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THE LEAD WITH JAKE TAPPER
Sweden's Coronavirus Gamble; Hospitals Running Out of Room for Dead Bodies?. Aired 4:30-5p ET
Aired April 13, 2020 - 16:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JAKE TAPPER, CNN HOST: One New Jersey hospital even is converting its cafeteria into space to hold the onslaught of patients.
And joining me now to discuss this is the chief physician executive at that hospital, Hackensack Meridian Health, Dr. Daniel Varga.
Dr. Varga, thank you so much for joining us, and thanks for the work you're doing.
You're converting the cafeteria to hold non-intensive care unit patients. You have openly talked about employees at your hospital getting sick, contracting coronavirus.
Tell us how serious, how dire conditions are at your hospital.
DR. DANIEL VARGA, HACKENSACK MERIDIAN HEALTH: Well, you know, we have got right now about 1,900 patients in our acute care hospitals.
If you look, count our nursing homes and other areas that we provide care, we're up around 2,600 patients total. We have actually at Hackensack University Medical Center, where you're talking about the cafeteria expansion, running just shy of 200 patients and ICU beds, a huge chunk of that being COVID patients, and most of those folks are on ventilators.
But what we did do with the cafeteria -- and this something that we have been doing continuously -- is converting space, mostly to convert normal hospital bed space into ICU space.
But, in this situation, knowing that we had taken away normal hospital bed space, we created a 72-bed unit down in our cafeteria in about a three-to-five-day period of time.
And we probably have that about two-thirds filled right now.
TAPPER: And, Doctor, do you have enough personal protective equipment, enough N95 masks, enough ventilators for the needs of your health care workers and the needs of your COVID-19 patients?
VARGA: So, Jake, right now, we have -- in the three big buckets of things you worry about, space, staff and material, we're actually doing pretty well with space, doing pretty well with material. And I think we have done well with ventilators. We have acquired a lot on our own. We have been lucky enough to get some from the National Stockpile as well. We have been very good at moving them around our system to make sure that everybody has them when they need them.
N95 masks are going to be a challenge for the next couple months. We are actually sourcing N95 masks anywhere we can, as well as sourcing the international equivalents of N95 . But right now, we're pretty good with that.
Our biggest challenge right now is our staff, and we have got a phenomenal set of front-line caregivers. But you can make beds and you can get equipment, but if you don't have people to staff those beds and take care of those folks, it doesn't really do a lot of good. Our folks are doing a great job, though. We're staying ahead of it.
TAPPER: You worked on one of the first Ebola cases in the United States. You have experience with outbreaks.
Have you ever seen anything like what we're going through right now?
VARGA: Nothing like this.
I mean, the scope of this is just so profound. I mean, it's -- our Ebola crisis arose with three patients in Dallas. It was obviously a worldwide issue, but the U.S. impact was three folks and then folks who happened to come to hospitals from overseas.
But this is a scenario that touches everybody. And I will bet there's not anybody out there in your audience right now who hasn't been personally touched by COVID-19.
The other piece is that we had had a little bit of experience with previous Ebola outbreaks. We have never seen this one before. So that makes it particularly challenging.
TAPPER: Your governor, Governor Murphy, said yesterday that there are some projections suggesting that New Jersey has hit its peak.
Other projections show the state has not hit its peak yet. What do you think, as somebody who's on the front lines of this? And if you think the peak is still potentially weeks away, how are you preparing to handle that?
VARGA: Well, Jake, knock on wood, it looks like we have at least slowed the amount of growth.
Over the last week, our admissions related to COVID-type individuals, either people under suspicion or confirmed COVID cases, dropped about 40 percent from the beginning of the week to the end of the week. That's about 100-admissions-per-day drop.
But, that said, we are still growing. I mean, three weeks ago, we were growing at 15 percent. A week before that -- the week after that, we were growing at about 7 percent. Last week, we kind of grew at about 2 to 3 percent. So, clearly, we're seeing some positive trends. What we really want to
see is the sort of curve that New York is starting to experience, where you see that rapid drop in hospital admissions and actually couple that with the good news of people being excavated from ventilators and discharged from the hospital.
TAPPER: I was just reading a story. It wasn't -- it's not new. It's a few weeks' old, but NJ.com was reporting that your hospital has enacted a DNR, a do not resuscitate order, for coronavirus patients.
Tell us about the decision to make that move.
VARGA: So, we're actually trying to build what we call a scarce resource allocation policy inside our organization. And we're really trying to move in concert with the state of New Jersey.
The good news is, as of right now, there's no rational -- no need to make decisions about triaging who gets a ventilator, who doesn't, because between what we have done internally, what the state's done, what we have been able to get from national resources, we have managed to stay ahead of that.
But, to a large extent, we have wanted to kind of get ahead of the situation, in case the surge gets to a place where it absolutely taps out our resources.
TAPPER: All right, Dr. Daniel Varga, thank you so much. And good luck to you and the staff at the hospitals you supervise and the incredible work you're doing.
VARGA: Thanks so much, Jake. We appreciate it.
TAPPER: Coming up next: horrific new images just in to CNN, one hospital in the U.S. so overwhelmed with corpses, some are being stored any place employees can find space.
Stay with us.
TAPPER: Some new photos from Sinai Grace Hospital in Detroit capturing just how dire and overwhelming the pandemic is in the city of Detroit, bodies filling freezer units, some even being stored in spare rooms originally meant for sleep studies.
I want to bring in CNN's Ryan Young, who's in Detroit right now.
Ryan, you recently visited this hospital. These pictures are just shocking when you see them.
RYAN YOUNG, CNN NATIONAL CORRESPONDENT: Yes, this is a tough sorry, Jake. In fact, we have been working in this area for about two weeks now,
talking to all the people who have been affected by COVID-19.
And what we started to do is, when we started talking to those heroic first responders all across the city, they started sharing stories with us. And this is one of the groups who started talking about what was going on inside this hospital.
Going to share you some of the pictures here -- show you some of the pictures here. Some of it's disturbing, but the first picture that I want to show you is inside what is considered a sleep study room.
We're told they had to store some bodies in here for at least one 12- hour shift, maybe because they were running out of space in other rooms. Then we have another shot inside a freezer that they brought in where you can see bodies on top of each other.
And as we were talking to staff, they were mortified by what they were having to do. In fact, we talked to several E.R. workers who basically told us not only were they worried about staffing shortages and the fact of so many patients coming in. They were concerned about the patients who were there that they were trying to care for.
But they never wanted anyone to lose a loved one to be stuck in a space like this. And, in fact, a lot of folks even went as far as to say -- two sources told us, at least, that they wanted to make sure that they had enough bed space for the folks who were inside the E.R.
The last portion that I will tell you this, two people did die in the hallway inside that hospital. The hospital has said they surged more employees into the area to sort of help patients. So,
Jake, this is an ongoing story that we will continue to follow.
TAPPER: Just terrifying.
Ryan Young, thank you so much. Appreciate it.
In addition to the scenes that we just showed you, doctors are also finding themselves in the grueling position of having to arrange conversations between critically ill patients and their family members who are not allowed to visit them.
One doctor sharing with "The New York Times" a text she sent to her colleagues, writing -- quote -- "You guys are going to see me with red puffy eyes for the next few weeks. I just feel like I went into this specialty to save lives, and it kills me that we can't save everybody" -- unquote.
Joining me now, Andrea Bonior, a clinical psychologist and professor of psychology at Georgetown University who we check in with every week, if not more.
Andrea, we talked to a psychiatrist last week who said that health care workers now and when this is all over are going to have post- traumatic stress, the same way that first responders after 9/11 or veterans after Vietnam did.
Do you think it will be that stark? And what should health care workers be doing right now to cope?
ANDREA BONIOR, PROFESSOR OF PSYCHOLOGY, GEORGETOWN UNIVERSITY: Yes, I certainly hope it won't be that stark, but I do think there's reason to be concerned that it will.
This is so unprecedented, because the normal human ritual of being able to gather around a dying loved one, the doctors are basically the people who are having to witness that being completely disrupted and having to use some stopgap measure to try to help people communicate with their loved ones on their deathbed.
This is something that is just not seen in these numbers, and hasn't been seen in these numbers. And a lot of physicians that I have talked to have also said the aspect of being alone and perhaps distanced from their families, their own families, is very difficult here too.
You have physicians who may have signed up to put their own lives at risk to some extent, but they didn't sign up to put their family's lives at risk. And so they're grappling with that anxiety as well about whether or not, just by virtue of the work that they're trying to do, they're endangering their own loved ones.
And so it's really an unprecedented situation. And it's heart- wrenching. And so I do think we are going to see some ripple effects for a very long time.
TAPPER: And then it's obviously tragic, no matter what when you lose a family member, but people are being denied, by this virus, the ability to grieve in the traditional ways.
Funeral homes have stopped, wakes. Cemeteries are limiting graveside gatherings. Some local officials are limiting the number of people for religious services. Some people who are grieving are in quarantine themselves.
What do you say to people like that? What's the best thing they should be doing to grieve, given these horrific circumstances?
BONIOR: Yes. Yes.
I mean, part of that ritual is so important for finding meaning. But I would say there are a couple of things to keep in mind. And one is that there are still ways to find meaning in your grief, even when it's so far, sort of being postponed being able to gather.
There are still ways to connect as much as possible, to find symbolism in the loss, to write, to draw, to talk about it over videoconferences, as awkward as that sounds. But I think, yes, that's part of this that is just so heart-wrenching.
We have such a human need to be able to help each other and touch each other and gather. And that's why this particular tragedy is so different than what we have seen before.
But I think part of what people need to do is to realize that, if we can connect to -- if we can connect to our values during this time -- so, in other words, for instance, the doctors on the front lines that are struggling, so much with how they're not saving as many lives as they want, and they're watching people dying alone, they can still go back to those original values of what brought them into medical school and the medical profession, and think about how, even though they are not there to save a life in that particular moment, they are still offering help.
They are still offering a human connection to somebody who is in need of it, because, ultimately, part of how grief -- how we come out of the other side of grief is to find meaning in it and to find connection with how it's impacted our lives in a way that helps us move forward.
And, again, I have spoken with other physicians that say, we're going to learn from this. Part of the pain and the chaos and the trauma that we're going through right now can help inform the practice of medicine for the future.
And that can be a way of finding meaning in all of this heartache too.
TAPPER: And then quickly, Dr. Bonior, if you could, it's obviously traumatic for not just health care workers, not just people who lose somebody, but it's traumatic for everybody going through this.
I mean, it's a worldwide trauma, people having to basically be prisoners in their own homes in some ways. What's your just general advice to people watching right now who are maybe losing it a little bit or having difficulty explaining to their kids why we're all going through this?
What's the best advice you can offer?
BONIOR: Yes, I think it's two-pronged.
Number one, label your feelings. There's a lot of data that says that if we can just allow ourselves to say, yes, this is grief, I'm scared, I'm sad, I'm angry, I'm confused, labeling those feelings, putting them into words helps them feel more manageable and helps them to -- helps us derive meaning from them.
And, second, pay attention to your body. Whenever we talk about trauma, we're talking about it being -- it's embedded in our body. So take care of your body as well. And that's so important.
TAPPER: All right, Dr. Andrea Bonior, thank you so much, as always. Good to see you.
It is a scene that makes many of us shudder, people hanging out in bars and restaurants amid this pandemic. The controversial gamble that one nation is making and the results so far -- next.
TAPPER: British Prime Minister Boris Johnson is out of the hospital and on the mend from his battle with coronavirus, but it appears his condition may have actually been a lot worse than Downing Street let on.
CNN's Bianca Nobilo joins me now from London.
Bianca, there's some confusion over just how dire Prime Minister Johnson's condition actually was.
BIANCA NOBILO, CNN CORRESPONDENT: In the sense that one day he was in hospital and the de facto deputy prime minister said he was still governing the country from his hospital bed and then, later that day, he moved into the intensive care unit.
So that does raise some questions over how ill he actually was. From what I can gather from government sources, it wasn't the Downing Street was being economical with the truth. It was the fact that they were just being economical with information.
The prime minister is a very private individual, and at the best or worst of times, Downing Street don't want to project the image of a prime minister who is vulnerable or frail, particularly at such a critical juncture in a national crisis.
And it's not actually unprecedented. If we look back to even Boris Johnson's own political hero, Winston Churchill, during the Second World War, he really underplayed the bouts of pneumonia that he had that meant that he ended up in hospital. There have been other prime ministers who have done the same.
Where this might raise legitimate concerns going forward is question marks over how transparent Downing Street have been overall. There's been a lot of criticism over the government strategy of herd immunity in the early days. Then they backtracked and said that that was never their strategy at all.
The same kind of mixed messaging concerns came out of Downing Street around the lockdown. Boris Johnson said that he was shaking hands. And then there was social distancing implemented.
So, even though the prime minister's own health, potentially, they could have been more transparent at the time, but I think what's most important here, Jake, where now over 11,000 people have been confirmed to have died from coronavirus in the U.K., is how transparent and how forthcoming the government are actually being with their strategy going forward.
TAPPER: All right, Bianca Nobilo, thank you so much.
In China, the government there is restricting publication of research on the origins of coronavirus, which, of course, originated in Wuhan, China.
CNN's Ivan Watson joins me now from Hong Kong.
And, Ivan, the Chinese government now is saying that it needs to approve any coronavirus related research before publication?
IVAN WATSON, CNN SENIOR INTERNATIONAL CORRESPONDENT: That's right.
And we learned about this from the Web pages of several Chinese universities. And after we inquired about these apparent new restrictions, those universities withdrew the Web pages.
But what they had shown were that there were these new regulations. Anybody wanting to publish research about the origin of the virus, they had to get permission first, and they would have to apply to a state committee to try to do that.
We have tried to reach out to a number of different Chinese ministries to get an explanation for why this is happening, and haven't heard back yet.
A number of doctors and researchers that we have talked to about this, independent researchers, have been disappointed, at the very least, have said that this smacks of censorship and it could create obstacles to sharing valuable data and research with the rest of the world, while all countries are struggling with this deadly disease.
It also says something about what a titanic political football the questions of its origin are, especially because of the tensions between the Trump administration and China about how this pandemic really began.
It was first documented in Wuhan, China, last December -- Jake.
TAPPER: All right, Ivan Watson, thank you so much.
Scandinavian countries reported the first coronavirus deaths, all of them, at roughly the same time, but the countries have taken very different approaches to how to handle the coronavirus.
Denmark, the second European country to impose a lockdown. Norway quarantined anyone coming back from abroad for two weeks.
And then there's Sweden, which, after refusing to shut down business, has seen 919 deaths much, higher than their two Scandinavian neighbors.
CNN's Phil Black now looks at how Sweden's relatively laissez-faire approach to the deadly pandemic may have dramatically impacted the spread.
PHIL BLACK, CNN CORRESPONDENT (voice-over): In these strange times, this is a strange sight, people just hanging out in bars and cafes, enjoying the sunny Easter weekend with friends and family. The coronavirus hasn't skipped Sweden. They're just dealing with it
very differently, no forced closures, no lockdown. Some, including President Trump, think the country is betting everything on that controversial theory, herd immunity, deliberately allowing the disease to move through the population, so younger people with antibodies surround and protect the elderly and more vulnerable.
DONALD TRUMP, PRESIDENT OF THE UNITED STATES: Sweden did that, the herd. They call it the herd. Sweden suffering very, very badly.
BLACK: Absolutely not true, says the Swedish government.
UNIDENTIFIED FEMALE: Our goal is the same as in most other countries. We want to save lives. We want to hinder the spreading of the virus.
BLACK: Swedish health officials say their approach is designed to slow the virus where it spreads most. And they don't think that's in bars and restaurants.
ANDERS TEGNELL, CHIEF STATE EPIDEMIOLOGIST, SWEDEN: Not convinced that lockdowns and these kind of things work very well.
BLACK: Anders Tegnell, Sweden's state epidemiologist, says their strategy's focus is asking everyone to avoid travel, work from home where possible, and isolate if you feel unwell.
And he says it's worked, flattening the curve, keeping critical cases within the capacity of the health system.
TEGNELL: I think one of the strong reasons for why we have been doing what we're doing in Sweden is that we feel that this is very sustainable. We can keep on doing this for long -- for months then, without any real harm to society.
BLACK: But the numbers tell a different story. For a small country, Sweden has suffered a relatively high number of deaths, now at 919.
The deaths per 100,000 people stands at 8.83, higher than that of the United States at 6.73, but still far less than Italy at nearly 33. And there's one especially disturbing trend in Sweden's experience so far.
Health officials say around half the total figure killed lived in homes for the elderly. The World Health Organization says it's imperative Sweden must do more. And 2,000 Swedish scientists have signed a petition, because they fear current policies will mean many more deaths.
UNIDENTIFIED FEMALE: Our authorities think they are in control. But what we are saying is that the catastrophe is looming around the corner, so you're not in control in two, three weeks' time.
BLACK: Critics say Sweden is now trapped in a high-risk experiment.
Swedish officials believe they have found the right balance. Either way, in the coming months, Sweden will have much to teach the world about how to best manage COVID-19. (END VIDEOTAPE)
BLACK: Now, Jake, if the Swedish health authorities are right, then the country is experiencing its peak right now.