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U.S. Records Deadliest Day; Top U.S. Doctor: Staying in Place Can Save Millions; 1 Ventilator, Multiple Patients. Aired 4-4:30a ET

Aired March 31, 2020 - 04:00   ET



ROSEMARY CHURCH, CNN ANCHOR: Hello, and welcome to our viewers joining us here in the United States and all around the world. You are watching CNN NEWSROOM, and I'm Rosemary Church.

Just ahead, coronavirus pandemic. The deadliest day yet in the United States, and one of its top doctors warns that after the apex the country will likely have to deal with round two in the fall.

Should we all be wearing facemasks right now? President Trump is considering it. The Czech Republic is mandating it. So how's it working for them? We will go live to Prague.

Plus, one ventilator, multiple patients. A doctor's discovery that could be a game changer in the battle against COVID-19.

And we begin in the United States where more than 3,000 people have died due to the coronavirus. Monday was the deadliest day yet with at least 574 deaths. And the rallying cry around the country is stay at home.

Even U.S. President Donald Trump took out that refrain.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: By very vigorously following these guidelines, we can save more than 1 million American lives, and this is a very vital 30 days. We're sort of putting it all on the line this 30 days. Over 1 million Americans have now been tested, more than any other country by far.


CHURCH: And right now, more than 3/4 of people in the United States are under some form of stay at home order. Life in cities, towns, counties has ground to a halt, but infectious disease experts say they had no choice. It was that or millions of deaths, and to make matters worse, we are looking at a potential round two in the fall.


DR. ANTHONY FAUCI, DIRECTOR, U.S. NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: In fact, I would anticipate that that would actually happen because of the degree of transmissibility. However, if you come back in the fall, it will be a totally different ball game of what happened when we first got hit with it in the beginning of this year. There will be several things that will be different. Our ability to go out and be able to test, identify, isolate and contact trace would be orders of magnitude better than what it was just a couple of months ago.


CHURCH: Meantime, New York is crying out for help.


GOV. ANDREW CUOMO (D), NEW YORK: If you don't have a health care crisis in your community, please come help us in New York now.


CHURCH: Doctors and nurses reusing protective gear and improvising when they run out of ventilators they are using anesthesia machines. Flying blind is what one of them told CNN.

In Central Park where one would normally see joggers or people sitting on benches, there are rows of hospital tents as hospitals run out of space, patients will be brought here for treatment.

Another doctor tells CNN, we are at the brink of not being able to care for patients.

And medical professionals keep repeating that same advice we just heard, stay at home. Listen to what one doctor told CNN's Don Lemon.


DR. CORNELIA BRIGGS, PEDIATRIC SURGERY FELLOW, COLUMBIA UNIVERSITY: It feels like coronavirus is everywhere and it feels like we have very little to protect us from getting sick ourselves as health care workers, but we are all trained and dedicated to the mission of saving lives, as many lives as we possibly can. And I want everyone at home to know that even though it feels like staying indoors and staying home and isolating yourself is futile, it's not. We need everyone at home to hold the line. Stay at home. Buy us time. Flatten the curve.


CHURCH: Stay at home. We need to do it.

But New York's cry for help has not gone unheard. Help is on the way. Health care workers from Atlanta boarded this flight to New York, reinforcements for the medical troops already fighting on the front lines of this coronavirus war.

And CNN's Nick Watt has more on how New York is coping with the coronavirus outbreak.

(BEGIN VIDEOTAPE) NICK WATT, CNN CORRESPONDENT (voice-over): A life lost in Brooklyn. One of thousands now across this country.

FAUCI: I'd like to avoid it, but I wouldn't be surprised if we saw 100,000 deaths.

WATT: Today, a Navy hospital ship docked in New York City.


UNIDENTIFIED MALE: The last time this great hospital ship was in New York was in the wake of 9/11.

WATT: A field hospital now in Central Park and fines for those who refuse to social distance.

MAYOR BILL DE BLASIO (D), NEW YORK CITY: The fines are in the range of $250 to $500. That will obviously be a violation, a summons that would be provided. I don't want to see that happen.

WATT: One research organization now projecting New York will reach peak death rate ten days from now at nearly 800 deaths that day. Michigan will peak a day later, California 25 days from now and Virginia not until mid May.

CUOMO: What you see us going through here you will see happening all across this country. There is no American who's immune to this virus.

WATT: In Michigan, confirmed cases exploded from around 50 to nearly 6,500 in two weeks.

FAUCI: We're also worried about Detroit. Detroit is starting to show some signs that they're going to take off.

WATT: State travel restrictions also spreading. Rhode Island now ordering all visitors to self-quarantine. They were just stopping cars with New York plates, and New York state threatened to sue. From noon today, anyone traveling to Texas from these states and cities must self-quarantine for 14 days, hot spots in all these places. And now, it's time we're told, for more rural areas to brace themselves.

DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR: If the metros and the rural areas don't take care now, by the time you see it, it has penetrated your community pretty significantly.

WATT: Louisiana today reporting 485 new cases and 34 deaths. Still, hundreds reportedly attended this church Sunday.

REV. TIMOTHY SPELL, FATHER OF REV. TONY SPELL, LIFE TABERNACLE CHURCH: The church is the most essential thing in all the world.

WATT: The pastor in Florida who once prayed over the president was arrested today for continuing to hold large services.

Doctors from the front line begging us all to stay home. DR. RAVI WETTASINGHE, MEDICAL DOCTOR: If you can think of it as your

lungs being filled by fluid, like you're drowning. And once you get to that point where you're drowning, you need a ventilator to stay alive, and we're running out of that equipment for people.

DR. BENJAMIN OBASEKI, MEDICAL DOCTOR: The one that's beeping in the background is a young patient who was presumably healthy before they came in. This is not something that's isolated to the old.

WATT (on camera): Here in the U.S., the federal government doesn't have any domestic travel restrictions in place, but the states are pretty much taking care of that themselves with these mandatory quarantine for people traveling in too many states.

But Monday, I think, a first, Kentucky, the governor has now banned all non-essential travel out of the state. They have a relatively low confirmed case. The governor doesn't want people leaving Kentucky, catching the virus, and then bringing it home.

Nick Watt, CNN, Los Angeles.


CHURCH: And officials in California are asking retired health care workers to come back to work and help fight the virus. So far, more than 3,000 medical professionals have volunteered to help. The city is also turning the Los Angeles Convention Center into a facility. The facility will be used to help patients who have the coronavirus.

Meanwhile, those already on the front lines are being stretched thin. Eighty-six employees from Vanderbilt University Medical Center in Tennessee have tested positive for the virus. And in the Boston area an even bigger number, 345 health care workers have tested positive for COVID-19 across four area hospitals.

Police forces are also struggling. There have been 29 new positive cases in the Chicago Police Department, bringing the total number there to 50. Meanwhile, in New York, two more NYPD officers have died, bringing the total number to five. Nearly 1,000 employees have the virus with more than 5,000 currently out sick.

Louisiana is emerging as a new hot spot for the virus. And scenes like this are not helping.

Authorities say more than 100 people took part in a funeral second line in New Orleans on Saturday. Right now, gatherings of more than one household are banned in the city. An arrest warrant was issued for the organizer who refused to disband a large gathering. New Orleans mayor says his family has since reached out to apologize. The city alone has more than 1,400 coronavirus cases.

Well, the World Health Organization's senior expert on emergencies says while lockdowns and travel restrictions should lead to some stabilization, there was still much more that needs to be done.

[04:10:12] (BEGIN VIDEO CLIP)

DR. MICHAEL J. RYAN, EXECUTIVE DIRECTOR, W.H.O. HEALTH EMERGENCES PROGRAM: Everyone's talked about the curve up and everyone talks about the stabilization. The question is how do you go down? And going down isn't just about a lockdown and let go. To get down from the numbers, not just stabilize, requires a redoubling of public health efforts to push down. Not -- it won't go down by itself, it will be pushed down, and that's what we need countries to focus on.


CHURCH: Dr. David Nabarro is a special envoy to the WHO on COVID-19, and he joins me now live from Geneva.

Thank you, sir, for talking with us.


CHURCH: So, we just heard from the WHO that countries around the globe need to redouble public health efforts to push down the number of infections, but how do they do that when all of their doctors and nurses are struggling to save lives and in some cases losing their own lives because they don't have sufficient personal protective equipment like masks and gowns?

NABARRO: When Mike Ryan talks about pushing down the outbreak curve, he's meaning that we have to take active efforts to get ahead of the virus, and the only way we do that is by detecting people with disease quickly before the big outbreaks like you have in so many parts of the U.S. build up. And we need to get that capacity to isolate in place now to help us push the outbreak curves down. And that does mean rigorous physical distancing. It does mean this terrible pain for everybody of being in a lockdown and respecting it.

It only requires one person who's got the virus who's transmitting a lot to move around and then to start up lots of new small outbreaks. If they get missed, then the big challenges emerge. So I'm really suggesting that everybody everywhere throughout the United States recognize that pushing down the outbreak curve is entirely in their hands. It's their behavior that will determine how easy it is to reduce the burden on doctors and nurses everywhere. Get the outbreak curve down.

CHURCH: There's definitely a push back in this country. A lot of people are not listening. We're seeing it. They're still gathering together, but we don't know why that message isn't landing.

But in the U.S. we learned Monday that even if we continue doing the social distancing and abiding by the stay at home order, we can still expect to lose up to 200,000 lives in this country. So what does the U.S. and, indeed, the rest of the world need to be doing to ebb sure all those lives are not lost?

I mean, there has to be something beyond this because it's a very slow flattening of the curve even by doing these stay at home measures, which not everyone is necessarily doing of course?

NABARRO: I understand. The way in which COVID-19 affects society is through lots of outbreaks and each of these outbreaks is a result of people transmitting the disease to each other. So, the way in which we have to operate is all of us taking action to limit the chance of new outbreaks developing. When we have big outbreaks, we have to also be incredibly careful to keep apart from each other.

It takes a bit of time because the disease now is the sign of what transmission occurred about two weeks ago. So it takes a few days for the impacts of our activeness to show through. But we have to keep asking everybody, even where you have very little apparent disease, to respect the lockdown requests.

If you don't, I'll tell you what will happen, if you don't respect this and if transmission goes on everywhere, the incredible difficulties we're having now will go on much longer and many, many more lives will be lost. It's because this pandemic when it builds up in any community accelerates at warp speed. It doubles in size every 2 1/2 days, and that's why acting very promptly and robustly, particularly where you've got not much disease, is the key to preventing these giant outbreaks like you have, for example, in New York from emerging and becoming a reality.

CHURCH: Yes, absolutely. Stay at home. That is the message. Keep that social distance. Wash those hands and any other measures. We can't send that message out enough to people.

NABARRO: Please keep saying it. Please keep saying it.

CHURCH: Keep saying it, we keep saying it.

NABARRO: Please make sure everybody knows it.


And if an individual says, oh, it doesn't matter to me, I'm young, or I don't have people, you have to remind them that you're young and you're excreting the virus but you might affect somebody else. Thank you.

CHURCH: Absolutely. David Nabarro, thank you so much for joining us. We appreciate it.

NABARRO: Thank you. Thanks.

CHURCH: Well, now to some alarming news out of Spain. The European nation has more confirmed cases of the coronavirus than China. That's according to Johns Hopkins University. There are more than 88,000 cases in Spain and more than 7,700 deaths.

But there are signs of hope. According to the government, the daily infection increase has slowed since strict shutdown measures were imposed.

Meantime, Europe's worst hit country Italy will move to extend its virus restrictions until at least April 12th, Easter Sunday. Italian authorities are now reporting more than 100,000 confirmed cases and well over 11,000 fatalities, and that figure includes dozens of doctors. At least 63 who contracted COVID-19 have now died.

They are among the nearly 9,000 Italian health workers who have tested positive.

And CNN contributor Barbie Nadeau joins us from Rome. Al Goodman is there in Madrid.

Thank you to both of you.

And, Barbie, let's start with you because the situation in Italy, there's been the lockdown. There has been some evidence that this is moving in the right direction but there have been some tragic stories along the way because the death toll is simply shocking.

BARBIE NADEAU, CNN CONTRIBUTOR: Yes, it is just incomprehensible. All of these people, 11,500 or more right now died. And, you know, these people are very buried alone. The funerals have been outlawed since March 10th. And the families don't have closure. It's just a tragedy upon tragedy.

Now, we do have cautious on optimism that the contagion is slowing and the lockdown is working, but at the great expense of the health care workers who don't have the right equipment to protect themselves who are being infected in great numbers and dying along with those victims, Rosemary.

CHURCH: Al Goodman, we will go to you.

Thank you so much, Barbie Nadeau.

But, Al Goodman, you're there in Madrid. Talk to us about the situation there numbers across the country because the numbers there are shocking there as well.

AL GOODMAN, JOURNALIST: They are, Rosemary.

And the health minister -- a slight note of optimism. The health minister saying if Spain is not at the peak yet of numbers of new cases, that he thinks they are getting close. He says since last Wednesday, officials have been monitoring the percentage increase of the new cases and the new deaths, and they're encouraged that they're close to the peak.

But the numbers are staggering. The death toll in Spain is the second highest in the world. And 44 percent of all the people who have died have died in just the past four days.

Medical workers are -- have been infected in huge numbers. More than 12,000 medical workers in Spain, more than in Italy, have been infected. Officials say most have mild cases and are at home. But some also have died like in Italy.

And medical workers in the impromptu medical center out near the airport, in the convention center, are complaining that they don't have the protective gear even though this hospital up by the convention center has been set up specifically to take the overload of patients -- Rosemary.

CHURCH: Indeed. And the tragedy of all of this is when these patients die, they die alone without family and friends around them.

Thank you so much, Barbie Nadeau and Al Goodman. Appreciate it.

Well, still to come, with hospitals across the U.S. facing a drastic shortage of ventilators, some doctors are taking desperate measures to keep patients alive.

There are millions of medical staff around the world doing heroic work on a daily basis, but before we go to break, I want to pay tribute to one doctor in particular, Dr. James Goodrich was a neurosurgeon who allowed CNN inside a remarkable operation in 2016. He led a team of 40 doctors in a 27-hour surgery to separate conjoined twins. On Monday, he died after complications related to COVID-19.

The hospital where he worked said Dr. Goodrich. His expertise and ability were second only to his kind heart and manner. He is survived by his wife and three sisters.




CHURCH: The Backstreet Boys performing from their homes for iHeart Radio's Living Room Concert for America. The concert on Sunday night was hosted by Sir Elton John. Artists like Mariah Carey, Alicia Keys and Billy Eilish performed to raise money for families affected by the coronavirus. The hour-long concert raised over $1 million, and before closing the concert with one of his own hits, Elton John left the audience with a message of hope.


ELTON JOHN, MUSICIAN: We all look forward to the day when concerts, events, and sports finally restart and things get back to normal, but while we wait, we can all support each other and keep the faith.


CHURCH: Very good message there.

And one hopeful break through that could save lives is the use of ventilators to treat multiple patients. Governors across the United States are warning of a scarcity of the life saving machines.

And as Paula Newton reports, some see the method as risky but others see it as vital.

(BEGIN VIDEOTAPE) PAULA NEWTON, CNN CORRESPONDENT (voice-over): Out of desperation, doctors in New York City and Italy are now using ventilators meant for one person to keep two patients alive. And doctors like Alain Gauthier say if they don't try it more patients could die.

DR. ALAIN GAUTHIER, CANADIAN ANESTHETIST: We know that difficult decisions will have to be taken.


I'm optimistic that we'll be able to save some lives if we try this. We've got nothing to lose.

NEWTON: Dr. Gauthier is a small town Canadian anesthetist and has a PhD is respiratory mechanics. He is now working with engineers and doctors across North America to refine a crude, but life-saving technique first seen here.

DR. CHARLENE BABCOCK, ER DOCTOR: So, here you have a T-tube here, here and here.

NEWTON: Dr. Charlene Babcock posted this YouTube video two weeks ago. As an ER doctor in Detroit, she wrote a study on the technique more than a decade ago. She says doctors all over the world have asked her for this how-to video.

She uses T-tubes as splitters in the video and shows how to use three adapters to split two valves into four ports, helping up to four patients at once.

BABCOCK: This is not a study in humans. I will tell you what has been done in humans.

NEWTON: In the tragic hours that followed the Las Vegas shooting, doctors used T-tubes and adopters to keep more of the injured on ventilators until they could be transferred to other hospitals. This is the kind of ventilator Dr. Gauthier is working to adopt.

GAUTHIER: What Dr. Babcock suggested is that we use T-connectors at both ports with appropriate filters to decrease the amount of cross- contamination from one patient to the other.

NEWTON: He is studying it closely teaming up with engineers at MIT to brain storm on best practices.

GAUTHIER: The challenge with that is the matching of those two patients. So, initially, we're going to try to put two patients that are the same size, same respiratory system properties, and we'll be able to ventilate them for a while.

NEWTON: New York Governor Andrew Cuomo has been blunt that more patients will die if his state runs out of ventilators. He has pushed the FDA to approve doubling up on those ventilators.

CUOMO: The tricky thing is the ventilator has a set pressure and normally you regulate the pressure to that patient's lungs. NEWTON: And that is why this technique is highly controversial. Some

respiratory specialists question whether multiple patients on one ventilator receive optimal treatment.

That's where specialists like Dr. Gauthier come in.

GAUTHIER: I know we will not be able to save everyone. There's going to be a lot of learning during this whole process. But I'm confident in the end that we'll be able to help people by this system.

NEWTON: Paula Newton, CNN, Ottawa.


CHURCH: This is why our hospitals need more ventilators. Let's do that. Let's get it done.

You're watching CNN NEWSROOM.

Still to come, days after the U.S. passed a massive economic stimulus bill, some business owners say they're worried the package may not be enough.

And some places in Europe, such as the Czech Republic, have made it compulsory to wear masks in public, and they say it's working. One of the country's leading medical experts joins us next to tell us why.