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Key Coronavirus Model Lowers Death Projections; Frontline Doctors Share COVID-19 Experience With CNN; Early Data Shows Black Americans At Higher Risk For Coronavirus. Aired 10-10:30a ET

Aired April 08, 2020 - 10:00   ET

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

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[10:00:00]

JIM SCIUTTO, CNN NEWSROOM: A very good Wednesday morning to you. I'm Jim Sciutto.

POPPY HARLOW, CNN NEWSROOM: And I'm Poppy Harlow.

This morning, a key model shows a shift downward in several predictions for the coronavirus pandemic, now, projecting that U.S. deaths could reach 60,000 by August. But that is down from the model's earlier prediction. That's where the somewhat good news is this morning. And it's far lower than the more than 200,000 deaths, the White House said, could happen.

SCIUTTO: True. Still lots of words of caution. Just moments ago, Dr. Anthony Fauci said this would be a sobering week for deaths in this country. In New York City, for instance, in the last 24 hours, 806 deaths reported in one day alone.

Also today, another report of an early warning within the Trump administration long before the crisis hit the United States, of course, long before the administration acknowledged it. This one from U.S. intelligence back in November.

HARLOW: Now, a new CNN poll, look at those numbers, shows that a majority of Americans, 55 percent, say the federal government, in their opinion, has done a poor job preventing the spread of coronavirus throughout the United States.

Let's begin with new numbers this morning. Do they show that we are making progress in fighting this virus? It appears to be the case. Our Senior Medical Correspondent Elizabeth Cohen is with us.

My only fear in this is that it will or could cause people to sort of drop their guard a bit, right?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Absolutely, Poppy. I have that same fear. So I will say that these numbers are going down because people are social distancing. The minute we let our guard up, these numbers could go right back up.

I also want to emphasize, this is modeling, which is an educated guess. So I want to give that caveat as well.

But let's get right to the numbers. What we're seeing according to this model by the University of Washington, which is a model the White House and others are following closely, the previous estimate was 8,766 deaths. The new estimate is 60,415. Those are by August 4th assuming that we continue with social distancing through May.

Let's look specifically at California and Louisiana, because those numbers are pretty stunning. California projection was 6,100. That is now gone down 1,600. That's a huge difference. And that is -- experts say that's largely because California has been doing a good job with social distancing. The rules there have been quite strict. In Louisiana, the projections go from 1,900 down to 900.

Unfortunately, the story is not the same in New Jersey. The projections went up from 2,100 to 5,300, in New York, up from 10,200 to 13,300.

I also want to emphasize that even though these numbers, overall, are looking better, still, you are talking about 60,000 dead Americans. That is absolutely no reason for any of us to feel good.

HARLOW: That's exactly right. And in such a short period of time, in just months. Elizabeth, thank you for that reporting.

So even after the deadliest day in New York City yet, the state's governor says there are signs, again, as Elizabeth just reiterated, social distancing is working.

Let's go to our National Correspondent, Athena Jones, again, live in New York. So what do we know this morning, Athena?

ATHENA JONES, CNN NATIONAL CORRESPONDENT: Good morning, Poppy. Well, I'll get to the kind of good news in a moment, but the sad milestone is then one you've mentioned, the single largest single day increase in deaths in New York. And look at this. New York Times captures it well. Look at New York City. This number of total deaths in New York City nearing 5,000. It is much bigger than the rest of the country. That number going all the way through the masthead with that spike there.

But the positive signs are that, according to Governor Cuomo, who we'll be getting a briefing from again in the next few minutes, the next hour, I should say, he says that it looks as though the curve is flattening in the State of New York.

Now, it's going to take a few days to see if that trend holds, but he noted that the number of hospitalizations is dropping. The number of people who are needing breathing tubes is dropping. And also the rate of increase in new cases is dropping as well. And now, we heard, you know, experts and officials say this is because of social distancing. It's because social distancing is working. And we already know that the governor has extended the stay-at-home orders in New York through April, to April 29th, I should say.

[10:05:02] And that is because of these high death tolls.

We should note that there are still concerns here. We don't yet know if we reach the apex of cases, that high point of cases, we don't know how quickly it's going to drop back down from that high point. So there's still a lot of concern here in New York City about making sure that they have all of the things they need to take care of patients at places like the Javits Center behind me, which is an overflow hospital, of course, to take the pressure off the system.

But we will be looking for that next update from the governor of New York to see if this trend is continuing and if this curve is indeed really beginning to flatten here. Poppy?

SCIUTTO: Got to watch the figures again. The governor always said, look at three-day averages, not any one single day. Athena Jones in New York.

With us now, Dr. Adam Jarrett, Chief Medical officer at Holy Name Medical Center in Teaneck, New Jersey, and Dr. Samuel Krass, Emergency Medicine Physician in Philadelphia. Thanks to both of you guys. You're dealing with patients every day, and we appreciate it. I know they and their families appreciate it.

Let's talk about what we're seeing in national trends here. And, again, I want to note, for instance, here in New Jersey, there, Dr. Jarrett, New jersey, actually, the death toll -- projected death toll has risen, not fallen. But are you seeing evidence that social distancing is helping to flatten the curve, and therefore, helping to alleviate demand for key medical supplies at the peak? Let me start if I can with you, Dr. Jarrett, given you're in one of the hot spots, really.

DR. ADAM JARRETT, CHIEF MEDICAL OFFICER, HOLY NAME MEDICAL CENTER: Sure. So I think we have seen the beginnings possibly of some slowing down of the curve. We actually have more patients here today than we did in previous days. so I don't want to say we flattened the curve by any means, but we are beginning to see, we think, a decrease in the rate of rise.

Unfortunately, we had to convert many beds to ICU beds. We are still seeing many critically ill patients. We have three times our normal capacity of critically ill patients and our emergency rooms are still very, very busy.

HARLOW: Dr. Krass, Dr. Jarrett has also talked about, yes, their busy emergency rooms, they have seen a lot of patients die, but they have also seen a lot of patients get better. And I wonder if the same is true for you and what's working? Is there a through-line for folks that are critically ill, perhaps placed on a ventilator and then do recover?

DR. SAMUEL KRASS, EMERGENCY MEDICINE PHYSICIAN, ABINGTON-LANSDALE HOSPITAL: So, good morning, Poppy, good morning, Jim. Thank you for having me. We have not yet seen that surge in the hospital that I work at. And so we are anticipating that, and we have done things to prepare like have the waiting room outfitted to accommodate patients.

And back to your other question, patients do survive and do have good outcomes after being placed on ventilation. Obviously, the chances of recovery are lower, but patients do -- some do recover.

SCIUTTO: Yes. Okay. You're learning so much, Dr. Jarrett. And, again, Teaneck has seen a lot of cases there. What are you learning about who is most vulnerable here and also about young people's vulnerability to the worst experience of this infection?

JARRETT: We have learned a lot, although this is still a very new virus. We are learning this virus, unlike the flu, really does impact a larger percentage of the population. And, unfortunately, we are seeing many young people who are having significant symptoms, some of them even becoming critically ill.

We think from our relatively small numbers that there may be a factor related to obesity. We are concerned that obesity may be a distinct risk factor. And then, like the flu, certainly, age and other comorbid conditions are a significant risk factor.

HARLOW: So much has changed just this week. I mean, I barely see anyone outside, at least in New York City, without a face mask on, Dr. Krass. And we're hearing more about if we do have to leave the house to go to work, like you guys do, if we should be isolating from our families, I understand you are doing that to an extent. Can you talk about what sort of -- what guidelines we should be following? I mean, it's not possible for a lot of us parents to isolate from our children, you know, unless absolutely mandatory.

KRASS: Right. So it's difficult to isolate while you're in your home with your children. But, certainly, if you have to go to the grocery store or the pharmacy or some other essential place, it is important to wear a face mask, as the CDC recommends. And to continue doing your best to social distance from friends and family at this time. We obviously have video chat, and that's a good way to stay connected. But I think social distancing, really, as the evidence shows, it really is making an impact to flatten that curve.

HARLOW: I guess I was just saying if we have to leave to go to work, and Dr. Jarrett, you know, we still can be with our family in our homes, right, or should we spend as much time away from our family as we can?

[10:10:07]

JARRETT: I think as much as possible, we should even socially distance at home, which I know is very challenging, especially for those of us who need to be at work and are out of the house throughout the day. So, as much as possible, we are recommending people social distance at home. It's very challenging to do.

And we are not going to prevent every single infection. We know we can't do that. But every time we prevent a single infection or that single spread of infection, we stop the cascade infections that occur and save lives.

SCIUTTO: Dr. Krass, I just want to follow up on something Dr. Jarrett said just a moment ago, that we're discovering the infection is more communicable, more easily -- it's more easier for you to infect other people than other strains of the flu. Is that what you're seeing, and tell us the significance of that?

KRASS: I think it is easier to infect other people. And that's why we take the precautions at the hospital. We're in with N95 masks when we go and treat these patients. With suspected flu patients, we weren't taking these precautions because it wasn't as easy to contract or spread.

And so that's why when we even go to intubate these patients and put them on mechanical ventilation, we wear a device called a PAPR, which is basically a hood with a face mask and that helps us to prevent us from contracting the virus potentially.

HARLOW: Can I just ask you, Dr. Jarrett, before we go, about hydroxychloroquine and if you have used it on patients.

JARRETT: We are using hydroxychloroquine, but we really don't know whether it works. The studies that have been done on it suggest it may be helpful. And unless we do double-blind control studies, we're just not going to know.

And the reality is that whenever you prescribe any medication, you need to weigh the risks and benefits of that medication. For hydroxychloroquine for coronavirus, we just don't know. And so you have to look at every individual patient and decide whether or not you think for that patient, the benefit outweighs the risks. And often, we think it does and it's worth a try because we know how seriously ill patients can get.

We have other classes of medicines that we are a little more optimistic here at Holy Name. So we are using medicines called interlukin-6 blocker, some of them on study and some of them being used off label. And my medical staff feels very strongly that we're seeing clinical responses to those.

HARLOW: And off label for people means, I think, if the FDA didn't approve it for that specific thing but it proves to be useful, right? Okay.

JARRETT: That is correct. These are drugs that are typically used for patients with rheumatoid arthritis, so they're available. They have not been proven yet for coronavirus. But we think we're seeing some good clinical responses if it's given to the right patient at the right time.

HARLOW: Okay. Thank you both for what you're doing and for this. It's been really eye-opening for us. We appreciate it, Dr. Adam Jarrett and Samuel Krass, doctors. Thank you. Still to come, new incredibly troubling data that continue to show the disparity. Black Americans are being infected at much greater levels by this virus. Our Dr. Sanjay Gupta is here on what can be done.

And photojournalists experiencing this crisis. Look at these images. They're going to tell us the stories behind what they're seeing from families across America at this moment of crisis.

SCIUTTO: Plus, what is happening now in the City of Wuhan, where the virus originated? We're going to be live from China with an update.

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SCIUTTO: Well, this disturbing trend line in the story, we're learning about the devastating and disproportionate effect the coronavirus is having on African-Americans.

HARLOW: CNN Chief Medical Correspondent Dr. Sanjay Gupta took a look at the disproportionate impact of the virus, what can possibly be done, he joins us now. Sanjay, I'm so glad you spent a lot of time looking into this. What did you find?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Thanks, Poppy, yes. You know, I think for a lot of people who heard these numbers start to come out that showed this disproportionate impact on African- Americans, there were two things that really jumped out. One is that it's tragic. But for many public health officials, not that surprising.

And a lot of people immediately thought, is this because of these underlying conditions, diabetes, heart disease, that we know can make people more vulnerable to COVID-19? Well, it turns out that's only part of the story, as we learned.

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GUPTA: In the beginning, COVID-19 was far away and it didn't even have a name.

DR. CAMARA JONES, FORMER PRESIDENT, AMERICAN PUBLIC HEALTH ASSOCIATION: It was coming over to our shores from people who had traveled.

GUPTA: But once it got a foothold in the United States, its true self was revealed.

C. JONES: Once people got infected, because of their diabetes and heart disease and the like, they would get it more severely and be at higher risk of dying.

GUPTA: Dr. Camara Jones is past president of the American Public Health Association.

I was really struck, Dr. Jones, we're both doctors. And as I was hearing the story, it sounded just all of a sudden tragically familiar. Is this a familiar story?

C. JONES: What we see is so familiar because the conditions of our lives haven't changed, significantly. And so what's happening is that we are carrying the burden of these limited opportunities in our bodies, and it shows up as diabetes, the heart disease, the hypertension, even in terms of immune compromised and all of that.

GUPTA: Already, we are hearing from some officials that blacks have been disproportionately hit by the outbreak.

[10:20:01]

Early data shows that in Michigan, where I grew up, 14 percent of the population is black, though they make up 41 percent of coronavirus deaths. In Illinois, 15 percent identify as African-American, but they make up 42 percent of deaths. Louisiana's population is 32 percent black, which accounts for about 70 percent of coronavirus deaths.

But here's the problem according to Dr. Jones. As inadequate as testing has been for the country, the problem is even worse for African-Americans.

C. JONES: Our whole national testing strategy has started out as a clinical strategy, not a public health strategy. That, of course, has disadvantaged the whole nation in terms of knowing who is infected. And I am told also that it has been harder for many people of color to get the test just because of where testing stations have been located.

GUPTA: While blacks are less likely to be tested, less likely to be treated, they are more likely to be on the front line, essential workers upon whom we all depend.

JASON HARGROVE DETROIT BUS DRIVER: We out here as public workers doing our job, trying to make an honest living to take care of our families.

GUPTA: Detroit bus driver Jason Hargrove posted this online on March 21st.

C. JONES: It is not as easy for them to shelter in place. And it's not as easy because I might front-facing jobs like home health aides or bus drivers or postal workers or working at Amazon and the like.

HARGROVE: For you to get on the bus and stand on the bus and cough several times without covering up your mouth, and you know that we're in the middle of a pandemic, that lets me know that some folks don't care.

GUPTA: Four days later, Hargrove, who was 50 years old, became ill. He died last Wednesday. It's still unclear how he got COVID-19.

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GUPTA: And I can tell you, obviously, we need to have better data. Even some of the data you just saw there was pretty challenging to come by. So states need to be reporting at demographic data as well. But you hear the story of Mr. Hargrove there, and you realize that hopefully we don't get to the point in this country where there may be a rationing of resources. We hopefully won't get there. But if there is, some of these same structural inequalities may manifest there as well. And I think that's the point Dr. Jones was really trying to make and hope we can avoid.

SCIUTTO: So sad to hear he lost his live. He gave such a prescient account there. So how, I imagine folks watching now have this question, how do you get more data? And who is standing in the way?

GUPTA: Well, you know, I think part of this is that the states -- you know, there's been inadequate testing throughout the country. I think everyone has sort of recognized that at this point. But now, we're at the point where even the testing that we are getting has not been stratified into good demographic data. Even by age, you know, you're starting to get better looks at the young who are getting sick, but certainly not by race. And you know, you have a few states that are starting to do it.

And you have senators, like Elizabeth Warren, I believe, Kamala Harris as well, who are now calling upon states to do this, writing a letter to the secretary of health, Alex Azar, saying this is going to be important as we go forward, not only for this pandemic, but also to hopefully not to just look at that data and put it in a drawer at the end of all this but to actually have some lessons for other health crises that come forward.

Again, these are, in some ways, the structural inequalities Dr. Jones really felt passionate about this, have been there for long time, but then a pandemic like this comes along and really exposes it. So if we don't get the demographic data, we won't have the lessons learned.

HARLOW: Yes. And as of this morning, I believe, Sanjay, that letter from a number of senators to HHS, we haven't been able to get an answer from HHS in terms of what they're going to do on this front or releasing this data.

Can I just ask you about -- there is a lot of concern and dismay that I have been reading from those who hear some folks say, well, why is this happening? We don't know why this is happening because so much of this we do know, right, as you laid out in your piece. We do know that the inequality is just being exacerbated here.

GUPTA: Yes. I think that's right. And I think, you know, again, a point that Dr. Jones makes is, look, there is underlying illness that is at higher rates, heart disease, hypertension, diabetes, but why is that? Why do African-Americans, why do black Americans in this country have higher rates of those diseases? Well, in large part, that is also because of structural inequalities, lack of access to good food, living in food deserts, lack of access to healthcare for preventative medicine, whatever that might be.

[10:25:07]

There are many, many layers to this. But I think the thing that I was most struck by and why we decided to focus on this in the piece is that we're in the midst of a time right now where people are being asked to stay at home. And we know for a lot of people, that is really not an option. They can't do it financially or because of the nature of their jobs, food delivery, you know, frontline workers, essential workers, things that we are all dependent on that maybe we don't even realize, and that proportion of those people who are doing those jobs is black America. And so that's also putting them more at risk. So harder to get tested, harder to get treated, concerns about rationing of care, and the most vulnerable because of that frontline status.

HARLOW: Yes, it's an American tragedy. Dr. Sanjay Gupta, thank you very much.

Be sure to join Sanjay tonight. He will be with Anderson Cooper for a new global CNN town hall. They'll also be joined by special guest, NBA legend Magic Johnson. That's tomorrow night starting at 8:00 Eastern only right here on CNN.

SCIUTTO: Well, across the nation, photographers, they have been out in the community. They have been documenting life during the coronavirus pandemic. They really put an emotional face on this, a personal one. We're going to bring you their stories and perspective next.

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