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Majority of Americans Told to Stay Home, Death Toll Over 5,000; Virus-Stricken Cruise Ships Remain in Limbo Off Florida Coast. Aired 6-6:30a ET

Aired April 2, 2020 - 06:00   ET



UNIDENTIFIED FEMALE: We really should have a national strategy instead of a patchwork of policies, but that's what we're doing.


DONALD TRUMP (R), PRESIDENT OF THE UNITED STATES: There are some states that don't have much of a problem. You have to give a little bit of flexibility.

GOV. ANDREW CUOMO (D-NY): It's a New York problem today. Tomorrow it's a Kansas problem and a Texas problem.

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASE: There's a lot of activity that has centered around a passive transfer of antibodies that could provide not only protection but also treatment.

UNIDENTIFIED MALE: There are nationwide shortages of the exact medications we need. After we put people on a ventilator, we need to increase that output immediately.

UNIDENTIFIED MALE: What are you waiting for? What more evidence do you need? You'll never regret overcompensating in the moment.


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

JOHN BERMAN, CNN ANCHOR: Welcome to our viewers in the United States and all around the world. This is NEW DAY. It is Thursday, April 2, 6 a.m. here in New York. And just step back this morning and think about how much America has changed in one month.

One month ago, there are fewer than 100 confirmed cases of coronavirus. Now, nearly 90 percent of the country is under a stay-at- home order; 5,000 people have died. We're going to get a report later this morning that could show up to 6 million Americans filed for unemployment last week.

The president has still not issued a national stay-at-home order. Five more states did add or expand theirs, including now, finally, Florida. Twelve states still have not imposed statewide orders. The message from California's governor, What are you waiting for? The nationwide death toll has doubled in the last three days.

ALISYN CAMEROTA, CNN ANCHOR: Also new this morning, the nation's stockpile of much-needed protective equipment is nearly depleted. President Trump says the supplies are being sent directly to hospitals, but governors across the country are reporting critical shortages.

New York City's mayor says the city has enough surgical masks to last until this coming Sunday. Then they'll face a dangerous shortage.

There are also new questions about the national ventilator stockpile. "The New York Times" reports that more than 2,000 breathing machines are unavailable, because they're broken or not functioning or have not been maintained.

Now overnight, Los Angeles, the second largest city in the country, became the first to urge residents to wear homemade masks in public.

And there's also some promising news on the medical front in terms of clinical trials of possible treatments for coronavirus. We have doctors standing by to talk about that. We'll get to them in a moment.

But let's begin our coverage with CNN's Brynn Gingras. She's live at one of New York's hardest-hit hospitals. What's the situation there this morning, Brynn?

BRYNN GINGRAS, CNN CORRESPONDENT: Yes, Alisyn, good morning.

You know, listen, we know the hope is that people actually stay at home and follow those orders to ease the burden on hospitals like the one here behind me or one that's in your community.

There are some areas around this country that are actually taking even stronger restrictions. For example, there are four cities in New Jersey that are on full lockdown this morning for the next week, meaning people can't even leave their homes except only for an emergency.

The city also shutting down, New York City shutting down playgrounds by order of the governor. This all the goal, of course -- this all the goal, of course, to have, you know, hands on deck.

We know that the issue here in New York City, again, as you mentioned, Alisyn, is the supply chain, right? They -- they say at this point, there are hospitals -- there are hospitals, we have all the beds. We have the overflow areas, like the Javits Center. They even mentioned, possibly, Madison Square Garden at some point.

But it's the equipment. They need the masks. They need the gowns, and they need those ventilators. Working ventilators. As you guys mentioned, the stockpile, the national stockpile dwindling.

We also have learned that the former NYPD commissioner, James O'Neill, he's actually coming back into service as a volunteer. He's actually going to work as a czar here in New York City, making sure all the hospitals around this area have the equipment they need, moving around equipment if they need to do that. And essentially, that's what's going to happen for the next week just to make sure everyone has what they need.

CAMEROTA: Yes. That was a real blow, Brynn, to know that 2,000 of the ventilators are not sort of in functioning condition. That's something that, obviously, New York hospitals, like the one you're standing in front of could have used right now.

So -- but again, some hospitals say that they have enough right now. And that's certainly good news.

So Brynn, thank you very much for all of that. We will check back with you.

Also developing overnight, Florida's governor says he has a solution for the two cruise ships that are hoping to dock in Florida. They're carrying dozens of passengers, potentially infected with coronavirus.

So far, eight people have tested positive, and four have died.

CNN's Rosa Flores is live at Port Everglades near Ft. Lauderdale with the latest. So what's going to happen today, Rosa?

ROSA FLORES, CNN CORRESPONDENT: Well, Alisyn, the ship is off the coast of Florida. And we are waiting to figure out what the fate of these people will be.

But here is the latest. Governor Ron DeSantis changing his tune, telling FOX News that once he realized that there were Floridians and Americans on board, he figured that there could be a solution to this problem, saying that he wants to make sure that Floridians are able to come on shore.

Here's the problem. It's not just his decision to make. This decision would be made by Broward County commissioners and unified command. They met for five hours on Tuesday. They tabled the issue for today. But we've checked. There's no meeting set up.

Meanwhile, the conditions on the ship have deteriorated. Here are the latest numbers from the cruise line. Four people have died. Eight have tested positive for COVID-19. Two hundred and thirty-three have exhibited flu-like symptoms. Forty-five have mild illness and are unfit to travel. And just under 10 people are in critical condition and need critical medical care as soon as they come on shore.


All this while Governor Ron DeSantis makes an about face, issuing a statewide stay-at-home order. According to the governor, he says he was taking his cues from the White House. He watched the press conference, noticed the change in demeanor in President Donald Trump. And it was when the president announced that he was extending for 30 days the social distancing guidelines that the governor says that he realized that life was not going to be normal again, and so he decided to issue this statewide order.

But not without controversy. This applies to all 21 million Floridians, but it has an exception for religious services, which means that people would be able to congregate at churches, synagogues and other places of worship, which John and Alisyn, that's the problem and that's the controversy. Because that's how this virus spreads.

BERMAN: Look, also the controversy is that it took him this long, in a state with such an older population, to issue the stay-at-home order. Interesting that he says it was only when he noticed some kind of change in perceived demeanor in the president that he realized it was serious. A lot of other governors realized it was serious beforehand.

Rosa Flores for us. Thank you very much.

Joining us now, CNN medical analyst and infectious disease specialist Dr. Celine Gounder. And Dr. Mark Supino. He's an emergency medicine physician at Jackson Memorial Hospital in Miami.

Dr. Supino, I want to start with you. Obviously, Miami-Dade, there has been a stay-at-home order for some time. So your situation hasn't changed, per se. It is new that Florida has issued this statewide stay-at-home order.

Just tell us what you've seen in your hospital you've seen over the last week and the changes you've seen.

DR. MARK SUPINO, EMERGENCY MEDICAL PHYSICIAN, JACKSON MEMORIAL HOSPITAL: Well, so, our overall patient volume has decreased. But our overall COVID volume has increased. We have seen a lot more sick COVID patients coming in, patients who require immediate medical attention.

What I will say, however, is that most patients with COVID will still do well, can still be discharged and managed at home safely and do not require hospitalization.

CAMEROTA: And Dr. Supino, just tell us the types of patients you're seeing that are infected with COVID. Does this stretch the age spectrum. Are you seeing, as we've heard from other hospitals, people, yes, in their 30s, and 40s, and 50s? Or are you mostly treating an older population? How sick are they? Just give us a sense of what you're tackling there.

SUPINO: Yes, no, that's a very good question. I think everybody wants to know what's going on.

Yes, it's a spectrum. It's across all ages, absolutely. But without a doubt, it is skewed towards the older patient population. Also, patients with comorbidities, so other medical conditions, will be affected.

Now, again, that's the spectrum of patients that we are seeing. Not all of them will be sick enough to require intensive-care-unit level of management. But it varies.

BERMAN: All right. Dr. Gounder, I want to jump around a little bit and focus on something we haven't talked about a huge amount on this show, because there hasn't been a lot of data. And that's possible treatments for COVID-19.

Now, there have been some early, early trials of hydroxychloroquine, including one just out of China, which tested, I understand, on people who were only moderately sick with not preexisting conditions; and they did find that some of them were getting better faster.

Explain to me if I described that correctly and what you take away from this study and what it really means.

DR. CELINE GOUNDER, CNN MEDICAL ANALYST: Right, John. So this was a study of about 60 people, all with very mild symptoms of COVID-19.

One thing I would point out is that some of them did receive steroids. And that's important, because the proposed -- the thought as to how hydroxychloroquine might work is as a mediator of your immune system. And steroids do that, as well.

And in looking at the paper, they don't really break down who got steroids and who didn't. So it's not clear if whatever effects that we see out of that study are from hydroxychloroquine or from steroids.

And quite frankly, they're not significant effects. And so if you're somebody who has more, you know, moderate or severe disease, as opposed to mild disease, would it make a difference for you? You know, that's the group that I really worry about, because they're the ones that don't get better on their own.

CAMEROTA: So the hydroxychloroquine is on the horizon. But let's talk about something, Dr. Gounder, that's happening, I think, right now.

And that is that blood donation centers across the country, the U.S., are already working to collect plasma from patients who have already had coronavirus, and then are -- is that already happening, where that plasma can be injected into current patients?

GOUNDER: So that has also been studied in China. There was a very small study published in the "Journal of the American Medical Association" earlier this week looking at that.


Again, this was a very small study, I believe, five patients. And there was no control. So we don't know if the patients got better because of the plasma or not.

But the idea here is that you're taking antibodies from patients who have recovered. And this is something we've done over and over again in other -- with other infectious diseases, going back even as far as the 1918 flu pandemic.

The question, though, is by this time you give patients these antibodies, is it going to reverse the course of disease? And it remains unclear what the impact is going to be, again, for patients who have moderate or severe disease; the patient who's on the ventilator, for example.

BERMAN: Just one last question, Dr. Gounder, on the epidemiology.

There is also -- and Dr. Birx really focused on this yesterday -- a great desire to test people to find out if they have the antibodies. Which is to say to test people to be able to tell if they've had coronavirus already.

Why is that important and how can that help, bigger picture, slow the spread?

GOUNDER: Well, to know if somebody has antibodies, basically, tells you have they been exposed and are they potentially immune?

And you know, one key factor here is, if they do have antibodies, are they immune? And we won't know 100 percent if that's a good marker until this is appropriately studied.

But you know, there's been a lot of discussion about, well, could we just put young healthy people back to work, for example, and just shield the older people, people with chronic medical conditions? Well, this is a much better way of dividing who might be able to go back to work. If you have antibodies, you know, potentially that would be a population that could go back to work.

The key there is not only are they probably immune, but that they wouldn't be contributing to transmission in the community. And you really want both, not just people who are at lower risk for severe disease, to be -- to have their social distancing restrictions lifted.

CAMEROTA: Dr. Supino, that leads us back to you. How do you think that Governor DeSantis' announcement yesterday of the stay-at-home order, how do you think that that will change the trajectory of what you're seeing in Florida?

SUPINO: I mean, the hope is really -- everyone talks about that curve, and that curve is so important. It's going to be impossible to completely stop everything in its tracks immediately.

But we're hoping to be able to lower all the cases, keep people as healthy as possible for as long as possible. And as people become immune from prior exposure, create a herd immunity that protects society. I think it's extremely important to socially distance ourselves and to keep ourselves at home as much as possible to prevent the spread.

BERMAN: As important as it is, Dr. Gounder, then how does it affect it as a matter of public policy when you have exceptions or exemptions for things like religious gatherings?

GOUNDER: Well, that is concerning, John. If you remember in South Korea, there was a huge, super spreading event involving a South Korean church. And so that -- you know, to me, it doesn't really matter what the purpose of the mass gathering is, the large gathering is. A large gathering is a large gathering that puts people at risk for transmitting the disease and becoming infected. CAMEROTA: Dr. Supino, just on a personal note, I know that your

hospital has already lost a colleague. A nurse who had worked at your hospital for 30 years was stricken by this.

SUPINO: Mm-hmm. It's -- it's a heartbreaking situation. And it hits home so hard when it starts happening within us and, really, our condolences go out to Araceli and her family and everybody that worked with her in the surgical ICU.

CAMEROTA: Yes. I mean, when -- and when you have to -- we've heard this from other doctors. You know, we've heard from doctors who, in New Jersey, have to intubate other E.R. doctors. You know, that -- and the emotional toll that that takes on them.

And so what is the feeling inside your hospital when you're seeing your colleagues get sick? And how many -- and would you say -- I mean, is she an anomaly, or do you have other colleagues who are getting sick?

SUPINO: I mean, fortunately, right now most people are staying healthy and, if they are getting sick, they're getting the mild form of disease. So we're very thankful for that.

But yes, these are difficult situations for all of us. And it's even more difficult when it's happening within us. A lot of it relies on our sense of community and our sense of being able to just have that conversation with each other to get us through it.

These are tough times we're all facing. The times are going to get tougher. But we went into this field with this sort of idealism of what we can do. And that idealism is actually reality; and we're able to move forward delivering the care we've always wanted to deliver and caring for our patients. And that's what we're here for.


BERMAN: Dr. Supino, Dr. Gounder, stick around. We have more questions for you, because there are many more new developments we want to touch on this morning. One, how close are scientists to developing an actual vaccine? The latest from Dr. Fauci, next.


CAMEROTA: How close are scientists to developing a coronavirus vaccine? Well, Dr. Anthony Fauci told reporters yesterday that public distribution is still 12 to 18 months out. That's the same numbers that we've been hearing, John, for weeks now, I mean, or months.

However, the first human trial is happening. It is on track. And that's good news.

So Dr. Celine Gounder and Dr. Mark Supino are back with us. So talk to us about that, Dr. Gounder. That we always heard that the vaccine was probably 12 to 18 months away. But the first trials started, I think, March 16, a couple of weeks ago. So that's promising. How much stock do you put in all of that? [06:20:07]

GOUNDER: So the phase one trial of Moderna's vaccine started to enroll back in Seattle a couple weeks ago. You know, but it has only been a couple of weeks into that 18-month period. And this is just a phase one trial, where we're really just looking to see, is this vaccine safe? You don't want something that's going to harm people. So that's the first step.

And then phase two trial will be the next step, where you look at, is this also looking at safety outcomes but also, is this something that is stimulating the immune system in the way that we'd like?

And then, finally, in the phase three, which is going to actually be the step that takes the longest and has the most number of patients, will -- will look to see, is the vaccine protecting those who receive it versus those who don't?

But that all takes time. And part of the time that's involved is for people in the phase three to actually be exposed to the virus and to see if the vaccine works.

BERMAN: Dr. Supino, there's some infuriating news about ventilators. The idea that some 2,000 ventilators aren't working the way they're supposed to because a contract wasn't fulfilled in time to provide maintenance for them. That's in "The New York Times" this morning. Like I said, that's infuriating.

But I'm not sure people fully understand the role that ventilators play in emergency rooms and ICUs and how many lives they can save. In some cases, I think, people might overemphasize their ability to bring people back. Yes, ventilators can prevent a death. But what percentage of people or, roughly, what happens with most people who end up on ventilators?

SUPINO: I mean, a ventilator is essentially a machine that breathes for the patient. What's key to management -- what's key to managing these cases is that they have severe respiratory problems and can't breathe on their own. So we have to take over their breathing.

The machine is just a surrogate to breathe for the patient. So we need machines to be able to do that for our patients.

The issue with managing patients on ventilators is getting patients on ventilators may sometimes be difficult to get them off the ventilator. With this disease, we don't have much of a choice when they get that sick. We need to intubate them and put them on a ventilator and manage them until they get healthy in that fashion.

BERMAN: It forces a decision much more quickly, in other words, than it might otherwise?

SUPINO: Absolutely. These are patients who, when they arrive by ambulance, need to be intubated in the next few minutes. And it just barely gives us enough time to put on our personal protective wear, gown up, get protected, get in the room ad intubate the patient. CAMEROTA: And just why is it hard, Dr. Supino, to then get them off a


SUPINO: They become sort of dependent on the ventilator in a sense. And their respiratory muscles weaken subsequently. And so the weaning process can be extended, and not every patient is able to make it.

But that being said, there are plenty of patients who do get intubated and get extubated very successfully and walk out of the hospital healthy.

BERMAN: Dr. Gounder, there's another bit of reporting overnight that I want your take on. And I'm not going to explain it with the right terminology. But it has to do with the immune systems of what appear to be largely healthy people. And it might explain why some, a small number of seemingly healthy people, are getting very sick or dying from COVID-19.

And it has to do with over-activating somehow the immune system or turning it on in a way that it can't be turned off. Can you explain this?

GOUNDER: Right. So some people asked me, Well, how can I make my immune system stronger? Are there vitamins I can take, and so on? And it's really not a question of having a stronger immune system. The immune system is really a balancing act, where you want it to protect you against outside germs, but you don't want it to turn on yourself.

And what we're seeing with COVID-19 is that the immune system is so exuberant that the inflammation it generates is actually turning on the body itself. The inflammation in the lungs is part of why COVID-19 is causing such severe pneumonia and the need to be on a ventilator.

So you know, it's really a balancing act. It's not about revving up your immune system too strongly either.

CAMEROTA: That's really interesting. Because you know, when we hear about healthy 30-year-olds, you know, in their 30s, with no underlying conditions dying, we all look for an explanation. That how -- this isn't -- we were told this wasn't supposed to happen.

And so the idea that their immune system is in overdrive sort of makes intuitive sense. Medically, you know, I don't know if that's what's happening, Doctor. But is that the explanation for otherwise inexplicable young people?


GOUNDER: I think that's part of it. I think the other part is the dose of virus that they're exposed to. And this is actually why we're seeing healthcare workers get very sick and pass away from COVID-19, even if they are young and healthy. And it's because, if you think about it, if you get many more virus particles in your body all at once, your immune system has less time to recognize what that foreign invader is and to mount a response. If you only have a tiny amount that you're infected with up front,

your immune system has a bit more of a head start, more time to respond and protect you.

CAMEROTA: That is really helpful information. Thank you both. Dr. Gounder, Dr. Supino, we really appreciate you giving us a status report and explaining what else is on the horizon. Thank you for all of the expertise.

And speaking of young people, more than 40 spring breakers from Texas who ignored public health advice are now positive for coronavirus. We have their story next.


CAMEROTA: Now some numbers for you. There are now more than 216,000.