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Trump Extends Social Distancing Guidelines Through April, Administration Says 100,000 in U.S. May Die; Trump Lashes Out at Critics, Including Speaker Pelosi; New York Hospital Workers on Frontlines of "Medical War Zone"; Dr. Jonathan Gelber Discusses Lessons Learned on Efforts to Flatten the Curve. Aired 11-11:30a ET
Aired March 30, 2020 - 11:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JOHN KING, CNN ANCHOR: Hello to our viewers in the United States and around the world. I'm John King, in Washington. This is CNN's continuing live coverage of the coronavirus pandemic.
Just the last hour, the "USNS Comfort" arriving in New York City, being welcomed by Governor Andrew Cuomo. The ship now part of the big response to the coronavirus crash in the epicenter of New York City.
Also a big continued global disruption today. And 93 more coronavirus deaths overnight in the Netherlands, for example. In Italy, 61 doctors now dead after contracting the virus while treating its overrun hospitals. The Olympics officially postponed to the summer of 2021.
But we begin the hour here in the United States with a big about-face by the president amid new frightening coronavirus projections of just how many Americans are expected to die. This hour the case stands at 121,000. Nearly 2,000 have died.
But the president last night walking away from his wish to reopen the country by Easter. The social distancing guidelines put in place by the White House now run until the end of April. The administration said it could go longer. Part of the reason why he changed his mind is harrowing situations at a Queens hospital and data like this from his own public health experts.
(BEGIN VIDEO CLIP)
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: It wouldn't have been good to pull back at a time when you need to really be putting your foot on the pedal as opposed to the brakes.
I don't like to see it. I'd like to avoid it. But I wouldn't be surprised if we saw 100,000 deaths.
(END VIDEO CLIP)
KING: He would be surprised. You hear it there.
The president is changing his approach to fighting this virus reaffirms the present coronavirus danger.
But the president isn't changing everything. Some personal slights and grievances remain part of in his coronavirus playbook. Quote, "The states should be getting it," is the president's view, about the medical equipment shorts that crash on the nation's hospitals in the coming days and weeks.
Also, a very pitched presidential reaction to criticism from the House Speaker. The president says Nancy Pelosi is, quote, "a sick puppy," who represents, quote, "a slum." The president again questioning whether Pelosi actually prays for him.
Here with me this hour to share their insides CNN chief medical correspondent, Dr. Sanjay Gupta, and our chief political correspondent, Dana Bash.
Sanjay, I'll get to the politics maybe later, but I want to start with what the overwhelming majority care about. The president has changed his mind and April is essentially gone. The president is shutting down the American economy for another month, telling Americans to fight this disease. They must stay sheltered for another month.
Sanjay, I want to start the conversation with listening to more from Dr. Fauci. The president last week said, if we can't open all of the country, maybe we can open pieces of it. There are pockets of states and counties with locations that are not so high. Dr. Fauci and Dr. Birx convinced the president with this statement.
(BEGIN VIDEO CLIP)
FAUCI: There are areas of the country that have relatively few cases. Those are the ones that are vulnerable and dangerous to go along and spike.
If you just look at those and say, there are very little infections in this area or that area or that area, we don't have to worry about it, you're making a big mistake. Because those are timbers that can turn into big fires.
So you have to do both. You have to mitigate the ones that are in obvious trouble, but you have to stop the ones that are starting to spark.
(END VIDEO CLIP)
KING: Sanjay, the public health experts have been saying that for months. The president was saying something very different. But finally, through persistence, they changed his mind.
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Look, John, this is a fundamental point here, because I think it really is the in inflection point between what we do now in terms of going forward for the whole country and what we do on a case-by-case basis, which has been this idea that's been floated a few times by the president, by many others as well.
I think what Dr. Fauci just said, and I hope people heard that and will maybe listen to it again, that those areas where you have fewer cases, those are actually the areas we have to pay very close attention to, not saying they're going to be fine. They haven't had many cases yet. They're going to be fine.
Dr. Fauci just said the exact opposite. It is a fundamental difference, John, between what we are hearing last week, this idea that maybe those places could start to be opened. Dr. Fauci has said pay more attention to them.
Practically speaking, John, it's really about the number of people per capita that are infected, not just the total number of people. Whenever you look at these maps, think about this per capita. New York obviously much more densely populated than some of these other areas.
But number two, we haven't been doing testing there yet. We really don't know how significant the problem is. Don't let those embers turn into flames. It's a really apt metaphor - John?
KING: If you look at the map, tiny places like Rhode Island, arrow going that way. Out in rural Idaho, arrow going that way.
The public health experts, Dana, finally convincing the president, sir, you have this wrong. Just because the map isn't filled in doesn't mean it's not coming. They showed him a chart that said do you want 2.2 million Americans to die, sir? Do you want to be that president? Or do you want 100,000 to 150,000 Americans die? Don't you prefer to be that president?
You could hear it from the president when he came into the Rose Garden yesterday, everybody saying, what is he going to decide? He said 2.2 million? No way.
(BEGIN VIDEO CLIP)
DONALD TRUMP, PRESIDENT OF THE UNITED STATES: You're talking about 2.2 million deaths, 2.2 million people from this. And so, if we could hold that down as we're saying to 100,000, it's a horrible number, maybe even less but to 100,000. So we have between 100,000 to 200,000. We all together have done a very good job.
(END VIDEO CLIP)
KING: The numbers, Dana, overwhelming, but they managed to present them almost in a Trumpian way, saying, Mr. President, these are huge. You can do something about it.
DANA BASH, CNN CHIEF POLITICAL CORRESPONDENT: That's exactly right. I heard the same thing. I talked to someone who was familiar with that briefing last night who said that the presentation that the doctors, the medical professionals gave, and in particular Dr. Fauci and Dr. Birx, was incredibly powerful. Not that much different in substance from what they have been saying
behind the scenes and in public, and what anyone has been listening to Sanjay say about the models has been understanding for a long time.
But it's difficult with a president who has pushed really hard against the grain, against the notion of doing this. He was convinced by this powerful presentation.
And our colleagues have some great reporting about the fact that it was that and the images out of Elmhurst Hospital, which the president himself said in the Rose Garden yesterday is a place that he's quite familiar with, right near where he grew up, that that was something that helped to persuade him as well.
I can tell you that I've talked to some people in and around the president who don't like this idea, who think that there's still -- these are not medical professionals, these are political policy people, who still think there's a way to do it piecemeal.
But right now, where we are right now, the president is listening to the medical professionals, listening to people like Sanjay.
KING: He has locked in on this, even saying he does not see any place in April he can do the county by county or region by region approach he had talked about last week.
KING: Sanjay, it sucks, I'm sorry to use that word, but it sucks trying to prepare the American people for this who, Sanjay said, still don't think this is a big deal. You're looking at 2,461 deaths. That is horrible.
But Dr. Fauci is saying we could get up to 100,000. We could get higher than 100,000. If you look at Michigan, Louisiana, Florida, cases doubling every two days, in New York every four days. I'm thinking of a major football stadium, a medium-sized city in America, 100,000, 150,000, 200,000 people.
What do we look for in the days and weeks ahead to show, yes, this is the scope of this, and anyone out there who doesn't believe the doctors and doesn't believe the science, you should finally believe the president and take this seriously?
GUPTA: Yes, John, I agree with you, this does suck. There's no two ways about it. And I don't think anybody gets any joy in citing those sorts of numbers.
This is a catastrophe, a pandemic that is sweeping around the world. Mother Nature is retaliating in this way, and that is something worth remembering. As we talked about, we're all in this together.
One thing I'll say, the idea that best-case scenario that's presented in the chart you just showed, the worst case 2.2 million, the best case around 100 to 200,000, that is still if we continue all the active mitigation measures we have in place right now, and it's not clear to me still that we're doing that. I can't believe, after two months of saying this, as we all have been, that it's still not clear.
Here in Georgia, where I am right now, it's not happening universally. The governor still said people who are medically vulnerable should stay home for the state. That's still happening right now even as the president is saying everyone should stay home until the end of April.
So it is still being applied very unevenly -- John?
KING: I saw some construction workers driving in. They were in like a football huddle, smoking, drinking, talking inches apart from each other.
Sanjay, Dana, I appreciate it. We'll continue this important conversation.
Here's one way to continue that conversation. It is one thing to hear about the dire situations, the hospitals and the health care workers on the front lines of this pandemic. It's quite another thing to see it yourself.
CNN takes you there with the brave reporting by our team, including Miguel Marquez, who went to the Brooklyn University Medical Center in Brooklyn.
Miguel, take us inside that hospital.
MIGUEL MARQUEZ, CNN CORRESPONDENT: If you need any other sobering example of what's at stake here and how difficult it is going to get and how long it's going to be difficult, go to Brookdale Hospital, their emergency room. This is in the Brownsville neighborhood of Brooklyn. Largely African-American and Latino, one of the poor neighborhoods in New York.
On a good day, on a great day, they have plenty coming through their front door that keeps them busy. Coronavirus is now pushing that hospital and many others to the very edge.
MARQUEZ (voice-over): Every corridor, every corner, every ward --
MARQUEZ: -- every inch of Brookdale Hospital Medical Center in Brooklyn now inundated with those suffering from COVID-19.
(on camera): What are you looking at on a daily basis? How difficult is this?
DR. ARABIA MOLLETTE, ER DOCTOR, BROOKDALE HOSPITAL: Well, this is a war zone. It's a medical war zone. Every day I come in, what I see on a daily basis is pain, despair, suffering, and health care disparities. MARQUEZ (voice-over): Through Sunday afternoon, Brookdale said it had
at least 100 confirmed cases of COVID-19 with nearly 80 awaiting confirmation. More than 20 people have died so far from the disease.
On top of its normal emergency flow, coronavirus is pushing the hospital to the max.
MOLLETTE: We are scared, too. We're fighting for your lives and we're fighting for our own lives. We're trying to keep our head above water and not drown.
MARQUEZ: Doctors, nurses, even those keeping the floors clean. They say rising tide, uncertain how long it will rise, unsure this coronavirus won't sicken them as they struggle to stay a step ahead.
(on camera): What do you need right now?
MOLLETTE: We need prayer. We need support. We need gowns. We need gloves. We need masks. We need more vents. We need more medical space.
We need psychosocial support as well. It's not easy coming here when you know that what you're getting ready to face.
MARQUEZ (voice-over): The deaths here keep coming, while filming another victim of COVID-19 was moved to the hospital's temporary morgue, a refrigerated semitrailer parked out back. The hospital's regular morgue filled to capacity.
(on camera): How much room do you have in your morgue?
KHARI EDWARDS, VP, EXTERNAL AFFAIRS, BROOKDALE HOSPITAL: Usually we have around 20-plus bodies that we can fit comfortably.
MARQUEZ: And you've gone over that?
EDWARDS: Gone over that and they've, the state has been gracious enough to bring us apparatus to help keep families and keep the bodies in comfortable areas, because we didn't want bodies piled on top of each other.
MARQUEZ (voice-over): Brookdale needs more of everything today. Edwards said the hospital has 370 beds. They'd like to add more, many more. Two weeks ago, this was the pediatric emergency room. Now it's dedicated to victims of COVID-19. Plastic tarp, taped to the ceiling offering some protection, and a bit of privacy.
The intensive care unit filled nearly to capacity and sealed, so fewer doors and less traffic than usual comes and goes. This window is the only place where family members can watch their loved one inside the unit, as they chat with them via cell phone. It's sometimes as close as they can get as COVID-19 takes another life.
As grim as it is right now, Dr. Mollette expects it will get worse.
MOLLETTE: It could end in the fall. It could end at the end of the year. But this is why we're begging everyone not just -- to only put that pressure on the emergency department but also for everybody to help us help them by staying home.
MARQUEZ (on camera): You think we're in it for the long haul?
MOLLETTE: Yes, definitely.
MARQUEZ: This is months, not weeks.
MARQUEZ (voice-over): Another worrisome thing she's seen coming through the doors, not just the elderly and those with compromised immune systems.
MOLLETTE: I work at two hospitals. So I work here in Brooklyn and then I work at another hospital in the Bronx and it's the same thing and the South Bronx is the same thing. I've had patients that who are in their 30s and they are now intubated and they're really sick. I've had patients that are well --
MARQUEZ (on camera): No underlying conditions?
MOLLETTE: No underlying conditions.
So the thing is about between life and death as far as this coronavirus is that this virus sees no -- there's no difference, has nothing to do with age, has nothing to do with lack of access to health care, has nothing to do with socioeconomics, race or ethnicity. This virus is killing a lot of people.
MARQUEZ (voice-over): Brookdale has one advantage. Hospital officials say it can do rapid testing for coronavirus on site, its own lab. Right now, up to 300 tests a day. They hope to get to 500 a day.
ANDREI LEGOUN, LAB TECHNICIAN, BROOKDALE HOSPITAL: And right now we have about 52 specimens in here, we're about to -- that we're preparing to test at the moment.
MARQUEZ: The hospital following Centers for Disease Control Guidelines on who gets coveted tests. Patients admitted for possible coronavirus, health care workers showing symptoms and symptomatic long-term patients. Each test a laborious and time-consuming process.
LEGOUN: Very easy to make a mistake, very easy, just from an extra milliliter of reagent, adding it to the machine, can mess up the entire, all the batch, entire batch, all the 52 specimens we would have to start all over from the beginning.
MARQUEZ: E.R. doctors are used to stress. Dr. Mollette says she has never experienced anything like this.
MOLLETTE: I don't really sleep that well at night. I worried about my family. I worry about my safety. I worry about my colleagues. I worry about how the shift is going to be the next time I come. I worry about if a family member is going to come and be a patient as well, fall victims to the coronavirus. I worry about a lot of things.
MARQUEZ: The disease, a marathon that health care workers alone cannot win or even finish.
MOLLETTE: It's not up to just only to the emergency department to pull through to make sure the curve is flat, and this is a responsibility for everybody in the country to help us pull through. So --
MARQUEZ (on camera): So stay the "F" home.
MOLLETTE: Exactly. I'm very calm.
MARQUEZ: Is that literally -- I mean, how --
MOLLETTE: No. Stay the "F" home, exactly. Exactly. Because it's not just on -- it's not just us that has to help flatten the curve and take care of everybody. Help us help you.
MARQUEZ (voice-over): She says it will take everyone pulling together.
The worst day she fears are still ahead.
MARQUEZ: Now, what is most shocking about going to that place, we went in, in full protective gear, the proper protective gear that was necessary. The people who work there, there are thousands of employees, they all need masks, they all need goggles, they all need gowns every single day. They don't have them.
They looked at us as though we were wearing the gold standard and they were almost jealous that we had it. Many people there telling us they go to home depot, eBay looking for stuff to buy and help others there at the hospital -- John?
KING: We hope that supply chain improves in the days ahead.
Miguel, thanks to you and your team. It's critical we actually get to see this. That's brave reporting. We appreciate it. It's critically important. Hats off to those workers, the nurses, the guys mopping the floor. It is remarkable what they're doing.
Up next, from New York to California, hospitals filling up there as well. I'll talk to an emergency room doctor about lessons learned and about the efforts to try to flatten the curve.
KING: California is now the nation's social distancing The Bay area was the first region in the country to impose shelter-in-place. Then it was adopted by the entire state. California the first statewide order covering 40 million residents.
As of now, over 5,200 cases in California, and, sadly, 118 deaths. Those numbers are well below what we see in New York. The big question is: At what rate will the California numbers climb in the days and weeks ahead?
Joining me now, Dr. Jonathan Gelber, an emergency room physician in Oakland, California.
Jonathan, it's good to see you. It's been too long. I don't like the circumstances.
Let's go through your experience. Your COVID-19 case load --
KING: Your COVID-19 caseload has been steady but not yet overwhelming. You believe that time has helped your hospital learn valuable lessons.
Let's start with patient care. On patient care, what have you learned in your drills from studying New York?
DR. JONATHAN GELBER, EMERGENCY ROOM PHYSICIAN: I think studying New York has been especially valuable, like Elmhurst Hospital in Queens. The hospital I work at, Highland Hospital in Oakland, is a safety net hospital. We do care predominantly for vulnerable patients, patients with unstable housing or the homeless.
And that helped us tremendously work a plan for discharges when we tell people shelter-in-place to make sure people have a place to shelter-in-place in. It's a lot easier to tell someone like me to go hang at home and get food delivered. It's a little harder when it's a 55-year-old gentleman who lives under a bypass with 15 other people.
We've learned how to plan for that and see our problems ahead of time before they arise, saying, hey, how do we keep the curve flat. How do we keep patients like this from infecting other patients at shelters, at homeless encampments, as well as the general patient population? And how do we keep the people in the emergency room safe from infecting each other, and in the lobby from infecting loved ones who are coming to visit?
We've learned a tremendous amount from our colleagues in New York, in Italy, China, Korea, all over the globe.
KING: I want to follow up on that, in terms of protecting the patients and all the people in the hospital.
KING: You're at a huge risk. The latest numbers from Italy are just stunning, 8,000 medical workers have contracted the virus, 61 have died.
You tell me you've studied how they were doing things and you're making big changes because of them that you think will help protect you and your colleagues. Tell me about those.
GELBER: Absolutely. First of all, we found that simple things that protect patients protect us. As simple as when someone comes into the E.R. lobby, they get a mask. It sounds super simple, but if you assume that everybody has some potential for having COVID-19 and put on a mask, little things like that can help reduce spread.
But in addition to the things we're doing to keep ourselves safe, in addition to PPE, personal protective equipment, we're making huge changes in the way we organize our emergency department and the way we approach somebody who may need life support for treatment of their COVID-19.
For example, that when somebody needs a breathing tube put in, it needs to be a little bit of all-hands-on-deck scenario. Medical students, residents, attendings, respiratory therapists, everybody coming in to lend a hand.
We're limiting the number of people in the room. We found that things like putting in a breathing tube is a completely high-risk procedure for health care providers, so we're limiting the number of people in the room. We're using video-assisted technology as much as possible to not physically look into the airway and be exposed to viral particles.
And we're making sure that people who are performing these procedures are wearing powered air purifying personal respirators to make sure we limit our exposure as health care providers.
KING: All right.
GELBER: These are things being done in Italy and China and now being done in the U.S.
KING: I want to ask you a question about non-COVID patients. You wrote to me about the stress of treating people in your area. A man comes off the street with a heart condition. You treat that people and they leave the hospital. Your fear is you're sending them back to a shelter or on the streets who are now immunocompromised where they could be exposed and at risk.
How do you handle that?
GELBER: That's a great question. That's one we're grappling with now. Communities like L.A., Chicago and San Francisco, we have a tremendous number of social workers, county administrators, docs and nurses working to make sure we have housing set up for these vulnerable populations.
As you said, it doesn't do much good to either the person I'm quarantining that I'm sending back to a homeless shelter or his bunkmate who is 60 years old, has heart disease, if I just return someone who I suspect has COVID to a homeless shelter.
As of now, we're working on a 100 to 200-bed motel/hotel setup where we arrange transportation, food, resources and possible transportation back to the hospital to allow people to effectively self-isolate and quarantine.
So to make sure that things like self-isolation and quarantine isn't just reserved for people like me, but to make sure our most vulnerable people we care for every day at hospitals like Highland and Elmhurst have the same level or chance to self-isolate just like I do.
These are some of the patients who are at the highest risk of potentially dying from COVID. These are patients who are elderly, have many medical morbidities. These aren't people in the 0.02 or 0.03 percent mortality risk like someone like me. These are ones that are much higher, at higher risk of really bad outcomes.
We're doing what we can to keep them safe at home and in a safe living environment.
KING: Dr. Gelber, we appreciate your insights. Keep in touch as the California challenge increases in the days and weeks ahead. I really appreciate it.
GELBER: Thank you.
KING: Most of all, stay safe as you take care of people.
We'll take a quick break. When we come back, more on the president's reaction. This includes a call to governors right now.