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U.S. Death Toll from Virus Almost Doubles in Last 3 Days; Florida Governor Under Pressure to Issue Statewide Shutdown; Dr. Marissa Levine Discusses Florida Governor Not Issuing Shutdown Orders; Dr. Jason Shatkin Discusses How Health Care Workers Are Overwhelmed and How What He's Seen Has Changed Him; Small Businesses Under Pressure as Bills Come Due. Aired 11-11:30a ET

Aired April 1, 2020 - 11:00   ET




KATE BOLDUAN, CNN ANCHOR: Hello, everyone. I'm Kate Bolduan. Thank you so much for joining me.

Here is the reality for this Wednesday. We knew that the death toll was going to rise. And it is. In fact, it has doubled over just the past three days. Now, reaching nearly 3900. Yesterday was another single day record for deaths in this country.

And the president now warns that the next 14 days are going to be rough. Listen.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: I want every American to be prepared for the hard days that lie ahead. We're going to go through a very tough two weeks.

This is going to be a very painful, very, very painful two weeks.


BOLDUAN: New models that the White House is working with estimate that 100,000 to 240,000 Americans could die from this virus. And that is if everyone abides by the strictest social distancing guidelines.

With the country facing such a steep mountain to climb and the drum beat demanding critical medical supplies, it grows louder. And if that sounds like a broken record, well, of course, it is because everyone from health care workers on the front lines to governors of red and blue states say they aren't getting what they need. They don't have what they need. And they need it now.

Let's start today with CNN's Shimon Prokupecz. He's at one of New York's hardest-hit hospitals.

Shimon, Elmhurst Hospital, where you are in Queens, has been under sage for days. Now they're starting to see a shift. What are you hearing there?

SHIMON PROKUPECZ, CNN CORRESPONDENT: The shift is the incoming. That's all that's changed. It doesn't mean that in any way this hospital behind me, specifically the emergency department, isn't still overwhelmed. There are patients everywhere.

Almost, entirely the emergency room, the department within this hospital, is made up of COVID patients. In many cases, some of them very critical, requiring ventilators.

They're doing other methods, CPAP machines. They're trying to prevent some of the patients from going on ventilators because usually they fear the outcome isn't always great at the end of that. So they're doing all sorts of tricks. One doctor told me they have learned some tricks.

They were running out of tubing for some of these ventilators. They now have some of these supplies.

The supplies, we should note, some of the good news, the supplies have been coming. Things are getting a little better on that end. They are getting the supplies that they need. They are getting the ventilators that they need.

But the big part is that they are still very much overwhelmed. A lot of patients are not going anywhere. So what the city has done, and it has relieved some of the pressure, is that they have transferred some of the patients, the less critical patients, out of the hospital.

One of the doctors told me, one of the saddest things going on inside this hospital is, as patients get moved to the rooms within the hospital, there's a lot of sadness, a lot of depressing stuff because people are dying. And that's one of the difficult things that the hospital has faced.

And quickly, Kate, this hospital, in many ways, sort of became the test case. They were the first hospital to really experience what this virus was doing to people and how the hospital was going to respond. And really, they hope that people have listened and that other hospitals now going forward will be prepared -- Kate?

BOLDUAN: Lessons to be learned, but urgently. Urgently need to be learned.

Shimon is there. Shimon, thank you so much.

Of course, we have to keep an eye on New York and what is happening here in New York.

We're also watching in Florida. Why is that? Because that's where Governor Ron DeSantis is facing growing criticism. There are now more than 6700 confirmed cases in that state. At least 84 people have died.

And despite having the largest population of residents 65 years old and older in the country, the governor has resisted doing what some 30 states have already done, issuing a statewide stay-at-home order or something like it.

CNN's Rosa Flores is in Port Everglades near Miami where there's a lot going on there.

Rosa, what are you hearing from there? Why does the governor think Florida doesn't need this?

ROSA FLORES, CNN CORRESPONDENT: You know, Kate, Governor DeSantis has maintained that, throughout this, that this virus has not touched every corner of this state and, therefore, it is not needed in the state of Florida.

But as you mentioned, he's had growing criticism from Democratic lawmakers here in Florida, the agriculture commissioner, experts as well, that say that there should be a statewide order in the state of Florida.


Instead, the governor focusing on airline passengers from New York, New Jersey, Connecticut, and later Louisiana, asking that airline passengers be quarantined for two weeks upon their arrival to Florida. That increased their criticism.

Here's what the govern did do. He issued a regional safer-at-home order a few days ago that impacts Miami-Dade, Broward, Palm Beach, and Monroe Counties. That's no mistake. Those first three counties account for about 60 percent of the more than 60 percent of the more than 6,700 cases here in the state of Florida.

But a lot of that criticism is, a little too late, is what some folks here in Florida are saying, Kate, because local governments had already issued safer-at-home orders in these areas.

BOLDUAN: Rosa, thank you so much.

A lot coming out of Florida. Let's stay there.

Joining me is Dr. Marissa Levine, a professor of public health and family medicine at the University of South Florida, in Tampa. She's joining me now by phone.

Dr. Levine, can you hear me?


BOLDUAN: Good morning. Thank you so much for getting on the phone. I really appreciate it.

We heard from Rosa said right there, that the governor in Florida is facing a lot of criticism for not doing more. You take issue with the governor's position on this here as well. What is your message to him?

LEVINE: So I understand what the governor is trying to do. He's trying to use data to make good policy decisions. Our problem is that the testing has been delayed, and so the testing doesn't really give a full picture of what's going on in Florida.

I'm worried that people might be misled by the testing that in areas where we haven't had a case or maybe very few cases there might be the conclusion there's been no spread of virus, but we don't really know that,.

And we also know that doing these efforts, the physical distancing early, makes a big difference. And you know, I think that we're out a time where those decisions have to be made.

BOLDUAN: Yes, and as we have seen very clearly, look at New York, look at Washington, pick a state at this point. Testing and those numbers, it's a lagging indicator. It comes after. If you're working off those numbers, you're working behind the eight-ball. That's what Dr. Anthony Fauci has said.

What do you think needs to be happening right now in your state?

LEVINE: Actually, there's a lot of work happening at the local level. I was working with some modelers here in the Tampa area, as the leaders were trying to make decisions. You know, in Hillsborough and Pinellas, where Tampa and St. Petersburg are, the local leaders have issued a safer-at-home order because they see what's potentially coming.

Here's the issue with this. We're very concerned about overwhelming the resources we have in our health care system. We're seeing it happen in New York. So we want to make sure that we can work within what we have both with our hospital beds and ICU beds.

And we know that if we can implicate these orders, and if we can implement them early, we have a chance. But it requires everybody doing their part. This is an important time for people to come together.

I think a mandate gives the message that this really matters. We're in unprecedented times.

I wasn't always a fan of mandates when I got into public health. But as state public health commissioner in Virginia, I saw policies make a huge difference.

And particularly a governor or a state health officer making it clear that these issues are here and they're affecting us and we all have to do something makes a big difference.

BOLDUAN: Look, quite simply, from your perspective on the ground, what you have seen and with your experience, does the governor need to -- I'm going to say lockdown, but offer, mandate some stricter stay-at- home order and do it now? What do you fear will happen if he doesn't?

LEVINE: Well, I think the challenge is, if we have a piecemeal approach, which we have now, that may have some local impact. But people are still mobile. And what we have seen is, with

coronavirus, it can spread pretty rapidly. We're learning as we go. We're learning more about coronavirus, but we know it spreads.

And we know that for every person who gets coronavirus without doing some type of physical distancing, two or three other people may pick it up.

We need to cut that in half if not more to really make a difference in terms of being able to live within our resources.

BOLDUAN: And if hearing the message you're putting out isn't enough, I fear and wonder what it will take for the governor then to make that decision if he isn't already getting the message that you're putting out clearly and many others are as well.

Dr. Levine, thank you for what you do. Thank you for coming on.

LEVINE: You're welcome. Thank you, Kate.

BOLDUAN: Thank you very much.

Still ahead for us, resources are running low. Hospitals are filling up. We know this. Health care workers, they're really starting to become overwhelmed. I'm going to talk with a pulmonologist in New Jersey who says this entire experience -- and it's not over yet -- this entire experience has changed him, what he's seeing.


Also, later, the sobering projections about the possible death toll from the White House, Vice President Mike Pence is speaking with CNN live about the White House's response, what the task force is doing in the face of the coronavirus pandemic.

We'll be right back.


BOLDUAN: New Jersey remains squarely in the epicenter of this crisis today. The state with the second-most cases in the country. As of now, 267 people have died in the state.

Dr. Deborah Birx, one of the top doctors leading the White House task force, drove that point home yesterday with this chart that you see on the screen right now, the striking trajectory of New Jersey and New York, trying to warn other states of what could come, what could be on the way.


Let me bring in someone who is on the front lines, fighting the virus on the ground in New Jersey. Dr. Jason Shatkin is a pulmonary critical care specialist at the Valley Hospital in New Jersey, one of the hardest-hit hospitals in the state.

Doctor, thank you for jumping on with me.


BOLDUAN: I really appreciate it.

I read you told a reporter the number of COVID cases you're seeing is rising exponentially. Can you describe what you're seeing at your hospital?

SHATKIN: We're seeing the overwhelming majority of cases of patients that we have in our hospital are from COVID-19. We have now outstripped our bed capacity with the number of patients that are admitted to the hospital.

Patients are boarding in areas of the hospital, such as the emergency room, the recovery rooms, and other areas. The hospital has done a great job in finding new places that we can board patients and keep them.



BOLDUAN: Sorry, Doctor.

And part of what there's a lot of talk about right now, when it comes to hospitals that are stretched and strapped is the talk of resources becoming scarce and so doctors are preparing to make extremely tough choices.

But you are not just preparing for that. You are already facing that. You have had a patient who was in your care, had been in your care for years, whose family gave permission to take her off a ventilator in the midst of all this.

Doctors make tough choices all the time. I have two doctors in my family. But did you ever think you would have to have that conversation with a family about the use of a ventilator?

SHATKIN: A couple of weeks ago, I was discussing the possibilities that we might have to start allocating resources based on whatever criteria. I couldn't believe that we had come to this so quickly.

The patient was a dear patient of mine. She had been my patient for over 16 years. And I was very close with her and her husband, who also passed on from COVID.

That patient was not doing well. It's a discussion that we would have with the patient's family anyway, regarding how they're doing, their progress.

After the conversation, where I told them that she wasn't doing well, that the chances of her coming off the ventilator were not promising, ventilators were at that point almost gone as far as the amount we had available. And that I recommended that they withdraw treatment because she was not going to get better.

He asked if he could think about it for a little while. And I said that you could, but please understand that the one silver lining to this will be that the ventilator can go to somebody else who needs it. Sort of like akin to organ donation. The one good thing that could come out of it.

They subsequently accepted removing the ventilator, and that ventilator was sterilized and given to another patient.

BOLDUAN: And she passed.

SHATKIN: And she passed.


BOLDUAN: That is one of -- I can only imagine so many crushing decisions that you're facing every day.

I have to say, you have been keeping a journal, as a way to deal with it, is what you told my producers. You shared some of that with us. If it is OK, Doctor, I would like to read part of what you've written. It is so striking.

And you wrote this as you were going in to see a COVID-positive patient. You wrote this. "As I gowned and walked into the room, I felt like a fireman running into the buildings on 9/11 as others ran out. But I did not feel brave, for as you know, I'm not that way. I was a nerd who was good at science in college. I cry during dog food commercials."

You write about how you were afraid. You are afraid. Your patients are afraid. I mean, this is heartbreaking for anyone to hear.

You also are a father of nine children. What do you want people to know about what it's like going through this?

SHATKIN: Well, it's something that -- that you can't imagine. Again, again, I wouldn't put myself in a category of firemen who run into buildings on 9/11, but -- because, you know, that's really much more enormous.


But every time, you know, we go into a room -- and it's not just me. It's the nurses at Valley Hospital, it's the respiratory therapists that are in the patient's faces, providing them care.

I feel like there are imaginary like scrap metal flying out. Any one time, you know, is my mask on completely right? Could it hit me in the wrong place? How many viruses can populate my nose before I become infected?

And, yes, I have a 4-year-old son, who happens to be an absolutely beautiful child. He is -- my greatest fear is I'm going to be nothing more than a fleeting memory to him. That he'll never remember, because who I am because who remembers anything at 4 years old? Yet right now, he's my entire world. And I'm his entire world.

I have a daughter who is getting married, and she's engaged. As I was talking to this patient, I was thinking in my mind, it was popping into my head, she'll be walking down the aisle and I won't be there. So that is absolutely part of this experience.

But I am in no way unique. This is an experience we're going through with everybody. The entire hospital, all of -- and every hospital and every provider that's there.

BOLDUAN: And that is why you need the protection that you deserve and require in order to do your job. God bless you.


BOLDUAN: Thank you so much, Doctor. I can't thank you enough.

SHATKIN: My pleasure. Thank you.

BOLDUAN: Thank you so much.

Still ahead for us this hour -- just amazing meeting that man. Still ahead for us this hour, Vice President Mike Pence will be speaking with CNN about the administration's response to the coronavirus as the death toll here in the United States nears 4,000.

And it's the first of the month, of course. For millions of Americans, that means bills are due, mortgage payments, rent is due. That's the first time since the economy came to a halt and so many small businesses have been forced to close their doors. We'll speak with one family who is facing this cruel reality right now today.

We'll be right back.



BOLDUAN: It's the first of the month, and for so many, that means rent is due, bills need to be paid. With millions of Americans laid off and businesses in every city, every state being forced to close their doors, what does that look like today?

Joining me right now are the owners of Coyote Hole Ciderworks, Chris and Laura Denkers. In better times, Coyote produces hard cider in Virginia. A three-year-old small business with plans to expand. Today is a very different day.

Thank you, guys, very much for being here.


BOLDUAN: Really appreciate it. Wonderful to meet you. I'm so sorry it's under these circumstances.

C. DENKERS: Yes. BOLDUAN: It is the first of the month. Bills are due. What does that mean for you guys today? How do you describe what's happened in the last month?

C. DENKERS: It's been almost a complete 180. We were, this year, we doubled our tank capacity. We were expanding our distribution into New York, New Jersey, and Maryland, outside of Virginia. Our projections had only been up and up and up.

All of a sudden, this hit. It's been really bad because we lost about 80 percent of our income. Distribution stopped. We can't have anyone in our tasting room and we can only do to-go orders.

It's been a touch week, a tough month. And it looks like it's going to be another tough month or two.

BOLDUAN: Laura, how does it feel?

LAURA DENKERS, CO-OWNER, COYOTE HOLE CIDERWORKS: Sorry. So we're hanging in there. We've got a lot of resources that look like they're coming down the pipeline that we're trying to figure out. And hopefully, it comes in time.

But like Chris said, I mean, we were about to launch into all these different states. And it was just a really good pivot point for us. And with all those businesses now struggling, we don't know if those same opportunities will be there. So.

BOLDUAN: What do you guys need? I mean, you have -- the Small Business Administration is saying, it's offering relief, saying that the stimulus bill that was put through provides relief for businesses like yours. You guys have been really facing some challenges with that.

C. DENKERS: Yes, we have. I mean, we tried to apply for the emergency disaster loan two weeks ago. We went back in to finish the application, and it was deleted. Then we re-did it this weekend. And come to find out that the SBA completely relaunched the application process. So we had to redo it again Monday.


And then from there, there's also the CARES Act that was just passed, for the paycheck protection program.