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Johns Hopkins: Nearly 582,600 U.S. Cases, 23,600+ Deaths; Trump Says He Has Ultimate Authority to Reopen Country; U.S. West Coast Governors Coordinate Reopenings; France Extends Emergency Measures Until May 11; U.K. Government: Increase in COVID-19 Deaths Expected This Week; Italy Allows Some Businesses to Reopen As It Extends Lockdown. Aired 5-5:30a ET

Aired April 14, 2020 - 05:00   ET



ROBYN CURNOW, CNN ANCHOR: Hi, everyone. Welcome to our viewers here in the U.S. and all around the world. Thanks for joining me. You're watching CNN. I'm Robyn Curnow.

Just ahead on the show --


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: When somebody's the president of the United States, the authority is total. And that's the way it's got to be.

REPORTER: It's total?


CURNOW: A defensive President Trump makes his case on his handling of the coronavirus pandemic, all the while the death toll continues to climb here in the U.S.

Plus, cities across Europe are seeing restrictions being lifted slowly. But are they ready to return to normal life? We have that story.

And South Korea is preparing to host local elections during the pandemic. We will take a look at the measures they are taking to keep voters safe.


CURNOW: So, the U.S. president is fiercely defending his response to the coronavirus pandemic, even as the death toll continues to rise at a high rate in the U.S. So according to Johns Hopkins University, the virus has now killed almost 24,000 people across the country.

However, in some areas, the outbreak appears to be leveling off. And several governors are now discussing plans to gradually reopen their parts of the country. But the U.S. president insists only he can make that call.


REPORTER: Just to clarify your understanding of your authority vis-a- vis governors, just to be very specific, for instance, if a governor issued a stay-at-home order --

TRUMP: When you say my authority, the president's authority. Not mine, because it's not me. When somebody's the president of the United States, the authority is total. And that's the way it's got to be.

REPORTER: Total? Your authority is total? .

TRUMP: It's total. And the governors know that. The governors know that. You have a couple of bands of -- excuse me, excuse me.

REPORTER: Could you rescind that order?

TRUMP: You have a couple of bands of Democrat governors. But they will agree to it. They will agree to it.

But the authority of the president of the United States having to do with the subject we're talking about is total.


CURNOW: Well, Mr. Trump also played this campaign-style video during the briefing that featured a timeline of his response efforts, including clips of governors praising his work.

Well, later, reporters challenged the claims he made throughout the briefing. But the president pushed back and attempted to then discredit the media.


KAITLAN COLLINS, CNN WHITE HOUSE CORRESPONDENT: You said when someone is president of the United States, their authority is total. That is not true. Who --

TRUMP: OK. You know what we're going to do? We're going to write up papers on this. It's not going to be necessary because the governors need us, one way or the other, because ultimately it comes with the federal government. That being said, we're getting along very well with the governors, and I feel very certain there won't be a problem.

COLLINS: Has any governor agreed that you have the authority to decide when their state --

TRUMP: I haven't asked anybody. You know why? Because I don't have to.

COLLINS: But who told you the president has total authority.

TRUMP: Enough. REPORTER: The argument is, you bought yourself some time and you

didn't need to prepare hospitals, you didn't use it to ramp up testing.

TRUMP: You're so disgraceful. It's so disgraceful the way you say that. Listen, I just went over it. I just went over it.


REPORTER: -- in an unprecedented crisis.

TRUMP: Nobody thought we should do it.

REPORTER: What did you do with the month of February? There is a gap for the month of February.

TRUMP: What did you do when you have no case in the whole United States -- excuse me. You reported it. Zero cases, zero deaths on January 17th. I said on January, on January 30 --


REPORTER: January. For the entire month of February, you have a complete gap. What did your administration do in February for the time that this travel ban --

TRUMP: A lot, a lot. And in fact, we will give you a list. Part of it was up there. We did a lot.

Look, look. You know you're a fake. You know that. Your whole network, the way you cover it is fake.


CURNOW: As you saw there, that reporter noted that the video skipped over the entire month of February.


That's when the president was criticized for not taking enough action.

Now, as part of his list of grievances, President Trump also blamed the media, too. He falsely claimed journalists and reporters were late to cover the coronavirus outbreak.

And I say falsely because I want you to take a look at this, what you are seeing here is a sample of CNN's early coverage. The first story published on January the 6th, as the world started to learn about this mysterious new virus spreading in Wuhan, China. On January 20, CNN began a daily live blog for coronavirus updates. All there.

So while Mr. Trump says it is he alone who can decide whether to reopen the economy, governors on both sides of the U.S. are taking matters into their own hands and calling the president's bluff. Several of them are forming regional pacts to coordinate how to lift stay-at-home orders and reopen their economies, as Nick Watt now reports.


GOV. GAVIN NEWSOM (D), CALIFORNIA: Using science to guide our decision-making, not political pressure.

NICK WATT, CNN CORRESPONDENT (voice-over): The three West Coast governors are now coordinating a plan to open up their economies.

NEWSOM: Tomorrow, we will lay out our California-based thinking on that effort.

WATT: Meanwhile, in the Northeast --

GOV. ANDREW CUOMO (D), NEW YORK: I believe the worst is over if we continue to be smart. And I believe we can now start on the path to normalcy.

WATT: New York and neighbors also just began collaborating to create a plan.

GOV. PHIL MURPHY (D), NEW JERSEY: An economic recovery only occurs on the back of a complete health care recovery.

WATT: Massachusetts is still 13 days from peak death rates, according to one model used by the White House.

UNIDENTIFIED MALE: It's a wave that's going to play out across the country at different points in time.

WATT: Florida and Texas also nearly two weeks away from their peaks.

GREG ABBOTT, TEXAS GOVERNOR: Later this week, we will outline both safe and healthy -- where we can begin the process of going about reopening businesses.

SYLVESTER TURNER, HOUSTON MAYOR: We're a long way from having the testing that we need across the city of Houston.

WATT: Six hundred seventy-one people died due to COVID-19 in New York on Easter Sunday alone.

CUOMO: But basically flat, and basically flat at a horrific level.

WATT: Hospitalizations also down a little over the weekend in this hardest hit state. .

DR. ROBERT REDFIELD, DIRECTOR OF THE U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION: We are stabilizing across the country right now in terms of the state of this outbreak.

WATT: The surgeon general tweeted today: NY, NJ and even Detroit and New Orleans appear to be leveling off.

Beyond a test for the virus, an antibody test could also be key in finding out who's had it and can return to work. But -- DR. TOM FRIEDEN, FORMER DIRECTOR, CDC: There are many bad tests,

inaccurate tests on the market.

WATT: Many say this isn't really over until there's a vaccine.

CUOMO: OK. When do we get there? Twelve months to 18 months.

WATT: The president had hoped to begin opening up the country this past weekend.

Instead, amidst deadly tornados, they were social distancing. In Mississippi shelters, a sailor just died among the near 600 infected from the USS Theodore Roosevelt. And in a Detroit hospital, bodies are stored in a sleep study room and stack indeed a freezer.

(on camera): People are still dying and some places still doubling down on social distancing. Here in Beverly Hills now, you're supposed to wear a mask even when you're just walking down the street. Why? Well, a study here in L.A. County found that if we stopped staying home right now and just went about our business as usual, more than 95 percent of us here in this county would be infected with the virus.

Nick Watt, CNN, Los Angeles.


CURNOW: Thanks to Nick for that report.

So let's stick with some of these modelings -- these models. A widely cited coronavirus model predicts that the U.S. will see zero deaths from the pandemic after June 21st. Some experts, though, are questioning these projections. And that's largely because it makes pretty broad assumptions about the country's ability to prevent another outbreak, once containment measures are lifted.

So, earlier, the creator of that model spoke with CNN's Anderson Cooper about the projections. Take a listen.


DR. CHRISTOPHER MURRAY, DIRECTOR, INSTITUTE FOR HEALTH METRICS AND EVALUATION: So, we get to know deaths by the middle of June on the same basis we've been saying that since two, three weeks ago. That's what happens if everybody stays the course on the closures right through -- through the end of May. Right now, we are having a national discussion about rolling opening. And if that does start to happen, then we will, of course, have to change our forecasts, because the risk of resurgence is really very large in some states.

Well, the one thing we absolutely know for sure is that social distancing measures work.


It leads to a situation where every case is affecting less than one other case. And that means if you keep the course, you will get transmission essentially down to zero. .


CURNOW: So, joining us now is Dr. Ron Daniels. He's a consultant in critical care at University Hospital in Birmingham in the U.K.

Doctor, great to have you on the show.

So, you've heard it all in the last five minutes, ten minutes of the show -- projections, models, political pressure. As a doctor, what is your response to all you've heard?

DR. RON DANIELS, UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST: So the first thing to say is lockdown is not a game. It is essential. And certainly what we are seeing in the U.K., it is the only thing that's made the difference between exponential growth of cases of COVID-19 and the current situation in which we are just beginning to see early signs on of a plateau.

If we release lockdown, the inevitable is going to happen. That second spike is going to happen. What I would propose is that governments consider a staged reengagement of the public rather than return to normal life, because that's going to be dangerous.

CURNOW: Dangerous for all of us. When you would work, and I want to talk about the conditions there in the U.K. But in many ways, it's been highlighted across the world in terms of what ICU doctors like you are facing. We have heard a lot about shortages, and I've asked other doctors about it.

How concerned are you, though, about shortages of drugs, the first line ICU medicines such as anesthetics and painkillers? How are you managing with that?

DANIELS: Well, absolutely. We hear about the shortages of PPE or access to PPE. We have heard about ventilators.

But the reality is, a ventilator on its own cannot fix a patient. It's simply a machine. What we need, the skilled staff. But we need those drugs.

We need the drugs to keep the patient to sleep while they're on the ventilator. We need the drugs to support their blood pressure. Those are also in short supply, along with the pumps with which we give them.

So we are starting to move towards using older, more long-acting drugs for sedation. We're starting to look to alternatives to keep somebody's blood pressure up. We have never been in a situation in my 18 years as a critical care consultant, clinician.

CURNOW: So, you are saying that you're looking at plan B or plan C, you kind of gerrymander the drug regime to try and help everybody.

What is it also they mean about ventilators? Are you -- I know you said that there's been too much emphasis on ventilators. Why is that? DANIELS: So, these patients with COVID-19, they're unusual. And we're

learning all the time. Our initial strategy with ventilation that was developed following information received from China and from Italy and other countries was probably wrong. We have refined it over time.

But we're also considering is that we might be ventilating too early. If you would like, there are two reasons for people with low oxygen to go on a ventilator. One is the numbers. The numbers on the blood gas samples we've taken. If they're low, we are concerned.

The other is the way the patient looks. There is a disconnect between the way the patient looks and their numbers. And too often we have been treating numbers. Some of these patients might not have needed to be put on a ventilator as well.

The other thing about ventilators is they're not the same. There's anesthetic ventilators, there's ventilators we use for transfer with emergency medical services, and then there's intensive care ventilators. They are very different beasts.

And governments certainly in the U.K. have heard the call for ventilators and assumed that one ventilator will be good enough for all purposes. And the reality is that's not the case either.

CURNOW: Oh, wow. That's interesting. When you talk about what patients look like, is there a commonality or a pattern to the folks you are seeing in the ICUs? Is there something that differentiates them between the ones that make it at home and the ones that have to be helped in ICU?

DANIELS: So, I'm hugely generalizing here because this is a very strange condition that has, as we have heard, very different symptoms between one patient and another. But in general, what we find, and there are exceptions, the patients coming to hospitals have been coming OK at home for around a week. They have suddenly deteriorated. But it might be that somebody noticed they have gone bluish, their work at breathing is harder, and they presented to hospital.

Now, it's a minority that need to go on a ventilator straight away. The majority continue to deteriorate for a few days in hospital or a day or two in hospital before we make the decision to ventilate. So, this is not straightforward. This is not the case that people are having heart attacks and strokes.

The clock starts ticking and we have to act.


This is a slowly progressing condition.

CURNOW: And I know it's also too early, but are you getting any feedback about the after effects? Once you release ICU patients, patients who have recovered, what do we know about, say, taste, smell, cognitive ability, even lung capacity?

DANIELS: Well, that's a great question, and I think it's early days to look at people who survived COVID-19, because there are only a few of them returning to the community right now. But I think we can look at analogies with other conditions that keep people in critical care for a long time. It's likely this will be no different.

So, ignoring for a moment the taste and sense of smell, those -- although those relatively minor symptoms, they can occur in people with non-COVID illnesses who have been in hospital care. Cognitive function, so poor judgment, poor decision-making, that's going to be affected in a significant proportion of these patients.

Physical problems afterwards, they can range from the seemingly trivial like loss of taste, like brittle hair, brittle nails, through to very significant, very severe chronic fatigue, disabling limb and joint pains. That again is likely to affect a portion of survivors.

And finally psychological, we know that intensive care survivors have a one in five risk of PTSD following an intensive care stay. And that's going to be a risk in these cases. That's why our charity in the U.K., the U.K. Sepsis Trust, has chosen to expand its support services that we normally offer to survivors of sepsis to patients with COVID-19.

CURNOW: Oh, that's fascinating. Dr. Ron Daniels, really appreciate you joining us. Fascinating conversation. And again, also, thank you to you and all of those who work with you for everything that you've done. Invaluable. Appreciate it. Thanks for your time as well.

OK. So, cities and countries around the world are looking at ways to slowly lift restrictions. We've been talking about this in an effort to return to normalcy.

Well, CNN is following developments across Europe. Take a look at this map. Cyril Vanier is in Normandy, France, Barbie Nadeau in Rome. Nick Paton Walsh in London.

Now, I want to start in France with the government is extending its emergency measures until May 11th. The president, Emmanuel Macron, made the announcement in a primetime address. Nearly 15,000 coronavirus deaths have been confirmed in the country, although the health ministry say cases do appear to be plateauing there.

Well, let's go to Cyril Vanier with the latest.

Hi, Cyril. What's it like there at the moment?


In just his third official address to the nation since this epidemic began here in France, Emmanuel Macron really gave us a road map for what's going to happen going forward. As you said, the national stay- at-home order continues for at least another month. That is intended to keep slowing down the spread of the virus and also to give the French health care system a chance to catch its breath because it has been under so much stress, more stress than it had ever bins since World War II. Then comes May 11th, a month from now. That is the pivotal date when

things gradually start to reopen in France. Gradually is the key word here.

So, what's going to happen on May 11th? Pupils, students, are going to start going back to day care centers and going back to school. Their parents are going to start going back to work.

The children in schools and the teachers are, according to the president, going to receive some form of equipment, protective equipment against the virus. We don't know if that means masks or more. Parents who are not able to work from home will be able to start going back to work.

Now, that's as normal as this gets. In many ways, life will still not be normal. First of all, because the elderly will not be allowed to go out of their homes, they will remain under stay-at-home orders, as well as people who have weakened immune systems. Secondly, bars, cafes, museums, festivals, you name it, any cultural events that involve large groups are canceled until at least mid-July and that could still be extended.

And thirdly, the borders, European borders but also French borders will stay closed. For now, it's just European borders, but France announced this morning, the French government, that they are willing to shut down borders until such time as they feel confident that having people come in and out of the country doesn't put the population at risk.

CURNOW: OK. Thanks for that update there, Cyril Vanier.

So, you're watching CNN, still to come, no plans from Britain's government to remove emergency measures, a warning that worse is to come.


UNIDENTIFIED MALE: This week's difficult. I think this week we're going to see a further increase thereafter we should see a plateau as the effects of the social distancing come through. That plateau may last for some time and then begin to decrease. That's what we would expect to see in this very unfortunate death curve.






CURNOW: Claps and rounds of applause there for Spanish health care workers. Meanwhile, Britain has been warned to expect an increase in the number

of COVID-19 deaths just this week. The government says that the country has not reached its peak and emergency measures are unlikely to be lifted this week. Meanwhile, there's also another grim statistic. More than 13 percent of care homes in the U.K. have reported outbreaks, including 92 people in just the last day.

So, let's go to London where Nick Paton Walsh joins me now.

That is a lot of old people in care homes to seem to be very, very vulnerable.

NICK PATON WALSH, CNN SENIOR INTERNATIONAL CORRESPONDENT: Absolutely. And the sort of slow trickle of at times confusing but often not particularly positive numbers has been coming out over the last 24 hours. Strangely at a time when the broad government message is their policy of social distancing expected to be extended during a review at some point during the middle of this week is, in fact, working.


But still, yes, you point out, one in seven care homes for the elderly having a coronavirus infection. Also, too, there has been a lot of pressure on the U.K. government to test the front line health care workers and the free U.K. health service called the National Health Service, and the small number who've been tested so far, about 17,000, or about a third of those appear to have tested positive.

That's not a reflection of the broad health care front line population here, because as I say, testing is hard to come by even if you're a front line health care workers as well. But this incredibly adds, Robyn, on one of the key issues here in the United Kingdom, and that is how widespread is the disease at this point? Those care home numbers opening perhaps a slight window onto the broader picture here.

None is really a government conspiracy. It's the time lag in reporting deaths that everybody is facing at the moment. But just in the last hour, we have received from the U.K., national statistics body some more numbers which do seem to suggest, and they use the tally up until the date of April 3rd as their key point. On that particular day, the U.K. public was told just over 4,000 people had lost their lives. That's a daily count done of the people who test positive in hospital that subsequently died.

These bigger numbers suggest there may have been over 6,000 people who lost their lives by that particular point of April 3rd. You can't broadly mathematically project anything here. But there is a substantial rise. And I think people are seeing that weekly as we see the new numbers come out. Some officials pointed to different ways of looking at those numbers, set to just perhaps the differences smaller, but slowly as the U.K. edges into what could be the plateau, possibly with a peak maybe somewhere behind it all right upon us now, we begin to get a clearer picture of how damaging this has been, Robyn.

CURNOW: OK. Thanks for that. Nick Paton Walsh there, appreciate it. So, the coronavirus death toll in Italy has now surpassed 20,000. The government says a month-long nationwide lockdown will be extended. But at the same time, some nonessential businesses will be allowed to reopen on Tuesday on a trial basis.

So, joining me now from Rome is Barbie Nadeau with more on that.

So, Rome edging forward here, dipping their toes in the water essentially. .

BARBIE NADEAU, CNN CONTRIBUTOR: That's right. You know, it feels like hey brave new world. Book stores are open. There are office supply stores are open. There are clothing stores for children that, you know, these people have little kids need the next size up. Those people will be able to buy things in person.

But the government has cautioned everyone. They still need to go to the stores in their neighborhoods. It is not like they have freedom of movement of any kind. We just have more stores we can go to and cue in line for outside those stores.

Their safety precautions are in place. Here in Rome, they decided to delay the opening of the bookstore, for instance, so they can rearrange the store to ensure safety. But this is all a step in the right direction of reopening the economy. We have plateaued here in terms of the number of cases, the death rate is still high. But they say there is about a 20-day lag with that.

And we are looking for these cases to go down, and the authorities are saying that the lockdown is working. We should see a decrease in cases. And more and more things can start to open up after that, Robyn.

CURNOW: OK, great to speak to you. Good to see you. Thanks, Barbie.

So, some U.S. governors are taking matters into their own hands by coordinating plans to restart their economies after the pandemic slowly and safely slows down. But the president has a much different take on opening up the country. More on that next.

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