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Americans Brace For Hardest Week As Deaths Near 10,000; How Disease Hunters Track Pandemics Around The World; Intensive Care Doctor On Her Fight With Coronavirus. Aired 7-7:30a ET

Aired April 6, 2020 - 07:00   ET



JOHN BERMAN, CNN NEW DAY: Welcome to our viewers in the United States and all around the world. This is New Day.

This morning, the surgeon general issuing an ominous warning to the nation, brace for a disaster on the scale of September 11th or Pearl Harbor.


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 going to be localized. It's going to be happening all over the country.


BERMAN: That was the surgeon general.

Then Dr. Anthony Fauci, the top infectious disease doctor, cautions that as many of half of those may be asymptomatic and says the United States is struggling to control the virus.

The U.S. is now losing more than 1,000 people a day as the death toll in this country may soon surpass 10,000. Dr. Deborah Birx is advising Americans to avoid even going to the pharmacy or grocery store this week.

And in one of the nation's hardest hit areas, New York, it's actually reporting its first drop in cases. But Governor Cuomo warns it's too early to tell if that will last.

ALISYN CAMEROTA, CNN NEW DAY: President Trump, meanwhile, continues to push for the use of the anti-malaria drug, hydroxychloroquine, despite scientific evidence of the drug's effectiveness.

Meanwhile, British Prime Minister Boris Johnson remains hospitalized this morning in London for coronavirus. Downing Street says it's a precautionary measure because of the persistent symptoms that he's had for nearly two weeks now. BERMAN: All right. Joining us now is CNN Chief Medical Correspondent Dr. Sanjay Gupta and Dr. James Crowe, the Director of the Vanderbilt Vaccine Center. His lab is working to develop an antibody therapy that perhaps could be used to treat coronavirus patients.

Sanjay, I just want to start with you. As we begin this new week, as we look forward to what might be the peak in the next week to ten days in New York, what are you looking for?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes. You know, we want to follow these numbers closely, John. Obviously, you know, you're looking for the change day-to-day but also the rate at which these numbers are changing.

Also, John, you keep in mind that we've seen obviously these cities around the country that, 10, 12 days ago really didn't have much in the way of positive confirmed cases. I want to make sure we keep track. Don't take your attention off these other cities as well. A lot of focus, obviously, on New York, understandably so, Louisiana, New Orleans specifically, Detroit, but what about these other cities as well?

As you remember, until testing ramped up in New York, we didn't really get a good sense of just how widespread the coronavirus was, how much it was spreading in communities. We want to make sure we don't miss that in other places as well so it can be addressed more quickly, John.

CAMEROTA: So, Dr. Crowe, as we brace ourselves for whatever is to come this week, and obviously these are ominous warnings from the surgeon general in terms of it being like 9/11 or Pearl Harbor, I know that you have sort of the light at the end of the tunnel that you're working on, and that's this antibody serum. And so can you just tell us what this would do and how close to being a reality?

DR. JAMES CROWE, DIRECTOR, VANDERBILT VACCINE CENTER: Yes. Well, antibodies are part of your body's natural immune response to viruses and they will protect you against infection or re-exposure. And so they can serve as a marker of immunity. So we may be able to use serum, antibody tests to see who has been infected, even if they weren't treated previously. And, possibly, these are proposed for the basis of certificates of immunity for people to go back to work.

Furthermore, there are now trials of plasma being collected in places like the New York Blood Center that will be transferred to individuals at risk to see if the antibodies in the plasma from one person who is immune can protect another.

What we're trying do is use techniques of modern molecular biology to capture individual cells from immune individuals and turn the antibody from that immune cell into a drug in the lab and manufacture it in a pharmaceutical setting.

We've already discovered antibodies that do that activity against the virus and we're racing to get them into clinical trials.

BERMAN: And that could be if it works out a promising development.

Sanjay, I want to talk about another area that the president, for whatever reason, spends a lot of his time at the White House podium talking about it, and that's hydroxychloroquine. It's this anti- malaria drug that many people are now trying in various kind of testing, trying on people to see if it matters or helps in these treatments.


Just give us the facts right now as you see them about what we know about how effective this really is.

GUPTA: Well, look, I mean, there's only been very small studies around this hydroxychloroquine. And, you know, there's been enthusiasm in the past for this particular drug, even going back some 10, 12 years, John, as a potential treatment for flu, just the regular flu virus. Back then, it showed a lot of promise in the laboratory, it didn't translate into human beings. It's got to be tested. I think that's the big concern.

Something to point out, John, and maybe this will make sense, but so far, it's really been trialed in patients with mild disease. That's who they're trialing it on. And they've had some evidence in China that maybe it decreased the duration of someone's symptoms, such as cough and fever, by about a day or so.

The issue, John, is that as you know, and this is a good thing, that most patients who have mild disease, most patients overall do recover from this. So if most patients are recovering regardless and then you're trialing a drug with mild disease, it's hard to really assess whether there's benefit. That's why you have to do larger and larger trials to make sure that's the case.

We just don't know yet. We just don't know. Obviously, everyone is hopeful. Everybody wants a therapeutic of some sort, but we just don't know yet. There's lots of different trials going on, different therapeutics. This is the one that's gotten a lot of the attention and a lot of the resources. You just don't want to miss something else that might end up being very promising as well.

CAMEROTA: Yes. And that does raise the question, something that we don't have a lot of visibility on, Dr. Crowe, and that's, how many people have recovered. So we see these numbers on our screen obviously every morning and they are grim in terms of the total cases and the total deaths, which obviously are going up this week. But in terms of the numbers of people recovered, it's hard to track them because maybe you never left your home, maybe you didn't know you had it.

Dr. Fauci now says that he thinks that it's possibly 50 percent of cases are asymptomatic. That's much higher than we knew. And so it's hard to get our heads around. I mean, maybe you all know something that we don't. But in terms of recoveries, how can we ever get our arms around that?

CROWE: Well, the testing that is being done principally right now is using a swab from the nose or throat to look for the virus itself. But there are tests now involving where we can use the blood of people who may or may not have been previously infected and to see if they're reacting to the virus by part of their immune system. And that serum test or serology that the CDC is starting to make those available, they'll be used very widely.

So this is an after the fact accounting of how many people were infected. And that will help us know exactly how much of that occurring (ph).

BERMAN: Yes. It would be interesting to see from a medical ethics perspective about what that means or how the United States uses that information. You talked about certificates of immunity for people to go back to work. We'll see how that works or if that is something that's implemented.

Sanjay, there's another piece of data that came out this week that I found interesting being a guy, which is that it turns out that men are being -- or showing symptoms of COVID-19 at higher rates than women and also dying at higher rates than women. Is there any explanation of why this is?

GUPTA: Well, as you might imagine, people are looking into this pretty deeply. I mean, the disparity between men and women was even more pronounced in China. And they thought perhaps it had to do with things like smoking, lifestyle behavioral things.

There are other teams that are looking at the genetics, do women, because they have two x chromosomes, their ability to actually protect themselves from a virus like this, is their immune system more robust and better equipped to do that? Perhaps. They don't know that yet.

Typically, when you have two X chromosomes and you have the exact same information on both X chromosomes, one deletes it out. So you're not basically getting two copies of the same thing. But that may not be happening here, and therefore, women may actually be better protected.

It does seem to be a trend that holds up. Again, China, the biggest disparity, I think it was almost two to one, but you saw that in Italy as well, you're seeing that in the United States, I think it's closer to like 60 percent, 40 percent, but people are looking into it.

They're also looking into, John, I should point out, over the weekend, I've been working pretty closely and talking to a bunch of researchers about what is going on really with young people. We don't -- the narrative has been this is really something that affects older people and people with pre-existing diseases, but there is a deepening mystery when it comes to younger people as well.


Why some young people are getting so sick so quickly, and some are even dying, and rarer than older people but it is happening.

CAMEROTA: Dr. Crowe, does your research give us any insight into who is getting sickest and why and who is recovering and why? CROWE: Well, we've been studying people who have recovered and looking at their immune system. And one of the things that seems quite unusual about this virus is that the immune response seems to be somewhat delayed compared to many of the other viruses we've looked at. And so it might be that even if you have a healthy immune system that the virus itself is doing something to evade that immune system. And in that case, lots of people would be more susceptible than they would to a conventional virus.

CAMEROTA: Well, we really appreciate all of your expertise. Thank you for letting us know what you're working and what may be coming down the pike. Sanjay, thank you, as always. We'll speak to you later in the program.

GUPTA: See you soon. Yes.

CAMEROTA: Developing this morning, CNN has learned that the Trump administration imposed new air travel restrictions for cruise ship passengers and crew arriving in the U.S. And CNN's Rosa Flores is live in Miami with the details. So what have you learned, Rosa?

ROSA FLORES, CNN CORRESPONDENT: Alisyn, good morning. The CDC announcing that it will require all cruise line passengers, regardless if they had symptoms or not to travel by charter flights and private transportation that will have to wear masks during their journey. And once they get home, they have to quarantine for 14 days.

There will be no part of the country more impacted than right here in South Florida because Miami is the cruise ship capital of the world. The U.S. Coast Guard announcing over the weekend that about 114 ships and about 93,000 crew on these ships are in and around U.S. waters.

Well, the overwhelming majority are right here in MiamI's area of responsibility, about 90 of those ships. That's why the Miami-Dade mayor, Carlos Jimenez, announcing over the weekend that he is worried about it, that he's talking to cruise lines about getting these crew members off the ships. But, of course, these CDC guidelines are going to make it a little more difficult.

The latest cruise ship to be impacted is the Coral Princess. It's actually behind me. They learned about these new CDC guidelines while they were disembarking passengers over the weekend. There were two people died on board, a third passenger died later in a hospital here locally.

And here is what they said about those guidelines. Quote, this will unfortunately result in further delays in disembarkation and onward travel for many guests as we work through this complex, challenging and unfortunate situation.

Now, there could be some easing of the rules. We have learned from administration officials that there could be an exception to foreign passengers. But, Alisyn, we're still trying to figure out exactly what those exceptions will be. Alisyn?

CAMEROTA: Okay. Rosa, thank you very much for all of that. So you've heard of storm chasers. You've heard of hurricane hunters. Up next, you'll meet a disease hunter who saw something happening in the data with coronavirus early on and knew that we were facing something different. He's going to share his data about the global pandemics, next.



CAMEROTA: The death toll in the United States from coronavirus will likely hit 10,000 people today. President Trump continues to say that nobody could have seen this coming, but our next guest did. Years ago, he came up with a pandemic tracking system for the City of New York. And last month, his data alerted him to what was coming with the coronavirus. Now, he has a message for the rest of us.

Joining us now is the CEO of Aledade Incorporated, Dr. Farzad Mostashari. He was a top official at the health departments for New York City and the U.S. Dr. Mostashari, great to see you.

I know this is pretty technical stuff and it involves data, but maybe you could just explain that you came up with this unique technique for, I guess, tracking global pandemics as sort of an early warning system. And you used it with the swine flu. And so how -- for the layperson, how did it work?

DR. FARZAD MOSTASHARI, FORMER NATIONAL CORRDINATOR FOR HEALTH I.T.: The fundamental idea here was that instead of waiting for people to be tested, the lab results to come back, and we've all seen so much of the challenges and the delays in getting confirmed, lab-confirmed tests as an indicator of outbreaks, it's just actually looking for symptoms, looking to see how many people are going to the emergency room, how many people are going to the doctor's office with cough and fever, non-specific symptoms and to track those using statistical methods and see when they're making an early indication of an outbreak coming.

That's what we saw in New York City very early on actually. The very first case was diagnosed in New York City on March 1st. By march 4th, there was an increase in -- a spike in fever, cough, respiratory, difficulty breathing emergency room visits weeks before the city was shut down. This data is now available throughout the country.

Actually when I was a U.S. National Coordinator for Health I.T., we required hospitals who were adopting electronic health records to report to public health every day their emergency room visits and allow public health to monitor them for these outbreaks.

And we have the data in every city and state, but also in New York City, that has made it public. And that's what we need, is we need more transparency in terms of not just the number of cases every day that is on every Chiron (ph) and every health department's reports. But we actually need to know what's happening to illness in the community, how many people are going to the emergency room with cough, fever to see when is it starting to go up, and then, hopefully, when does it start to flatten out and begin to come down aa the earliest indications that we're getting through this pandemic.

CAMEROTA: I think this is really interesting. Basically, you're saying we have the technology to have seen this coming. And what you saw was just a spike in symptoms and it was beyond the seasonal flu.


And so if somebody could have seen that and sounded the alarm in an official capacity, maybe hospitals could have begun getting ready because, again, you say that the signs were there. And so is it your impression that New York was too late to notice this and the CDC was too late to notice this and the White House?

MOSTASHARI: I think that these are smoke alarms. And smoke alarms need investigators. They need firemen to go and investigate to see what's actually going on here. So, actually, New York City was just the only one who has made it public. I'm sure there's many other places. But what we needed to do was quickly investigate those cases. Are they -- were they well (ph)? Is it flu? Is it some other virus? We need to be able to have the public health resources to be able to investigate these, the boots on the ground to go and get to the bedside and figure out what's happening rapidly.

You know, every time we have a pandemic or some big public fear, we put some money into public health. And then between two panics, we get complacent and we cut funding for basic public health infrastructure and resources to be able to investigate these.

So, look, we're here now. And I think moving forward, what I'm most concerned about is that we bring that same level of transparency that we have in New York City in terms of what's happening day-to-day with emergency room visits for respiratory complaints and others. We need to bring that to every other state. And it should be just part of the standard thing that everyone has asked because the data is there. We need to be using it. We need to be looking at it. We need to be seeing what's happening to emergency room visits.

CAMEROTA: That's just so important. I mean, the fact that it already exists, the data is there, the collection is already happening. The smoke alarm is already going off. We just need to be able to hear it.

And I know that you're also talking right now to general practitioners and you want to sound an alarm about what they're telling you. So what are you hearing from them?

MOSTASHARI: Yes. Our company supports primary care practices who 550 of them in 30 different states. These are the frontline practices all throughout the country. And they are serving their communities and they're suffering. They are dealing with the same shortages of masks and gloves and protective equipment. They're being exposed, at risk every day, their staff.

But the other challenges they're facing is, as they are pushing patients to stay home and stay safe, they're doing parking lot visits and tons of phone calls, and they're doing porch visits, their incomes are going through the floor and these small practices may not survive just at a time when we need the frontline practices the most. We're actually not supporting them and they could be in serious financial trouble.

So we are sounding the alarm. Our practices are going to be fine. But there's a lot of community practices and the family doctors who just when we need them the most, when we're asking the most from them, are going to going out of business.

CAMEROTA: That is an important reminder for all of us. Dr. Mostashari, thank you very much for explaining all of this to us in layman's terms for the rest of us. We really appreciate it.


CAMEROTA: So, many doctors and nurses who treat coronavirus patients end up getting sick themselves. As you know, a critical care doctor who is now battling the virus shares her story and what she told her kids, next.



BERMAN: Doctors and nurses treating critically sick patients with coronavirus are too often getting infected themselves. 14 days ago, Intensive Care Doctor Julie John felt the first symptoms of what would turned out to be coronavirus. And Dr. Julie John joins us now.

Dr. John, great to see you with us this morning. Thanks so much for being here. You have said that your body thinks it's a 90-year-old woman with emphysema. How are you feeling this morning?

DR. JULIE JOHN, INTENSIVE CARE DOCTOR WITH CORONAVIRUS: I have been sleeping in days since my diagnosis. So today is day 14. I can walk up to three minutes and my saturation will go from 99 to 88 to 90. So it's much better than the 80 percent. It was a few days ago. I'm not where I'm supposed to be, the (INAUDIBLE) said that is, I am 38 years old and my body is not healing fast enough.

BERMAN: It's got to be frustrating. I'm sure you would like to get better more quickly. Now, when you first suspected that you might have COVID-19 14 days ago, you were reluctant to call 911 because you didn't want your children to see the paramedics. Talk to me about that.

JOHN: I had a lot of difficulty breathing -- sorry. I had a lot of difficulty breathing and my daughter was sleeping nearby. My six-year- old son was nearby. And I couldn't catch my breath because I was drowning in my lungs and I was breathing faster and I checked my home pulse socks (ph), and it was down to almost 85. And I knew if I called 911, what EMT would want to do to somebody like me who was working this hard to breathe.

So I got down on my knees and I put my forehead to the ground and I prayed to God, I prayed Psalm 91, I prayed to be under his wing and to heal me and to give me time and to let me live because I was so scared of them seeing me leaving my house intubated and like one of my patients.


And I just -- And that's what I did. I prayed.