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CNN LIVE EVENT/SPECIAL
White House Releases Guidelines For Reopening the Country in 3 Phases; Nearly 33,000 Coronavirus Deaths in the U.S.; U.S. Explored Possibility Coronavirus Spread Started From Chinese Lab, Not a Market; Austria and Italy Reopen Some Shops as Lockdown Eased; New Projections on Coronavirus in the U.S.; Researcher: New Models will Predict a Lower Death Rate; White House Releases New Guidelines to Reopen Economy. Aired 8-9p ET
Aired April 16, 2020 - 20:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ANDERSON COOPER, CNN HOST: Welcome. I'm Anderson Cooper in New York.
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: And I'm Dr. Sanjay Gupta. This is the "CNN GLOBAL TOWN HALL, CORONAVIRUS: FACTS AND FEARS". It's our seventh one in as many weeks. Tonight, White House coronavirus response coordinator, Dr. Deborah Birx is going to be here to answer your questions.
COOPER: She was also part of the process that led up to today's announcement by the White House, with suggestions for a phased lifting of some of the disease fighting restrictions that so many of us have been living under. It's, of course, up to each state to actually decide when and how to lift any restrictions.
President Trump says he wants it to start happening just two weeks from now, May 1st, or even sooner in some places. We'll talk to Dr. Birx about that, as well as whether the federal government is prepared to provide states with tools like widespread testing to do it safely without risking a second wave of the outbreak.
GUPTA: Also tonight, taking your questions, Democratic presidential front-runner and former vice president Joe Biden, plus we're going to talk with Facebook founder and CEO Mark Zuckerberg along with his wife, Dr. Priscilla Chan, and how Facebook and the Chan Zuckerberg Initiative are working now to combat the coronavirus.
COOPER: At the bottom of your screen, as always, you will see our social media scroll. You can tweet us your questions with #CNNTownHall. You can also leave a comment on the CNN Facebook page. A lot of you have also sent in video questions, and we'll try to get to as many of those as we can. We also have reports from around the country and around the world on the fight against the virus, and of course, the effort to get back to business.
GUPTA: We're going to start right where the country is now, as new cases are plateauing, even going down in some key hotspots, but at the same time the death toll does keep climbing. COOPER: In fact, it's nearly doubled in the week since our last Town
Hall, making the search for a return to some kind of normal, whatever that may mean, such a tough slog on a bitter road.
UNIDENTIFIED MALE: We are getting some new details about what life will look like when things begin to reopen -- radically different.
UNIDENTIFIED FEMALE: The president continues to suggest May 1st. That's just a few weeks from now for a possible reopening of the country.
UNIDENTIFIED MALE: The CDC director warns that we should expect a second wave of coronavirus infections in the fall.
COOPER (voice-over): There are now more than 650,000 confirmed cases of coronavirus in the United States. More than 32,000 people have died in less than two months since the first death from COVID-19 in the U.S. on February 29th.
But there are signs the number of cases is leveling off in some states and there's more focus on when the U.S. might start to reopen.
DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: There's no doubt what we've seen over the last several days is a flattening out. Hopefully that trend will continue.
COOPER (voice-over): Governors across the country are forming coalitions to figure out the next steps in opening up. California's governor warns of a new normal.
GOV. GAVIN NEWSOM (D-CA): You may be having dinner with a waiter wearing gloves, maybe a facemask -- dinner where the menu is disposable.
COOPER (voice-over): A Harvard study says, without a vaccine, social distancing measures may need to stay in place until 2022. Scientists at the National Institutes of Health say they are working on one that could be available as early as this fall.
KIZZMEKIA CORBETT, SCIENTIFIC LEAD FOR CORONAVIRUS VACCINE RESEARCH, NATIONAL INSTITUTES OF HEALTH: We are targeting fall for the emergency use. So that would be for healthcare workers and people who might be in constant contact and risk of being exposed over and over.
COOPER (voice-over): If successful, it could be available to the wider public by spring of next year. But the situation remains extremely serious. Places like New York and Detroit where some of the bodies of the dead are overflowing morgues and hospitals. Images like these, a reminder of the human cost of this pandemic.
COOPER: And it's with just that in mind and the sense of caution it invokes, that we turn to the question of where we stand and whether the suggestions unveiled today for easing some restrictions in phases and places, with state governors taking the lead and implicitly the responsibility, are realistic or not. Sanjay.
GUPTA: Yes. We see the numbers. Everyone is paying attention to the numbers. The number of deaths sadly continues to go up but we are hearing of progress, Anderson. There's plateaus, even some places where the rate of infection is starting to go down. We see that. We know that.
We also hear that maybe there is some promise around a vaccine, as you just heard in that piece, a vaccine possibly available to the general public as early as next spring. That would change everything.
But then there's a lot that we still don't know. We are now learning that people who are pre-symptomatic can actually spread this virus more than even when they get sick. Before they develop symptoms might be the time where they spread this the most.
And also, we're hearing, you know, about what the country might look like as we start to reopen. We're still starting to learn about that as well, Anderson.
COOPER: Also, every epidemiologist and scientist we've -- discussed testing. Testing, contact tracing -- testing, contact tracing, different forms of testing, antibody testing, testing people who are asymptomatic in order to get the country back to work.
Didn't hear a lot about that from the White House today, it's not in their phased plan.
GUPTA: Well, they talk about a bit about the fact that the states, this is a core state responsibility for the states to be able to have efficient and safe testing but, you know, I think that practically speaking, we always focus so much on the numbers.
But I think the question people should probably be asking themselves who are watching is right now if I needed to get tested, do I know who to call, where to go, how I'd get my results. Everybody in the country is going to need to be able to answer that question, Anderson. If you go into a place of business, if you go into a place - a restaurant, whatever it might be, there may be these additional sort of protocols in order to make sure that people are trying are, you know, to try and reduce the spread of the virus as much as possible. That's got to be a thing that's part of coming out of the back side of this curve.
COOPER: We'll have a lot more about testing throughout the next two hours. I want to get to our reporters around the globe now starting with Erica Hill who has more on the guidelines from the White House and how they may work. Erica.
ERICA HILL, CNN NATIONAL CORRESPONDENT: So there are actually three phases to these guidelines, Anderson although it's important to point out before you even get to phase one, there are some criteria that needs to be met. There needs to be a sustained decrease in cases for 14 days.
There needs to be available testing, as you were just talking about with Sanjay, also an available supply of PPE and hospitals at a pre- crisis level. So once that's met, there are these criteria for both, or guidelines I should so for both individuals and employers, three different phases.
In the first phase, individuals are told they should continue to maximize physical distancing when they're out. Limit gatherings to groups of ten or less and also limit non-essential travel. As you move into phase two for individuals, the recommendations are that vulnerable individuals should continue to shelter in place.
Social meetings, you'll notice the increase here in the number of people, should be limited to 50 people or less and non-essential travel resumes. And then when you move into phase three, the recommendations are that vulnerable individuals can actually resume their public interactions and low-risk populations should consider minimizing the time they spend in really crowded environments, Anderson.
GUPTA: And Erica, when you look at the various criteria, you're in New York. When could a place like New York or New York City possibly even go into phase one where some stuff starts to re-open?
HILL: Honestly, Sanjay, it's hard to imagine that happening. We know the President was saying some states could be in phase One tomorrow. New York is not one of those states. Governor Cuomo today extending New York pause here through May 15th.
And the governor continues to point out, without the testing that you have talked so much about, without a vaccine it's still impossible to know who can be out and about and also, he says, they still need to assess which businesses could open safely. So there is a lot of work still to be done here.
COOPER: Erica Hill, Erica thanks. Want to go next to China which has come under broader suspicion for its lack of transparency and questions about the viruses possible origin. David Culver is in Shanghai for us. So David, let's talk about the origin of the virus in China.
We spoke last night about an Associated Press investigation. CNN is investigating whether the virus came out of a lab. What more do we know at this point?
DAVID CULVER, CNN CORRESPONDENT: Well, that investigation is something that U.S. intelligence officials have told CNN is one of the things they're looking into as a possible theory in how this all started. And of course the Chinese from really the start of them making this public have directed our attention to that wet market, the Wuhan seafood market.
And that was seen as really the epicenter of all of this. Now, with this new investigation that's apparently underway by U.S. officials, it seems they're looking into the potential that this started in a lab and then spread outside of that.
And CNN has been reporting that they don't believe the U.S. -- that is, that this was done in some sort of bioweapons fashion, however, it does raise a lot of questions as to how much transparency they're getting here from the Chinese government in particular.
And you mentioned that A.P. report because that brings up some concerns, Anderson. In particular, how that was handled early on and what could have been done, perhaps, that would have maybe stopped the spread of this. In particular, over six states.
So you're looking at January 14th to January 20th. Now, according to the Associated Press, there was a teleconference on January 14th in which health officials made known to top government officials the potential severity of this outbreak.
What we saw publicly from the 14th up until the 20th was that things were downplayed significantly here. In fact we even on the 19th, five days after that call, had one of the leading health officials saying that everything was preventable, controllable and not contagious.
It was only until the next day did things take a dramatic turn, and they did admit that there is likely human-to-human transmission.
And so people ask, you know, why do we look at this with such skepticism and I think it's important, because if we're looking at China as the bellwether of what the rest of the world is going to be going through, we need to know truthfully how it's been handled and how the rest of the world should be stepping forward if they're looking to see some sort of progress in all of this, Anderson. Sanjay.
GUPTA: Yes, and of course we got to be able to trust what's coming out of China, if it's going to be the bellwether. But what -- David, what does this mean in terms of where China and the United States are right now? One point they're actually helping each other fight the pandemic. Obviously, there's been a lot of criticism lately. Where do things stand from your point of view?
CULVER: You know, Sanjay, I've been reflecting on this a lot, because I think this is a really dire situation that perhaps will go past this outbreak. And I think what we are seeing here is the potential decoupling of the world's two largest economies. And you notice it mostly from the ground level, at, for one, the rhetoric that we see, and it's a really a blame rhetoric, that's not only happening at the politicized level, which is certainly an intense back and forth, but also amongst state media and on Chinese social media, too.
And it's echoed in U.S. social media to be quite fair. But even walking around here, we've noticed an increased distrust of foreigners and we've noticed that this is something that is not backing down. It's only seeming to intensify with each passing day.
So you can only imagine that if that's what's really playing out, that's where we're headed, any sort of cooperation in how to handle this is going to fall through. And you don't even have agencies like WHO, which certainly the U.S. has backed down on funding and puts a lot of question and skepticism in, to be able to be that overarching power to say, let's see how these two economies and these two countries can work together at this. It's becoming really a difficult situation that's getting worse with every passing day, it seems.
COOPER: David Culver. David, thank you very much, from Shanghai.
GUPTA: Thank you, David.
COOPER: Europe next, where some countries are starting to cautiously ease restrictions, but others, notably the United Kingdom, have just extended them. Joining us now from London, CNN Chief International Anchor, Christiane Amanpour.
Christiane, thanks for joining us. I just want to start with the easing restrictions in some places. Where, and what are they doing?
CHRISTIANE AMANPOUR, CNN CHIEF INTERNATIONAL ANCHOR: Well, we've been reporting over the last couple of days that places like Austria and Denmark have been slowly re-opening.
But now Germany, from April 20th, is going to start to slowly re-open some non-essential businesses, and very specifically, only businesses that are about 800 square meters in -- you know, in size, and they're not going to be opening restaurants and gyms and cinemas and sports and all of that. That's not going to happen.
But early May they're going to start school again, and they're starting at the older age, at the high school age, for schools. So they believe that their very, very intensive, early action, testing, tracing, isolating, has allowed them to keep this pandemic in their nation under control.
Yes, they've had infections, but their mortality rate has been dramatically less than practically anywhere else in Europe, by a huge factor. And so -- you know, they had ICU beds, they had a huge amount of infrastructure and ventilators and the whole lot.
I spoke to the health minister today, and they say, well, now it's going to be a new normal and we're going to have to re-assess in two weeks. But from April 20th they'll start non-essential businesses and then May 2nd the schools. And I think everybody should be watching Germany.
GUPTA: And, Christiane, you know, a lot of comparisons drawn between the United States and Italy. I mean, there's other countries that are at the other end of the spectrum, so to speak. What about them? What do you think is next for them?
AMANPOUR: Well, Italy's been, you know, seeing, as you've been reporting, of course, intensively, you know, a drop-off in the number of infections and more of a stabilization. I think one of the things, whether it's Italy -- you know, there was a G7 call today.
President Trump was on a conference call with Italy and Germany and France and Canada and all the major allies. And they come to the conclusion in this over and over again that there needs to be a global sustained effort to fix this. There absolutely has to be.
And to that point, they reasserted their support for the WHO. The German health minister said to me that, you know, he doesn't think that it's the right time now to either be defunding the WHO, which is the only international organization dealing with it, not only in the developed world but soon to be the only one in the developing world.
So he said, you know, this is a setback, this withdrawal of money, and it's about people's lives. So politics shouldn't be involved here. And all the other allies gave their support for the WHO at this time as well.
COOPER: Christiane Amanpour. Thanks so much, Christiane, as always. Joining us next is White House coronavirus response coordinator, Dr. Deborah Birx. We'll be right back.
COOPER: We laid out the news at the top of the hour, the President unveiling possible guidelines for lifting coronavirus restrictions state by state in phases. It's of course up to the states to decide how and when they start lifting those restrictions.
Right now, we want to talk more about just what that means with one of the key advisers in drafting the plan, Dr. Deborah Birx is the White House coronavirus response coordinator. In addition, she serves as coordinator of U.S. government activities to combat HIV/Aids and is state department special representative for global health diplomacy. Dr Birx thanks so much for being with us. First time in the town hall, we really appreciate it, just from a logistical standpoint.
DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR: Thank you.
COOPER: Are individual states, you think, ready with enough equipment, tests, supplies, you know, people to actually do real serious contact tracing to begin doing this?
BIRX: I think there's two really critical pieces there. One is mapping every single platform that can run these tests, and that's what we've spent the last week doing.
To really work with governments and work with governors and mayors to really understand the depth and breadth of equipment that can run these tests in their state and in their cities and that's been really critical. And then we're marrying that up with CDC, CDC already has about 500 plus people on the ground in many of the states.
They will be ensuring that there's people in every state to really support the local governments and the state public health officials to really analyze each one of these gating criteria and determine exactly where they are and what needs to be done. [20:20:00]
GUPTA: We're going to talk a little bit more about testing, Dr. Birx. And thank you, by the way, for your service. Really appreciate it.
The contact tracing though, I've heard estimates that, you know, you could need hundreds of thousands of people to adequately do contact tracing. Now we're learning that people may spread this even before they have symptoms, and in the pre-symptomatic phase they could be more contagious. Do we have enough infrastructure to contact trace the way that we need to?
BIRX: I think that's why the criteria that you can see the -- that the federal government has recommended are fairly strict, and that's to give states really the time to really set up exactly how they're going to contact trace with the CDC in the background supporting.
I think those two pieces together will really need to move forward over the next few weeks as the states move through and really decrease the number of cases. And again, I want to just start by saying, we know mortality is a lagging indicator and we know that that's going to continue as it did last week into this week.
COOPER: I mean, is the -- this may not be in your purview, but if a state is wanting to hire, you know, 1,000 people or 2,000 people to do contact tracing with the public health department and quickly train them and get them to do that, is there money that the federal government will give to the state to do that?
BIRX: Well, I think you know in the CARE Act, and even the Act for phase 1, there was funding given to CDC for this very reason, to really strengthen the public health responsiveness at the state level. And that's really going to be critical, both for right now and potential for a reoccurrence in the fall to make sure we're really ready.
Because then we're going to have both the combination of flu and COVID. And so we really not only have to have testing and really working closely with the states, but we really have to make sure we can contact trace rapidly.
GUPTA: And Dr. Birx, you know, obviously, you know, people, including yourself and Dr. Fauci, have said testing in the beginning at least was inadequate.
As we go forward, if you look at the state core responsibilities, it says that they have to have safe and efficient testing. But we're hearing from states that they don't have the capacity to do this. They need help from the federal government just in terms of the equipment, for example.
Whose responsibility is it now going forward to make sure everyone who needs to be tested can be tested, the states or the federal government?
BIRX: So we have a -- at the task force level we have a federal task force that's really working on testing strategy and partnership with the states and local governments, and together -- this isn't possible unless we work as a seamless team.
So we're working with them to identify all the laboratories, all the things that they need, and they are working very seamlessly to work on getting those things. If you see what FDA has done, just in the last three weeks we've moved from that nasopharyngeal swab to a single polyester swab and now the FDA is working very closely to see whether cotton Q-tip like swabs can be utilized.
We moved from viral transport media all the way to normal saline. So these kinds of changes have really come to -- come to be possible because the FDA has been hearing from the states about what their problems are, and looking for alternatives and really doing testing with the commercial labs to see what else can be utilizable.
And so, I know it's been dynamic. It continues to be a work in progress, but it's really a partnership between the state and the federal government.
COOPER: But a lot of the states are saying -- I mean, the governors are saying, we don't have the resources to hire 1,000 or 10,000 people to do contact tracing or to have, you know, very fast testing on hundreds of thousands of people who want to go back to work, and companies want rapid testing to see if employees can go back to work.
BIRX: Yes, thank you, Anderson. I think your key statement in that was rapid testing, and I think really figuring out what combination of point-of-care tests, and we do have some of those now, to medium throughput tests to really industry level testing where you want to test tens or hundreds of people at once.
And what I have discovered in HIV/AIDS is you really have to match the need to the capacity and really working through that, ensuring all of those are in alignment. And that's part of what states are working through right now -- is to really identify where all of that equipment is, where the point-of-care tests are and how we need to work together to really create that alignment.
I know it seems daunting at times, but I've done this all over the world in resource-limited settings, and we've been able to really align need with capacity so that you can really respond to what the communities need.
GUPTA: You know, Dr. Birx, just this scenario. Let's say Anderson is going back to work at some point because New York is reopening. I've heard scenarios from public health officials people might need to get tested every week, even more frequently than that, before they could walk into the building.
First of all, is that -- could that be the case, that we'd need to be tested on a regular basis? And, again, do states or businesses or whoever would be doing that, at this point have the capacity to do that kind of testing? BIRX: Well, let's say we had 140 million workers in the United States.
There is no disease where we test 140 million workers on a weekly basis. And I think that's why we have to be strategic and smart enough that we combine surveillance opportunities in the community. Because the virus doesn't come from nowhere. It has to actually be in the community.
And so that's why you have to really have a combination of sentinel surveillance, some early warning systems like the syndromic and the influenza-like illness, combined with testing. Any one piece by itself will not be able to accomplish what we need.
And so that's why the focus is on bringing together the talents of the state with the surveillance and the activities that we can really understand, because states have used these for decades, really understanding influenza-like illness and syndromic early alert systems.
Using that early alert system with sentinel surveillance and with testing and contact tracing -- all three of those have to come together and be designed in a way so that that worker will know that there's not coronavirus in the community and in addition, if it is, then all of that contact tracing and activity wraps around to really surge both personnel and testing capacity into that particular community.
COOPER: We've got questions from our viewers. This is from Mo in Pittsford, New York. He sent in a video. Listen.
(BEGIN VIDEO CLIP)
MO MCCANN, SMALL BUSINESS OWNER: Both South Korea and China are reporting multiple cases of patients who recovered from the coronavirus, tested negative, then re-contracted the virus. If that's the case, what's the implication of it on the ongoing effort to develop vaccines and antibody tests?
(END VIDEO CLIP)
COOPER: Dr. Birx?
BIRX: This is -- yes, this is a really important question. So the -- all of the recent data talks about finding RNA fragments. We don't know if that's full-length RNA. We found that in other diseases that people will shed, as cells are broken down, partial elements of RNA.
Remember, the tests that we're using are highly sensitive. They can find small amounts of RNA. And so I think what's the -- the jury is really out to understand, is there late shedding in someone who recovers and have antibodies of actually full-length infectious virus?
And that's a question that's still outstanding and hasn't been answered in the studies to date, although people are working on that now, and culturing the virus, and see if it's -- that potential exists. GUPTA: And then, I guess the worst-case reason that somebody would
have been diagnosed with the virus again is because they got actually re-infected. It wasn't a breakdown of the virus. It wasn't a reactivation -- they actually got re-infected. Could that be the case?
BIRX: You know, of course -- you know, in biology you never want to say that that's not possible. I mean, certainly coming out of a field where we don't have an effective model of effective immunity, seeing people develop an immune response and recover and have those two linked, at least in the progress of disease we've seen to date, is reassuring to me.
But there's always that small per chance person who doesn't make effective antibody, or for another reason doesn't have effective neutrophils or effective immune response, or points out a little defect that wasn't ever discovered in their genetic response -- their immune response to a specific virus. Those outliers always exist, but right now we don't have an evidence that that's a common thing that we see.
COOPER: Pardon my ignorance. I was -- I studied political science and I'm still not even sure what political science means. And I -- real science, I don't know much about. But -- so just in layman's terms, the bottom line is, we don't know for sure a hundred percent for sure if somebody is immune after getting the virus, is that correct?
BIRX: The example of is the biology of someone getting infected, recovering and developing antibody and so in traditional infections disease that is the progress you would normally see and that antibody would be effective in controlling subsequent infections.
If the agent is the same and is there shared proteins that are then that antibody combine to and prevent re-infection. I don't ever want to say never, but that's what we're seeing in most patients is that they recover and they have antibody.
I think the other piece of this is we know now from the early studies with the plasma, it does look like the plasma, though it's very early and anecdotal, we'll get some hints about whether the antibodies are helpful in helping people who are fighting the disease in that moment and that can help really focus you on understanding that that antibody is important in immunity.
COOPER: This is another question; this is from Beth Shaw in Connecticut.
(BEGIN VIDEO CLIP)
BETH SHAW, SCHOOL COUNSELOR: My husband tested positive last Wednesday. On day eight from presumed exposure, he has now lost his sense of taste completely. Can you tell by the symptoms if it's the start, middle or end of the virus? Is there a set order of events and symptoms?
(END VIDEO CLIP)
BIRX You know, that's a great question, and I wish we knew the answer to it and because we don't know what percent of individuals are asymptomatic, we can't really tell you what the standard course is.
What if we found out that 50% of the patients that were infected were asymptomatic, then it would be very difficult to say what a middle, beginning and end looks like. At least we're hearing from cases, that we know of, that some individuals appear to do -- get better and start to improve at day 7, 8 or 9 and then have a very -- resurgence of a very rocky course thereafter.
In trying to understand that, I mean, you see the new reports about maybe it's involving cardiac or renal or other organs in the body. These are the pieces that really need to be understood so that we know how to bring therapeutics in a clear way to help every client that we're serving.
COOPER: Dr. Birx, we appreciate what you're doing and we appreciate you talking to us tonight and thank you.
BIRX: thank you.
GUPTA: Thank you, Dr. Birx.
COOPER: I want to take a quick break, more of your questions next. Also, we have new numbers about the course of this pandemic may take, numbers that may determine how soon the states can re-open or begin to reopen. The director of the institute that publishes the model that has been cited by the White House joins us next.
COOPER: Welcome back to our CNN Global Town Hall. In a moment, more viewer questions. First, a lot to talk about tonight. The push for states to reopen their economies -- always a concern, of course, what happens if we reopen too early.
Joining Sanjay and I to talk about it is Dr. Chris Murray. Dr. Murray is the Director of the Institute for Health Metrics and Evaluation at the University of Washington. It's his institute's coronavirus modeling that the White House decided, as it develops policy to confront the pandemic.
Tonight, Dr. Murray has some new projections about the course the pandemic may take. So, I know the data is still being processed and the models will be completed late tonight. What can you tell us?
DR. CHRIS MURRAY, CHAIR, HEALTH METRICS SCIENCES, UNIVERSITY OF WASHINGTON: Well, we made a big push to try to take into account how people actually move around, like direct measurement through cell phone data. And there's a bunch of providers out there sharing cell phone movement data, of course, anonymized to protect people's privacy. But what that tells us is that there's been more social distancing
across the country than I think we expected, even in some of the states that haven't had as hard -- as strong mandates. So that's going to factor into our new estimates that we'll come out with tomorrow. It looks like a number of states in the south, for example, will have smaller epidemics than we were expecting.
COOPER: What are your current -- I know you will have new numbers later tonight. What are your current numbers about your projection for the path this may take, the death toll?
MURRAY: Well, our numbers are being -- around about 68,000 deaths total with, you know, a peak happening about now nationally, but with different peaks around the country, and that's going to be really important for this idea of rolling opening.
And certainly, we're trying to get a deeper understanding of where states are still on the upswing and where states are on the downswing.
GUPTA: One of the things, Professor Murray, that's going to be happening now, I guess, probable cases are also going to be counted. Not just confirmed cases but probable cases. And I remember that happening in China as well, and you all of a sudden saw a significant increase in the number of cases. How are you going to sort of incorporate that into your modeling?
MURRAY: Well, I think five states so far have started to report probable cases. I'm sure it will spread. We're trying to look at that because I think the confirmed cases may be at the low end. The counting -- all probable cases may be sort of an overcount.
A bigger issue for sort of getting the trajectory and helping hospitals plan for the surge is that if you count all those missing deaths in one day and put them out, it really can throw off our understanding of the trajectory. So we're trying to dig into the details for each state and sort of tease that apart.
COOPER: In the known numbers that are coming out, if the death rate -- if there's more social distancing in southern states than expected, would the death rate for those states also decrease and, therefore, the overall death rate prediction for the entire country might be lower as well?
MURRAY: I think so. Certainly, they're going to go down for a number of states in the south. Places, you know, like Florida will certainly come down. The other phenomenon that's sort of a little bit of a counterbalance to that is that places like New York seem to be stuck at the peak for longer than we originally expected.
So yes, overall, nationally the numbers are probably going to come down, but there is this sort of phenomenon of a longer peak. We're seeing this in Italy and parts of Spain as well. And it's not something that I think anybody expected to see, that people would -- instead of two or three days at the peak, they're spending a longer period and then cases will start to come down.
GUPTA: Professor Murray, there's this phrase. I'm sure you've heard it and I'm sure you hate it. It says all models are wrong but some are useful. With regard to this model, what is the variability? I mean, how precise -- when we hear these numbers like you just gave Anderson, what degree of confidence do we have in these numbers?
MURRAY: Well, you know, all models are wrong but some -- I couldn't agree more with the statement. But I think the key thing is to be useful, particularly for our hospitals and state, you know, authorities trying to plan for the next phase.
What we're trying to do, like a good weather forecast, is take in all the data and keep the models as up to date as possible to reflect all the new insights that are coming in from the data. I think, you know, this is a new pandemic and you can't expect that, at the beginning, you know everything that's going to play out.
You know, why are we seeing such an epidemic in New York and we haven't seen it in other large cities, like, with -- commensurate to what's happened in New York? So there's things that we don't really have an answer, and so we just want to have the data drive the forecasts.
COOPER: Well, Dr. Murray, we appreciate what you're doing. And we've been talking to you a lot and hope to continue. Thank you so much.
GUPTA: Thank you.
MURRAY: Thank you so much. Cheers.
COOPER: Yes. A reminder, at the bottom of the screen you'll see our social media scroll that shows there are questions people are asking. You can tweet us your questions with the hashtag #cnntownhall. You can also leave a comment on the CNN Facebook.
Back now with Sanjay. And I want to bring in Dr. Leana Wen, an emergency room physician, former Baltimore health commissioner and a new mom. We haven't seen you, or I haven't seen you, since you had a baby. Congratulations.
DR. LEANA WEN, EMERGENCY ROOM PHYSICIAN: That's right. I have -- thank you very much. Baby Isabella is doing very well. Thank you.
COOPER: That's great. So what needs to happen in your view before, you know, reopening schools and businesses and the like? Because we heard from the White House today, it's going to be up to the governors. We didn't hear much really from test -- about testing and contact tracing as perhaps one might expect we would have.
WEN: Well, Anderson, we definitely need those components. So we need three things in order to reopen safely. One is, we do need widespread testing. We need testing for everyone who needs a test who has symptoms. We need testing for everyone who wants a test and wants to know whether or not they can go back to work or school safely. And we need testing for surveillance so that we really understand what
is happenings in communities around the country. And then we also need public health infrastructure that you mentioned to do contact tracing, and we need for our health care system to be stabilized, not only so that we can treat every patient with COVID-19 who comes in, but also so that we can treat people with routine health conditions like diabetes and heart disease, who are now having trouble accessing the health care system.
COOPER: What Dr. Murray said, though -- I mean, it sounds -- that sounds like a positive development, that social distancing was being more rigorously adhered to than perhaps predicted in some states, even in states that didn't have huge numbers of cases and that, therefore, the overall projected death toll may lower.
WEN: I think it's wonderful that the American people are heeding the advice of public health experts, but this is not a time for us to celebrate yet. Because even if we have reached a peak in some places, there are many other communities around the country that have yet to see their peak and don't even know the true rate of community spread there.
And we don't want to let down our guard too soon because we keep on talking about this possible second wave, where the last thing we want to do is to loosen our restrictions too soon and then we have a second wave of deaths, and then we wonder what were all of the sacrifices that we made -- what was that for? And so all the decisions have to continue to be made based on science and data and evidence.
COOPER: Well, let's go to viewer questions. This is Suzi in Bakersfield, California, sent in this question.
(BEGIN VIDEO CLIP)
SUZI GUEST, LIAISON FOR HOMELESS AND FOSTER STUDENTS: Is there a way to clean or de-sanitize N95 masks at home so that they can be re-used? I found a couple of packaged N95 masks like this left over from past plumbing work at my house. I have worn one of the masks, like, three times when I've gone out for essentials.
Is there anything that I can do to take precautions to safely re-use these masks for the rare times that I do have to go out? Would something like hydrogen peroxide be effective to use, or are there any other household products?
(END VIDEO CLIP)
COOPER: Dr. Wen?
WEN: So N95 masks are not meant to be re-sanitized and re-used although, because of the shortage in health care settings, there are studies that are ongoing about how they can be sanitized for health care workers. For non-health care workers the advice is to ware something like a cloth mask and that can be washed and re-used very easily, you can throw it into the laundry and it could be re-used.
Just remember that no matter what type of mask you use, to always wash your hands well with soap and water afterwards to avoid spreading any virus.
COOPER: This next question came in via twitter with our hashtag cnntownhall, it's there at the bottom of your screen. It reads are there breathing exercises we can do to strengthen our lungs if we are not currently sick. Sanjay could there be breathing exercises that help?
GUPTA: You know who was talking about this a lot is our colleague.
GUPTA: Yeah Chris, he talks about the breathing exercises. I don't know that there's formal, sort of, breathing exercises that are recommended across the board, but I have heard this from several doctors, that they do recommend some sort of breathing exercise, different maybe for different people.
One thing I found really interesting, Anderson, is that people who have become ill, you know, maybe even needing to go to the hospital, one of the things that doctors are doing for these patients, you know, maybe not necessarily putting a breathing tube in but just having them lie prone, on their belly instead of on their back, to try and actually create more lung capacity.
Sounds like a very simple thing, but for some reason just placing -- they call it proning, putting the patient in prone - seems to have an impact. So breathing exercises, increasing lung capacity certainly can be very valuable.
COOPER: Dr. Wen, Cynthia in Arizona sent in this video.
(BEGIN VIDEO CLIP)
CYNTHIA CANTU, PREGNANT WITH FOURTH CHILD: Good evening. My name is Cynthia Cantu and I'm 31 weeks pregnant with my fourth child. Is there any evidence to suggest that there is antibody protection for a newborn if a mother has been exposed to COVID-19 either across the placenta during gestation or through breast milk?
(END VIDEO CLIP)
COOPER: It's a great question, Dr. Wen.
WEN: Well, first, congratulations Cynthia. I appreciate your question and I've been thinking a lot about this as a new mother myself and there is a lot that's not yet known about COVID-19 and pregnancy. We do know that the antibody to coronavirus does cross the placenta and there are studies ongoing now to look at how much of the antibody, if any, is present in breast milk.
There is a question that remains though because even if the newborn is able to get those antibodies in some way, we still don't know if that gives that newborn immunity. Meaning that the newborn somehow is less affected by coronavirus or gets a less severe form of it, that we don't know yet. And so in the meantime we should consider pregnant women and babies to be particularly medically vulnerable and so they should take extra precautions.
COOPER; Sanjay, Rhona sent in this video. Let's watch.
(BEGIN VIDEO CLIP)
RHONA LISHINSKY: Hi, my name is Rhona Lishinsky, I'm from Walnut Creek, California and my question is this, the public has been advised repeatedly to use soap and water for washing our hands rather than relying on hand sanitizer so I was wondering why not use soap and water to disinfect household surfaces such as kitchen countertops and packaging rather than relying on disinfecting wipes and sprays? Thanks for taking my question.
(END VIDEO CLIP)
GUPTA: Yeah, Rhona, this is probably one of our most common questions and the answer is, yes. I mean, you can use soap and water in the same way you might use some of these other household cleaners They can be very effective. We know about that for your hands but for other parts of your house as well, it can actually do the job.
COOPER: I just saw a question going across the screen about making your own mask. Last week you showed us how to make your own mask, your daughter made me an amazing one - I literally have been checking the - waiting for the mail every single day.
GUPTA: I've been tracking it, yes.
COOPER; Okay good, I'm very hopeful. This week we asked if you could show us the effectiveness of cleaning with soap and water. Let's take a look.
(BEGIN VIDEO CLIP)
GUPTA: By now you know that viruses, including the coronavirus, can live on surfaces for a while. Several hours, even several days, which means we have to be cleaning all the time and we also get a lot of emails saying, look, I'm running out of these cleaners.
Well, the good news is not only is soap and water, which is in here, a good alternative, many scientists argue it's actually a better alternative. Calie Thordoson has got a great twitter thread about this from Sydney. He reminds us viruses are fundamentally just three things, they're made up of RNA, proteins which are the building blocks and this lipid envelope.
Well, it turns out that soap, especially when you put it on surfaces like this, can actually break apart that lipid envelope causing the virus to be destroyed and pretty easily. Dr. John Williams from the University of Pittsburgh said it's like how you clean a buttery dish. You wouldn't use just water; you wouldn't use an alcohol-based
sanitizer but soap and water does the job. So just soap and water, don't forget your high tech surfaces either like your phone. Make sure to clean those I would use lots of soap and water on that. And even things like light switches and doorknobs.
This is how you actually prevent yourself from touching the virus, touching yourself and getting infected. Hope that helps.
(END VIDEO CLIP)
COOPER: That's great, because it's hard to find all this sanitizer stuff. Sanjay, next week I'm hoping you make a tutorial about how to give yourself a haircut, because last night I took a razor and buzzed my head, and I gave myself a giant bald spot over here, which I find very -- I thought it was a 7 and it was a 5, and -- I don't know. So I've been walking around all day with my hand on my head.
GUPTA: This whole staring straight at the camera thing is working out for you.
COOPER: It's fine straight on. I just have to be seen only this way, because as soon as -- it all gives it away.
GUPTA: I hope that grows back, Anderson. I think it will. Not sure, but I think it will.
COOPER: Maybe that's for next week. You can do a tutorial. Dr. Wen, this is -- William in Illinois sent in this video. Let's take a look.
(BEGIN VIDEO CLIP)
WILLIAM HEISER, VETERAN: I'm a veteran, and a couple of weeks ago I received an email from the Navy Exchange where I shop. They asked us not to use paper money or coins as the viruses tend to live on them for a long time. Why hasn't the public been warned of this also?
(END VIDEO CLIP)
COOPER: Dr. Wen, what about that?
WEN: Well, viruses can live on surfaces and objects, including on money. Although your chance of actually getting COVID-19 from cash is probably very low. Remember that if you're touching cash, to wash your hands well with soap and water. And if you can, go to use contactless methods of payment.
Although, also keep in mind that if you're handing your credit card to someone, that's also -- you also have to wash your hands after that. And also, if you're using your phone but then you're touching your shopping cart and then your phone, you're also potentially infecting, or you are also potentially transferring the virus to your phone, too. So, wash your hands well with soap and water is the most important thing. COOPER: Sanjay, Jerry in Indianapolis sent in this video.
(BEGIN VIDEO CLIP)
JERRY LABONTE: Over the past years there have been several viral outbreaks such as SARS, H1N1, Ebola and MERS. All of them no longer appear to be ongoing issues. Is that because there are vaccines or anti-viral drugs that control these viruses?
I also don't remember these other viruses shutting down the economy. What is peculiar with the coronavirus that we need to practice such extreme social distancing?
(END VIDEO CLIP)
COOPER: It's a very good question -- Sanjay.
GUPTA: It is a good question. It's an involved answer, but let me just take SARS and H1N1, for example. SARS was also a coronavirus, and it was a new virus at the time, 2003. In the end, we know that SARS ended up infecting 8,000 people roughly around the world, just 8,000 total, and causing around 800 deaths. So a very high fatality rate, but it didn't turn out to be very contagious.
H1N1 was very contagious. It infected some 60 million people in the United States alone within a year, but it was far less lethal than the flu even, like a third as lethal as the flu. So, the difference with this, and I think the reason there's been so many more measures, is that this is both very contagious -- one person can spread it to two or three, we think, and it appears to be far more lethal than the flu as well.
So both those things in combination, I think, are why we're taking this so seriously. You want to try and decrease how many people get infected because of that fatality rate.
COOPER: Dr Wen, thank you so much and I'm so glad you and the baby are healthy and happy, and congratulations again.
WEN: Thank you.
COOPER: Much more of our Global Town Hall ahead. Democratic presidential candidate Joe Biden joins us, as do Facebook's Mark Zuckerberg and his wife, Dr. Priscilla Chan. Also checking in with Chris Cuomo. As you may know, his wife now has been diagnosed with coronavirus.
COOPER: And welcome again to CNN GLOBAL TOWN HALL CORONAVIRUS FACTS AND FEARS. It's our seventh town hall.
It's on a day that we saw President Trump lay out some federal guidelines, suggestions for states to begin lifting outbreak fighting restrictions by or before May 1st, even if some states extended those measures for weeks before that already -- New York and Los Angeles, Washington, D.C. as well. Also a day that saw the number of lost jobs in just the last four weeks hit 22 million.
GUPTA: In this hour, Democratic presidential candidate and former vice president Joe Biden is going to be taking your questions. Also, Facebook founder, Mark Zuckerberg, and his wife, Dr. Priscilla Chan, will be joining us as well.
COOPER: Yes. We're also going to talk to Chris Cuomo very shortly about how he is doing and how his family is doing. As you know, yesterday he let people know that his wife has tested positive, so we want to see how she is doing.
Sanjay, just in terms of where we are in this, a lot of emphasis today on discussion of how states may come back online, so to speak, reopen in stages. We did not hear, though, much from the White House about testing.
And clearly this president does not -- you know, any type of question he gets about, you know, are you going to push for more testing, are you going to enable states -- are you going to give them the funding and back them up and enable them to get more testing -- he reverts back to saying, you know, we have the best tests, we have the most tests, we have the greatest tests, you know, the most powerful tests, when in fact there clearly is not enough testing nationwide and even state by state.
GUPTA: The thing that's so striking to me about this, Anderson, is this, is the fact that I think for people who are watching, they're saying, we see that the tests are going up, and then there's places where they can more easily get one.
But the idea that someone who's worried about this -- they think they may be infected or, you know, they're hearing that pre-symptomatic or asymptomatic people can carry it, and they're worried about their family members -- whatever it may be, do they know how to get tested right now? Can they get tested? Who would they call? Where would they go? How would it happen?
That's the practicality of it. That's what it means to have widespread testing available. It doesn't mean, as Dr. Birx said, Anderson, that, you know, 325 million people are going to be tested. You can start to get an idea of what the country looks like.