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U.S. Braces for a Devastating Week as Death Toll Climbs; Georgia Governor Opens Beaches Day After Statewide Stay-at-Home Order; Louisiana Surpasses 13,000 Confirmed Cases of Coronavirus; U.S. Enters Pivotal Week as Hot Spots Near Peak Infection Days; Inside NYC Hospital Emergency Room During Coronavirus Fight. Aired 9-9:30a ET

Aired April 6, 2020 - 09:00   ET



POPPY HARLOW, CNN ANCHOR: All right, good Monday morning, everyone. I'm Poppy Harlow.

JIM SCIUTTO, CNN ANCHOR: And I'm Jim Sciutto. America bracing a pivotal, what could be a devastating week ahead in the fight against the coronavirus as the death toll grows. The surgeon general not holding back.


DR. JEROME ADAMS, U.S. SURGEON GENERAL: This is going to be the hardest and the saddest week of most Americans' lives, quite frankly. This is going to be our Pearl Harbor moment, our 9/11 moment, only it's not going to be localized. It's going to be happening all over the country, and I want America to understand that.


HARLOW: It's pretty stunning statement by the surgeon general, and this morning, a stunning report to match it from a top government watchdog. Here is the headline, "The nation's hospitals are facing severe and widespread shortages of desperately needed medical supplies." Those shortages making it harder for hospitals to test and protect their own staff. Of course those on the frontlines.

Here in New York, the mayor says the city is hours away from possibly running out of those critical supplies and the nation's top infectious disease expert says the U.S. does not, Jim, does not have this under control yet.

SCIUTTO: Yes. And it's not. On the heartening side, we are seeing signs that social distancing is making a difference in states such as Washington, California, perhaps some early signs in New York.

We're following all the breaking headlines, getting a firsthand look inside a New York emergency room. First, let's get to Athena Jones. She's outside the Javits Convention Center in New York. This is one of those hospitals set up to handle the overflow of cases from all the other hospitals. How busy is it there right now? ATHENA JONES, CNN NATIONAL CORRESPONDENT: Good morning, Jim. Boy, is

this necessary? Governor Cuomo pointing to the fact that Javits, this Javits Convention Center you see behind me is now going to be opening its doors to COVID-19 patients, starting today, and that is very important, because as Governor Cuomo said, that will represent a big operational shift. If this works as they hope and think that it will, it will make a dramatic change and it's coming at a time when the city desperately needs it because of a huge surge of patients, sick patients with COVID who are showing up at New York hospitals and really overwhelming the system. And so that is the hope here that this convention center's 2500 beds will help relieve that pressure quite a bit.

And one thing that I should point out, you know, a hospital administrator said he's relieved that the Javits Center is now going to be housing these COVID patients saying that it was unrealistic to think that it wouldn't be, because for all practical -- as a practical matter, the patients that New York hospitals are seeing almost to a tee are COVID patients and, you know, I'm hearing this from my reporting as well, I spoke with an emergency room doctor at a hospital in Brooklyn who told me, look, even the patients coming in with appendicitis or a stroke or another kind of infection, when they end up admitting these patients and doing a chest x-ray, which is typical at this hospital, when admitting patients, they find evidence of interstitial pneumonia, interstitial bilateral pneumonia.

That means pneumonia in both lungs. They said this is a classic telltale signs of COVID. So bottom line here most of the patients these hospitals are seeing are COVID patients, and that is why a place like the Javits Center is going to be so important to making sure they can handle this coming surge.

SCIUTTO: And cities all over the country doing similar things. We saw similar in Detroit, other communities.

Athena Jones, thanks very much.

CNN was given exclusive access inside the emergency room at one New York City hospital suffering through this, is one of the three in the state now treating only coronavirus patients. They're specializing here because of the overflow.

CNN's Miguel Marquez joins us now.

Miguel, tell us what it's like inside because I think these views inside the hospital are something our viewers rarely get and they're very revealing about just how severe this crisis is.

MIGUEL MARQUEZ, CNN INTERNATIONAL CORRESPONDENT: I mean, in a word, it is absolutely sobering what's happening in there. We were at SUNY Downstate, and so they are receiving some of the sickest patients in the area and in the city, and about a quarter of the people who are there now die.

We've been into two ERs in the last week or so, CNN has, and the reason the administrators and these doctors want us in and they are letting us in to see this, they want the world, they want the U.S., they want everyone to see just how intense this crisis is.


MARQUEZ (voice-over): The frontline in the fight against coronavirus. The Brooklyn emergency room of SUNY Downstate Health Sciences University. Patient after patient, struggling to breathe. This morning has been brutal.


DR. CYNTHIA BENSON, EMERGENCY ROOM PHYSICIAN, SUNY DOWNSTATE: Today is pretty intense. We've had a bunch of people die in a very short period of time which we, you know, are prepared for, but when it happens so many times in one shift, it's pretty hard to tolerate.

MARQUEZ: As we arrive in the E.R., the latest victim of coronavirus at SUNY Downstate is being wrapped up in the emergency room bay where doctors tried to save them.

We visited SUNY Downstate for about three hours midday Friday. In the short time we were there, in the emergency room alone, six patients coded. In other words, they suffered heart or respiratory failure. Four of them died. A devastating part of just one day.

BENSON: This is what we trained to do and this is what we signed up for. Just not in this volume. You know, you may have a code. Maybe on a bad shift you may have two codes where you carry that emotion and you wonder if you did everything that you could. I think it's emotionally hard to prepare for this level of sickness and suffering and morbidity and mortality in such a short period of time. I don't think any of us are well-prepared for it.

MARQUEZ (on camera): Have you ever seen this E.R. jammed like this?


MARQUEZ: You're not at max yet, but you're pushing it.

PALADINO: Yes. We're pushing it. So at times the emergency room here there's no room to move. But we have a system of where we decompress them out behind here in the hallways. Our other room is the fast pack. Not many people have been bringing in their children so we've taken over part of pediatrics. There's also clinics back here that we can turn into beds and they wait there once they're stabilized from here, and then go upstairs.

MARQUEZ (voice-over): The corridors in the E.R. here lined with those suffering from coronavirus. Patients unresponsive, struggling to breathe. It is the hard reality of this virus. For some patients it attacks the lungs, depriving them of oxygen, slowly suffocating them.

PALADINO: With COVID, the pneumonia is not just in one lung, but rather in both lungs, leaving the patient with no good lung. And it's also widespread throughout both lungs with a massive inflammatory reaction that's damaging the lungs. MARQUEZ: Keeping the most critically ill patients suffering from

coronavirus breathing, it is as simple as it gets in medicine. But still a mystery as coronavirus resists treatments, confounds doctors and kills patients.

PALADINO: Here in terms of the airway, we have to manage their airway once they become so altered from the lack of oxygen that they're unable to keep it open themselves.

MARQUEZ (on camera): And what is the mortality rate? Once they go on a vent, what happens to mortality?

PALADINO: It increases exponentially.

MARQUEZ: More patients die in other words?

PALADINO: They do. The numbers are not exactly the same from country to country. And there are various factors for that. But we all agree that it skyrockets.

MARQUEZ (voice-over): Dr. Lorenzo Paladino is an E.R. doctor who has done groundbreaking work on putting more than one person on a single ventilator. It's research he hopes that will never have to be used here.

PALADINO: What keeps us up at night is precisely what motivates us to do that kind of research here at SUNY Downstate, is that we want an alternative to give to these patients. And not just the ventilators, but also for CPAP and isolation, oxygenation high flow. We try all sorts of maneuvers in order to keep them breathing and keeping them from suffocating or having a cardiac arrest.


MARQUEZ: And it's not just in the emergency room where patients struggle to breathe and code.


MARQUEZ: While interviewing doctors in other parts of the hospital --


MARQUEZ: -- nearly constant overhead announcements.


MARQUEZ: That another patient has coded.


MARQUEZ: Those announcements for patients already admitted, not those in the E.R.

(On camera): Can I just stop you for a second? This --


MARQUEZ: This is the fifth or sixth code 99.

DR. ROBERT FORONJY, CHIEF OF PULMONARY AND CRITICAL CARE MEDICINE, SUNY DOWNSTATE: Code 99 is typically a rare event. We're having I would say 10 code 99s every 12 hours at least.

MARQUEZ: Well, we've been here for about 30, 40 minutes and that's the fifth or sixth one.

FORONJY: And a lot of that -- what that represents is calling for a team to put an individual -- a patient on a breathing machine.

MARQUEZ (voice-over): What is most jarring about seeing the inside of an E.R. and hospital making the transition to being one of three in New York state that will only treat patients suffering from coronavirus, outside it is quiet and feels like an early spring day.

(On camera): It's slow moving. And it's damn boring for a lot of people. But this is a disaster.

DR, ROBERT GORE, EMERGENCY ROOM PHYSICIAN, SUNY DOWNSTATE: This is definitely a disaster. It's kind of difficult to -- for people from the general public who don't work in the hospitals because when you walk -- when you drive down Clarkson Avenue, you're driving on New York Avenue, on Nostrand Avenue, which are pretty busy thoroughfares, it's almost crickets.


But then here in the Emergency Department it's a level of intensity that you only see in disaster zones that have been televised around the world.


MARQUEZ: Now here's another data point somewhat disturbing about how SUNY Downstate is preparing. Keep in mind, they are a COVID-19 only clinic or hospital going forward. Their regular morgue has been overwhelmed. They have two tractor trailers out there. They are talking about putting shelves into those tractor trailer, so that they can put more bodies into them. They're also talking about shutting down one of those streets around the hospitals so they can bring three more trailers in.

SCIUTTO: Terrifying.

HARLOW: And those trailers, makeshift morgues, to house all of the body. It's unbelievable. And Miguel, you're right, the sunshine and the flowers blooming outside is just deceiving to the crisis going on in the inside.

Can you talk about how they are dealing with all of the incoming and all of those code 99s right now while also preparing for the peak or the crest that is still to come, meaning a bigger disaster and even more? MARQUEZ: This is what they are all still preparing for. They have a

second hospital that they took over a few years ago, just a couple of miles away in Bay Ridge, and it was out of commission. Now that is coming back into use, hoping to add about 140 beds there. They've cleared out the cafeteria for the employees there. That will be a COVID-19 only ward.

They have tents. They have -- you know, Jim's been in many war zones before and you see those Quonset hut like tents out there that are now just jam-packed with beds. They're negative pressure tents so that anything in there will be vented up and out. They are -- in some ways, they're more high-tech than their entire E.R. is but they are preparing for an absolute onslaught.

SCIUTTO: Yes. I mean, it's not a gratuitous comparison to say it's a war-time response to this, right, as you see the measures they're taking.

Miguel, we hear de Blasio, we have Cuomo talking about running out of ventilators in New York in the next several days. You say they've done research there about using a ventilator for more than one patient. How close is that hospital to reaching that point, where they may run out of ventilators or do they have a plan?

MARQUEZ: They're not close yet. They have about 65 ventilators in total. They have about 30 people on ventilators. They might be able to get a few more that are coming in now. So they think they can manage for right now. What they don't know is how big the crest of that wave will be, and even if they do have to go on, put two patients on a single ventilator, it's not very simple. If they have other sort of issue, if they have asthma or they have other breathing issues other than COVID-19, then putting two people on that same ventilator is not always the best answer.

The other thing that came out that was very, very clear from this, if you go on a ventilator, that's not good news. This virus, this disease in some people is so aggressive it just destroys their lungs and makes it very, very difficult for them to survive.

HARLOW: That a ventilator cannot save them in some circumstances, as you said, just confounding to the doctors and nurses.

Miguel, thank you again. Just such an important look inside the front lines.


HARLOW: Up next, you've got a lot of questions. We have a lot of questions. We will get them answered with a doctor again on the frontlines here in New York City, and the governor of Georgia issuing a state stay-at-home order but allowing beaches to remain open. Why? We will ask the lieutenant governor ahead.

SCIUTTO: And British Prime Minister Boris Johnson just spent the night in the hospital battling symptoms of coronavirus. We're going to get a live update from London. (COMMERCIAL BREAK)


JIM SCIUTTO, CO-ANCHOR, NEWSROOM: Officials in New York, they're warning of just a devastating week ahead. For doctors who are treating patients every day, they're seeing them, it's been an intense battle, Poppy.

POPPY HARLOW, CO-ANCHOR, NEWSROOM: The numbers are just -- leave me speechless, I think all of us this morning, the nationwide death toll inches closer and closer to 10,000. With us now is Dr. Susannah Hills; a surgeon at Columbia Presbyterian here in New York, she's been treating COVID patients at her hospital over the last few weeks. Doctor, thank you for what you're doing and thank you very much for being here.

We're hearing the words "peak" or "crest" here in New York. At some point this week, what should everyone at home take away from what that really means?

SUSANNAH HILLS, EAR, NOSE & THROAT SURGEON, COLUMBIA PRESBYTERIAN HOSPITAL: I think it is really too early to know for sure. Wouldn't we all love that to be the case. I think that would be the best news possible. I think we'll need a few more days' worth of data to know for sure if we are hitting a plateau or a peak.

Regardless, I think all of us are of the mindset that we are in this for the long haul, particularly, those who are really at the front lines, the emergency room workers, the ICU workers, people like me, we're here starting to back up those other services, taking shifts in the ICU and the emergency department to help out because we're anticipating that this is going to continue for weeks to months ahead.

If this is a plateau, if this is a peak, and we're going to start to see things stabilizing, it will absolutely be to the credit of every New Yorker who has been staying at home, making that sacrifice to keep the health system intact, so we can --


HILLS: Treat the people that are coming in.


SCIUTTO: Yes, we heard Vice President Pence, even the president yesterday complimenting New Yorkers for their compliance with this. We have Dr. Hills, a bizarre situation here where public officials with no medical expertise are contradicting the public officials who have that expertise and whose job it is to respond to outbreaks like this. I want to give you an example because it occurred on our air just less than an hour ago.

This is the White House trade adviser disagreeing with Dr. Fauci, who is of course one of the leaders of the response here on the use of a malaria drug. Have a listen to his comments there and I want to get your response.


JOHN BERMAN, ANCHOR, NEW DAY: So why is Dr. Anthony Fauci; the lead infectious disease doctor in the country wrong about this in your opinion?

PETER NAVARRO, TRADE ADVISER FOR WHITE HOUSE: Sure, I'll let him speak for himself, John, but I would have two words for you, second opinion. Basically, what I have said, and the only thing I have said is that the scientific studies that I have seen point to the possibility that it has both therapeutic efficacy as well as possible prophylactic efficacy.

And one thing I would ask you to do, John, as you speak to these doctors and nurses and at the people at the frontlines, ask them how many of them are taking hydroxy as a prophylactic in the war zone. So, I'd appreciate it here, John, this is -- this is a situation where this drug could save lives and I think there needs to be a debate.


SCIUTTO: Two questions I have for you, Dr. Hills, one, who do you listen to, Fauci or Navarro on this key question here. But also, is there a benefit to kind of experimenting in real time with a malaria treatment in response to coronavirus?

HILLS: So, I think we absolutely have to be listening to the health experts, the medical professionals when we consider using drugs and medications to treat any disease especially when we're considering using drugs in experimental ways that have not yet been FDA approved or scientifically proven to have a benefit. So far, we do not have any controlled trials that suggest or prove that hydroxychloroquine is going to be the treatment we should be using for COVID-19.

It is absolutely being used in special circumstances and under the care of a physician and the care of a medical team, that can be very appropriate. But absolutely, the medical providers are the ones with the experience and the knowledge to be dived in use of these new treatments. We still are learning so much about this disease every day, and --

HARLOW: Right --

HILLS: Proceeding with caution, with guidance is critical.

HARLOW: Well, look, the president said over the weekend, he miss -- you know, he said something that it is in fact, that it was FDA approved. It's not FDA-approved to treat COVID as Dr. Fauci. He said, can you just remind people of what the adverse effects of it can be, and the toxicity that can result in taking it if it doesn't work the way that you hope it will?

HILLS: I actually took hydroxychloroquine when I had malaria about 15 years ago, and it's a very toxic drug. It can damage the organs, it can do more harm than good in certain circumstances especially when you have a disease that's already affecting the organ systems in the body, in advance, like we've seen advanced stages of COVID-19. So yes, all medications have side effects. All medications have benefits.

Hydroxychloroquine needs to be treated with a great deal of care, and treated on an individual case-by-case basis, by a medical team that has the expertise to guide use of those medications.

SCIUTTO: Dr. Hills, good luck to you, good luck to the patients you're going to be seeing in these coming days and weeks. We really do wish you the best of luck --


HILLS: Yes, thank you so much for having me. It's been the honor of my life to participate in helping patients with the disease, to serve alongside the emergency worker thing, the ICU workers in the weeks ahead --


HILLS: But they are the ones who are really fighting this battle.

SCIUTTO: Well, you're all doing --

HARLOW: Thank you --

SCIUTTO: Us proud.

HARLOW: Yes --

SCIUTTO: You really are --

HILLS: Yes --

SCIUTTO: You're doing us in the country proud --

HILLS: Thank you so much.

SCIUTTO: Well, a day after announcing a state-wide stay-at-home order in Georgia, the governor has now reopened the state's beaches, angering some community officials who had decided otherwise. We're going to speak with Georgia's lieutenant governor about that decision and more. Stay with us.



HARLOW: In New Orleans today, a convention center-turned hospital is taking coronavirus patients for the first time. This comes as the city's coroner's office says they have already reached capacity at the morgues there. The state saw its largest single day death toll yesterday with 68 deaths. Let's go to Ed Lavandera, he joins us in New Orleans. So, at least, they have this capacity now to take in more patients. What is the word on the ground there right now? ED LAVANDERA, CNN NATIONAL CORRESPONDENT: Well, just like everywhere

else, this is a week with a great deal of concern here in Louisiana. There is a kind of some mixed bag of news, and I think health officials here in this state are trying to make sense of it all. If you look at the latest numbers, the number of overall cases jumped to over 13,000, slightly less increase than we've seen over the last couple of days before that, that could be in large part to the number of test results being returned.

But 477 deaths now, and that was a large jump from over a course of a 24-hour period. But there are now fewer people using ventilators here in this state, only by 10 or so, but that number had been going up. So any downward trend, and of course, one day does not a trend make, but we will continue to monitor that as well. But state officials here continue to warn that the coming days will be the biggest test on the medical.