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Coronavirus Crisis Across the Country; Struggling with End of Life Decisions; New York Nurse Struggled to Get Tested for Coronavirus; Financial Tips for Surviving the Economic Slump. Aired 6:30-7a ET

Aired April 01, 2020 - 06:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[06:30:00]

ALISYN CAMEROTA, CNN ANCHOR: Assume that everyone there is positive until they get test results. The faculty has been closed to visitors for weeks.

JOHN BERMAN, CNN ANCHOR: Assume everyone is positive.

California, just one of the states where nursing homes are struggling with the spread of the coronavirus. Maryland, Illinois, Massachusetts, Louisiana, also dealing with a surge in cases at long-term facilities.

We have reporters across the country covering all these developments.

(BEGIN VIDEOTAPE)

BRIAN TODD, CNN CORRESPONDENT: I'm Brian Todd in Washington, where the toll of the pandemic at nursing homes has hit very close to home in nearby Carroll County, Maryland. Officials there saying that a second person at the Pleasant View Nursing Home in Carroll County has died of coronavirus. They now have a total of almost 80 people at that one nursing home that have tested positive for coronavirus. This is the largest outbreak since the outbreak at the Life Care Center near Seattle several weeks ago which killed several people.

OMAR JIMENEZ, CNN CORRESPONDENT: I'm Omar Jimenez in Chicago, where we are now reporting a sixth death at a single Chicagoland nursing facility. It was just a few days ago we were reporting the first. Not to mention more than 30 residents infected and at least 16 staff members.

And these are the situations that are concerning to officials, locations for a potential new outbreaks in places where practices like social distancing aren't as easily possible and these are the most concerning populations, those that are elderly and those with pre- existing conditions.

ATHENA JONES, CNN CORRESPONDENT: I'm Anita Jones in New York.

Thirteen veteran residents at a home for veterans in Massachusetts have died. Six of them tested positive for coronavirus with test results still pending for several others. Massachusetts Governor Charlie Baker calling the deaths at Soldiers Home in Holy Oak, Massachusetts, a gut wrenching loss that is nothing short of devastating for all of us. The governor has implemented a change in leadership at the facility and public health experts are conducting a thorough review of the health status of all residents and staff.

AMARA WALKER, CNN CORRESPONDENT: I'm Amara Walker in Atlanta.

Some encouraging news coming from a retirement community in Louisiana called Lambeth (ph) House. All residents who tested positive for coronavirus there are now virus-free and they've cleared CDC protocol. This according to a statement released by Lambeth House.

Now, the Louisiana Department of Health identified 42 Covid-19 patients there and reported 11 deaths. In the meantime, the state of Louisiana dealing with an alarming outbreak continually seeing cases continue to rise. In fact, state health officials tell us that they are monitoring 40 clusters at long-term care facilities.

(END VIDEOTAPE)

BERMAN: Again, such a major area of concern right now. Why Florida, why people are raising questions about Florida, why there's not a statewide stay-at-home order there.

OK, our next guest says that families need to prepare to have heart- wrenching end of life conversations with each other and with doctors. Do it now. We're going to discuss the difficult decisions confronting so many, next.

(COMMERCIAL BREAK)

[06:36:57]

BERMAN: We've heard so many stories on the difficult situations doctors and nurses find themselves in while fighting the virus, from the long hours, to the shortages of personal protective equipment, to the risk of catching the virus. But many political professionals or medical professionals, I should say, tell us that the biggest strain is the decisions they know they will soon face over who gets certain treatment, who gets the scarce equipment, who gets the ventilator.

Joining us now is someone who is grappling with these issues, Dr. Brendan Carr. He is the chairman of Emergency Medicine from Mt. Sinai Health System, which has large hospitals in the New York metro area.

Dr. Carr, it's great to have you on this morning. This is something that I know you've been struggling with and you have a lot of points you'd like to make.

Number one, you point out, we're not there just yet. You're trying to build capacity, correct?

DR. BRENDAN CARR, CHAIR OF EMERGENCY MEDICINE, MOUNT SINAI HEALTH SYSTEM: That is true.

Thanks for having me, John. We are trying hard to build capacity. And we think, in terms of a slow

pivot from the way that we are used to practicing medicine, having plenty of everything, plenty of beds plenty of providers, plenty of nurses, to a place where we are stretched and tight, to a place where ultimately we fear we might end up overwhelmed.

BERMAN: And, at this point, and we saw NYU Langone yesterday saying that it's time to think more critically about who we intubate. That's a different health care system. But you do say it's irresponsible not to be thinking about that now. Why?

CARR: You know, I mean I guess I would say that it is irresponsible to not be thinking about that all the time. The -- the -- you know, I'm the pointy end of the spear in emergency medicine and in the critical care world. The questions happen often and happen quickly. And although it -- we don't talk about it on the news every day, these decisions are made every day. But they aren't made in the way that it's been framed as who we -- who we will withhold from, how will we allocate, what is our decision guideline. They're made in concert with families. We talk about shared decision-making. The question you get asked is not, what am I going to do, am I going to intubate you or not, it's what would your -- what would your dad want, you know, if he were to end up critically ill like this? And we can't have that conversation without engaging them -- you, without engaging the public.

BERMAN: And that's why I think you are pleading with people, look, people are being asked to help battle this virus by staying home right now, but there are other ways you can help too. And you're suggesting one of those ways is to start having these discussions at home.

CARR: I am. I -- you know, again, my expertise is not in palliative care. My expertise is not in ethics. But I am the one who, when confronted in the moment, often has to -- often has to have the conversation. That conversation is much easier if people have asked what people would want.

And I would even go so far as to say I think we're living in a time where it's not unrealistic to ask your loved one about the tradeoffs that they would make, about their values. What if this were not the conventional standard that we're accustomed to, where we can always do as much as we want for everyone?

[06:40:06]

What if we had slipped out of conventional thinking into -- into, you know, what we would call contingency thinking with where we're bending the rules a little bit but still feel like we're safe, because the other end of that continuum is crisis standards of care, and that is -- that is the conversation that we've been focused on. I just want to pull us back a little bit to the contingency place where we make these decisions together.

BERMAN: I understand. People know what DNR means, do not resuscitate. But I do understand there's another standard that's DNI, do not intubate. You can actually declare that you don't want to be intubated, correct?

CARR: You very much can. It is most often done for folks who are already critically ill. The hardest conversation is when people are not critically ill. When you're, you know, an age as a cutoff it gets talked about all the time, there are plenty of people who are well into their 80s and their 90s who are living a wonderful life. They don't expect to have to make a DNR decision or a DNI decision. And yet this disease happens pretty quickly and having the conversations ahead of time is helpful.

I'll tell you, another group that does not expect to be having that conversation a whole lot and who have had it a whole lot in the last couple weeks are my faculty and my nurses and our collective staff. The number of folks that have needed a notary for a will or for a medical power of attorney or to sort of assign ownership of their kids in the last couple weeks and months in health care has been sobering.

BERMAN: That is sobering. The idea that medical professionals are having to deal with their own mortality in ways that they haven't before.

And one other thing you note. I was reading that, yes, they're dealing with this, and they're exhausted, and they're stretched, but you're also getting people, and, in some ways, more people than you've ever seen before volunteering, asking to come in to treat people.

CARR: Yes, let's begin with the fact that today the Samaritans Purse organization and opens their field hospital in the east meadow of Central Park in front of Mt. Sinai Hospital on the upper east side. It's pretty extraordinary. That was a single phone call that said, we have a capacity problem. We are worried that we're going to need help. And the answer was, we're on the way.

You know, it's -- it is a -- and then that -- and then, yes, of course, as you've suggested, lots and lots of personal reach-outs. Lots of people calling us and saying, how do I get involved, I have a skill set, I would like to help.

BERMAN: Dr. Brendan Carr, look, we thank you for the work you're doing. We know it's not easy. On a personal note, I know you haven't been home in three weeks. And I know your family and I know your wife. Please send our love to all of them. I really appreciate it.

CARR: Thank you, John. That's very kind of you. Take care.

BERMAN: So a New York nurse worked for a week at two hospitals while infected with coronavirus. How could that happen? What she told CNN, next.

(COMMERCIAL BREAK)

[06:46:59]

CAMEROTA: Testing remains a major probable as hospitals grapple with the shortage of test kits and long wait times for results. This reality is particularly dangerous for healthcare workers. CNN's Elizabeth Cohen spoke with one New York nurse who struggled to

get tested and worked for a week while she was infected. Here's her story.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN CORRESPONDENT (voice over): This nurse says she worked for about seven days at two New York City hospitals while infected with the coronavirus. She went undetected because her hospital wasn't testing the staff. She doesn't want to reveal her name or where she works for fear she'll be fired.

UNIDENTIFIED FEMALE: Two weeks ago I was feeling back pain, a lot of back pain. And then one night I had really bad chest pain.

COHEN (on camera): Did you ask your hospital to test you?

UNIDENTIFIED FEMALE: I was told the hospital was not testing staff. That's what I was told when I asked about getting tested.

COHEN (voice over): She continued to work.

COHEN (on camera): You wore the same mask the entire day from patient to patient to patient?

UNIDENTIFIED FEMALE: Yes. Yes, we do. I'm touching that mask. It's on my face. Putting it back on. Virus flies in the air. It goes right up in my nose. It's so easy to get contaminated when you have to put on something that already has virus on it.

COHEN: And you wore the same gown all day from patient to patient to patient?

UNIDENTIFIED FEMALE: Yes, the same gown.

COHEN (voice over): She says the emergency room refused to test staff, so she went there in the middle of the night when she knew a friend would be on duty.

UNIDENTIFIED FEMALE: I said, please, just this one time, do it. I want to make sure I don't have it. I don't want to spread anything. She said, OK, and she tested me.

COHEN: It took five days for the results to come back. She tested positive.

COHEN (on camera): Do you worry that you might have infected patients?

UNIDENTIFIED FEMALE: Oh, definitely. I'm worried I infected staff members, visitors, patients.

COHEN (voice over): We shared the nurse's story with the author of "Safe Patients, Smart Hospitals" Dr. Peter Pronovost.

DR. PETER PRONOVOST, CHIEF CLINICAL TRANSFORMATION OFFICER, UNIVERSITY HOSPITALS: That story is heart-wrenching. And as a clinician or just a human being, it's horrible.

COHEN: Pronovost says he wishes the U.S. could do what's being done in some other countries. At Hadassah Hospital in Israel, utilizing tests that aren't needed for patients, they test all health care workers every five days.

DR. YORAM WEISS, HADASSAH MEDICAL CENTER: We feel that this is extremely important in order to protect our entire workforce and our patients.

COHEN: But this can't be done in the U.S.

PRONOVOST: Sadly, we just don't have enough tests to do that right now.

COHEN: Which is how this nurse ended up working while infected.

Fortunately, she's feeling better now and is in isolation at home.

COHEN (on camera): Do you think right now there are doctors and nurses working in the hospitals where you work who are positive for coronavirus?

UNIDENTIFIED FEMALE: Yes. I do.

COHEN: Does that scare you?

UNIDENTIFIED FEMALE: Yes, it does. Nobody wants to get this virus.

(END VIDEOTAPE)

COHEN: At Hadassah Hospital in Israel, when they did their screening, they found more than a dozen health care workers were positive who were completely asymptomatic.

[06:50:03]

Also, when we think about this nurse, she had only mild symptoms. She never had a fever, a cough, or shortness of breath, which are the official symptoms of coronavirus. So that's why doctors say this screening is so important. Otherwise, you don't know how many of your health care workers are sick.

Alisyn.

CAMEROTA: That is an amazing story, Elizabeth, thank you very much for bringing it to us.

So the coronavirus pandemic is causing a massive financial strain on millions of Americans. The top tips from our best business minds on how to stay afloat during these next several weeks. That's next.

(COMMERCIAL BREAK)

CAMEROTA: OK, we have some info for you now if you own a small business that you've had to close during this time. The Treasury Department has released new guidelines about the government resources that are available.

Also, we have tips for everyone on how to weather the tough economic times ahead.

[06:55:01]

So joining us is CNN's chief business correspondent Christine Romans and CNN anchor and correspondent Julia Chatterley.

Great to see both of you.

OK, let's start with the tip for everyone.

Christine, give us your tips of what people need to be doing to get through these weeks.

CHRISTINE ROMANS, CNN CHIEF BUSINESS CORRESPONDENT: Well, you need to be prepared to be on the phone with your lender because you need to -- if you can't pay your mortgage payment or if you have a loan payment that is due, you need to get on the phone with a lender right away and find out what kind of relief they're offering.

You need to -- if you've lost your job, seek relief in unemployment benefit. We're really relying on the states to make sure that they are coming through here. They are just being crushed by all the demands. But your unemployment checks will be retroactive to the day you lost your job.

And you can seek relief for small business loans. That -- those -- that can start tomorrow. So that's important here.

And then save. I know that sounds sort of cruel, but you're going to have to pay those paused bills eventually. So don't be lulled into thinking that a pause on the mortgage payment, for example, means you don't have to pay it in July. We're hearing from a lot of people who are working with their banks and they've been told, you don't have to pay maybe for the next three months your mortgage payment, but then it's all due on July 1st. So be careful about that.

CAMEROTA: OK, Julia, what are your top tips?

JULIA CHATTERLEY, CNN ANCHOR AND CORRESPONDENT: I'm right there with Christine on the top one, communication is key. What you're looking for here is leniency policies. All of these lenders will have adopted lenient policies. But they may not have made them widely known because, in the end, they want people to pay if they can. So that's what you need to do, as Christine said, get on the phone and talk to these people.

Also, I've had a look across all the individual states and they vary very widely in terms of whether they've allowed mortgage payment forgiveness, whether they've stopped utility payments. In the end, even in the worst case, where they haven't stopped foreclosure proceedings, in the fine print they say they're not going to process those filings. So that does buy you a little bit of time to continue to get on the phone. Next thing, understand your cash flow. Food is a priority. Medicine is

the priority. Your health insurance, if you have it. Once you've sort of got that to grips, or got to grips with what that is, then look at what you've got left. Can you make even a small payment on your rent or your mortgage just to show willing and give you a stronger negotiating position?

And then other sources of money. If you have a 401(k), there's no penalty for borrowing against that at this moment. Also, if you have a retirement account, again, you can extract money from this and there's no penalty at this moment.

And back to the savings. Now is the time, if you have any emergency savings, and you've got money coming from the government, use it now.

CAMEROTA: That's really interesting to know that you have these alternative cash flows that you may not have considered.

OK.

So, Christine, tell us about, if you own a small business, what do people need to know right now?

ROMANS: OK, so right now they already have this two-page form for what's called the Paycheck Protection Program. You can go to sba.gov/coronavirus and you can get it there. And it shows you the information you need to start this process. They want to get this money out the door. It's $350 billion in money for small business and it's meant to tide you over for your payroll costs, including the benefits for your employees. Interest on your mortgage, rent, utilities, a couple of months of all of this overhead, the government's going to give you money to keep you afloat. This is a lifeline.

And if you keep your employees, if you keep your employees, this is going to become a grant, right? Some of this money is going to be a grant. So this is incredibly important. It's meant to protect the paycheck, exactly what it's called here, so that people can stay in business and people can stay employed until we get to the other side of this.

CAMEROTA: Julia, Christine, thank you both very much. Really important information. I know our viewers look forward to these segments.

Thank you both.

So the White House has new projections about what to expect for the next two months.

NEW DAY continues right now.

(BEGIN VIDEO CLIP)

DR. ANTHONY FAUCI, DIRECTOR, NIAID: People are suffering. People are dying. As we look forward to the next 30 days, we do it with all the intensity and force that we can. DONALD TRUMP, PRESIDENT OF THE UNITED STATES: They're very sobering

when you see 100,000 people, at that's at a minimum number.

UNIDENTIFIED FEMALE: These are the optimistic estimates. That's assuming that we are doing everything, which we know that we're not.

UNIDENTIFIED MALE: The stark message that we got in that briefing room is unmistakable, this country is about to go through a horrendous, terrible experience.

GOV. ANDREW CUOMO (D-NY): It's like being on eBay with 50 other states bidding on a ventilator.

UNIDENTIFIED MALE: We're putting our people through hell and back. This is a war. We have to behave like it's a war.

(END VIDEO CLIP)

ANNOUNCER: This is NEW DAY with Alisyn Camerota and John Berman.

BERMAN: Welcome to our viewers in the United States and all around the world. This is NEW DAY.

And this morning, up to 240,000 Americans could die from coronavirus even if we do everything right from here on out. The White House announced that, according to the latest models, even with strict social distancing, 100,000 to 240,000 Americans are projected to die from the Covid-19 virus in the coming weeks.

[07:00:05]

So, this morning, is there anything we can still do? What can --