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Trump Administration Delaying Deal to Produce Ventilators?; Interview With Former Acting CDC Director Dr. Richard Besser. Aired 3- 3:30p ET

Aired March 27, 2020 - 15:00   ET





And, of course, in the back of my mind, which I'm trying not to think about, was, is that what happened with Kious?


BRIANNA KEILAR, CNN HOST: And a correction there. Kious Kelly was just 48 years old.

Our heart goes out, of course, to his family and all of the families who have lost loved ones in this crisis.

Our special coverage will continue now with Jake Tapper.

ANNOUNCER: This is CNN breaking news.

JAKE TAPPER, CNN HOST: Welcome to THE LEAD. I'm Jake Tapper.

Soon, we expect President Trump to sign into law the $2 trillion stimulus package to try to help ease some of the economic pain of the coronavirus pandemic.

But we're going to begin this hour with the pandemic itself, which continues to spread and accelerate across the United States.

We started this month with one death in the United States, one. We began this week, Monday, with 501 reported deaths from coronavirus. We are now at this hour almost three times that, the death toll today, at this hour, a devastating 1,451.

And just minutes ago, we hit another horrific record in the United States. It is only 3:00 Eastern, but we have already had more deaths reported today than on any other day so far, at least 265 deaths just so far today.

Also today, the United States surgeon general is warning of potential new hot spots in the United States, places such as Detroit, Chicago, and New Orleans. He predicts we will soon see a surge like we have seen in other parts of the country, including New York City, the hardest-hit area so far in the country

Makeshift morgues now being constructed in the city for the first time since the 9/11 terrorist attacks. Today, the U.S. Navy hospital ship Mercy arrived at the Port of Los Angeles to help local hospitals in L.A. manage the influx of non-coronavirus patients, so that the local health care workers can focus on the pandemic as much as possible.

And while President Trump has suggested, the nation, he wants to get back to work by Easter, which is just over two weeks from now. Dr. Anthony Fauci, the nation's top infectious disease expert, is downplaying that.


DR. ANTHONY FAUCI, NIAID DIRECTOR: He is making an aspirational projection to give people some hope. But he's listening to us when we say we really got to reevaluate it in real time.


TAPPER: Businessman Bill Gates, who has in the past sounded the alarm over the potential of a pandemic such as the one we're going through, said right here on CNN that the entire country needs to shut down for six to eight weeks in order to effectively fight the pandemic.

Today, the New York City mayor suggested there could soon be fines imposed for those who disobey restrictions there.

CNN's Shimon Prokupecz is live for us from New York City, specifically the Javits Center, which is being converted into a hospital.

Shimon, today, Governor Cuomo said that there are more than 44,000 confirmed coronavirus cases and more than 500 deaths just in New York state. And that's up from 37,000 cases, 385 deaths, yesterday. Cuomo saying that, even though the cases are going up, he believes the overall rate is slowing down.

Explain that for us.


And that rate is the hospitalization rate. They are seeing slivers of good news here. And I think whatever good news we can give folks right now, I think that's important.

What's happening is they feel, because of the social distancing and what they have done in this state and around this city, it's decreasing the number of people that are going to the hospital. So what he's saying, the governor is, that, at one point, the hospitalization rate, the amount of times people were going to the hospital was doubling every 2.5 days.

What they're finding now is that it's doubling every four days. It doesn't mean that people aren't going to continue to go to the hospital, they're not going to need urgent care, serious medical care, but they're seeing a slowdown and the number of people that are running to the hospital, so that gives him some good news that he was able to share.

The other thing, I just want to throw out some other numbers Jake here, is that the number of people in the intensive care units around the state is growing, over 200 just in the last 24 hours. That's now at nearly 1,600.

And that is a key number that the governor certainly is watching, because those are the patients that need the ventilators. So that number continues to rise. The state also, important to note, is testing more than any other state.

Another thing the governor said, it's a good thing because it's giving them indications of where the virus is. The key now obviously continues that, as we approach the apex the governor says at 21 days, is to keep building out hospitals, giving them supplies, and, of course, Jake getting those ventilators in place.


TAPPER: That's right, those ventilators.

Shimon Prokupecz, thanks so much.

New York's neighbor, the state of New Jersey, is now seeing the second highest number of confirmed coronavirus cases in the United States. That's nearly 9,000 cases, with more than 100 deaths just in New Jersey.

CNN's Athena Jones us live from PNC Art Center. That's a makeshift testing center in Holmdel, New Jersey.

And, Athena, you have been at this testing site all day. Tell us what you have seen.


This is a drive-through testing site. You can see it's still behind me. That's because everything is still behind me because they reached capacity a while ago, the capacity of 250 tests or so.

When we arrived here several hours ago, there were lines and lines of cars lining up in three lines passing by tents, getting swabbed by health care workers who were wearing full protective gear, full-on suits, head to head to toe in protective gear, in order to do that testing.

You mentioned, Jake, that New Jersey has the second highest number of cases, second to New York. That number, nearly 9,000, that jumped by 2,000 just overnight, and that is because so much testing is now going on.

This is one of two state-run testing sites. It's a joint effort with the health department of the state and also the state's National Guard. And today, at least, anyone who comes who is a New Jersey resident who is showing symptoms was allowed to be tested here at this site. They're trying to get testing available for as many who are able to

get it -- Jake.

TAPPER: And, Athena, New Jersey's also offering testing sites for first responders only. There's one in Trenton, New Jersey. You say that the site you're at will test first responders tomorrow.

Tell us how that's going to work.

JONES: That's right.

In Trenton, that site opened on Wednesday. It tested about 200 first responders over the first couple of days. Today, they were not testing. But here tomorrow and at the other state-run site, Bergen County Community College, they will be testing not only first responders, but health care workers.

Any first responders or health care workers who are symptomatic will be able to come here and be tested. And this is so important, Jake, because we have been hearing from so many health care workers and first responders, EMTs, paramedics, firefighters, police officers, and, of course, doctors and nurses, who are concerned with being exposed to the virus, catching the virus, and then exposing other people to it, whether it's a vulnerable person in their home like a pregnant wife or an elderly parent, or just members of the community.

We already know of one EMS worker who caught the virus from her co- workers, despite having no contact with patients -- Jake.

TAPPER: All right, Athena in New Jersey, thank you so much.

In California, another coronavirus hot spot, with more than 3,000 cases and 65 deaths, a U.S. Navy ship arrived at the Port of Los Angeles, there to provide relief for hospitals overwhelmed with coronavirus patients.

CNN's Stephanie Elam is live for us right now at the Port of Los Angeles.

And, Stephanie, how do (AUDIO GAP) in California plan on using this Navy hospital ship?


Well, Jake, what you're looking at here behind me with this Mercy Hospital here, this floating hospital, is about 1,000 beds that it is bringing. It also has 12 fully equipped operating rooms. It has a pharmacy on board. It can handle a myriad of (AUDIO GAP) anyone may need here.

The idea being is that they will treat these adults here, not anyone who is suffering from COVID-19. This is -- the idea being to pull these people out of area hospitals and bring them here, so that there is more room on these land-based hospitals for what they do expect to be an overwhelming need for space, for beds, for ventilators inside of these hospitals. They say that they're going to work with local officials, state officials, to figure out which patients are the ones that need to be transferred here to this referral hospital.

When you look at it overall, how many people are on board, you have got about 1,200 Navy medical and communication personnel that are on board to work with these people here. They say that they should be up and operating as soon as tomorrow here.

And when you look at the demand overall, the mayor of Los Angeles saying that they do believe that we are pacing about six days behind where New York City is right now, Jake.

TAPPER: All right, Stephanie Elam, stay safe out there in Los Angeles.

Life-or-death decisions, a frightening directive from one hospital system. Which patients would get priority if the situation were to become that dire?

Then I'm going to talk with a former CDC director. Is it inevitable that we will get to that point?

Stay with us.



TAPPER: Welcome back.

We know hospitals across the country are preparing for the absolute worst and for heart-wrenching situations. But we saw what that looks like in a black-and-white letter from a hospital leaked from a Michigan hospital system, the Henry Ford Health System, to be precise.

They say, in a worst-case scenario, worst-case, doctors will have to choose which coronavirus patients will get care and which ones will not, writing in a letter, if it gets to that point -- quote -- "Patients who have the best chance of getting better are our first priority. And patients who are treated with a ventilator or intensive care unit care may have these treatments stopped if they do not improve over time" -- unquote.

CNN's Omar Jimenez joins me live.

And, Omar, it's fair to say this isn't the decision anyone wants to have to make. And we're not there yet. No one in the United States is there yet, although they are there in Italy. Does the hospital system believe it's close to reaching this worst-case scenario? What do they have to say?

OMAR JIMENEZ, CNN CORRESPONDENT: At this point, the short answer is no. But it's all going into that worst-case scenario preparations.

They say they are not at capacity yet. They do have enough ventilators to go through. Their supply is OK. But when you look at just a week ago in Michigan, for example, they had 350 confirmed cases. They are now closing in on 3,000, with at least 60 deaths to come with it.


So it's that type of trajectory that has officials considering all types of scenarios, the worst of which we saw come out in this letter that was circulated that detailed which patients would get priority over others.

And, of course, you touched on one of the more notable portions of that letter, saying that patients who are treated with a ventilator or ICU care may have these treatments stopped if they do not improve over time.

Now, the Henry Ford health care system in Michigan runs a lot of hospitals in Detroit, and they say -- they emphasize, rather, that is not their current policy. It is a worst-case scenario, one they hope they don't have to get to, but, as we are seeing, they are now preparing for.

And this comes in the midst of the state saying they are struggling to get adequate supplies of personal protective equipment for those on the front lines of this, even, again, as we are seeing a surge in cases in Michigan, and as well as other places in the Midwest, Jake.

TAPPER: All right, Omar Jimenez in Chicago, thank you so much for us.

Joining me right now, Dr. Richard Besser. He is the former acting director of the Centers for Disease Control and Prevention, the CDC.

Dr. Besser, good to see you, as always.

Do you think hospitals and hospital systems across the country are having similar conversations right now to what we saw in that memo from the henry Ford Health Center?


As you're saying, you hope never to have to use this. But part of pandemic preparedness and planning is coming up with frameworks for rationing scarce resources.

This is something during bird flu preparedness in the mid-2000s we did. We held focus groups across the country to try and understand what people's values were, because there are different ethical frameworks that you want to use.

We ration health care in this country all the time, and you don't want it to be rationed based on social connection or income or race or immigration status. You definitely don't want it to be rationed based on whether someone has a disability.

This is something, where if you plan ahead, then you do everything under your power to never have to use those guidelines. It takes the pressure off those people on the front line, those heroes who are taking care of patients.

TAPPER: Is it inevitable that hospitals in the U.S. will get to that point?

BESSER: I don't think it's inevitable. It depends what we do as a nation.

At the Robert Wood Johnson Foundation, what we say is, we can know everything about this virus and how to control it, but if we don't give people the tools and the ability to follow the directions, follow the social distancing, we're going to fail.

And we need to ensure that we're doing everything, we don't -- so that we don't lift up these social distancing recommendations too soon, that we do everything to make sure that there's more ventilators being manufactured, that we look at some of these strategies to possibly use one ventilator for more than one patient.

You get creative, but you want to make sure you have got those plans in place in case you have to go to them.

TAPPER: The guidance from Henry Ford Health says, in this worst-case scenario -- again, they have not enacted it -- but in this scenario -- quote -- "Patients who are treated with a ventilator or ICU, intensive care unit, care may have these treatments stopped, stopped if they do not improve over time."

New York Governor Andrew Cuomo said today that the longer you're on a ventilator, the less likely you are to ever come off that ventilator.

Is -- explain for us or explore for us the ethics of handling a crisis like this that way.


You may have hard decisions to make. Going in, you want to make sure you're not excluding any big groups of patients. There's some great guidance that's out there and ethical frameworks around this.

One of them has to do with how many years of life you have left. In the focus group work, it was clear that people wanted to prioritize very young people, children, who haven't gone through teen years and their 20s and their 30s, have so many more years of their life that they haven't even experienced, to set priorities there over people who are near the end of their life, to set priorities over people who are -- who you expect, based on their conditions, based on their status and their scoring systems, based on their status, are they likely to recover and leave the hospital?

And you don't want to make those decisions too early, especially with a disease where we don't have that long of an experience with it. But, yes, there are times where you may have to decide that you don't want to continue with a treatment if it's not having any signs of improvement and you don't expect the patient to come off the ventilator and go home.

TAPPER: These are the kinds of decisions that the medics and physician's assistants on the battlefield make.

There are five people who are wounded, they can only handle one, two at a time. It's not normally, right, the kind of thing that a doctor or a nurse in an American emergency room or ICU has to make.


How difficult is it to make such a call?

BESSER: I think it's more difficult if you don't have a structure, if you have something where it comes down to, well, who do you know, how much money do you have, any other kind of issue.

We do have other systems of rationing. If you look at the organ procurement system in this country, there's scoring. There are different factors that go into there. And people agree to that. And it makes it much easier on the people who are taking care of patients to say, here's the system, here's what was agreed to. As hard as it is, we may not have an organ for you.

Here's a system where hopefully we won't get to the point where we have to have that hard conversation with a family, with a patient and say, I'm sorry. We want to make you comfortable. We want to make you as comfortable as possible, but we don't have a ventilator for you.

But if we do all we can take the pressure off the health care system and the social distancing, there's signs that social distancing is slowing things down in certain areas. If we do that, hopefully, no one will have to make these decisions.

TAPPER: Let's hope and pray we never get to that point with this pandemic in this country.

Dr. Richard Besser, always good to talk to you. Thank you so much for your time. Stay safe, my friend.

Coming up next: A potential deal to make more ventilators hit a roadblock -- why some Trump administration officials are questioning the timeline and the price tag.

Stay with us.



TAPPER: Soon, we expect President Trump to sign the historic stimulus package. We're going to bring that to you live once it begins.

Meantime, President Trump has been lashing out at three Democratic governors in three of the states hardest-hit by coronavirus. They dared to ask him for federal assistance with badly needed medical supplies.

Let's go to CNN's Kaitlan Collins at the White House for us. And, Kaitlan, New York Governor Andrew Cuomo now pushing back after President Trump last night on his favorite channel questioned whether New York actually will need 30,000 ventilators.

KAITLAN COLLINS, CNN WHITE HOUSE CORRESPONDENT: Yes, the president seemed to scoff at that idea, saying that hospitals didn't need that many ventilators before, so why would they need them now?

Of course, the circumstances have changed drastically, as we are now in the middle of this pandemic. But also today the president accused Governor Cuomo, saying he was stockpiling the ventilators that New York did have.

And Governor Cuomo spoke with our colleague Shimon. He said that was not an accurate portrayal of exactly what's doing -- what's going on. Listen to how he explained why they are putting these ventilators that they're getting in storage.


GOV. ANDREW CUOMO (D-NY): That is incorrect and grossly uninformed.

The point is, we have ventilators in the stockpile, and we didn't send them to the hospitals yet. Of course we didn't. That's the whole point.


COLLINS: Now, the president has been paying close attention to pretty much every press conference that you have seen Governor Cuomo giving, and he's also been tracking which governors throughout all of this have been praising him or criticizing the federal government, saying that they aren't getting what they need from have them.

TAPPER: And, Kaitlan, President Trump is also fighting with General Motors today. Can you explain that?

COLLINS: Yes, this is notable, because it does come, after last night, the president downplayed the need for these ventilators.

And today he's lashing out at car companies, saying that they aren't making ventilators quickly enough. Now, the background of the president's tweets, where he's lashing out at General Motors, telling them to start making ventilators now, is that they had been in talks here at the administration with GM and this other company to talk about a joint venture to make ventilators.

But they kind of put it on hold when they came close to announcing it because they were worried about how long it was going to take the ventilators to get made and how much it was going to cost.

But now, today, after the president's been lashing out at them, GM announced they are moving forward with making these ventilators anyway, though they did not say if they're going to have the federal government and FEMA's help with the financial aspect of it.

TAPPER: All right, Kaitlan Collins, thank you so much.

Let's bring in CNN business anchor Julia Chatterley to talk more about all this.

So, Julia, talks with General Motors seem to hit a snag of some sort when the administration questioned the price tag that GM was offering and the timeline. The president's communications remain kind of confusing about whether or not he is invoking or will invoke the Defense Production Act, which would allow him to mandate that companies manufacture well-needed goods.

Do you think he should officially ordered GM to manufacture ventilators?

JULIA CHATTERLEY, CNN BUSINESS ANCHOR: The irony here, Jake, is that they were already trying to help anyway.

Yes, he could invoke this act. He could order them, whether it's Ford or GM, to produce. But this act is way more powerful than that. Remember, it assumes a degree of responsibility, a coordination of the entire production, an understanding -- and this is critical -- of the supply chain.

We have had medical device companies coming out today and saying, hang on a second, if these big automakers are making ventilators, they're going to deprive other manufacturers of key hard-to-get component pieces.

Their suggestion was how, about we have GM and Ford make those component pieces themselves?

The bottom line is, this act should be used for efficiency. How do we make the most amount of ventilators in the shortest amount of time? It requires leadership, Jake, ultimately, and assuming responsibility.