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Field Hospital Set Up in New York Central Park; Experimental Treatment Uses Blood Plasma From Survivors. Aired 2-2:30p ET
Aired March 30, 2020 - 14:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. ANNE RIMOIN, INFECTIOUS DISEASES SPECIALIST: We know if people do the right thing, if people social distance, if we prepare the hospitals well, we can reduce spread and we could reduce mortality. These are all things that we have under our control.
And that's why I think that what Cuomo was saying is very, very important. Stay home. Do the things that we can do. We are not powerless. And if people do what they are supposed to do, and we can prepare our hospitals, give them the PPE, get the ventilators in place, you know, we can have an impact on this.
These models are not our destiny. They are our future if we do not change what we're doing right now.
ANDERSON COOPER, CNN HOST: Yes. Dr. Rimoin, I mean, that's one of the things that gives me hope in all of this is that science actually -- this is not a complete mystery. Science knows how to attack this. They know how to deal with a virus like this. It's just difficult. And you know, it's painful and it has economic ramifications.
But this is not something that we are flying blind in -- and that personally gives me hope. What's important is for everybody to take part in, you know, staying at home and social distancing if you are outside.
RIMOIN: Exactly. I think, Anderson, you've been to Congo, even my own site in the DRC and you can understand, you know that what we have in other places that we may have not had to do here before is to work as communities working together to reduce spread of disease. This is something new to the American public, I think.
And I think this is where we can make a very big difference. We have infrastructures in place that need to be bolstered, and so we need to be able to get on top of it. We need more PPE. We need universal testing, because that's another piece that we have not talked about yet today, which is that we don't really know where we are on this curve because we don't have the universal testing yet.
And anything that we know today is only about what's happened in the last two weeks. So what we need to be doing, we need to be hitting hard and I think that Cuomo is making this point clear. Stay at home. Let's get the testing ramped up. Let's have a coordinated effort in place. We can't have people, you know, different hospitals doing different
things. We need to be working together. I think his message is clear and very sound.
COOPER: Yes, Dr. Hotez one of the things, you know, let's talk about that testing that Anne mentioned, because that is so important.
I talked to Bill Gates about this last week and Dr. Fauci, one of the things Dr. Fauci, said is, in states that haven't seen a large number of cases, largely because they don't have testing or widespread testing., but in those states, Dr. Fauci was saying it is very important that there is significant testing going on to get a full picture of what's happening, and even testing in the general population, so you get kind of a sense, overall of the size of this thing.
Last week, Fauci was saying that really isn't going on to the extent that they would like to see it in a lot of these states.
DR. PETER HOTEZ, PROFESSOR AND DEAN OF TROPICAL MEDICINE, BAYLOR COLLEGE OF MEDICINE: Yes, he is absolutely right. I mean, what we're seeing is too often, cities are first learning that they have a COVID- 19 epidemic when patients are showing up at their Intensive Care Units and we're seeing this play out in New Orleans, in Atlanta, possibly Detroit.
And by then -- it's not that it's too late, but then you're really playing catch up and it makes things very problematic.
So, you know, we continue to hear testing, testing, testing and it is starting to happen. Admiral Giroir is making progress on this, but I think we have to go to a backup plan and start looking at what I call syndromic surveillance, that is having sentinel sites where we monitor patients that are coming in to emergency rooms and outpatient clinics with fever and cough.
And the CDC has a lot of experience of this through their influenza surveillance. We have to expand that for this purpose. And I mentioned this new app platform for identifying the first sign of fever and infections.
And the reason that's important is if we rely only on testing, we seem to be missing some very important urban epidemics, and this is what we're dealing with now here in Houston, Texas, where we're seeing an increase from 69 patients to 232 patients. Is that significant or not?
I mean, could it be that now tomorrow, we're seeing more and just relying on the hoping that testing will expand will not do it for us.
So we have to build in now a new type of system around syndromic surveillance.
COOPER: Yes. Dr. Hotez, I appreciate it. Dr. Anne Rimoin as well. Thank you so much.
Also today, New York officials are getting ready to open a field hospital built in New York Central Park. We are going to go to CNN's Erica Hill who is at Central Park.
So another field hospital -- how many people can this take? Obviously the U.S. NS Comfort also arrived. Talk a little bit about what's happening in Central Park.
ERICA HILL, CNN ANCHOR AND NATIONAL CORRESPONDENT: So we're seeing here in Central Park and this should be operational by tomorrow, Anderson. The tents behind me will have 68 beds, but what's different about this field hospital as opposed to the Comfort or even what we're seeing at the Javits Center, these are beds that are specifically for coronavirus patients.
Now, just behind those tents is actually Mount Sinai Hospital. So some of their patients could come over here. Last check on their website, they had about 1,200 coronavirus patients, they were saying.
So again, these beds will be for coronavirus patients specifically. What we're seeing in some of the other field hospitals, these overflow areas is that patients can go there who are not dealing with coronavirus, which obviously then frees up beds in the hospitals and also allows them to be in an environment where hopefully, there is not as much of that virus, it is not spreading in the same way for healthcare workers who are on board that ship or even over at the Javits Center.
COOPER: Erica, it's extraordinary in New York Central Park to see hospital beds being constructed, hospital tents being constructed.
HILL: Yes, it really isn't. And my producer, Elizabeth and I were just talking about that about how odd it seems. You almost feel like you're watching a movie, whether it's, you know, honestly "Gone with the Wind" or something from World War I. The thought of Central Park now being home to hospital tense really does take a moment to wrap your head around, especially as, Anderson, and I know you were talking about this a short time ago, life is sort of continuing almost as normal in Central Park.
There are fewer people here, but there are a ton of people out right now. They are running. They are riding their bikes. I still saw kids on the playground, which is interesting, too as you hear Governor Cuomo and Mayor de Blasio continue to drive home this message of stay inside. It's not just about you. It's about the people around you, as well -- Anderson.
COOPER: No, social distancing outside -- when you are outside. Erica Hill, thanks very much. Also from New York comes a warning from an emergency room resident doctor at Elmhurst Hospital in Queens.
Governor Andrew Cuomo just said the hospital is struggling as doctors have called it apocalyptic. Dr. Fred Milgrim writes in "The Atlantic" magazine, "We are overwhelmed. There was a time for testing in New York and we missed it. China warned Italy. Italy warned U.S. We didn't listen. Now the onus is on the rest of America to listen to New York." We wanted to listen to Dr. Milgrim and hopefully the rest of the
country hear what he has to say. Dr. Milgrim spoke -- I spoke to him earlier.
COOPER: First of all, thank you so much for what you and the nurses and the lab folks and everybody at the hospital are doing.
I wanted to talk to you because what you wrote is truly -- it is extraordinary what you and all the medical professionals are doing every day.
You say the nation needs to listen to and watch what's happening right now in New York. Just talk about that a little bit.
DR. FRED MILGRIM, ER DOCTOR, ELMHURST HOSPITAL: Yes, so we're seeing obviously a huge influx of patients. I think part of the numbers that you're seeing In New York is the increased amount of testing and Governor Cuomo has obviously put a huge emphasis on that.
But we're also seeing it inside our hospitals. You know, work in a city hospital in Queens at Elmhurst, which, you know, we're already under resourced, and we see lots of patients.
But we're definitely seeing a lot more and the majority of them are coming in for concern about coronavirus, and many of them do have it, unfortunately.
COOPER: One of the things you wrote in the article was, you know, you don't want to see people in the hospital essentially, don't come to the hospital, unless you know, you really need to come because you described a situation, and you've talked about it a little bit about the waiting room is packed with people.
And one of the things you wrote you said, "If they didn't have coronavirus before they came to the hospital. They probably do now because they're waiting for up to 10 hours."
MILGRIM: Yes, so I want to start off by saying that things have gotten better from that standpoint since the article was written, since a lot of the press came out from "The New York Times" as well.
We have seen a decrease of the busyness of the waiting room both because we now have tents outside that are doing testing, thanks both to our own tent and also to F.E.M.A.'s assistance.
But as I described in the article, you have lots of people sitting in the waiting room coughing, and unfortunately, the waiting room itself can be a vector of sorts for passing on coronavirus.
Thankfully, we've managed to shrink those numbers from what was sometimes 150 or more patients, now down to 50 or fewer because we are able to redirect people towards testing because a lot of people are coming in just because they would like to be tested. COOPER: So even though there have been, you know, countless
announcements of, you know, don't go to the hospital unless you really need to. Don't just come to the hospital because you want to get tested, people are still coming in and just asking for tests.
MILGRIM: I think that definitely people are coming in out of fear and we completely understand it. It is a concerning time. People are hearing a lot about what coronavirus can do to you from a respiratory standpoint.
MILGRIM: I think one of the most challenging things about working in Queens is that the messaging, maybe is a little bit tougher to get out.
We take care of an amazing population of folks in Queens, but it's the most diverse zip code, I think in America, if not the world. It's truly, truly a melting pot.
And for that reason, the language barrier and potentially lack of primary care can lead to a lack of dissemination of information to not come to the hospital unless you really are short of breath and need emergency care.
Nevertheless, we are going to talk to those patients, reassure them and if they need care, obviously we will be taking them into the hospital.
COOPER: What were, you know, the lessons of Italy that that we didn't listen to what did we not learn in time? Clearly, testing was a huge problem here, a huge issue and equipment as well.
MILGRIM: Yes, so I think I did say in my article that the time for testing is passed. I'm not saying the testing isn't still vitally important. I'm just worried that people were going to come to the emergency room for testing, when we really need to be focusing our work on treating those who are actually sick.
I do think testing should continue to happen around the country. But the thing about Italy that really struck me, I listened to a podcast from the daily "The New York Times" podcast, interviewing one of the Italian doctors describing the situation there, and this was about two or three weeks ago.
And from the things that I heard him describing, as I was working at Elmhurst day in and day out, I could see the beginnings of those things starting to happen, and I already knew it was too late at that point because the influx I think had already began.
COOPER: And also, I mean, one watches the recommendations from health officials change and you get the sense that it's obviously not necessarily best practices. It's because equipment is short and you write in the article about how early on, you would change your PPE, your personal protective equipment after every patient.
Now, or at the time you wrote the article, you keep the same stuff on all day long.
MILGRIM: Yes, so that is typically how N-95s are used in the hospital. The thing that we use them most often for is when you have a patient who you suspect that has tuberculosis, because that, as we know, is an airborne pathogen and can be passed just by hanging in the air.
So typically, we'll put those masks on, go into a negative pressure room, assess a patient come out, take the mask off and throw it in the trash. And that's when we have enough equipment for that typically.
Now, because we're wearing these N-95s for every patient encounter, it would just be far wasteful to be taking those masks off at all times especially because we now have entire areas of the emergency room dedicated to taking care of coronavirus patients.
It would be both unsafe to us to be taking off the mask at all times and also potentially a resource stuck if we were to get -- to take off all those masks every single time.
COOPER: If you can talk to me about what you've learned about this virus, what you've seen in terms of the speed with which it can change a person's status? You write about, I think it was a woman coming in. She was basically discharged even before she actually got picked up from the hospital, he fever spiked, to I think was to like 102.
And then basically she got admitted and then I think, it was shortly afterward you saw her being wheeled with somebody on top of her doing chest compressions.
MILGRIM: Yes. That was obviously a very unfortunate case. She was older and she did have some medical comorbidities. But I think, we know already that the disease progress; around Day 5 is when you start to really see symptoms.
And then within about 10 days of symptom onset, your lungs really start to feel the effects.
But nevertheless, it's affecting different people in different ways, we know that older folks with comorbidities are more greatly affected, but we're seeing pretty extensive disease in younger folks as well.
Fortunately, you know, by treating them, I think they have better outcomes potentially. But it's very complicated and there's no one pattern that we're seeing necessarily for every single patient.
COOPER: How are you and the other medical professionals -- I mean, how are you -- I mean, how are you doing?
MILGRIM: I think so, for myself, I'm a first year resident. My co- residents are all really stepping up to the plate and we're working our normal schedule. I think the shifts themselves are a lot more grueling than usual.
It's definitely taxing when you're keeping that mask on at all times with a face shield over it. Your goggles are fogging up, that can be tough.
MILGRIM: And you know, I really want to commend everyone else in the hospital. Our attending doctors are taking extra shifts. The hospital is really well staffed in the emergency room right now because the attendings are stepping up and obviously our new nurses are working so hard, our techs, administrators. Everyone is really stepping up to the plate.
But I think there's a lot of fear, understandably so. But right now, everyone is sort of getting each other through this and trying to keep our chin up.
COOPER: Dr. Fred Milgrim, I appreciate all you, you and your colleagues are doing and you're keeping people alive. It's incredible. Thank you very much.
MILGRIM: Thank you so much, Anderson.
COOPER: Yes. Amazing. Doctors all around the country. Some families are now pinning their hopes on an experimental treatment to fight coronavirus.
I'm going to speak with the wife of one patient who is fighting for his life.
Plus Amazon workers in Staten Island, New York staging a walkout after reports that employees had tested positive. I'll tell you what they're demanding before they're willing to come back to work.
COOPER: As the coronavirus continues to quickly spread around the world, doctors are racing to find new medicines to try to treat patients.
Developmental treatments are being researched and one of those treatments was just approved by the F.D.A. under emergency protocols, plasma from patients who've recovered from coronavirus is injected into new patients who are infected with the virus.
The idea is that the plasma may have life-saving antibodies giving new hope to those stricken with coronavirus, of course and their families.
Joining me now is Amy Breslow. Her husband is currently in the ICU fighting coronavirus. Amy, your husband Brett, how is he doing?
AMY BRESLOW, HUSBAND IS IN ICU WITH CORONAVIRUS: We had a little bit of encouraging news this morning. He is a fighter. Some of his labs are improving. But you know, the doctors tell me that he's still very critical, and they're taking excellent care of him in the ICU. I am, you know, forever grateful to them for that.
But he is really fighting this virus. It has really attacked his lungs very quickly.
COOPER: You know, there's a lot of people out there listening and I think you have information that can help them just in case one of their loved ones gets ill.
Your husband Brett is 50 years old and doesn't have preexisting conditions. He's a Navy veteran, first served in the first Gulf War. Just talk a little bit about -- you know, he started feeling badly.
I know he was tested initially for the flu because there weren't actual tests that were available for coronavirus where you are. When did you realize that he needed to go to the hospital?
BRESLOW: I want to say Thursday, March 19th, he started with a little cough and shortness of breath and then the following day, we were able to arrange for him to have a coronavirus test in the afternoon and after that that Friday evening, the 20th, he just became much worse and I took him to the emergency room that night.
They would not allow me to accompany him into the ER. The hospitals were on lockdown due to the virus, so I watched from outside while they checked him in and took him back in a wheelchair to see the doctors.
I went back out to my car and I texted him to let him know that I was there and to keep me updated, and he texted me back and he told me, they put him in a room and that I should go home, and that he loved me.
And that was the last time I communicated with him. I haven't heard from him or seen him since that time.
COOPER: I mean, to not be able to be there, it's just -- it's one of the horrible things for families going through this. Your husband is waiting for this new experimental treatment. Do you have any idea when it could start?
BRESLOW: Well, we ran into some issues being able to have some donors that we had located give plasma. So at the present time, we're working with the American Red Cross. There will be a donor form that will be posted online this afternoon.
And the Red Cross has informed us that they are launching a website shortly so that donors are able to get additional information and sign up to donate.
COOPER: And who can donate?
BRESLOW: They worked very, very hard -- I'm sorry -- with all the reps in our state and the governor to get this accomplished, it's really been a whirlwind the last 24 to 48 hours.
COOPER: Who can possibly donate plasma? What are the requirements?
BRESLOW: So, the initial requirements that we were told where you had to test positive initially for coronavirus, and you need to be 14 days symptom-free in order to give. There may be some additional restrictions that the Red Cross will put on their website, so that's why we want to get the information out there so anyone who signs up to donate that they know that they're eligible, too.
COOPER: So you need to have had the virus and have 14 days where you're symptom free?
COOPER: Well, Amy, I hope this -- I hope this gets online quickly and that a lot of people are able to donate plasma and that this works and we wish you and Brett and your whole family just the best and we'll keep in touch with you.
BRESLOW: Thank you very much.
COOPER: Thank you, Amy. I appreciate it. Stay strong. More than 60 doctors have now died in Italy after treating coronavirus patients.
Here in the U.S., some healthcare workers who may be positive are being told to come back to work as long as they're not showing symptoms.
I'll speak to a doctor in Atlanta who is facing that situation. We'll be right back.