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Dire Alarm, People Are Dying As Hospitals Overwhelmed; U.S. Sees Deadliest Day Yet, Coronavirus Death Top 1,000; Los Angeles Mayor Warns City May Be Shut Down For Months. Aired 1-1:30p ET

Aired March 26, 2020 - 13:00   ET





And in a war, we see the blood, we see the caskets, we see the aftermath of bombings on communities and countries. But in this war, we cannot see the horror unfolding because it is going on behind closed doors, in our own hospital. It's happening on ambulances, on the beds of those who are dying only to quickly to be filled by the next ones who needs them. And it is still so early on in this coronavirus pandemic.

But in America alone, there are families already planning a 1,067 funerals. Many of those funerals won't even be held, at least not for a long time. Many of these families can't even find solace in the arms of loved ones because they can't be close to them. And for those who have died, many of them died alone. Families are not allowed in hospitals, not allowed or near the virus.

The ones who work closest to them before during their last breaths are the doctors, nurses, the EMS workers. And right now, they are overwhelmed. And for every day that the nation is slow to get more ventilators or debating and dismissing the need to stay home, these soldiers are working tirelessly around the clock to save lives.

In one New York hospital, The New York Times describes a doctor performing chest compressions on a man in her 80s, a man in his 60s and a 38-yearold, and that is one shift, all suffering from coronavirus, all who died. They described the scene as apocalyptic.

Doctors and nurses, quote, struggle to make do with a few dozen ventilators. Calls over loudspeaker of Team 700, the code for when a patient is on the verge of death comes several times a shift. Some have died inside the emergency room while waiting for a bed. A refrigerated truck has been stationed outside to hold the bodies of the dead.

And in this hospital, at least 13 people have died in just 24 hours. And the sick, well, they are too ill to tell you their stories, but doctors can, like this one.

(BEGIN VIDEO CLIP) DR. COLLEEN SMITH, EMERGENCY ROOM DOCTOR, ELMHURST HOSPITAL: Leaders in various offices, from the president to the head of health and hospitals, saying things like we're going to be fine. Everything is fine. And from our perspective, everything is not fine. I don't have the support that I need and even just the materials that I need physically to take care of my patients. And it's America, and we're supposed to be a first world country.


KEILAR: These pleas, pleas like that of frontline healthcare workers are the alarmed.

I'm going to talk now to two people who are putting their lives on the line every day during this pandemic, one in the east coast, one in the Midwest.

Dr. Rana Awdish is a critical care physician and the Director -- the Medical Director of Care Experience for the Henry Ford Health System. Dr. Susannah Hills is an ear, nose and throat surgeon at Columbia University Medical Center.

And, Dr. Hills, let's start with you. You are in New York City. There are nearly 18,000 cases there. Just tell us what you are experiencing.

DR. SUSANNAH HILLS, HEAD AND NECK SURGEON, COLUMBIA PRESBYTERIAN MEDICAL CENTER: Right now, I think we are experiencing some of the same things that everyone across the country is experiencing. We are all anxious. We are worried. We are worried about our patients, our families. We're worried about each other. And right now, things are really changing on an hour-to-hour basis as we brace for what's coming ahead over the next few weeks.

KEILAR: And, Dr. Awdish, what are you seeing?

DR. RANA AWDISH, MEDICAL DIRECTOR OF CARE EXPERIENCE, HENRY FORD HEALTH SYSTEM: It changes day-by-day and hour-by-hour. We've had to create surge capacity within our hospitals, create ICUs in places that we're caring for different patients before. We are mobilizing teams. We're ready for what we know is coming.

KEILAR: And, Dr. Hills, do you say that you expect to get the coronavirus?

HILLS: I think everybody here in New York is at high-risk for exposure. And I think all of our healthcare workers feel like it's almost inevitable that we'll be exposed. So that is right now the situation that we are dealing with and we are doing our best to try to keep our patients and ourselves protected.


And we want to be able to be here for patients when they get sick. We want to be standing when people meet us. And right now, we are doing everything possible to keep ourselves and the teams that we work are healthy. KEILAR: And, Dr. Awdish, you're in Detroit, Wayne County. Today, your governor said, Wayne County has the seventh highest number of confirmed cases in the United States. You must be confronting this reality as well. How do you prepare for the possibility of getting this?

AWDISH: You know, I cared for my first COVID-19 positive patient ten days ago. I did all of the procedures that we do to protect ourselves with personal equipment. We're all willing to go into these rooms day after day. We just want to be protected and we want to be able to protect our patients and our families and our colleagues.

We worry less about ourselves. As you said, we all sort of expect the exposure and do get it. But we don't want to transmit it to people who didn't choose this work.

KEILAR: Yes. And, Dr. Awdish, you just tweeted just really -- sorry, go on, Dr. Hills.

HILLS: No, I fully agree. I think our priority is our patients and we are all working together across the country to try to think about creative ways that we can make protective equipment last as long as possible or work together to try to keep healthcare providers standing so that we could be there for patients when they come in.

KEILAR: How are you doing that Dr. Hills? What are creative ways that you and your colleagues are making protective equipment, and is it enough?

HILLS: So what we are thinking about, really, is the long game. We're expecting the surge to hit here in New York in a couple of weeks, two to three weeks. And right now, we are so grateful for everybody who is staying inside and helping us to slow the spread of the virus. I think that that's going to be ultimately the most powerful tool that we have to prevent the spread and help us to conserve the resources that we have to protect ourselves and protect our patients.

But when we think about two, three, four weeks from now, eight weeks from now, given the equipment that we have now, we don't know where we are going to be in a couple of weeks. There are guidelines that have come out recently from the CDC in what to do in a critical shortage of equipment and the suggestions that are out there to consider to re- sterilizing masks and using other not so protective equipment, like bandanas, that we know aren't going to be effective against the virus.

And right now, we're not in that situation, but the way things are looking, we've got to start thinking about what are we going to do in a couple of weeks when we hit a crisis here if we don't get the equipment that we need.

KEILAR: Because you could very much be in that situation.

And, Dr. Awdish, you tweeted just really a heartbreaking message about how you've made personal preparations for the, quote, break the glass scenario. Explain what you're talking about and what led you to taking these actions. AWDISH: All of us who are taking care of these patients all understand that things could change on a dime. And so you can't get two or three doctors together where they don't start saying, okay, just so you know, this is the plan, this is who you call if I'm intubated. This is who I want my kids to go to, what people think about of their pets and their security.

We've all developed these rituals of decontamination when go home, where we remove all of our clothing from the hospital and attempt to sterilize ourselves because physicians and nurses and respiratory therapists, they're sleeping in spare bedrooms, garages, basement trying to protect their family.

KEILAR: No, we have heard so many stories of people, doctors. They go into their garages and they strip off their clothes and head straight for the shower and have to make a decision about how they behave at home, do they separate themselves.

Dr. Hills, we are learning that some hospitals are weighing whether they make changes to our DNR policies, the do not resuscitate policies, as part of a way to reduce risks to their staff. Is your hospital have that conversations?

HILLS: Things are changing every day. The situation is changing every day. So this going to be a situation that evolves. And looking at other countries, where these things are happening, like Italy, for example, we have to look at those countries and those experiences and think that is something that could be happening here.


So I think what we are seeing happening elsewhere in the world is really very educational for us and we have to pay attention to what is going on in places like Iran and places like Italy, the creative ways that they're having to manage this this disease and the very difficult decisions that they're having to make.

And when we look at China, that's a tremendous wealth of information that's coming out of China. They published information on a collection of 72,000 cases last month. Those experiences of what is happening, what's going on and how they're handling it are things that we should be watching and seeing and really taking to heart and learning from. And this is a pandemic situation. It's affecting every country. It's global. And we are all in this together. And we need to really watch what's happening around the world.

KEILAR: And, look, thank you guys for being our eyes and ears. We're going to continue to check in with you to see how this is going. Because, as you say, it is changing day-to-day. Dr. Rana Awdish, Dr. Susannah Hills, thank you both.

Fast-tracking of treatments for patients who are seriously ill with coronavirus, the truth behind the drugs that you have been hearing so much about.

Plus, the worst jobless claims number in history. I'll talk to White House Trade Adviser Peter Navarro why he says it's totally expected.

And with New Orleans, the epicenter of coronavirus in Louisiana, some say Mardi Gras might be to blame.



KEILAR: Welcome back to CNN's special coverage of the coronavirus pandemic. You can see that the numbers are up obviously very much today on the right side of your screen, more than 75,000 cases. And there was a grim milestone today and that was that there were more than a thousand deaths there have been so far.

New York is really the epicenter of this pandemic in the U.S. with more than half of all of the confirmed cases. Today, Governor Andrew Cuomo talked about the challenges that are facing hospitals there. He applauded the healthcare workers who were on the frontlines.


GOV. ANDREW CUOMO (D-NY): Those healthcare professionals who are dealing the virus that they didn't even understand, they still don't understand. And they're there working, many of them, seven days a week. So, yes, we are tired. But, look at what others among us have to do and the challenge they are under and how they are stepping up. And who am I to complain about being tired when so many people are doing such heroic efforts?


KEILAR: Tomorrow, the House is expected to vote on the $2 trillion stimulus bill, which was approved last night in the Senate. And this is a bill that delivers billions of dollars to hospitals. It sends money directly to impacted workers. House Speaker Nancy Pelosi says she expects a strong bipartisan vote for this bill.

The Navy will now test all 5,000 sailors aboard the USS Theodore Roosevelt because, right now, 23 sailors have tested positive for coronavirus aboard that aircraft carrier.

And doctors are searching for answers about how to attack this virus with so many critically ill patients packed in the hospital just coast to coast.

I want to bring in CNN Senior Medical Correspondent, Elizabeth Cohen. Let's talk, Elizabeth, about two of these potential treatments. One was touted by the president, chloroquine, and one is now getting more focus from the FDA, these blood plasma treatments. What is the truth -- what is the promise behind these?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: So let's take chloroquine first. So it's actually hydroxychloroquine, which is sort of a relative of chloroquine, a less toxic one, thank goodness, and as you said, the president has been very enthusiastic. But when you talk to doctors, Brianna, what they say is not so fast. We have to study this. We don't know if it works in patients with coronavirus and we don't know if it's safe for them. This drug can be toxic. So they say, look, we are not going to get enthusiastic until we see the results of the trial.

Luckily, they are speeding up these trials and they hope to have answers in weeks to months, not in years, which is how clinical trials usually work.

Now, you mentioned plasma donation. It's actually incredibly simple, really. Once you've recovered from coronavirus, you have antibodies to the disease. And so you're, you know, immune to it basically. And so they're going to take these antibodies out of the persons who recovered and give it to someone who is still stick.

It's worked for other diseases, it hasn't worked for some other diseases, and so it's unclear if it will work here. Again, they need to study it.

KEILAR: A question about that, I mean, if you think you had it, and you're young so they didn't test you to confirm it, I mean, what do you do, because you're not necessarily a confirmed coronavirus case?

COHEN: Right, that's an excellent question, because they're probably a quite a few people out there who fit the category that you're talking about.

I have talked to some doctors who, for their trials, are interested in finding those people because they want as many people as they can get who have recovered. So I think it really depends on which trial you are talking about and, you know, the rules may be different. Some places are going to say, no, I want you to already have the test, I want it documented, I don't want have to test you because we don't have enough tests. So it will be interesting to see. Are they only going to use people with confirm test or can you go and literally roll up your sleeves and say hey, test me, I think I might have had it.

KEILAR: They can miss a lot of people without knowing obviously who's really had it.



Elizabeth, thank you so much for walking us through that. We are so curious about those possible treatments.

And I'm going to talk with Dr. David Aronoff, Director of the Division of Infectious Diseases at the Vanderbilt University School of Medicine. Thank you so much, sir, for being with us.

And I wonder which avenue you find promising, the blood plasma trials or trials using existing medications that are approved for other diseases or do you just see this as one big body of work.

DR. DAVID ARONOFF, DIRECTOR, DIVISION OF INFECTIOUS DISEASES, VANDERBILT UNIVERSITY MEDICAL SCHOOL: Well, it is a great question. Right now, it is really one big body of work. We don't know whether these existing drugs are going to be effective or how effective or whether they're best used to prevent infection or to treat people early until the course of disease or to treat people late. And the same thing is true about this antibody treatment. We really don't know yet what its place will be. And, of course, there are also new drugs that have yet to be used in clinical trials that are coming online that are not previous existing drugs but new ones, and they may even prove to be more effective.

KEILAR: What do you do with that? Elizabeth and I were just discussing. You need to identify people who may have antibodies but there are tons of people out there who are assumed coronavirus positive and have recovered but they were never actually officially tested.

ARONOFF: Yes, she really hit the nail on the head. Some trialists may be willing to enroll those patients and test to them to see if they do indeed have antibodies against coronavirus. And if they do, then they could probably use their plasma in those studies. Fortunately, there are ways on a research basis to tell if people have been exposed to the virus.

KEILAR: Germany has ramped up their coronavirus testing to half a million people a week. Is that a number that the U.S. needs to achieved as well? Does everyone need to be tested?

ARONOFF: Well, we're learning that probably not everybody needs to be tested but we're also facing a situation where we clearly don't have this -- the test capacity that we need, even to handle people who are newly symptomatic or who may be in long term care facilities where it would be potentially devastating to have an outbreak.

So our testing capacity is not where it needs to be, not clear that we need to test every single person but we're going to learn more about that as time goes by.

KEILAR: You signed onto a letter from healthcare experts in Tennessee to Governor Bill Lee last week. You were asking for a stay-at-home order. And the governor has since closed bars and restaurants, gyms, fitness center. He's encouraging people to work from home. Is that enough to you or do you think that Tennessee needs to go further?

ARONOFF: Well, I think it is a great start. And, unfortunately, we look at the stories coming out of New York devastating, or Detroit. And we 're heading in the direction of having more and more cases. We're nearing a thousand cases in Tennessee now, we're over 300 cases in Nashville. And this virus needs to be slowed down.

So I think a shelter-in-place, a safer at home policy that's enacted across the state is really where we need to be heading if we are going to flatten the curve and not overwhelm our healthcare facilities with patients.

KEILAR: All right, Dr. David Aronoff, thank you so much.

ARONOFF: You're welcome. KEILAR: Be sure to join CNN tonight to get some of your questions answered. Dr. Anthony Fauci and Bill Gates will join Anderson Cooper and Dr. Sanjay Gupta for a live town hall, Coronavirus, Facts and Fears. That is tonight at 8:00 Eastern.

Desperate times now in Americans hospital. Why don't medical workers have the equipment they need? I'll be asking the man in-charge of FEMA supply chain, White House Trade Adviser Peter Navarro, up next.

And preparing for the worse in Louisiana, why that state is in danger of becoming the next coronavirus hotspot.



KEILAR: A dire warning of coronavirus to people in the City of Los Angeles. Mayor Eric Garcetti, says, despite President Trump desire to lift some stay-at-home restriction by Easter, it could be late fall before his city reopens and gets back to normal.

State health officials say cases in California are doubling every three or four days. The mayor saying that when the virus peaks in Los Angeles, quote, it will be bad.


MAYOR ERIC GARCETTI (D- CA): If anything we have learned in this crisis is that we have to be prepared. And as I have shared with you this crisis is isn't over just in the first explosion. Until there is a vaccine or until we have drugs that can treat this, we may see a second or even a third explosion of this as we do in the flu season. We may see that in the fall as early as October or November.


KEILAR: Now, Garcetti did see the city stay-at-home measures appear to be working, but state health officials predict a surge on new coronavirus cases in the next couple of weeks.

And then explosion of coronavirus cases in Louisiana, an additional 510 positive cases and 18 deaths just since yesterday. The governor there said, the outbreak in Louisiana is the worst in the world in terms of trajectory.


One New Orleans official telling CNN, this is going to be the disaster that defines our generation.