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U.S Death Toll Surpasses 3,000 After Deadliest Day; Trump To Formally Unveil New Distancing Guidelines Based On Models; E.R. Nurse Says, Health Care Workers Are All On Edge. Aired 1-1:30p ET

Aired March 31, 2020 - 13:00   ET




ANDERSON COOPER, CNN ANCHOR: I'm Anderson Cooper. This is CNN's continuing coverage of the global coronavirus pandemic.

Right now, the grim reality, more than 174,000 cases here in the United States and more than 3,400 deaths thus far. Monday was a single deadly day for the United States so far. New York getting some good news as they opened a new field hospital in Central Park. The rate of infection is slowing slightly. It's still going up, it's just going up at a slower rate.

Gvoernor Andrew Cuomo says it is still an uphill battle. He also pointed out the problems with the procurement process right now and the competition for critical medical equipment, competition between states. Take a look.


GOV. ANDREW CUOMO (D-NY): So you have 50 states competing to buy the same item. We all wind up bidding up each other and competing against each other where you now literally will have a company call you up and say well, California just outbid you. It's like being on eBay with 50 other states bidding on a ventilator.

And then FEMA gets involved and FEMA starts bidding. And now, FEMA is bidding on top of the 50. So FEMA is driving up the price. What sense does this make?


COOPER: Well, Tennessee has now become the latest state to issued stay-at-home order for residents. Three of every four Americans are now under stay-at-home orders. 15 days ago, Presidnet Trump issued his 15-day guidance on coronavirus. Today, the White House is expected to reissue the guidance with possible tweaks. The president has already said he wants to extend the guideline to the end of April.

In New York, the massive hospital ship is ready to receive the first patients from overcrowded hospital. Our Shimon Prokupecz is there for us.

So, Shimon, who is being transferred to the thousand-bed floating hospital? Have patients already begun to arriving?

SHIMON PROKUPECZ, CNN CORRESPONDENT: There are no patients. We have not received any patients yet. There is no word that the ship here has received any patients. What they are doing, as city and state officials, and I talked to state officials about this, is they're doing what's called decanting. And, literally, that's the word he used.

And how they're going about it is they're going to COVID hospitals, hospitals that have a large amount of critically ill COVID patients and picking out patients who are not suffering from the coronavirus, who are not COVID positive, they're plucking them out and are going to eventually bring them to the field hospitals across the state and across the city, like the ship behind me, and also the Javits Center, just about 30 blocks from here.

The point is to relieve the stress, the pressure that you heard the governor talked about that a lot of the healthcare officials are facing and having to deal with some of the most critical patients as a result of the coronavirus. These are patients that are on ventilators. That is the big thing. They require a lot of care, a lot of attention, a lot of staff members, nurses and doctors and other officials in hospitals to take care of them. They want to relieve some of that pressure.

So what they're doing is they're going through all these hospitals looking for patients who fit the criteria and then will move them to places like the ship behind me, Anderson.

COOPER: All right. Shimon Prokupecz, I appreciate it. Thanks very much.

Some news just in on how long the White House will recommend that Americans continue social distancing. CNN'S White House Correspondent, Kaitlan Collins, joins me now live.

So, Kaitlan, what's the latest on this?

KAITLAN COLLINS, CNN WHITE HOUSE CORRESPONDENT: Yes, Anderson, they're going to reissue these guidelines that you heard the president announced on Sunday. Somewhat surprisingly to some people that he was going to extend them for another 30 days. We are expecting them to largely look like what they gave us about two weeks ago, though there could be a few tweaks to that.

But what is interesting is we are expecting to get a first look at these models that the president in part based his decision on. These are these models that you've seen Dr. Fauci and Dr. Birx talking about the ones that predicts that even if the social distancing measures are executed perfectly, still 100,000 to 200,000 could potentially die.

So expect some pretty grim figures coming out of that and what it is that the president has been looking at, because we know it was not only these charts that played a factor into the president's decision but also those images of that Elmhurst Hospital in New York, just a few miles from where the president grew up and also polling that was shown to him that showed that most Americans actually favored keeping those stricter measures in place for now.


Now, the thing you have to consider when you are going to be looking at these models, we don't know exactly how they're going to show it to us today, Dr. Birx just said we would get some kind of a look at it, is that they are not universally believed inside the West Wing. There are some people, members of the president's coronavirus task force who believe these models have actually been overblown and they're not entirely accurate. So they actually had some people who advocated for the president only extending these guidelines for another 15 days, not another month.

But then, of course, in the end, the president decided it was better to go longer than to go shorter and be able to ease them earlier than have to add in more restrictions later on. So that's why they haven't gone there yet.

And, of course, these models though are not -- they can't be entirely accurate because they are basically predicting what could happen. They're working off of new information that's coming in by the day. But that is what we are expecting for now to see at this briefing that we are going to have at the White House this afternoon.

COOPER: And, Kaitlan, is there talk among people in the White House or the president's team about just having nationwide guidelines on stay- at-home? I mean, I know it's up to governors right now. It does seem -- you have talked to experts, I've talked to Bill Gates about this last week, and he was pointing out it's got to be something that's done nationwide. Because if some states don't start to do this until a few months from now, it affects everybody else who's already been staying at home.

COLLINS: Yes. And that's why people were so confused when you saw the president pin that letter to governors saying they were going to classify counties potentially by high-risk, medium-risk, low-risk. The doctors and the health experts did not think that was going to be an effective strategy because they said it's so easily spreadable and it's really hard to contain people in situations like that.

So there actually has been discussion of a nationwide, not lockdown, I don't want to say, per se, because they were essentially can only be guidelines. They don't actually think that the president can enforce that. But the president himself has not been a fan of pursuing that route.

He said yesterday he still thinks it's unlikely that they would go that way. But it has been under discussion at times, because people like Dr. Fauci and others have said they do think that -- they agree with Bill Gates. They think that would be a more effective method. But right now, that doesn't seem to be the case.

And, of course, Anderson, we still have to question what the president's mindset on all of this is going to be, because just days ago, he was still hoping for that Easter date. There was that turn around over the weekend. And so the question is what's going to change as they are getting new images, new data over the next several days.

COOPER: Kaitlan Collins, I appreciate it. Thanks very much.

And these models that Kaitlan mentioned were on the April 30th recommendation by the White House task force. Take a listen.


DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS TASK FORCE: And when we finished the other group that was working in parallel, which we did not know about, HIME, and Chris Murray ended up at the same numbers. And so if you go on his website, you can see the concern that we had with the growing number of potential fatalities.


COOPER: The man that Dr. Birx just mentioned in that, Dr. Chris Murray is with me now. He's the Department Chair and Professor of Health Metric Sciences at the University of Washington. Also with us is our CNN's Chief Medical Correspondent, Dr. Sanjay Gupta.

Dr. Murray, your numbers certainly paint a sobering picture of what lies ahead. In just a little more than two weeks, April 15th, according to your estimate, the U.S. will hit peak use of its hospital beds, the ICUs and ventilators. The country will be about 60,000 beds short of what's needed. You also project the nation will see nearly 84,000 deaths by August 4th. If you could just talk a little bit about sort of how you've come to this and are this number, this idea of 84,000 deaths by early August, is that based on the idea of current social distancing as it now continues or that it becomes more strict or less?

DR. CHRIS MURRAY, FOUNDER AND DIRECTOR, INSTITUTE FOR HEALTH METRICS AND EVALUATION: So this is a planning model. We started out from -- to help hospitals, our own hospitals here at the University of Washington planned (ph). So we are trying to make the best possible predictions of what the course of the epidemic is going to be.

And when we've done that, we've made the assumption because we actually think this is what will happen that social distancing, including the stay-at-home orders, will continue to the end of May. And those states that have not put them in place already would put them in place within a week.

And we run the models every day, and the website reflects up-to-date information. So when states do put them in place, that does change the forecast somewhat.

COOPER: Do you think all states by the end of next week will have them in place?

MURRAY: Well, as we the numbers go up, I think the public's concern rises. And that's what we built in.


And if we get better information, we'll include that. But that's the basis of our 84,000 deaths by early June.

COOPER: Sanjay, one of the things that so, I think, extraordinary about this, to me, is that all states do not already have stay-at-home orders in place. I mean, every scientists I've talked to, and Dr. Murray has just said this through the modelling, every scientists have said, and, Sanjay, you know this better than anyone, has said this needs to be nationwide. Because even if states don't have a lot of numbers yet, a lot of people testing positive, they just don't have a lot of tests.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes. Look, I mean, that part is quite striking to me, Anderson, given that what we have seen in this country, what we've seen around the world, even here, I'm in Georgia now, there is not a full sort of stay-at-home recommendation for the state It's only for the elderly and people who have some pre-existing condition.

So it's striking that people are still trying to sort of balance, I guess, this idea of public health of the economy, you know? It's important to point out, I guess, Professor Murray just said, until the end of May is what he's basing these models and not the end of April, which is what we currently have for the country.

So I think if it happens within the next week, that's great. It's, I think, to your point, Anderson, very surprising to me. At this point, three months into this with all that we have seen that there are still governors out there who aren't recommending this and, frankly, that we haven't done this as a country yet.

COOPER: Yes. Dr. Murray, we just saw the governor of Kentucky, he was on with John King in the last hour, he has instituted and early on instituted, and the governor of Tennessee has just instituted Tennessee, and you can see the difference already between Kentucky and Tennessee because of social distancing. It has had fewer -- less of a rise, where Tennessee has had much more of a rise in the number of cases.

If your modelling right now is social distancing until the -- or stay- at-home until the end of May, if in fact the president decides at the end of April to end it, the death toll will go up based on your modelling, correct?

MURRAY: The death toll will go up. In fact, we are trying to produce that scenario about what would happen if there was an earlier release of social distancing. And by the end of April, some states will be down to a pretty low case number. Out here in the west, it seems like social distancing has been working at least in lowering the trajectory of the cases.

And the big question would be if some do it, some don't, you get reintroduction of cases from those where the epidemics are going longer and going to get to a larger peak.

COOPER: Sanjay, and I know you've got questions for Dr. Murray, but, again, I just don't understand logically. Science knows what works. We know scientists know what works in stopping this virus and lessening this virus. The idea that we are not following science is just stunning to me.

GUPTA: Having talked to a lot of people who some of whom are at the heart of making these decisions, I think sometimes they look at the social distancing states that have done this and are still saying -- expecting to have shown significant results right away, I think, not fully understanding that it does take time to see the impact.

We are, as you pointed out, Anderson, seeing the impact in some states, but I think some people are still looking at that and saying, well, we are not doing anything different in our state and we have the same transmission numbers as them, so why do we need to change, why do we need to be more aggressive. That's a flawed way of thinking about it, don't get me wrong.

But I'm wondering, Professor Murray, if I could ask you a question, I guess, models, one of the things about models is they're only as good as the assumptions that you put into them. And one of the things that's happening with regard to hospitals now is that you are seeing increase hospital capacities starting to happen, in New York, for example, the Javits Convention Center, these hospitals, these field hospitals in Central Park, does that fit into your modeling in terms of shortages and things like that?

MURRAY: So because every state has a different testing regime and different access to tests, we don't put a lot of confidence in the case numbers. We decide to build the model for (INAUDIBLE) of death numbers, because they are much more reliable. Because even tests are scarce, the very sick are getting preferentially the tests.

So we track the epidemic by deaths. And as the epidemic rolls in and the death numbers go up, we are able to back in from the death forecast, the hospital use, the ICU use and the ventilator use that's required.


And as more data comes in everyday, we are getting much better information by states to the practice pattern. What fraction do people need a ventilator, how many are very sick, needs oxygen, and that's why we are updating our forecast every day to try to reflect all that new information that's going in.

But you have to be careful to not overinterpret the case or misinterpret the case numbers because they are such a function of skeptic.

COOPER: Dr. Murray, just quickly, if other states who have not instituted stay-at-home orders, if they say, it takes them three more weeks to institute them, does that extend the time that all the other states then have to maintain stay-at-home orders so that there is a countrywide stay-at-home?

MURRAY: Yes. This is a tricky thing. And I think the short answer to that is probably yes. I mean, even in a -- if you go back to Wuhan on January 23rd, they put in place social distancing. It took four weeks from then for deaths to peak and for it to go down. So there is a long lag but it works.

Now, if we start to see places that don't put in social distancing, they have larger and later epidemic, the risks for other states where we started earlier and the epidemic seems to be coming down when that starts to happen, it's going to be a very significant risk. And I think the other -- there are two sides (ph) there. Everybody keeping social distancing in place until every state is under control, until the nation is under control. The other possibility is really strategic math testing, contact tracing and quarantine and control of people coming in and out of state.

Something has to be done to stop the infection coming back and going back to the community spreads. Because even when you get to June, the vast majority of Americans will not be resistant. They would not have been infected. And so you will have a susceptible population that didn't -- you know, if it gets back in the community, we could be right back to where we are now in July or August.

COOPER: Well, that obviously argues for, again, nationwide, everybody being on the same page in terms of staying at home. Dr. Chris Murray, thank you for all you are doing. I mean, your modeling is extraordinary. We really appreciate it. Dr. Gupta as well, thank you so much, Sanjay. We'll talk to you later.

Should average Americans be wearing masks right now, the debate growing on that, which just took a new turn as Dr. Fauci weighs in.

Plus, I'll speak live with an E.R. nurse who said she and her colleagues are on edge and the lack of testing is a big reason.



COOPER: In the face of uncertainty and unprecedented upheaval of American life, the people are asked to step forward and step up. We are talking, of course, about healthcare workers who go to hospitals every day with an incredible amount of courage and determination to care for the sick, even as the critical equipment that would keep them safe is incredibly still in short supply.

Elissa Rill is one of them. She's an emergency room nurse at Northridge Hospital in Los Angeles. Melissa, you recently tested negative from coronavirus, I'm happy to say. You were feeling sick. I want to get to that in a moment. But I also imagine you and your colleagues are feeling -- I mean, I can't even imagine the range of emotions you all are feeling. Can you describe what it is like now in the hospital?

ELISSA RILL, E.R. NURSE, NORTHRIDGE HOSPITAL: I mean it's just this overwhelming sense of dread every time we walk onto the floor every morning, because we just don't know what to expect. It's are we going to have enough ventilators, are we going to have enough masks, are we going to have enough supplies? So, every day, we come out and we just don't know what's going to greet us. COOPER: I mean, history is not going to look kindly on our leaders for the lack of supplies that you and others are facing. Your hospital actually ran out of N95 masks. You got masks donated by the community, the local community, and that's why there are still currently mask, but I know they are being rationed. You are trying to come up with ways to stretch the supply.

RILL: Yes. I mean, so recently, the union that we're members of, SEIU 121RN, just acquired 39 million masks that they're shipping out to many of the hospitals. We have nurses that are going online to try to buy masks. We are contacting dentist's office and nail salons ourselves just trying to able to get all the masks that we need.

And it's sort of boggling to me that this is a national -- like why isn't our leaders that are doing this? Why is it that it's nursing staff ourselves that are the ones responsible for trying to find the supplies that we need?

COOPER: And the price of these things -- the White House held this press conference a while ago about price gouging and concerns of a price gouging, I mean, the price of mask that hospitals are being asked to pay has gone up ridiculous amount. I mean, it used to cost a couple of cents, less than a dollar, I think, for a mask. It's now gone up to several dollars. We just heard the governor of New York talk about how every state is having to try to negotiate for ventilators, and then FEMA comes in and tries to outbid states and it's this ridiculous system.


What -- we've heard officials say now that the majority of Americans don't need to wear masks. That's what they have been say all along, unless they were sick. There does seem to be now growing doubt about that among some people. And I want you to listen to what Dr. Anthony Fauci told my colleague, Jim Sciutto, this morning.


DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: The idea of getting a much more broad communitywide use of masks outside of the healthcare setting is under very active discussion.

The thing that has inhibited that a bit is to make sure that we don't take away the supply of masks from the healthcare workers who need them. But when we get in a situation where we have enough masks, I believe there would be some very serious consideration about more broadening this recommendation of using masks. We are not there yet but I think we are close to coming to some determination.


COOPER: If suddenly now everybody tries to get masks, that's going to lead for even more problems for healthcare workers.

RILL: I mean, I can understand though why people are afraid. We're inundated by images of people wearing masks. I think a lot of people know that hospitals are short of masks. So I can't fault people for wanting to try and protect themselves.

What I can fault is the fact that there's price gouging going on right now for the cost of masks. I'm sorry, how is it like allowed that companies that are making these life-saving medical equipment are somehow allowed to double, triple, quadruple the prices of something that we desperately need to protect ourselves and our patients?

COOPER: Yes. I don't know understand why that is allowed. It just shouldn't be especially, if this is a war, which it certainly seems to be, that shouldn't be allowed in wartime.

RILL: No. I mean, I just feel like a war. This is constant sort of like going into battle, feeling every morning when we go to work. And I don't understand -- well, it's like sending out your soldiers without the proper equipment. You wouldn't send a soldier out on to the battlefield with flip-flops. So why is it that we're forced to use the same respirator all day long?

COOPER: We're also asking soldiers to find their own bullets, find their own guns, find their own boots.

RILL: Exactly, yes. Right.

COOPER: Elissa, thank you for what you are doing, and it's extraordinary, nurses make the world go around. And thank you for keeping people alive and everything. And to all your colleagues, we wish you god speed and wish you stay healthy and stay strong. Thank you.

RILL: Thank you so much, Anderson.

COOPER: New field hospitals are being built in several states, the serious consequences for disobeying stay-at-home orders. We'll take you to the emerging hot spots across America.