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U.S Death Toll Surpasses 3,000 On Deadliest Day; New York Neurosurgeon Who Separated Conjoined Twins Dies; Maryland Issues Stay- At-Home Order With Jail Time, Fines. Aired 7-7:30a ET

Aired March 31, 2020 - 07:00   ET


CHRISTINE ROMANS, CNN CHIEF BUSINESS CORRESPONDENT: What does the new normal look like, right?


It's probably not going to be what we saw in February, right, or certainly what we saw last fall? So what would that look like? But there will be pent-up demand and there will be people going back to work and you will see an economy that will begin to heal.

This has been a short and deep and drastic decline. And now, the big debate is what does it look like on the other side. There is no playbook for this. There is no playbook for this. This is about virology, not about normal profit loss statements of American countries.

JOHN BERMAN, CNN NEW DAY: All right, brace yourself, everyone. Top of the hour, New Day continues right now.

ALISYN CAMEROTA, CNN NEW DAY: We want to welcome our viewers in the United States and all around the world. This is New Day, and we have some numbers for you.

As of this morning, coronavirus deaths in the United States have passed 3,000. And according to the country's leading health experts, this is just the beginning.

Yesterday was the deadliest day yet in the United States. We saw more than 550 deaths reported in one day. There are now more than 160,000 cases across the United States, and more than 1,200 people just in New York alone have died.

The governors of New York and California are making urgent appeals for help. Governor Cuomo in New York says his state needs 1 million more workers to tackle this crisis.

BERMAN: There is still mounting frustration about equipment shortages, healthcare workers getting sick, which means they cannot take care of the influx of patients. A trauma physician in Miami tells CNN, quote, we are slowly descending into chaos.

This morning, The Wall Street Journal reports that one New York hospital is beginning to advise doctors to, quote, think more critically about which patients get ventilators.

Three quarters of Americans under stay-at-home orders after Maryland, Virginia and Arizona issued new directives on Monday. Some states, including Florida, have resisted statewide orders despite Miami becoming a hot spot. Other hot spots this morning, Detroit and New Orleans.

We want to begin our coverage in New York City with CNN's Brynn Gingras. She is live right next to Central Park, and behind you, tent hospitals built in the park where so many people go for a stroll, go for a run. It is a remarkable image, Brynn.

BRYNN GINGRAS, CNN NATIONAL CORRESPONDENT: Exactly, John. I mean, this is so strange. This, like you said, is an area of Central Park where people are exercising, they're relaxing, there's baseball fields nearby where actually I played some baseball games and now it's a hospital.

Let me show it to you. Essentially, here, there are 68 beds for coronavirus patients. It's really overflow from a nearby hospital right across the street. It's help from a Christian group out of North Carolina who put this up in just days, this as governors across the country are pleading for more supplies and more personnel.


GINGRAS: New York Governor Andrew Cuomo sending a desperate plea.

GOV. ANDREW CUOMO (D-NY): I am asking healthcare professionals across the country, if you don't have a healthcare crisis in your community, please come help us in New York now. We need relief.

And we will return the favor.

GINGRAS: Earlier, some relief arriving to New York City in the form of the U.S. naval hospital ship Comfort. On board, 1,000 beds and more than 1,100 medical personnel ready to treat patients who are not fighting the coronavirus. The vessel, the latest temporary hospital to deal with overcrowding in the city's medical centers.

MAYOR BILL DE BLASIO (D-NEW YORK CITY, NY): But I want you to understand the sheer magnitude of the plan, we need to triple our hospital bed capacity in New York City by May.

GINGRAS: The Wall Street Journal reports that one city hospital is asking doctors to think more critically about which patients get ventilators. Inside one of New York's intensive care units, a nurse practitioner showing the harsh reality.


These are patients that are the sickest I've ever seen.

GINGRAS: This as officials brace for the days ahead in emerging hot spots across the country, like New Orleans, Detroit and Miami. In California, the Los Angeles Convention Center will be used to help the sick. But the governor says that along with the equipment, the state also urgently needs more healthcare staff, as coronavirus- related hospitalizations doubled there within the past four days.


GOV. GAVIN NEWSOM (D-CA): We're in the middle of this. We believe very strongly the stay-at-home order has helped advance our efforts in reducing the stress on the system.

GINGRAS: Three out of four Americans are under stay-at-home orders this morning. That's more than 250 million people. President Trump says it's unlikely he'll enact them nationwide.

DONALD TRUMP, U.S. PRESIDENT: We've talked about it.

Just was something that was very unwieldy, very tough to enforce and something we didn't want to do.

GINGRAS: State leaders once again asking the Trump administration for more critical supplies and test kits, saying it's unfair to compete with others domestically and internationally for what they need.

GOV. J.B. PRITZKER (D-IL): I can't emphasize enough how much we need the federal government to step up and amplify the size of their PPE deliveries to Illinois and, frankly, across the nation.


GINGRAS: There are a hundred New Yorkers, volunteers who are joining forces with about 70 staff members inside those tents. Again, they came here from North Carolina over the weekend. They'll start seeing patients today for as long that they'll be here, Alisyn, the answer really is as long as we need to be.

CAMEROTA: Understood, Brynn. Thank you very much for your reporting.

Joining us now, is CNN's Chief Medical Correspondent, Dr. Sanjay Gupta, and Dr. Carlos del Rio. He is the Executive Associate Dean and chair of the Department of Global Health at Emory University School of Medicine. It's great to see both of you.

Dr. del Rio, I want to start with you because you were on New Day exactly two weeks ago, it feels like two months, and we all remember it because you were really the first to try to kind of pull the fire alarm and alert everybody of what you saw coming. And back then, you told us testing is not fixed, testing is a big problem. You told us you were seeing droves of patients coming in to E.R.s. You told us that we needed a nationwide lockdown to try to stop this, and that you were seeing healthcare providers start to get really sick. I mean, you were basically our Paul Revere of coronavirus. And so what are you seeing today that we need to know about?

DR. CARLOS DEL RIO, EXECUTIVE ASSOCIATE DEAN, EMORY UNIVERSITY SCHOOL OF MEDICINE: Well, what we're seeing throughout the nation, I tell people that we have multiple Wuhans in the United States. We have a Wuhan in New York City, there's a Wuhan in Washington State, there's a Wuhan in Miami, there's a Wuhan in Atlanta. So each one of these are different outbreaks.

So we don't have a national epidemic, we have regional, focused that had hot spots. And that's what makes it very hard to respond. You need national leadership, but you also need local response. And the response has to be local and has to be tailored to what's happening there. New York needs certain things. Georgia may need very different things.

And so we really have to listen to our governors, we have to listen to our local governments and we have to listen to our local hospitals and see what they need. Because, I'll give you an example, at my hospital, Grady Hospital, we have sufficient N95s but we have not enough surgical masks. While, I go to a hospital up the street at Emory University Hospital, it's a little bit like the opposite. They have a great supply of surgical masks but shorter, you know, little more constrained in N95 masks. So you really have to work with the local hospital leadership to get them what they need.

BERMAN: In New York, it sounds like they need everything at this point. Number of deaths in the United States reached its highest level yesterday, more than 550 deaths in a single day, more than 3,000 total, Sanjay, and that's tough for people to wake up and see, especially when they're being told it's going to get worse.

Now, on the other hand, there was a study that was published overnight in Lancet, the esteemed journal, which talks about the mortality rate from this virus, this pandemic, and there is some news in that, Sanjay.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes. I mean, when these researchers started to look at the general population, people who had both shown up at the hospital with symptoms but also started to do more of this what we've been referring to as the sort of surveillance, looking at, John, for people who are asymptomatic, didn't show any symptoms, and seeing if they had the virus and sort of, you know, if they had gotten sick at all, what they started to find is that the fatality rate, the likelihood of someone dying from this was closer to 0.66 percent.

Now, again, I'll remind you that the flu, for example, fatality rate is around 0.1 percent. So this is still six to seven times higher than that, but lower than the 1 percent or 2 percent that some of the initial projections sort of showed.

Now, again there is one study among many when they started to take out some of those asymptomatic people, as you can imagine, the case fatality rate went up quite a bit higher. And also they found among older people, people over the age of 80, the fatality rate was right around 8 percent. So, you know, again, quite a bit lower than before, but higher than the average population.

[07:10:02] These numbers are going to keep coming out, John. They're still going to keep figuring these numbers out. But that's -- you know, at least we're starting to get a deeper look at what the data is showing.

CAMEROTA: And, Dr. del Rio, is that comforting to hear that Lancet study and this news that the death rate may be lower? Because right now, it feels as though everybody is in such triage mode that it's hard to imagine that somehow that's good news.

DEL RIO: The problem is the numbers. The problem is the sheer number of people infected. Even if you have 1 percent dying or a little bit under 1 percent, if you have 100 million Americans, a third of the population of this country infected, which some people believe we could have, a 1 percent mortality would be 1 million deaths.

So, you know, the president yesterday talked about maybe 100,000 deaths. 100,000 deaths is still a lot of deaths. I mean, you said we just reached 3,000. Well, we have 900, you know, 997,000, you know, deaths to go. So it's still a huge number and we need to be aware of that, that the numbers are simply incredible. It's not just a percentage, it's really the denominator.

BERMAN: Sanjay, a lot of news overnight, and a lot of shifting guidelines or shifting in the way we think about this. The Washington Post is reporting that the CDC might come out with new recommendations about whether people should wear masks in their daily lives. Not the N95, the not hard masks that they need in the hospitals, but cloth masks when they leave the house. Explain to us what's going on here and why there could be a shift.

GUPTA: Yes. I think this point that these are not the medical masks, first of all, that people are talking about, the N95 or even the surgical masks because, you know, obviously, there's a shortage of those. This idea, John, that this is a virus spreading in the communities, that more people might have it than realize it and that they could be shedding virus unknowingly I think is what's driving a lot of this, John.

So this is really, again, cloth masks, not medical masks, to try and prevent people who are shedding the virus, asymptomatic shedders of the virus from shedding it as much. It's not going to be a perfect solution, because as we've talked about, these are not air tight masks. But someone coughs or sneezes or even as just breathing could you possibly reduce the amount of virus getting out into the environment.

World Health Organization and CDC still say no, they don't recommend this, they think it could lull people into a false sense of security and it might make them less likely to social distance, but I think that this is starting to gain a lot of traction.

As we know, in China, they did recommend people wearing these masks for this very reason. It may have been one of their more successful strategies, we're not sure yet. But I think that this is something that's really starting to be discussed at all levels, John. CAMEROTA: Dr. del Rio, just quickly, as you've described that we have multiple Wuhans here, that would mean, I assume, they would have would rolling peaks. And so the peak in New York will look different than the peak in Michigan. But is there any way to, on a national level, give people a sense of when we would be on the other side of this?

DEL RIO: Well, it depends how -- what happens over the next several weeks in what we do. And I think as more people stay at home, as testing is really scaled up, I think we will see see some flattening of the curve. And that may actually make this last a little longer, but the impact in hospitals is going to be lower.

So getting to the other side of the peak is not just getting over the peak. It's really actually making sure that peak is not so high that overwhelms our healthcare system. So I'd rather have a lower peak at a later date than a higher peak at an earlier date.

BERMAN: Sanjay, very quickly, The Wall Street Journal is reporting that doctors at NYU Langone received an email talking about the need to shift the thinking about who gets intubate and when. A quote from this email is, for those patients who you feel intubation will not change their ultimate clinical outcome, for example, cardiac arrests and chronic disease patients and end of life patients, et cetera, you will have support in your decision-making at the department and institutional level to withhold futile intubations.

What does it tell you now that these discussions are happening?

GUPTA: And These are tough discussions, John, They're happening, I can tell you, in many hospital systems around the country. In part, I mean, this is I think jarring for the public to hear because they're not usually sort of let in on essentially what feels like rationing of healthcare, not providing these types of advanced care for people who have a lower chance of surviving.

But, you know, it is clear that, you know, as things stand now, as Dr. del Rio is talking about, the demand for some of these critical resources, such as these breathing machines and intubation is the breathing tube that goes in to put someone on one of these breathing machines, that those resources are being outstripped by the demand.


So this is what has to happen. There's also been these committees, independent committees, John, that have been set up in hospitals so that an independent committee, aside from the treating medical team, can help make some of these decisions to sort of create a little bit of distance, separation between these decisions and the treating physicians themselves. It's tough. I mean, there's no two ways about it.

And I should just add, you know, as much as we talk about these fatality rates and things like that, the vast majority of people do survive. But they can get sick, really sick for a long period of time. Average length of hospitalization, 25 days in that same Lancet study. So this is what hospitals are going to have to be dealing with for some time.

BERMAN: Really sick at younger ages than we initially thought. So much of our thinking has changed on this over the last few months. Dr. Sanjay Gupta, Dr. del Rio, thank you very much for being with us this morning. I appreciate it.

DEL RIO: Thank you, John.

CAMEROTA: Maryland has a new stay-at-home order, and if you violate it, you could actually end up in jail. So Maryland's governor is going to explain next.



BERMAN: This morning, the coronavirus pandemic is taking a devastating toll on medical heroes on the frontlines fighting it. In Italy, 61 doctors have died from the virus. More than 8,000 healthcare workers in Italy have contracted coronavirus. Here in the United States, hundreds of doctors and nurses now sick. Some have lost their battle, including renowned pediatric neurosurgeon Dr. Jim Goodrich, who died on Monday.

Dr. Goodrich was a friend and colleague of CNN's Chief Medical Correspondent Dr. Sanjay Gupta. And Sanjay is back with us now.

Sanjay, we're so sorry for your loss, and we've watched with such great interest over the years as you have reported on and gotten to know Dr. Goodrich.

GUPTA: Yes, I mean, this was a tough one, John. I mean, I woke up yesterday morning to the news. I had heard that he was sick and, you know, it's one of those things where you know this is happening, you know this virus is spreading. Many of us, hopefully not too many, but many of us will know somebody who was directly affected by this. And for me, that's already happened. Take a look.


GUPTA: You may not have immediately recognized him behind the mask, but the tufts of gray hair and twinkling eyes would eventually give him away.

For 27 hours, we sat together as he meticulously operated on Anais and Jadon McDonald separating their brains. Two children, among countless others, alive, thriving because of Dr. James Goodrich.

DR. JAMES GOODRICH, NEUROSURGEON: You've got to think after a while they kind of like become your own kids, my God, the Christmas cards you get from families you've been taking care of for 30 years. It's like you operate on a child that's just been born, it's a life- altering experience for a parent.

GUPTA: For Anais and Jadon's mom, Nicole, it was like watching a superhero. NICOLE MCDONALD, ANIAS' AND JADON'S MOTHER: I was so blessed to say that not only did I get to see him with his cape on doing the most brilliant, complex surgeries that anybody could do, and I got to know him with his cape off.

GUPTA: We bonded over our shared calling, neurosurgery. In our world, we pretty much all know each other because there are just about 4,600 neurosurgeons in the country. And we also bonded over our shared love of kids, all kids.

MCDONALD: This is for you and all the work that you've done and what you did to make our family whole by making our babies separate. We love you.

GUPTA: So dedicated to his work, Dr. Goodrich never had kids of his own.

Was it his conscious decision not to have kids because you didn't want that emotionally?

GOODRICH: Not really consciousness, but I was in the military before college and so when I came out I had to go back basically community college and then college, then I did an M.D. PhD, so then graduate school and medical school, the residency. And we kept talking about it but I just kept postponing. Next thing I know, too old.

GUPTA: You've been busy taking care of the world's kids.

GOODRICH: It seems that way at times.

GUPTA: Next to him for the past ten years, helping him take care of those kids, cranial facial surgeon, Dr. Oren Tepper.

DR. OREN TEPPER, CRANIOFACIAL SURGEON, MONTEFIORE MEDICAL CENTER: He used to joke that we would call him the world's most interesting man, because he was. He was a wine connoisseur, he was a surfer. At those very last days, I imagine he was surfing.

GUPTA: There will be too many cruel and unfair stories like this one. This new disease thrust upon us. COVID-19 doesn't discriminate based on what you do or who you are, in this case, robbing the life of someone who had saved so many.

This past Monday morning, he died.

MCDONALD: He fought with ferocity for my family in a way that I will never ever forget, that I will forever appreciate. There will never be another James Goodrich, not even close. You will never be matched, let alone replaced in the world.

GUPTA: We knew the losses would come, but they are no less painful when they do.


GUPTA: And I can tell you, John, I mean, it's a tough one. I mean, the neurosurgery community in this country is very small. We all cross paths at one time or another. I have received hundreds of emails yesterday from a lot of friends I hadn't heard from in a long time, neurosurgery members who knew that I knew Dr. Goodrich well and offered up a lot of their descriptions and reflections of him.


But, you know, he was one of the really -- he was the giants, one of the giants as I mentioned in the piece. And it's going to -- people are going to feel this for a long time, John.

BERMAN: I think we all feel it, Sanjay. Again, we're so sorry for your loss. But his work lives on in the work that you do and it lives on in all the lives, all the kids that he saved. James Goodrich will be with us forever. Thanks, Sanjay.

GUPTA: You got it. Thank you.

BERMAN: So, violate Maryland's new stay-at-home order and you could end up in jail. Maryland's governor joins us next.


BERMAN: This morning, nearly 249 million Americans are under some kind of stay-at-home order, that's three quarters of the U.S. population.

Joining us now, Maryland's governor, Larry Hogan. He issued a stay-at- home order for his state yesterday. Governor Hogan, good morning. Great to see you.

Last week we had you on and you had issued an order to close non- essential businesses but hadn't yet issued a stay-at-home order.


Now as of this morning, the full order goes into place. Why the change?