it's not a cure, they treat the symptoms of COVID-19, correct? What exactly does that mean?

RANNEY: Yes, that's right. So there're a few different drugs that are out there that are being tested right now. One is a brand new drug being created by Gilead that's been allowed to be used under compassionate use, which similar to how we started using some of the HIV-AIDS drugs. The other is a combination of old drugs that already out on the market.

We don't completely know how either of these are going to work but we're hoping that they're going to work the way some of our drugs do for other viruses, which is to suppress the virus, and so that you get less sick, so to give us as doctors a better chance of treating you in a critical illness.

There is, as Dr. Gupta talked about earlier, the one study that suggests that that combo of drugs might clear COVID-19 from your body quicker, but that study is just not reliable and is not ready for primetime.

BERMAN: A lot of reasons to question that study, as Sanjay made clear. All right, Dr. Gupta, Dr. Ranney, Dr. Kong, thank you all for being with us this morning. And I will say it every time I see you, thank you for the work that you are all doing. It's an example to all of us.

KONG: Thank you.

RANNEY: Thank you.

BERMAN: All right. A drive-thru testing site in New Jersey has been at capacity every day in just minutes with lines more than a mile long. New Jersey Governor Phil Murphy joins us live, next.