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White House Projects 100,000 to 240,000 Americans Could Die. Aired 6-6:30a ET
Aired April 1, 2020 - 06:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DONALD TRUMP (R), PRESIDENT OF THE UNITED STATES: We're going to go through a very tough two weeks.
DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR: What would happen if people stayed home? It takes us down to 100,000 to 200,000 deaths, which is still way too much.
UNIDENTIFIED MALE: Eighty percent of the people in America are under these kinds of orders. I don't know why other governors haven't taken these steps.
GOV. RON DESANTIS (R-FL): The task force has not recommended that to me. If they do, obviously, that would be something that would carry a lot of weight with me.
UNIDENTIFIED MALE; Everyone requires oxygen. Everyone is borderline critical. According to our institutional protocol, we cannot work them up unless they have a certain O2 saturation.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASE; Now is the time, whenever you're having an effect, not to take the foot off the accelerator.
ANNOUNCER: This is NEW DAY with Alisyn Camerota and John Berman.
ALISYN CAMEROTA, CNN ANCHOR: We want to welcome our viewers in the United States and all around the world. This is NEW DAY. It is Wednesday, April 1, 6 a.m. here in New York.
This morning, we have some new projections to share with you. These are the models the White House is using to predict how long the coronavirus will last and how many Americans will be killed by the time it's all over.
According to the latest models, even with strict social distancing, 100,000 to 240,000 Americans are projected to die from COVID-19 in the coming weeks. Without the strict social distancing, that number could be as high as 2 million Americans. So this morning, is there anything we can still do to bring down those
death tolls before there is a treatment, of course, or a vaccine? At the moment, all 50 states have a different answer to that.
JOHN BERMAN, CNN ANCHOR: This morning, the total death toll in the United States stands at nearly 3,900. On Tuesday, another single-day record was set for fatalities, just like on Monday, just like on Sunday.
There are more than 185,000 known cases in the country. Governors in at least three states are warning they're close to running out of ventilators and are not getting the support they need or want from the federal government. They say they're bidding against each other and against FEMA for desperately-needed equipment.
President Trump continues to downplay their concerns, insisting he is holding back 10,000 breathing machines for the upcoming surge.
The director of the CDC believes as many as 25 percent of those infected may not show symptoms but can still spread the virus. This is significant. And it may be one reason why Dr. Anthony Fauci says he is leaning towards recommending that everyone wear homemade masks.
Let's begin our coverage with Brynn Gingras. She is live outside of one of New York's hard-hit hospitals, New York. Brynn, I should say you're back at Elmhurst, I think, with the tents behind you, intake sections obviously still struggling.
BRYNN GINGRAS, CNN CORRESPONDENT: Yes, and remember, John, CNN sources say seeing pictures of what's happening inside the hospital here behind me is partly why the president has somewhat changed his tune, right?
Well, let me explain what is happening inside. We're hearing from doctors that the conditions are just getting worse and worse. And we know, within the last 48 hours, 19 patients had to be intubated. That means those 19 patients each need a ventilator.
Of course, this is happening all across New York City and day by day, it's happening in more and more cities across the country.
GINGRAS (voice-over): The White House coronavirus task force presenting a chilling outlook.
TRUMP: This is going to be a rough two-week period.
GINGRAS: Dr. Anthony Fauci says some models project 100,000 or more Americans could die from the coronavirus, and he encourages stay-at- home measures as a key tool to mitigate the disease.
FAUCI: It's inconvenient from a societal standpoint, from an economic standpoint, to go through this, but this is going to be the answer to our problems. GINGRAS: The White House's goal is twofold: slowing the spread in New
York and preventing cities like Chicago, Detroit and Los Angeles from seeing runaway cases over the next 30 days.
BIRX: There's no magic bullet. There's no magic vaccine or therapy. It's just behaviors. Each of our behaviors translating into something that changes the course of this viral pandemic.
GINGRAS: But as states like Illinois watch case numbers rise in New York, the governor says he's worried a lack of federal help for critical supplies will leave him short-handed.
GOV. J.B. PRITZKER (D-IL): If we don't have those ventilators delivered in the next week, we're not going to be prepared across the state for the kind of onslaught that we're going to see.
GINGRAS: New York Governor Andrew Cuomo frustrated by the lack of a national plan.
GOV. ANDREW CUOMO (D-NY): So you have 50 states competing to buy the same item. It's like being on eBay with 50 other states bidding on a ventilator.
GINGRAS: Meantime, President Trump says the federal government is keeping almost 10,000 ventilators on stand-by.
TRUMP: We have to hold them back, because the surge is coming.
GINGRAS: While states struggle to purchase equipment, they also need more trained personnel to treat patients.
GOV. GINA RAIMONDO (D-RI): Doctors, nurses, CNEs, physician assistants, therapists, social workers. If you're out there, I'm calling you up. I'm asking you, please, to respond.
GINGRAS: And in many hospitals, like where critical care nurse Carley Rice works in south Georgia, there's a fear of not being able to do enough to help everyone.
CARLEY RICE, CRITICAL CARE NURSE, PHOEBE PUTNEY HEALTH SYSTEM: We have what we need. But eventually, we're going to run out of space, and we'll have to rely on the other communities. And I just pray that each patient is taken care of the way that they need to be taken care of, and we have everything that we need to.
GINGRAS: And that's the fear here, of course, and I'm sure for many doctors and nurses at this point.
Listen, the volume at this hospital is actually down. But what we're learning is that when patients are coming in, they're not in good condition. Their condition is getting worse.
So patients are actually having to sleep in the E.R., because there's not enough beds in the ICU. So that's what's happening here in this New York hospital which, of
course, we can know it's just going to get repeated across the country. And again, doctors and nurses worry the surge is still ahead of them -- John and Alisyn.
CAMEROTA: Brynn, just hearing how many people had to be intubated at just that hospital just last night is so jaw-dropping for all of us. Thank you very much for an update.
OK. Joining us now to talk about all of this, we have CNN medical analyst Dr. Celine Gounder. She's an infectious disease specialist. And Dr. Ashish Jha, the director of Harvard Global Health Institute. Great to see both of you.
So let's start with these new -- I mean, I don't know that these are new models. But this is now -- everybody's, it seems, using this, Dr. Gounder. So this is what the White House showed us yesterday. That there's a difference.
We can either have 100 to 200,000 Americans dead over the next several weeks, or 2 million. And really, it just comes down to our behavior. That's all we have. We don't have a treatment right now. It's just how we handle this.
Also, one more thing. The timeline is a little bit different. People wake up every morning, thinking how long are we going to be in this situation? Is there a light at the end of the tunnel? And Dr. Gounder, it sounds like, for these models, the timeline has stretched till the end not of April but of May. Do I have that right?
GOUNDER: Yes, that's right, Alisyn. And I think the key is to understand that we really have to implement these very strictly across the nation, through the end of May to be reaching that kind of effect, to be reaching a suppression of deaths down to the hundred to 240,000 level.
And one really big concern to me is that much of the country still is not implementing these kinds of measures effectively. And so it's concerning, because it means that we may not achieve this.
BERMAN: And Dr. Jha, I want to point one thing out. First of all, the president made the case that there are people suggesting we do nothing. And if we did nothing, 2 million people would die. No one's suggesting doing nothing. That's a straw man. OK?
The other side of that, which is more interesting to me, is they are suggesting or stating that the best-case scenario, the best case that they're looking at is 100,000 to 240,000 deaths. And you look at this and you look at the modeling, Dr. Jha, and you worry that that might be a rosy projection. Why?
DR. ASHISH JHA, DIRECTOR, HARVARD GLOBAL HEALTH INSTITUTE: Yes, so good morning, and thanks for having me on.
First of all, yes, the idea that we would just do nothing and let millions of Americans die, and that was one of the alternatives, I think, is clearly not kind of within the realm of, you know, possibility. We would never let that happen. So I think that is a straw man.
Now, the 100 to 200,000 deaths that are the projection coming out of (UNINTELLIGIBLE) Washington, look, that assumes, as Dr. Gounder said, that everybody does their part, all the states are essentially on lockdown, at least through April but probably through May. And it assumes that the disease doesn't come back again in the fall, which a lot of us are worried about.
The problem here is we started attacking this or addressing this virus really late. We wasted two months. Here we are. And now, we've got to let the science drive us. And that means everybody in the country, every state needs to shut down. Like, this idea that people are just going to go it alone makes all of us at risk.
CAMEROTA: And Dr. Gounder, 20 states still do not have statewide stay- at-home orders. There is no kind of national order here.
You know, I think that what the White House has been saying is that it's up to governors and that it's a different situation in each state. And that's true. Different states are having different rates of this.
There are some places that have one single -- I don't mean a state, but there are some counties or cities that -- that have very, very low rates. But without a nationwide order, what's going to happen?
DR. CELINE GOUNDER, CNN MEDICAL ANALYST: Well, another aspect of that, Alisyn, that's very concerning is the states that do not have stay-at- home orders also very much overlap with the states that did not expand Medicaid.
So in other words, these are states that have very high rates of un -- no insurance. People who just don't have insurance, don't have access to care. And so this is very concerning, because you're going to have, potentially, very high rates of illness in the very states where people don't have health insurance.
BERMAN: And Dr. Jha, we're also learning a little bit more. In addition to these projections, they also put some demographic meat on the bones as to who is getting sick and who's getting the sickest. What have we learned?
JHA: So we've known from China, from Italy, from other countries, that obviously, people who are older are at higher risk. And that is true, and we still know that.
But what we're learning is there are a lot of young, previously seemingly very healthy people, who are getting very, very sick. So this idea that young healthy people would do fine with this disease, and it's only a disease that affects older people or people with chronic disease, I think what we're learning in the U.S. is that's not true. There are definitely young healthy people who are getting really sick, getting intubated, even dying. So I think it's affecting all of us. [06:10:10]
CAMEROTA: Yes. And Dr. Gounder, I don't know if you were able to hear Brynn Gingras's report right before you came on, but the fact that at one hospital, 19 patients had to be intubated last night. I mean, all hospitals are wrestling with this right now.
We've been talking about this for days. They say they don't have enough for what's coming. And the idea that they're running around intubating people, and for how long people stay intubated, is just -- has just been another stunning development with this disease.
GOUNDER: Well, that's right. So people are needing to be on ventilators for two or three weeks at a time. Not a couple days at a time. And this idea that you would be holding back ventilators for a surge, if you had an opposing army that was getting ready to attack, you would have your troops on the frontlines. You wouldn't be holding back. So we need to be getting those ventilators to the very places where we see this onslaught coming.
BERMAN: Dr. Jha, we're going to talk about ventilators much more in a little bit. Because I think the numbers are hugely important.
But there is one thing that you touched on that I want to go back to, because it did come up in this briefing yesterday. Dr. Birx and Dr. Fauci were pressed on, if the United States had taken action sooner, mitigation action sooner, would that be curve be lower? Would the projection of deaths be lower? They did a little dancing. They didn't really want to answer it. And I understand why. But Dr. Fauci did approach it. I think you have an opinion on this. You think that we got into this too late.
JHA: Yes, I don't -- Look, Dr. Fauci and Dr. Birx are both terrific, both doing a very good job. And I have no interest in contradicting them.
But I think -- I don't know any public health expert who does not believe that, if we had gotten our testing together, if we had gotten our hospitals ready, if we had communicated and gotten a lot of our lockdown orders going much earlier, we wouldn't have a very different situation. We clearly would have. So I think -- again, I don't like to look backwards, but it clearly would have been different.
BERMAN: The only reason I'm bringing it up, and I'm with you. I don't want to look backwards either. But it does inform where we are today and how we should behave going forward and how seriously we have to take it going forward. Which does get to some of the things that Alisyn and Dr. Gounder were talking about, which is some states don't have the stay-at-home orders. There are different rules in place. Sometimes the direction from the top is a little confused.
JHA: Absolutely. And the one other thing I would add to a really important point that Dr. Gounder made, is that a lot of states that looked like they don't have a lot of cases aren't doing a lot of testing. So I'm not actually convinced that they don't have a lot of cases. They just aren't testing people. And if you aren't testing people, you're not going to be finding cases.
So testing is still a problem in many states across the country.
CAMEROTA: Dr. Gounder, one last thing, in our waning seconds here. Even if you do have testing, we know people -- and I'm sure you've been hearing this, as well -- they have the symptoms. They go -- I know one case just yesterday -- to get tested. They won't get their results, they're told, between -- until seven to ten days.
How is that helping? Even if you're getting testing, if you're not getting results for seven to ten days, how can you know which way to go?
GOUNDER: Well, quite frankly, Alisyn, we're trying to target testing at people who are in the hospital where it's going to change our medical management. So it's really about very key decision points. You know, do we want to treat for other conditions? Maybe this patient also has heart failure or emphysema. And so it's really to help distinguish those treatment decisions.
And I think there are a lot of people who just want to know for themselves. And so there's a limited amount of testing in that context. And that's why they're having to wait much longer. Because it's really not going to change what we do as physicians in their care.
CAMEROTA: OK. That's really helpful. That is really -- I actually didn't understand that. That is really helpful to know, that you really need the testing in hospitals, because that determines which way the doctors go, rather than people who just are desperate to get the testing at home.
We have so many more questions for you guys. Please stick around. Thank you for all of the expertise thus far.
Several states still say they do not have enough ventilators to meet the expected demand. So how can the federal government help? We discuss next.
(BEGIN VIDEO CLIP)
PRITZKER: We asked for 1.7 million N-95 masks, and we've gotten about 400,000 total. We asked for many, many gloves and gowns and so on. We've gotten about 10 percent of what we asked for. We're going to run out of ventilators, and the federal government really isn't helping at all.
(END VIDEO CLIP)
BERMAN: That's Illinois Gov. J.B. Pritzker telling CNN that his state is desperately in need of ventilators. And he says he isn't getting the help -- You heard him right there -- from the federal government that he wants.
It does come as President Trump continues to say that the federal government is helping.
Back with us is Dr. Celine Gounder and Dr. Jha.
Dr. Gounder, I just want to start with you. Obviously, there is a need out there. Obviously, the governors feel like they are not getting the support they want. These ventilators need to be in place. What is the impact if they are not?
GOUNDER: Well, this is something that's really critical to understand. Is if a patient needs to be put on a ventilator, you don't have days; you don't have hours. You have minutes to get them on that ventilator.
And so this idea that we need to wait, we need to hold back ventilators for a surge. If you have a surge of patients coming, you need those ventilators in the hospital, ready for those patients. And there's really no other way around it. Otherwise, you're going to see patients dying because they don't have access to that life-saving treatment.
CAMEROTA: But Dr. Jha, at the same time, we do hear that we're not near the peak yet. That the peak, I mean, if you follow those models we were using in the last segment, is somewhere like two weeks from now. And so if there's still 10,000 ventilators in the national stockpile, should they dole them out more slowly?
JHA: Yes, so, first of all, the peak is going to be in different cities at different times. So New York is going to peak, I think, in the next week to ten days. New Orleans will peak a little bit after that. We will see peaks in Atlanta, L.A., other places in the weeks ahead.
I think as Dr. Gounder said, you've got to get the ventilators out now, to New York. And when the peak happens and then the number of cases starts declining, you can move those ventilators to New Orleans or Atlanta or Chicago or wherever it's needed.
But the bottom line is, it takes a while to ship them, get them set up and get them ready so that when a critically-ill patient shows up, you can put them on the ventilator and take care of them.
BERMAN: So Dr. Gounder, another development over the last 24 hours is the CDC is now saying as many as 25 percent of people who have coronavirus are asymptomatic. Now, we knew that there were people walking around who weren't feeling any symptoms. That's a high number. If a quarter of the people don't know they have it and are spreading, that poses serious public health challenges, doesn't it?
GOUNDER: Well and this is precisely why the CDC is now weighing recommending that perhaps everybody in the general public be wearing masks.
And I want to be very clear. There's two reasons for wearing masks. There's the reason that healthcare providers wear masks, which is to protect themselves from infection. They're having very high doses of exposure, repeated exposures.
And then there's the reason the CDC is recommending, perhaps, that the general public wear masks, and that's really so that they don't spread to others. So if you have somebody, you know, you have 25 percent of the population is walking around with this, we don't want them spreading to others. And that's really a very different reason for perhaps recommending that everyone wear masks.
CAMEROTA: But Dr. Jha, how is that possible? I mean, we just hear about these awful symptoms that people with COVID-19 have. How is it possible that 25 percent of people with it could be asymptomatic, meaning they already have the antibodies to fight it somehow?
JHA: So what we have is -- first of all, this is a new virus. We're still learning a lot about it. It does seem like about 25 percent of people, adults who get infected and even higher proportion of kids who get it, end up really having no symptoms at all or very, very mild symptoms that they don't notice.
But during that time, they're still infected with the virus, and they're still spreading it. And they haven't become immune yet. So they're infected the way other people who have symptoms are infected. They just, for whatever reason, their immune system is such that they're not exhibiting any symptoms from the disease itself.
BERMAN: And Dr. Gounder, this is why testing is such an important issue. Yes, I understand that the way that testing evolved in the United States, we could only -- or maybe can only test people who are symptomatic at hospitals and for whom the test would change the outcome or their treatment.
But if you want to use testing as a preventative measure, if you want to use testing as a public health prophylactic, it has to be at much higher numbers, including asymptomatic people, doesn't it?
GOUNDER: Well and that's right. And Alisyn, actually, sort of touched on this issue of antibodies. So there's some new tests that are coming out that are testing antibodies, not just for the virus's genetic material. So it's useful to check for that genetic material when somebody's actively infected.
But it doesn't tell you anything about did somebody have an infection one month ago or two months ago?
And these antibody tests, there's a number that have been submitted to the FDA for review. Hopefully, some of them will receive emergency use authorizations soon. Because that would really help us figure out, you know, what proportion of the population has been infected, is now immune, and then who's still is at risk.
CAMEROTA: Dr. Jha, one last thing that -- about the governors having to struggle in this sort of "Lord of the Flies" way to outbid each other for all the supplies they need.
I mean, this is what Governor Cuomo was describing. He said it was like eBay, where he would bid on a ventilator or surgical mask, and then he'd be outbid by FEMA or he'd be outbid by -- by California.
In the countries where they've done this well, the countries that we can look to for models, how did they handle the supplies and getting them to the hospitals that needed them?
JHA: Yes, so great question, Alisyn. You know, the thing to remember is that we are all in this together, all the states, territories. We are all in this together as Americans. That's the approach that other countries took. They had a coordinated response.
If we can -- and look, we know that we haven't had that coordinated response so far. But even now, if all the states pull together, if we coordinate our buying, if we coordinate everybody shutting down, building up our testing, we can still get through this without hundreds of thousands of people dying.
But it's going to take a national coordinated response. It's not going to be 50 different responses all going on at the same time.
BERMAN: Dr. Jha, Dr. Gounder, in absentia, we thank you both for this discussion. It's been really informative.
You know, it's interesting. All these days in, Alisyn, we can still learn so much from these doctors who are in the middle of this.
CAMEROTA: Every morning, John. Every morning I -- my understanding, I hope, deepens, but there are still so many questions. And every morning we get new information in terms of the modeling.
I mean, I think that people are waking up, and they want to know how long are we in this situation and what do we need to be mentally prepared for? And we have a lot of that information this morning.
BERMAN: Yes. I think the answer is a long time, and we have to be prepared for a lot.
So some of the most vulnerable people in the United States live in nursing homes. We have new details on a new outbreak overnight. That's next.
CAMEROTA: Developing this morning, 51 residents of one Southern California nursing home have tested positive for coronavirus, along with six staff members. Two residents there have died.
Authorities say that this may be the state's largest outbreak at a single facility. County public health officials have told the nursing home to assume that everyone there is positive until they get test results. The faculty [SIC] has been closed to visitors for weeks.
BERMAN: Assume everyone is positive.