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The Lead with Jake Tapper

Hospitals Planning For Worst-Case Scenarios; U.S. Passes 1,500 Coronavirus Deaths. Aired 4-4:30p ET

Aired March 27, 2020 - 16:00   ET

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

[16:00:28]

ANNOUNCER: This is CNN breaking news.

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

At any moment, we're expecting President Trump to sign the $2 trillion stimulus bill into law. We are going to bring that to you when it happens.

An aide telling CNN that House Speaker Nancy Pelosi has not, not been invited to the ceremony at the White House. We learned earlier this week that she and President Trump have not spoken in at least five months.

But now to the coronavirus pandemic itself and a turning point in the United States, the U.S. now reporting the most coronavirus cases in the world, more than 97,000. That is more confirmed cases than Italy, which has so far seen more than 8,000 deaths, though a top Italian health official is warning today that Italy has not yet even hit the peak of the pandemic in that country.

That is also more confirmed cases than the Chinese government is reporting, though, of course, an important caveat, the Chinese government has not exactly been a paragon of transparency and candor for facts during this crisis.

In the United Kingdom, Prime Minister Boris Johnson has now become the first world leader to be infected with the coronavirus that we know of, along with the U.K.'s health secretary. Both are in self-isolation as of now.

In the U.S., the death toll currently stands at 1,495. That is up 44 deaths in just the last hour. We have already surpassed the record set yesterday for most coronavirus deaths in the U.S. reported in just one day.

The governor of New York, Andrew Cuomo, today saying that -- quote -- "This is a moment that is going to change this nation" -- unquote.

Hard to argue with that.

And, as CNN's Nick Watt reports, now U.S. Navy ships are lending additional support in the battle against coronavirus. (BEGIN VIDEOTAPE)

NICK WATT, CNN CORRESPONDENT (voice-over): With 1,000 beds on board, the Mercy docked in L.A. this morning. Confirmed cases here are climbing.

ERIC GARCETTI (D), MAYOR OF LOS ANGELES: That, if this rate of increase continues, in six days, we will be where New York is today.

WATT: A second Navy hospital ship, the Comfort, expected to dock in New York City Monday, where the mayor believes more than half the city's population will catch this virus.

GOV. ANDREW CUOMO (D-NY): We're going to seek to build another four temporary emergency hospitals.

WATT: More than 500 now dead in New York state, among them a nurse at Mount Sinai and an NYPD employee.

The governor says the rate of increase now falling, peak infections still three weeks away, and more ventilators still needed. His advice to the rest of the country?

CUOMO: Get the equipment and get it sooner. And if you don't get it now, you're not going to have it when you need it.

WATT: Detroit now among the nation's emerging hot spots.

DR. JONEIGH KHALDUN, MICHIGAN CHIEF MEDICAL EXECUTIVE: We think we're still on the aggressive upslope. And we still have several weeks to go as far as when we hit that peak.

WATT: More than 500 new confirmed cases Michigan in just 24 hours. Do health workers there have what they need to stay safe?

KHALDUN: Absolutely not. I have now got doctors and nurses on the front lines who are using one mask for their entire shift.

WATT: One Detroit hospital system is preparing for possible life-and- death decisions ahead.

A letter ready to send to patients and families reads in part: "Because of shortages, we will need to be careful with resources. Patients who have the best chance of getting better are our first priority."

A company spokesperson telling CNN: "This letter is part of a larger policy document developed for an absolute worst-case scenario. It is not an active policy."

MIKE DUGGAN (D), MAYOR OF DETROIT: Every major hospital system in New York and Detroit and Chicago and Seattle are having exactly these same conversations internally.

WATT: Chicago, another growing hot spot, a refrigerated trailer now at the Cook County morgue increasing capacity. The president still talking about opening up at least parts of the

country for Easter.

DR. ANTHONY FAUCI, NIAID DIRECTOR: Well, I think that the president was trying to do -- he was 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. And any decision we make has to be based on the data.

(END VIDEOTAPE)

[16:05:04]

WATT: Now, that is the 1,000 bed Mercy hospital ship behind me, a strange sight for peacetime. The governor and the mayor are visiting it this West Coast lunchtime.

The plan is to get regular patients out of Los Angeles hospitals and put them on the ship to clear space for the expected COVID-19 wave.

And we just got some updated numbers from L.A. County. They say that confirmed cases here tripled in just the past six days. And those numbers are expected to continue to climb -- Jake.

TAPPER: All right, Nick Watt, thank you so much.

And we should just note, we started this broadcast, the death toll was 1,451. The death toll is now 1505. We have passed the grim milestone of 1,500, as the death rate from this virus keeps going up.

Let's bring in CNN Dr. Sanjay Gupta joining me now.

And, Sanjay, an internal memo from a Michigan hospital system has been getting a lot of attention. It details -- and the hospital has confirmed it's real -- it details how, in a worst-case scenario, they are preparing protocols for life-and-death decisions that might have to be made during an emergency.

Who gets a ventilator? Who does not? How long does somebody get to stay on a ventilator?

Part of the letter says -- to quote from it -- quote -- "Some patients will be extremely sick and very unlikely to survive their illness, even with critical treatment. Treating the patients would take away resources for patients who might survive."

Now, I should underline that the Henry Ford Health System told CNN that none of their hospitals are near -- anywhere near having to enact such protocols, and none of them are at capacity with coronavirus patients.

But, I mean, we have seen what happened in Italy, and we're tracking -- we're about -- the U.S. has been following Italy by about 10 or 11 days. It could happen. I mean, we need to be honest about that.

DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Yes, look, I think we do have to be honest about that.

And I can tell you, Jake, first of all, Michigan's my home state. I know many of the doctors there. I have been speaking to some of them off the record on background today.

And a couple things really struck me. One is that, as you point out, this is a real letter. They all they all knew about this. They all knew that this letter was being circulated. And they weren't -- there was no degree of surprise by this at all when I talk to these physicians.

Based on what they're seeing, and the projections that they're hearing, when you hear a doubling rate that happens every couple of days, the numbers double every couple of days, I mean, it goes -- that's exponential growth.

So you really can't sit here at any point really in Michigan, or many of these places around the country, and say things look OK for now. You just can't think that way, I think, when the numbers are growing back quickly.

So they are talking about this. Many physicians, many physician groups are talking about this. These are real conversations that are happening in the country right now. It is challenging, obviously, because a lot of people, who -- especially those not in the health care profession, are hearing about rationing decisions, which is what this is.

They're hearing about rationing decisions up front in a way that they have never probably ever heard before. And it's jarring, I admit it, but it's real, Jake, and not just there, but in many hospital systems.

TAPPER: Yes.

And I have seen some people criticize members of the media for even covering this, covering it as if we're fear-mongering. It's very clear we're not at that point. But it's also clear other Western countries like Italy have reached that point.

I want you to take a listen to the mayor of Detroit, Mike Duggan. He applauded the approach and the forthrightness from -- of this health care system talking about a worst-case scenario.

(BEGIN VIDEO CLIP)

DUGGAN: Henry Ford is one of America's great health care systems. And what they put out was honest.

We're trying to bend the curve. The governor of the state has put a shelter-in-place order in, and where everybody is doing everything we can to stop it. But you would be irresponsible as a health care system CEO if you weren't planning for that eventuality.

(END VIDEO CLIP)

TAPPER: Do you agree? And do you think most hospital systems and hospitals have plans like this in place, whether or not they acknowledge it publicly?

GUPTA: Yes, I think most hospital systems do have plans in place.

And I can tell you that -- what I have been doing is spending a lot of time talking to people in various places around the country to really get a sense of how things stand. And you do hear about this.

In fact, Jake, in "The New England Journal of Medicine' this week, there was an article -- this is a journal that many people in the medical community read -- and they basically talk specifically about what might rationing look like? Should there be independent committees that are set up in a hospital, for example, so that the treating physicians and nurses don't have to be the ones that are -- there can be an independent body helping make these decisions?

I mean, these are real discussions happening.

[16:10:00]

And, Jake, look, of course, no one wants or hopes that this will happen. But this is the sort of preparation that has to take place, because, all of a sudden, if people are confronted with it, and they have no sort of plan or idea or sort of way of thinking through this, that's tough on everybody as well.

It's tough no matter what. But that makes it even tougher.

TAPPER: And, Sanjay, you and I have been yelling this now for weeks and weeks, if not months, at this point. The hospitals do not have what they need. They don't have the personal protective equipment. They don't have the ventilators.

Now, in terms of the PPE, according to the Italian Association of Doctors, 51 Italian doctors who tested positive for coronavirus have now died. That's a lot of people to die. And that's a huge shock to the health care system.

GUPTA: Look, I mean, this was tragic. I saw that alert come across, 51 physicians, 32 of them in this northern area.

I mean, these are entire communities of medical professionals that are -- whose lives are being lost right now. It's really sad, Jake.

I think that the this idea that people have been screaming, the Italian Medical Federation screaming as well for some time, that they needed more PPE, this wasn't a precaution. It's protective equipment.

But it was essential. And I think, just as many countries around the world did not pay attention to Italy, you hear from people in Spain that I have been talking to: Yes, we thought that it was over there, it's not really going to come here. They were watching what happens in Italy. And still some of the same precautions were not being taken.

This -- what happened to these doctors, 51 doctors who've now passed, 32 in just the northern region of Italy alone. I mean, everyone should listen to this, because we can learn a lesson. We can better prepare. It was not just precautionary sort of principles.

It was essential principles. And it's also a reminder that, in health care settings, in hospitals, that's where people are most likely to get sick. The virus is clearly circulating even more robustly there. You can't keep safe distance away from each other. The patients are aerosolizing -- more likely to aerosolize the virus in those settings.

So (AUDIO GAP) pay attention to this. And, look, I know that there's places around the country where they say, yes, so far, we're good. We have enough PPE right now.

The numbers are doubling every couple of days, Jake. Their hospital systems have gone through months' worth of their PPE in just weeks. So they really need it. And we should heed the lesson from Italy.

TAPPER: So -- and lastly, Sanjay.

It's been made very clear by not only Dr. Fauci, but even Vice President Pence, that this goal of opening up America, so that church pews can be crowded in Easter, which is just two weeks in a couple days away, that that's aspirational, which is another nice way of saying, President Trump's push for that is -- that's what he wants to happen, but we're not going to be able to do that, and also save lives.

When do you think there will be at least some ability for the nation to think about a return to normalcy?

GUPTA: Well, I have asked just about everybody that question, including Fauci, including Bill Gates last night. I have talked to various hospital systems.

You probably saw Governor DeWine in Ohio, who was very aggressive early on, closing Ohio State University early. People thought, what are you doing? He did that very early. And he even is saying, look, it's looking like maybe end of April, May.

Nobody knows for sure. We don't know exactly where we are on that curve. I think if we see a few days where that doubling number starts to come down, that's going to be a good sign, sort of saying that we have gotten close to the peak.

But, I mean, I think most people are saying that the entire cycle is probably eight to 10 weeks. So, the peak may be four or so five weeks into this.

TAPPER: Dr. Sanjay Gupta, thank you so much, as always. We will have this conversation again on Monday.

Have a great, safe and healthy weekend with you and your family.

GUPTA: Absolutely. You too, Jake.

TAPPER: Coming up, we're continuing to monitor the White House, where President Trump is about to hold a signing ceremony for the stimulus package. We will bring that to you. He did not invite the House speaker, Nancy

Pelosi. Even though the president is constantly talking about the need for the country to pull together, he's not inviting the person who got the bill through the House.

Plus, breaking news on the Defense Production Act. We will bring that to you next. Stay with us.

(COMMERCIAL BREAK)

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TAPPER: Breaking news, after months of governors begging him to do it, we've just learned President Trump has finally invoked the Defense Production Act for the first time. This comes as President Trump is set to sign the historic $2 trillion stimulus package that just passed the House.

An aide tells CNN that House Speaker Nancy Pelosi, who of course helped shepherd the package through the House of Representatives, has not been invited to the signing ceremony, in fact, it appears that no Democrats have been invited to the White House.

CNN's Kaitlan Collins is at the White House.

Kaitlan, start with the Defense Production Act. What are you learning? What might this mean?

KAITLAN COLLINS, CNN WHITE HOUSE CORRESPONDENT: Yes. Jake, this is notable, because for weeks we have heard these confusing statements from the president over whether or not he had actually used the federal powers he had granted to him by signing the Defense Production Act. He would say publicly that he had used it and then aides would later tell us no, we actually have not used it to compel any companies to make any products, any of these needed medical supplies yet. But now, we do have an official statement from the White House saying that the president has used it.

And it's notable the situation he's using it in. Now, from the statement they say that basically they are granting using the authority that they have, that General Motors must accept, perform, and prioritize federal contracts for ventilators. The president says in his statement, our negotiations with GM regarding its ability to supply ventilators have been productive but the fight is too urgent to allow this give and take to go on, and he says pretty blunt, quote, GM was wasting time.

[16:20:05]

Now, the background on this is that the White House and GM and these other companies that makes ventilators had been in talks for joint production to start making ventilators. But those talks got put on hold because they weren't sure how long it was going to take them to make them. They thought it was going to cost too much. So, they've essentially been reassessing the terms of that. But, Jake, I spoke to several people about this this morning, they

were still hopeful this would pan out and there were not plans to use the Defense Production Act as of this morning. So, now, a few hours later, they're actually invoking it.

But, of course, Jake, the other thing that's important for people to remember is signing the DPA is not some magic wand. It's not going to create factories that already ready to make ventilators, it's going to make them ready by tomorrow or the amount that we've heard states and governors say that they need. It's still going to have to require for GM to retool their factories because they currently don't make ventilators because they currently don't make them at this plant in Indiana.

So, the question still here is going to be the timeline, whether or not these companies will be able to produce this at a time that these hospitals say it's sufficient for them to have the ventilators they need to treat people who have coronavirus. And we should note these are machines used for people who cannot breathe on their own, the worst end for coronavirus patients.

TAPPER: That's right.

And, Kaitlan, on the signing ceremony it appears no Democrats have been invited to President Trump's signing ceremony despite the fact that every now and then he says that the country needs to come together, how great it is that the bill passed the Senate 96-0. Is there a strategy behind this, is he trying to make it seem as though only Republicans are bringing this well-needed aid to the American people? Or is this just petulance and pettiness?

COLLINS: Well, it depends. I mean, this morning, the president said working with Democrats is hell, that's what he said in a tweet when a Republican was trying to have a vote where people have to come in person to vote on this bill. Of course, that actually did not happen, they got it passed pretty quickly after the drama subsided this morning.

But, yes, no Democrats have been invited, it's only Republicans if you look at the list the White House gave us. The most obvious person missing is House Speaker Nancy Pelosi but also Senate Minority Leader Chuck Schumer who the treasury secretary spent a fair amount of time with as they were going back and forth on these negotiations.

They spoke multiple times. We also know that Pelosi and Mnuchin spoke multiple times, as well they were really shepherding through this process, trying to find something that everyone can agree on because I think both sides of the aisle realized they had to get something pass or there was going to be political hell for them to pay coming on the other end of this.

But it is notable that the president does not want Nancy Pelosi here. We know because of Manu Raju that they have not spoken in five months and it doesn't appear that today is going to change that.

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

The administration's response today noted (ph) and the invocation of the Defense Production Act, especially compared to exactly four weeks ago today. Exactly four weeks ago today, then-acting White House chief of staff Mick Mulvaney publicly questioned journalists who were covering what is clearly now a pandemic, one that has now killed more than 1,500 Americans.

(BEGIN VIDEO CLIP)

MICK MULVANEY, THEN-ACTING WHITE HOUSE CHIEF OF STAFF: The press was -- was -- was covering their hoax of the day because they thought it would bring down the president. The reason you're seeing so much attention to it today is they think this is going to be what brings down the president. That's what this is all about.

(END VIDEO CLIP)

TAPPER: That's obviously a lie. It was not about that. This is about sounding the alarm about a public health crisis that now has a devastating body count.

Mulvaney made those remarks, we should note, a conservative conference, CPAC, just outside Washington, D.C. And "The Washington Post" reports that Mulvaney, before he made those comments, had been tested for coronavirus, and thankfully he tested negative.

Moreover, per "The Post," at least three attendees of that very conference, of CPAC, have since tested positive for coronavirus. One of them had contact with high profile players including five lawmakers such as Senator Ted Cruz who then had to self-quarantine.

It really is hard to imagine anything more emblematic of how the White House downplayed the threat of this pandemic than the White House chief of staff saying one month ago that coverage of this deadly virus was not legitimate while, A, he had already been tested for the virus, and B, he was talking to a room full of people potentially being exposed to it at that very moment.

Fifty-one doctors now confirmed dead in Italy from the coronavirus, with almost 1,000 total deaths just yesterday. Why one top official says it will still get worse for Italy.

Stay with us.

(COMMERCIAL BREAK)

TAPPER: Welcome back.

Italy is now reporting the deadliest day on record, 969 dead in one day. One official saying they had not even reached the peak of coronavirus cases in the country.

We have reporters around the world.

And, let's begin with Delia Gallagher in Italy. And, Delia, the number of deaths in the past day staggering, almost

1,000. What are things like in Italy?

DELIA GALLAGHER, CNN CORRESPONDENT: Well, listen, Jake, on the numbers, you know, statistics are pointing that -- to the fact that these patients are overwhelming -- overwhelmingly, excuse me, elderly --

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