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Italy Reporting More Than 77,600 Active Cases; U.S. Hospitals Revamped For COVID-19 Patients; China Prepares For Influx Of Imported Cases; Trump Warns of "Very Painful" Two Weeks Ahead; Cruise Ship off Florida Reports at least Four Deaths; Illinois Governor: White House Sent the Wrong Masks; Inside Look at Spain's Makeshift Hospital; Countries Crack Down on Those Violating Lockdown; South Africa Reporting Nearly 1,400 Cases and Five Deaths. Aired 2-3a ET

Aired April 1, 2020 - 02:00   ET




JOHN VAUSE, CNN ANCHOR (voice-over): Hello and welcome to our viewers in the United States and around the world. I'm John Vause.

Coming up on CNN NEWSROOM, reality bites. The U.S. president warns of a painful two weeks ahead, with confirmed cases and the number of dead from the coronavirus expected to surge.

Ahead of the curve, with the U.K. expecting the worst of the pandemic next week, the rush is on to build a field hospital on the banks of the Thames.

And surviving COVID-19: she had all the symptoms, including a chest infection which lasted for weeks but doctors in the U.K. refused to test her, despite a promise by the government to ramp up the rate of testing.


VAUSE: A grim and almost apprehensive U.S. president warned Americans of a painful two weeks to come. The number of confirmed cases of the coronavirus is expected to surge and with that so too the number of dead. For a second day, White House predictions were stunning.

A best-case scenario would see a final death toll somewhere between 100,000 and 200,000. That is the best-case. Keep in mind, global number of fatalities right now is just over 40,000 while, in China, just over 3,000 people died from the virus.

Field hospitals are being opened in New York, Miami and other cities ahead of an unexpected flood of new patients. Refrigerated morgue trucks are now parked on New York City streets, ready to collect the dead.

With a shortage of masks for health care workers, the president is urging anyone in the public to use scarves or other material to cover their face and try and reduce the rate of transmission. Senior health officials within the administration explain why now is not the time to ease up on restrictions of movement.


TRUMP: You can use a scarf. A scarf is -- everybody -- a lot of people have scarves, and you can use a scarf. Scarf would be very good. And I -- my feeling is, if people want to do it, there's certainly no harm to it. I would say do it. But use a scarf if you want, you know? Rather than going out and getting a mask or whatever.

We're making millions and millions of masks but we want them to go to the hospitals. I mean, one of the things that Dr. Fauci told me today is, we don't want them competing, we don't want everybody competing with the hospitals, where you really need them. So you can use scarves, you can use something else.


VAUSE: For almost three months, President Trump seemed either dismissive or unconcerned by the threat posed by this outbreak. At one point, he likened it to the seasonal flu, calling it a hoax.

But on Tuesday, Trump made a point of saying, not only is the coronavirus not the flu, he said it is vicious. He spoke of a friend who is now hospitalized because of COVID-19. The president's realization comes as hospitals in New York City start to buckle under the pressure of this health crisis. Erica Hill reports.


ERICA HILL, CNN CORRESPONDENT (voice-over): The headline across America: hospitals need help.

GINA RAIMONDO, RHODE ISLAND GOVERNOR: More testing, more beds, more ventilators, more doctors.

HILL (voice-over): Convention centers in Chicago, Detroit, New Orleans and Los Angeles being transformed into overflow facilities as emergency rooms are overwhelmed with the coronavirus.

Navy hospital ships on both coasts available for non-COVID patients, while in Central Park, a field hospital is starting to treat those who have tested positive.

FAUCI: We are still in a very difficult situation. We hope and I believe it will happen, that we may start seeing a turnaround. But we haven't seen it yet. We are just pushing on the mitigation to hope that we do see that turnaround.

HILL (voice-over): As beds, staff and supplies run low, there are new concerns about the impact on care.

UNIDENTIFIED MALE: Right now, it's kind of like drinking out of a fire hydrant. HILL (voice-over): The chair of NYU Langone's emergency medicine

department telling doctors in an email to, quote, "think more critically about who we intubate," according to "The Wall Street Journal."

In Georgia, the state's nurses' association estimates as many as 3,500 retired nurses have asked to return to work -- and they are needed.

New modeling predicts the coming weeks will see a significant surge in cases. By mid April, 2000 people could die each day in the U.S.

ANDREW CUOMO (D), GOVERNOR OF NEW YORK: We have been behind it from day one since it got here and we have been playing catch-up. You don't win playing catch-up. We have to get ahead of it.

HILL (voice-over): In New York City, new data on who is affected. More than half of the nearly 41,000 positive cases are under age 50.

Across the country, a renewed push for serious social distancing, as the White House considers new guidelines.


DR. ANTHONY FAUCI, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: When we get in a situation where we have enough masks, I believe there will be some very serious consideration about more broadening this recommendation of using masks. We are not there yet.

HILL (voice-over): On board the Holland America Zaandam cruise ship, making its way toward Florida, the company says eight people have tested positive. Nearly 200 have flulike symptoms. Four older passengers have died. Their cause of death has not been released.

It is not clear when anyone will be back on land. Florida has not yet approved the ship to dock.

MAXIMILIAN JO, SON OF CRUISE SHIP PASSENGERS: It's truly a nightmare scenario. If your own country won't take you in, where are you supposed to go?

HILL (voice-over): As more Americans begin to feel the economic impact of the pandemic, other needs are increasingly apparent. The line for this food bank outside of Pittsburgh stretching for more than one mile on Monday. Officials say they saw the demand increase three weeks ago when the virus first hit the area.

HILL: Here at the field hospital that is being finished behind me, they are ready to begin receiving patients tomorrow. Meantime in New York City, the mayor announcing today an additional 250 ambulances and 500 EMTs and paramedics being sent to the city to help deal with the massive influx of 9-1-1 calls -- back to you.



VAUSE: Dr. Raj Kalsi is a board certified emergency medicine physician, with us this hour from Illinois.

Doctor, thank you so much for being with us. And thank you for coming back to talk to CNN.

First, how are you holding up?

DR. RAJ KALSI, EMERGENCY MEDICINE PHYSICIAN: Thank you for asking. We are doing OK. Every day is a new day. We are checking our own symptoms, asking ourselves if we are feeling OK.

And I have to be honest, I get a little anxiety when I get a tickle in my throat or if I have a dry cough because you always wonder that we are going to get this COVID. We are doing well.

VAUSE: That's good news. You are about to face the worst of this crisis in a week or so, like so many hospitals around the world, you will be facing this crisis with a shortage of protective equipment, other medical supplies. I want to listen to an emergency room nurse in Los Angeles, who spoke with Anderson Cooper. Here she is.


ELISSA RILL, E.R. NURSE: We have nurses that are going online to try to buy masks. We are contacting dentists' offices and nail salons ourselves, just trying to be able to get all the masks that we need. And it's sort of boggling to me that this isn't a national -- like why isn't it 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?


VAUSE: Is it a similar situation where you are, trying to find and source and finance your own equipment?

KALSI: I feel that I'm a little bit more privileged than some of these horrific tales I'm hearing from different parts of the country, even maybe different parts of the world. The organizations that I work with, I work with eight different organizations. So far we've been able to provide at least the bare minimum requirement of surgical masks.

And, for us, on the front lines, E.R. doctors, I am getting N-95 or full PAPR, which is an acronym for -- P-A-P-R, which is kind of like an astronaut suit that you see in Italy and some of the Asian doctors wearing.

So for that purpose, I'm actually doing very well. And they are allowing us to go online and buy our own equipment. Some of my organizations allow us to get them fit tested, which means qualified by hospital protocols so we can use them in the hospital and feel like we have our own that we can just keep using and then replacing our own filters.

VAUSE: You may be getting the N-95 masks, which is critical, but I'd like you to listen to the governor of your state, Illinois, talking about the problems he's had, specifically to do with those masks. Here he is.


J.B. PRITZKER, ILLINOIS GOVERNOR: My team is sorting through the shipment of 300,000 N-95 masks the White House personally told me would be sent to our state.

And while we do not have a final count on this yet, I can say with certainty that what they sent were not the N-95 masks that were promised but instead were surgical masks, which is not what we asked for.


VAUSE: There's a big difference when it comes to protective equipment between an N-95 and a surgical mask, right?

KALSI: That is correct. The surgical mask, if you've ever seen one, I think people that are not in medical fields will feel like they are about the same. They look the same. But when you wear one, when you actually apply one, the surgical mask is open on the sides and on the bottom.


KALSI: And that allows a lot of vectors, meaning viruses and other particulates, to come into the side, up into the bottom, where the top is sealed.

An N-95 is designed to be fitted to your face so it's completely sealed on all four corners, under your chin so that when you breathe out, it allows exhaust from your breath but it does not allow you to bring in anything other than through the filtration system, designed in the mask.

VAUSE: It's designed to protect against viruses, it does offer some protection but not as much. Erica Hill's report touched on this, this memo from the head of a New York hospital, the emergency department, to fellow doctors with this advice. This is about ventilators.

"We do not have the luxury of time, data or committees to help with our critical triage decisions."

He then urged them to think more critically about who to intubate, then he added that doctors will have support in decision-making at the department and institutional level to withhold futile intubations.

So in other words, doctors in that E.R. will be making life and death decisions pretty much on the fly and, when they do, the hospital will trust their judgment.

Are you expecting a similar situation for where you are?

KALSI: If the surge happens where I am at -- and we are in the suburbs and the rural communities outside of Chicago -- I think we will get to the same point. Our expected surge date can be anywhere between April 7th and April 16th, based on the models.

And if we get to that point, I'm not sure that we will have blanket carte blanche to make the decisions that want to make. Often as doctors we are worried about medical legal liability.

I have not heard much talk about that anywhere in the media. We are bound by our oath, the Hippocratic oath, bound by our ethics and morals as people and also by the law. No one is talking about a moratorium about evaluating the tort laws for doctors in this pandemic.

It's something I'd really like to hear more about. We are afraid of the consequences of making those decisions, making people DNR and refusing intubation for one person because they're elderly with multiple medical problems, to save a younger person with no medical problems.

That scares me and bothers me. We need more national talk about that.

VAUSE: Dr. Kalsi, thank you for being with us.

KALSI: Thank you so much. Appreciate it.


VAUSE: The U.K., France and Spain all reported their single highest one day death tolls on Tuesday. Spanish health officials say they are close to peaking. The health ministry reported 850 dead in 24 hours. The government is increasing financial help to households and suspending evictions, also exempting small businesses from making social security payments.

Al Goodman has details now live from Madrid.

Also, it seems that health care workers in Spain have a very similar complaint to their colleagues in the U.S., despite what government officials may say, that protective equipment which they need just is not showing up.

GOODMAN: That's right. Let's talk first about those deaths. More than 800 deaths have been recorded, each in the past four days. That is now 40 percent of all of the deaths that have come in the past four days.

Regarding the equipment, let's talk about this. There are now more than 13,000 health care workers infected with coronavirus in Spain. That's 14 percent of all the cases and many of them say it's because they didn't have the protective equipment in recent weeks as they were taking care of the initial batch of cases.

A flashpoint for this whole discussion about lack of equipment has been the huge field hospital out at the Madrid convention center, where a team from CNN, a second team in Madrid was out there yesterday, talking to people. It's a flashpoint, because medical workers there refused to go in and

take care of patients because they didn't have the proper gear. This is run by the regional government, which says they apologize. They have been making things better.

Our team there yesterday found that people were saying things were better but we also talked to a young doctor, who has been on national radio here. We have talked to him and were talking to him more this day.

He was out there. He just finished his residency. He was assigned, like many other young doctors, to go out there. He found what he described as organizational chaos. They waited a long time to get protective gear on and then they waited an even longer time, sometimes an entire shift. He has been out there several days already, standing in the anteroom, not actually going in to take care of patients.

So these are the kinds of things being seen around Spain and Europe and maybe in the United States as officials and doctors are trying to scramble just to take care of the patients and the surging numbers are what is coming to overwhelm them.

Spanish officials are moderately optimistic that the peak of the curve is approaching, because, although the deaths and number of new cases is going up, it is not going up as fast. They want to get to the peak as soon as possible and then try to push it down.


GOODMAN: So they can get clear --


VAUSE: Sorry; three weeks on lockdown so far. That seems to be taking its toll besides unrest in some parts of the country.

GOODMAN: You have seen protests against the government every night at 8 o'clock, local time. Spaniards across the country come out and applaud health care workers. At 9 o'clock local time, some Spaniards also get on their balcony to call out the government, saying they are not doing enough.

So far there has been a fair amount of unity between the socialist government and the conservative opposition with the latest batch of economic measures, all non essential workers told to stay home starting this week for the next through weeks. There has been increasing protests about how this project is being handled.

Did the government get on it fast enough?

Why wasn't there enough equipment?

Why is there still not enough equipment?

There have been various mishaps in terms of testing kits that did not work and all sorts of problems like that. It's an organizational nightmare for the people trying to run this thing. It is such a dilemma for the doctors, as we just heard.

The doctor you were talking to said what they are trying to do and the choices there trying to make. It's a difficult time here in Spain, which has the second highest number of deaths worldwide.

VAUSE: It is difficult now. It will be a lot more difficult in the days to come. Thank you for that.

We will take a short break. When we come, back from conference center to mega makeshift hospital, a new hospital in the U.K. will have thousands of beds in a health system straining under the weight of this pandemic.

Also, ahead, in Johannesburg, thousands of homeless have been relocated to temporary shelters. But thousands more still have nowhere to go.




VAUSE: With more than a third of the planet under some sort of lockdown, the way the lockdown is enforced varies greatly from country to country. In Iraq, thousands were arrested for breaking a nighttime curfew in Baghdad.

Army tanks enforcing stay-at-home orders in Morocco and Indonesia. A cricket stadium in India has been converted into a temporary jail for hundreds of lockdown violators.


VAUSE: Italy has deployed drones to try and spot those out and about in defiance of restrictions. Many will be fine but if they are infected, they could be sent to jail. Dozens have been arrested in France and Spain for violating stay-at-home orders.

And Russia is threatening violators with up to seven years in prison. U.K. police have new powers to invoice stay-at-home orders, with heavy fines and court orders. Officials in Hungary have warned anyone infringing efforts to contain the coronavirus or spreading misinformation about it could go to jail.

As many governments implemented emergency laws to enforce those restrictions, an E.U. leader has warned of the dangers to democracy.


ERIC MARNER, EUROPEAN COMMISSION SPOKESPERSON: Any emergency measures must be limited to what is necessary and strictly proportionate. They must not last indefinitely. Moreover, governments must make sure that such measures are subject to regular scrutiny.

(END VIDEO CLIP) VAUSE: Some states in the U.S. are also warning of heavy fines or jail time. Earlier this week the leader of a mega church in Florida was arrested for holding a mass gathering in defiance of local orders.

South Africa is right now in the first week of a three-week lockdown. In Johannesburg, thousands of homeless people are being relocated to temporary shelters. We go live to David McKenzie in Johannesburg.

What is the latest on this and also the homeless?

Where are they right now?

DAVID MCKENZIE, CNN CORRESPONDENT: The homeless have been pulled off the streets in large numbers. If you look behind me, this should be teeming with people. It is a secondhand clothing market here in downtown Johannesburg. It is largely emptied out. All these businesses are shuttered behind me.

You do see people walking around. Many of them don't have a choice. They have to go out and get necessities or they are forced to work because that's the only way they can get by.

But there were many thousands of homeless on the street here in Johannesburg and in the capital Pretoria. Here is what happened to them.


MCKENZIE (voice-over): On day one of the lockdown, the army and police ordered them to go to a home they do not have.

MCKENZIE: What do you think about this whole lockdown?

UNIDENTIFIED MALE: It's going to give us a tough time.

MCKENZIE (voice-over): On day four, around 1,000 of them were taken here, to a soccer stadium in the nation's capital. South Africa's homeless were rounded up and confined 10 people to a tent, many instead choosing to sleep in the stands.

UNIDENTIFIED MALE: Our hope is that no one here has COVID-19.

MCKENZIE: But it is a real risk. If one person gets, it everyone can get it.

UNIDENTIFIED MALE: It'll be like wildfire.

MCKENZIE (voice-over): Before the pandemic, Sasha Lalla's (ph) program treated many of these men for substance abuse. Now he is here to make sure they are not locked away and forgotten.

MCKENZIE: Why does it worry you if COVID-19 could get into these communities?

SASHA LALLA, COSUP: Because I think then we will be seeing a situation where people with compromised immune systems are not just at risk of COVID-19. They are at risk of death. So we have a responsibility to keep our most vulnerable safe.

MCKENZIE (voice-over): The city says it is working on more permanent, safer shelters. But the need is now.

MCKENZIE: It strikes me that even if one person in here becomes positive, it is almost impossible to slow this virus.

UNIDENTIFIED FEMALE: Almost impossible but we are really hoping we don't have anyone right now who has contracted the disease. If that is the case, we will be taking them to quarantine facilities.

MCKENZIE (voice-over): Here, the positive cases number more than 1,300 but the virus is already hurting everyone. Africa's economic capital is shuttered and millions could lose their jobs in South Africa alone.

Across the continent, the U.N. says half of all jobs are at direct risk because of the virus. For any government, there are no easy answers to this pandemic. But in South Africa, where social distancing is a privilege, the task is enormous.

MCKENZIE: Are you scared about this virus?

UNIDENTIFIED MALE: Very scared. Two weeks and we are carrying out dead bodies here.

MCKENZIE: And the cost of getting it wrong, unimaginable.


MCKENZIE: Social distancing is certainly a privilege and you see it here behind me. Like in the Johannesburg CBD as well as across the continent in informal settlements, where people are living right next to each other in shacks, often.

Just how governments are going to handle that as this pandemic sweeps the continent remains to be seen. Here in South Africa, they are making aggressive steps and going on the offense. Some 10,000 health care workers will be out in rural areas and townships and other parts of the country.

There testing what may be clusters of this outbreak and trying to aggressively stamp this out before it becomes completely out of control -- John.


VAUSE: And good luck to them. David, thank. You David McKenzie live in Johannesburg.

Now to London, where the death of a 13-year-old boy on Tuesday from the coronavirus marks the youngest known victim in the U.K. A day earlier, the virus claimed the life of a 12-year-old girl in Belgium. But adults age 60 and over are still more likely to develop life- threatening symptoms. The U.K. has reported a 14 percent spike in cases and, for those on

the front lines, a parking lot of an IKEA in London is being converted into a drive-through testing center just for health care workers.

Also in London, a sprawling conference center is being remade into a mega makeshift hospital. As CNN's Nick Paton Walsh reports, when it's operating at full capacity, thousands of more beds will be added to an already strained National Health Service.


NICK PATON WALSH, CNN INTERNATIONAL SECURITY EDITOR: This is NHS Nightingale, potentially a 4,000-bed capacity pop-up hospital here in just over a week. Behind me is very much the showcase of what they want us to see about the United Kingdom's readiness for the surge in cases they think could possibly be happening in the week ahead.

But it is still a work in progress. Tireless efforts to get out these separate booths in an area which was an empty conference center just 10 days ago. Startling to be sure, but in the event that they have to receive the overflow from other hospitals in London, the equipment and beds already here.

UNIDENTIFIED FEMALE: We will only receive patients who have COVID-19.

WALSH: You have to have a positive test to come here?

UNIDENTIFIED FEMALE: That's right. I understand that if we have to open all our beds, then, yes, I believe we will be one of the biggest hospitals.

WALSH: Of course, it is important to stress this will not be a hospital that directly receives patients. They will have to coordinate the task of trying to work out who amongst the other facilities in London and the United Kingdom urgently needs this kind of help and also manage expectations.


DR. ALAN MCGLENNAN, CHASE FARM HOSPITAL: It is worth emphasizing over and over again that this is a hospital that gets referred to by another NHS hospital. So we don't have (INAUDIBLE). We don't have a front door. It is very important that any physical care nurse could volunteer, (INAUDIBLE) elsewhere, if they come back into the system, that would be excellent for us. Because those are the ones that are in a shorter supply.

WALSH: There has been a lot of publicity about what this venue might be able to do. But in the weeks ahead, they will find out what the limits of that exactly are and also the troubling truth about exactly how many patients there will be that will require intensive care in the surge in the United Kingdom that could possibly happen over the next 2-3 weeks.

It is the only country whose leader has been tested positive for coronavirus and the efforts here are a bid to reassure people in the U.K. that everything possible is being done to ensure they are ready for whatever numbers come in the weeks ahead -- Nick Paton Walsh, CNN, inside the ExCel Centre in London.


VAUSE: The coronavirus has taken the life of a man known as a giant in the field of neurosurgery. When we come, back Dr. Sanjay Gupta looks at the life of the renowned doctor James Goodrich.



JOHN VAUSE, CNN INTERNATIONAL ANCHOR: Welcome back to CNN NEWSROOM. I'm John Vause with the headlines this hour. The U.S. is reporting instantly so far with more than 800 new coronavirus fatalities. But President Donald Trump and his White House Task Force say things will get much worse over the next two weeks.

Modeling suggests the virus could kill between 100,000 and 200,000 Americans. For perspective, the global digital right now is just about 40,000. The U.K., France, and Spain all reported the highest single- day number of deaths on Tuesday. Spain's Health Ministry said 849 people died in just one 24-hour period. Officials say the numbers are stabilizing. The country isn't at the peak of the current virus. It's very close.

Italy's senior health official says the death toll may have been underestimated. The head of the National Health Institute told reporters only coronavirus deaths that are confirmed with a positive swab have been officially recorded. He said many other people died who were not tested. Barbie Nadeau is live this hour from Rome.

So Barbie, what is the latest now if you look at the difference between what the official death toll is and what it actually might be if they haven't recorded everybody who's died?

BARBIE NADEAU, CNN CONTRIBUTOR: That's right. You know, they're looking at a lot of deaths that occurred in people's homes or in nursing home facilities where those people weren't being treated for coronavirus, had never been tested for it, but died during this period of time.

Now, they're also talking about maybe 10 times more infections because they're just not doing enough test. It's really difficult to get a good read on the mortality rate here because of that. There just isn't enough widespread testing. A lot of people reporting symptoms told to just stay at home for two weeks.

And you know, only be if they do an antibody test later on that will know the full extent of these total infections, and then you can take a look at what the mortality rate really is. But it's disturbing to think that 12,400 deaths that we've recorded so far could be an underestimation, John.

VAUSE: Also, we've had a situation in Italy, where there's been quite sort of inspirational moments when people come out on their balconies and have been singing, you know, to encourage the healthcare workers, but it seems that those moments are sort of coming to an end. I mean, some social unrest.

NADEAU: Yes, you know, it is -- it's been a long haul here. We're in the fourth week and people are nervous and their economic situation is getting more and more difficult for them. People miss paychecks yet rent is still due, bills are still due. We've seen in the south especially, police on the streets in Palermo to try to stop calls for unrest.

We've seen looting in grocery stores, people just taking what they want walking out without paying for their basic supplies, and you know the clerks are really unable to stop them because they're afraid of contracting the coronavirus. It's a very difficult situation for so many people under the lockdown.

You know, we concentrate so much on the north, which is the epicenter of the outbreak, but all across this country of 60 million people, there are people suffering in unthinkable ways, John.

VAUSE: Yes. Barbie, thank you for the update. Barbie Nadeau there live for us in Rome. Well, the coronavirus has upended routines and practices and hospitals around the world. It's highly infectious, can survive for days on surfaces, so that means a new reality of how doctors and nurses treat patients with this disease. CNN's Sara Sidner takes us inside one hospital completely revamped for this fight against COVID-19.


SARA SIDNER, CNN CORRESPONDENT: Harborview Medical Center here in Seattle is believed to be the first Hospital in America to have a patient die of COVID-19. That was more than a month ago. And since then, everything has changed.

UNIDENTIFIED MALE: It's changed how it runs.

SIDNER: Nurses and doctors at Seattle's Harborview Medical Center suit up. To go to battle with coronavirus, they have to go through an exhaustive dressing regimen. Hoods and tubes and masks and gowns just to enter a patient's room.

UNIDENTIFIED MALE: We think the greatest risk actually for healthcare workers is when they remove things that they contaminate themselves.

SIDNER: They have a checklist and a spotter helping with every step. They also have to adapt to new realities and shortages.

UNIDENTIFIED MALE: So these are what are called PAPR hoods. These are the hoods that hook up to these machines that filter air.

UNIDENTIFIED FEMALE: That's the hose that hooks up with the back or the hood.

UNIDENTIFIED MALE: They do get cleaned inside and out so they can be reused. Because the way they were built was for one-time use, but that's not the way -- if we did that, we would already be out of it.


They have completely revamped two intensive care units.

UNIDENTIFIED MALE: So this whole unit was meant to be for people with brain injuries and strokes and so forth. And so now we have to move all them someplace else because we have to continue their care.


SIDNER: So all the people with brain injuries were moved and this was turned into a COVID-19 ICU unit.


SIDNER: All to try and help coronavirus patients live, isolate them from others, and keep the staff safe too.

So I am not wearing the full personal protection equipment because in these rooms where the actual COVID-19 patients are, these are considered negative pressure rooms. That means that we are considered in a safe space, not wearing full personal protection.

Patients are being cared for, but we don't need to wear the full apparatus unless you're a doctor or nurse who has to go into the room to care for the patient.

Inside the rooms, patients are hooked up to a shocking number of tubes, using those precious ventilators, the only thing keeping them breathing.

UNIDENTIFIED MALE: So, for the ICU patients, they tend to stay -- they get very sick and they'd stay sick very long. So it requires the ventilator for weeks at a time and that's really the big issue.

SIDNER: Across just there four hospitals, 60 coronavirus patients were hospitalized last week. Already this week, it's at least 100. For each one, a delicate dance to keep staff healthy and patients alive.

It is -- just coming in here and seeing the work that's being done and seeing the patients being cared for, it's stressful. It's kind of -- I'm scared for their families, as well. And so, as you walk through when you see the hard work being done and people doing everything they need to take care of patients, just (INAUDIBLE) considering the fact that they too could be putting themselves in harm's way.

Outside the hospital, a large tent has been erected to assess and test potential coronavirus patients. And this is happening before the anticipated surge here.

I feel dread and I feel fear and I'm not working on the front line. What are you feeling as you're dealing with all these COVID-19 patients?

ARIEL ROGOZINSKI, REGISTERED NURSE: There's certainly a sense of anxiety because we, you know, right now, we're kind of wondering what it's going to be like when that peak comes and when people are you know, flooding in.

SIDNER: While the number of new infections in Washington seems to be slowing down. There's a growing sense, they haven't seen the worst of it yet.

UNIDENTIFIED MALE: What they do every day is heroic. Going and taking care of patients without protection is not acceptable.

SIDNER: The surge everyone is worried about is expected to happen here on April 19th. And all of the hospitals in this region are hoping they're prepared. Sara Sidner, CNN, Seattle, Washington.


VAUSE: The coronavirus has claimed the life of a man who saved so many others. Renowned neurosurgeon James -- Dr. James Goodrich. CNN's Dr. Sanjay Gupta knew doctor Goodrich and once spent 27 hours with him in an operating room during a procedure to separate conjoined twins. Here's Sanjay reflecting on the time they spent together.


SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: You may immediately recognize 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 Anias and Jadon McDonald, separating their brains. Two children, among countless others, alive, thriving because of Dr. James Goodrich.

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

GUPTA: For Anias and Jadon's mom Nicole, it was like watching a superhero.

NICOLE MCDONALD, MOTHER OF ANIAS AND JADEN: I'm so blessed to say that not only did I get to see Dr. Goodrich with his cape on doing the most brilliant complex surgeries that anybody could do, but 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 a conscious decision not to have kids because you don't want

that emotional --

GOODRICH: Not really consciousness. But the problem is I was in the military before college. And so when I came out, I had to go back basically community college, then college, then I did an MD Ph.D. So then graduate school, medical school, then residency, and we kept talking about it but 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 10 years, helping him take care of those kids, craniofacial surgeon Dr. Oren Tepper.

UNIDENTIFIED MALE: We used to joke. We would call him the world's most interesting man, because he was. He was a wine connoisseur, he was a surfer. Until his very last days, I imagined 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 would save so many. This past Monday morning, he died.

MCDONALD: The fought the 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. He 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.



VAUSE: 500 additional U.S. troops are being sent to the southern border with Mexico. Americans say they're being deployed to help border enforcement agents with coronavirus related issues. With the latest now from Mexico City, here's CNN's Matt Rivers.


MATT RIVERS, CNN CORRESPONDENT: Well, the number of cases and the number of deaths continue to rise here in Mexico. The new case total as of Tuesday evening, 25 people have died as a result of this virus, while some 1,215 people have tested positive so far. That's about three times the amount of positive cases as compared to this time exactly one week ago.

As a result, Mexican health officials, federal officials, have put in place a health emergency at this point. That means shuttering all non- essential businesses, government offices, all schools are closed, and everyone is being asked to stay at home and to properly social distance with other people around them. This is going to go through April 30th.

And it's a good thing because I was speaking to one doctor here in Mexico City last week and he was telling me that there is no way that the public health system here in Mexico could deal with anything remotely close to what we're seeing going on in places like the United States at this point. And perhaps that's the reason why we heard from the deputy health secretary here in Mexico over the weekend where he said that Mexico -- this would be its last chance, as he put it, to stop this outbreak from spreading.


And yet despite all those warnings, we're getting mixed messages from the president of Mexico. So on the one hand, over the weekend, he posted a video about 15 minutes long, telling people this is serious, telling people they need to stay at home. And at the same time, another video went viral over the weekend, and that would be of the president in the western Mexican state of Sinaloa where he briefly met and shook hands with the mother of famed drug lord and former boss of the Sinaloa drug cartel Joaquin El Chapo Guzman. He met her briefly during his trip out there.

Now, aside from the obvious questions that that encounter brings up, he also was very clearly not following the safety protocols that he's been promoting, stay at home and socially distance. He didn't do that and clearly shook her hand. Now asked about that, asked about the criticisms that really sparked online after that video spread, the President said that as far as the woman goes, he would shake the hand of any 92-year-old woman who wanted to shake his hand. And as -- in regards to the criticisms, surrounding him, touching another person, he said that it would have hurt his heart not to shake someone else's hand. That has been very difficult for him not to hug and shake people's hands.

So clearly, the President of Mexico saying one thing when it comes to this outbreak, and doing another. Matt rivers CNN, Mexico City.


VAUSE: Officials in China are changing the way they count the number of coronavirus cases. Patients showing no symptoms will now be included. According to Johns Hopkins University, there are more than 82,000 confirmed cases in China. Even so, officials are now starting to ease containment measures and some restrictions. For more, live to CNN's Steven Jiang in Beijing. So what is behind this decision to change the way this count is being done, to include those who are asymptomatic?

STEVEN JIANG, CNN SENIOR PRODUCER: Well, John, there was some confusion over their language of what they announced this new way of counting cases. But they just released their latest figures for Tuesday. Now we know they're still not counting these asymptomatic cases in the total of confirmed cases. But what they are doing is now they're updating these numbers on a daily basis. So the asymptomatic cases are now being included in their daily

reporting even though -- even though they're still not part of the total confirmed cases. So, for Tuesday, for example, now the government said they added -- the country added 36 new confirmed cases, but also adding 130 new asymptomatic cases.

Now, these cases and they're close contacts according to the authorities will be placed under a 14-day quarantine. Now, if you're in this window -- you're in this window, if they develop any symptoms, they will become confirmed cases. And there were apparently two such cases on Tuesday.

So there is still a bit of confusion here, but it seems they're sticking to their guidelines in terms of not counting people who have tested positive but without any symptoms as confirmed the cases, but they're also at the same time -- at the same time saying we are being more transparent addressing growing public concern over these cases. Because there was one recent example of a woman in central China become infected of this -- of this virus after she came close -- after she came into close contact with a local friend who turned out to be one asymptomatic case.

So John, so there was still a bit of, you know, game here in terms of how they account these cases. But at least, right now, from today onwards, they're going to include these cases in daily reporting. John?

VAUSE: We shall see. Steven, thank you. Steven Jiang live in Beijing. China is preparing for an influx of imported cases. Officials in Beijing are now rerouting all international flights to other cities in a bid to streamline strict screenings. As CNN's David Culver reports, so he's returning to the mainland, can now expect many hours of testing once they've landed.


DAVID CULVER, CNN INTERNATIONAL CORRESPONDENT: China taking no chances when it comes to people entering the country, shutting down its borders this past weekend to nearly every foreigner. Those who managed to get in before the closure and during hours of screening, mandatory testing, and for some, immediate quarantine.

ELAINE CHOW, TRAVELED FROM JAPAN TO SHANGHAI: So this is me before in my tiny little room here in Osaka.

CULVER: Elaine Chow, an American living in Shanghai chronicled her journey back into Mainland China from Japan.

CHOW: When I first landed, seeing all of those people and hazmat suits, they come up to you and you know, hold like a temperature gun to your head, was quite like unsettling but at the same time, you're like, OK, they definitely take this whole not getting infected thing pretty seriously.

[02:50:03 CULVER: It is a time-consuming process. As passengers go through a health screening, a detailed interview about their travel history, and finally customs. Three and a half hours later, and Chow boarded a bus to her district's testing center. The nasal and throat swab done under these tents. About eight hours after that, she got the all-clear, negative for the coronavirus, and then began her 14 days at-home quarantine.

Kim Wong is also mid quarantined after flying in from New Jersey to Shanghai. She takes her temperature twice a day and sends it to a community doctor by WeChat. Outside her door, sensor to make sure she does not break quarantine.

KIMBERLY WONG, TRAVELED FROM NEW JERSEY TO SHANGHAI: Going through the U.S. and Japan, like I thought by far this was the most organized and streamlined process that I've seen.

CULVER: A very different experience returning to China for American Michael Rosenblum. After crossing over from Hong Kong, he says he was forced to pay for this government designated quarantine hotel stay.

MICHAEL ROSENBLUM, TRAVELED TO GUANGZHOU, CHINA: Every layer of the process, I was voluntarily confined because obviously A, they're trying to protect people. And B, you know, that's the law.

CULVER: Rosenblum says he had already tested negative not once but twice. He later learned it was his neighborhood committee that determined he should be in quarantine before returning to the community.

ROSENBLUM: In so many words, somebody basically said to me, look, you know, they're not going to allow you to leave. Like well, I was told I could go home if my test result was negative. How long am I expected to stay? And they said, well, at least for 14 days.

CULVER: After six days, the local health officials finally allowed him to go back to his home and Guangzhou.

China says it's bolstering of its borders is a direct result of more imported cases of the virus getting into the country. As locked down restrictions within China ease and people start to move around again, there's also a growing concern here that asymptomatic carriers could expose others to the virus, potentially leading to another spike where the outbreak began. David Culver, CNN, Shanghai.


VAUSE: And when we come back, a tasty tribute to the man leading the fight against the coronavirus in the United States.


VAUSE: Well, cheering and applause for healthcare workers and first responders is nothing new in this age of the coronavirus. But New Yorkers have their own unique way of saying thank you. Here is Jeanne Moos. (BEGIN VIDEOTAPE)

JEANNE MOOS, CNN CORRESPONDENT: Why are New Yorkers heading to the windows at seven sharp every night? To clap. They're clapping from balconies, they're clapping some doors too. It's a standing ovation for the performance by nurses, doctors, sanitation workers, and store clerks.

UNIDENTIFIED FEMALE: Thank you. We're so appreciative.

MOOS: It comes across as a distant gift. Across the cityscape are aloud woo up close. Normally, cool New Yorkers are banging pots and ringing cowbell, though who knows we're a New Yorker get the cowbell. It's enough to touch even a comedian's heart.

STEPHEN COLBERT, COMEDIAN: I have never been more moved by applause that wasn't for me.

MOOS: Online, it goes by the #clapbecausewecare.

UNIDENTIFIED FEMALE: We got to keep clapping for two minutes.

MOOS: In addition to applause, the Empire State Building with itself up like a flashing police light to honor first responders. And how about a hand for Dr. Anthony Fauci. And we don't mean a hand on his head for his shining role.



MOOS: He's been plastered on T-shirts, even turned into customized socks. Peter's clam bar on Long Island has named a linguini with white clam sauce dish after him. Just order the Fauci. And the doughnuts delight in Rochester New York that added his image to their doughnuts has now been imitated by other bakers. Adding butterscotch, COVID cream, and quarantining sprinkles.

JIMMY KIMMEL, COMEDIAN: Making donuts to bring attention to a health crisis might be the most American thing.

MOOS: The accolades aren't a cure, but the I Love New York treatment makes it all feel a little better, even man's best friend (INAUDIBLE). Jeanne Moos, CNN, New York.


VAUSE: And we'll finish with the files that they've been housebound, way too long. We bring you the Moos family from England in their own unique quarantine version of a musical classic.


UNIDENTIFIED FEMALE: One day more. UNIDENTIFIED MALE: One more day's home education, let's just let them

run amuck. We're not ready for these schoolboys because they just don't give a --


UNIDENTIFIED FEMALE: Watch our daddy drink, see our mommy sigh, clapping for the NHS can make them cry. Here's a little walk, there's a little ride, sunshine is a bummer when we're stuck inside.

UNIDENTIFIED MALE: One day to a new beginning.

UNIDENTIFIED FEMALE: Make some respirators now.


VAUSE: It is sheer genius. The family says, they made the video for family and friends, had no expectation it would go viral. So far, about 3.5 million hits on Facebook alone. Notedly, they have apologized for butchering a classic. Thank you for joining us. I'm John Vause. CNN NEWSROOM continues next hour with Rosemary Church. Thanks for watching.



UNIDENTIFIED MALE: Our grandparents are miles away. They can't work Skype, we're broken-hearted.

UNIDENTIFIED FEMALE: One more day all on my phone.



ROSEMARY CHURCH, CNN INTERNATIONAL ANCHOR: This hour, an alarming message from the American president.