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Trump Outlines New Guidelines For Reopening Country As U.S Death Toll Passes 33,000; Seven Midwest States Partner To Reopen Economy; Nearly 40 New Clinical Trials Into Treatments Registered In One Day. Aired 10-10:30a ET

Aired April 17, 2020 - 10:00   ET




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

POPPY HARLOW, CNN NEWSROOM: And I'm Poppy Harlow. We're glad you're with us today.

On the same day when coronavirus has killed more than 2,400 people in the U.S., the president releases a road map for reopening the economy, suggesting under new guidelines some states could reopen even today.


DONALD TRUMP, U.S. PRESIDENT: We have very different states. If you look at Montana, Wyoming, North Dakota, that's a lot different than New York, it's a lot different than New Jersey.

They will be able to go literally tomorrow.


HARLOW: But Coronavirus Response Coordinator Dr. Deborah Birx says these guidelines will not be easy to meet. Listen to her.


DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS TASK FORCE COORDINATOR: The criteria that you can see the gates 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 and the background supporting. I think those two pieces together, we really need to move forward over the next few weeks as the states move through and really decrease the number of cases.


SCIUTTO: All right. So let's talk details here. Phase 1, schools that are currently closed stay closed, so do bars, but gyms and restaurants could open though with strict social distancing while employees who can telework should keep working from home, that is, of course, folks who can telework.

HARLOW: Yes. And, look, this has proved a lot of people can.

Phase 2, shelter the vulnerable while schools reopen, keep gatherings to fewer than 50 people. Jim, I should, look, a lot of people can work from home. They are lucky enough to. Not the case for so many of those essential workers. Of course, they have been helping all of us through this.

SCIUTTO: Yes. You can't deliver packages from home. You can't drive a bus from home.


SCIUTTO: Phase 3, the vulnerable can go back out in public, but they also must maintain social distancing, work restrictions end big venues like stadiums can reopen but with physical distancing and strict sanitation.

HARLOW: That's right. For more on how this plan is being received by governors, let's begin this hour with our White House Correspondent, John Harwood.

It's so interesting. So the headline this morning is the president tells governors they can make their own decision when they could always make their own decision.

JOHN HARWOOD, CNN WHITE HOUSE CORRESPONDENT: That's right. And the governors were already moving in the direction that are consistent with these guidelines. So I think governors were pleased that the president wasn't making too much of May 1st or any date in particular. He did have those gating requirements that Deborah Birx mentioned.

And although the president said, some can do it tomorrow if they want. I don't think any state, at least I'm not aware of any state, that has met the hospital crisis care, the contact tracing and testing requirements, as well as the 14 days of case reductions that would get them into phase 1.

But these are consistent with what experts are saying is a gradual reintroduction based on what the evidence is on the ground, and I think that's exactly what the governors in these regional contacts both from the east and on the west were headed to do, anyway.

HARLOW: Yes, it sounds like it. We'll see how many are actually going to reopen, at least in part, today as was indicated possible for some, John. Thanks very much.

So this morning, the Infectious Disease Society of America is warning that the U.S. -- we know this -- does not have enough tests, not nearly enough to reopen safely.

SCIUTTO: We've heard from, literally, every state and local official we've talked to. They don't have the capacity necessary to do this. And as John Harwood laid out, it's really a multi-step approach that's necessary. CNN's Sanjay Gupta breaks down what those initial days of reopening could look like.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: What everyone is talking about what the country might look like when it starts to reopen, and I think most people are saying that there's going to be phases to this reopening. So let's talk specifically about what they're saying in these guidelines regarding phase 1, at least.

Vulnerable people, people who have preexisting illnesses, elderly, are still going to need to stay home as much as possible, at least for a little while.


According to these guidelines, there will be a lot of teleworking and returning people to work in phases, maybe staggered work time, so not everyone is in the workplace at the same. Schools that are closed will remain closed, gatherings not larger than ten people, minimizing essential travel.

Now, in terms of what can potentially open, movie theaters, restaurants, sports venues, places of worship, gyms, start having elective operations. So keep in mind, with all those things, physical distancing will still need to be in place. So if you can go to a restaurant, you may not have as many people there, you may be wearing a mask, the waiters may be wearing a mask at least, so you can get an idea of what it might look like.

What I think is important as we go forward is to really understand what these criteria are. What are the criteria for getting back to this phase 1? Actually seeing things like a 14-day decrease in symptoms, clusters of symptoms of influenza-like illness. It's very important. This isn't the confirmed cases, but they also want to see a 14-day reduction in those as well. They want to make sure that we have testing available.

And I think the best way to think about this is could someone get a test right now if they needed to get a test? Could they get that test? Would they know who to call, where to go, how to get their results? Everyone in the country is going to need to know how to do that. I'm not saying everyone in the country needs to be tested, but workers who are going into situations where they may be more at risk, can they get tested? Might they have to do it regularly? Those are all going to be very important questions.

I think of it sort of like diabetes test. Diabetics can test their blood sugar on a regular basis. Could there be a similar approach, not a blood borne infection, but a similar sort of approach when it comes to coronavirus? That's probably the way to think about it.

Also there's no numbers in terms of what actually triggers the re- openings here. They just say 14-day downward trend. If you remember, Chris Murray from the University of Washington sort of gave a number. He said there needs to be fewer than 90 new infections a day, I believe is what he said. So 90 new infections a day across country, obviously, a much lower amount than we're seeing right now. So we're going to get more details on how this is likely to play out, but I don't think we're going to see any states that meet these gating criteria right away. We'll keep an eye on those as well.

SCIUTTO: Sanjay Gupta there.

With us now, Dr. Derek Angus. He is a Professor and Chair of the Department of Critical Care Medicine at the University of Pittsburgh and UPMC Health System at UPMC as, right now, fast-tracking a clinical trial in the hopes of finding a secure treatment soon. Doctor, great to have you on this morning.

Can you tell us which trials -- which drugs you're testing out now and which are showing the best promise of success here?

DR. DEREK ANGUS, CHAIR, CRITICAL CARE MEDICINE DEPARTMENT, UNIVERSITY OF PITTSBURGH AND UPMC HEALTH SYSTEM: So I can't tell you which is showing the best promise of success. One of the issues with clinical trials is you can't, as an investigator or a clinician, know what's going on. You can try to create a trial where the central coordinating can assign the best performing therapies, but you can't know until a set number of patients (INAUDIBLE).

We are interested in testing multiple therapies simultaneously simply because, first of all, there are potential drugs that could work. And secondly, they target different parts of the problem. So we have a design that tries to both target interventions, such as hydroxychloroquine that are attacking the virus, but then also simultaneously trying to help the immune system, the role of steroids, the role of targeted so-called immune modulation agents.

HARLOW: Doctor, you're quoted in the New York Post talking about how chaotic this process has been in terms of a lack of collaboration on a national level for all of you folks out there testing these things and working on treatments and a vaccine. You say, quote, it's a cacophony, it's not orchestra, there is no conductor.

So what is going on and where should the sort of central leadership on this? Is it the NIH? Where should that be coming from?

ANGUS: So I wasn't saying it about our national response, I was actually saying it more generally about the international response.

HARLOW: Got it.

ANGUS: People are incredibly well-meaning. Everyone is trying their best. But the clinical research enterprise is -- in a way, it's like a big market or a cottage industry. We are not on a war footing. We don't all work as one integrated project. And so, consequently, everyone rushes to come up with their idea and their trial.


And so one example I gave was that there are 94 trials of hydroxychloroquine. And who knows how many of the 94 will get done. It will be much better to have just, for example, two or three large definitive trials of hydroxychloroquine.

SCIUTTO: Okay. So the lack of a national plan is something we hear across the board, states, communities, Republican or Democrat on the clinical trial regime. What about on testing? Because every health official and every sitting lawmaker says that you need widespread testing to safely reopen. It doesn't appear that there is. Will there be by next month when some of these relaxing restrictions are going to happen?

ANGUS: So I think the federal government actually is trying to come up with a plan for both, for testing. Brett Giroir and others are trying to have a coordinated plan and are working with many of the companies that make testing.

And actually, just today, Francis Collins has come out with a very aspirational and impressive plan to try to coordinate all of the pharmaceutical companies and academia, et cetera, to work with government to try to address this chaos of multiple different interventions.

So the federal government is definitely -- I mean, everyone, the whole planet is playing catch-up, but the federal government is definitely trying to step in and have a vision for trying to bring more coordination about both clinical trials for new interventions and about trying to have -- trying to get more production of effective tests available to everyone.

HARLOW: Yes, that was good news, Francis Collins, Director of NIH, I think it was just earlier this week, the importance of a public/private partnership in all of this. We appreciate your work, Dr. Derek Angus. Thank you.

ANGUS: Thank you very much.

HARLOW: Sure. Still to come across the nation, nursing homes, long care facilities for the elderly have been hit so hard by this pandemic. We're going to talk about what's being done to protect those seniors and all the people that work there and care for them.

SCIUTTO: For sure, more frontline workers.

Plus, Wuhan has revised its death toll from the virus upwards, pushing it up by a staggering 55.0 percent. We're going to be live in Shanghai to understand what is behind that new figure.



HARLOW: Welcome back. Seven governors across the Midwest are now joining forces to reopen their economies across the region. The bipartisan group plan plans to use four major factors to determine when it is time to bring business back.

Our Correspondent, Omar Jimenez, is in Chicago this morning. I mean, you're seeing these regional decisions made on the east coast and the west coast and now across the Midwest. What are those factors?

OMAR JIMENEZ, CNN CORRESPONDENT: Yes, Poppy, a lot of factors going into this when you look at these seven states across the Midwest here. The regional portion especially important because people can drive from state to state so they want to make sure there is some kind of unified approach when making these big decisions.

Now, first off, these states across the Midwest are Illinois, Wisconsin, Michigan, Ohio, Minnesota and Indiana and Kentucky as well. And when you talk about some of those main factors they're going to be looking at in this, the top one is going to be sustaining the rate -- or sustaining control, I should say, of the rate of new infections and hospitalizations, the enhanced ability to test and trace coronavirus, sufficient healthcare capacity to handle resurgence and best practices for social distancing in the workplace.

And while their guidelines are the same, that doesn't necessarily mean they're going to be going about reopening their economies the exact same way. Case and point, here is Michigan Governor Gretchen Whitmer.


GOV. GRETCHEN WHITMER (D-MI): Banding together is a good thing because we're going to work regionally. We're going to share intelligence and we're going to make informed decisions. But it doesn't mean that each of us is going to take the exact same steps. I do hope to have some relaxing come May 1st but it's two weeks away and the information and the data and our ability to test is changing so rapidly, it's hard to say precisely where we'll be in a week from now, much less two.


JIMENEZ: And we've already seen some of this dynamic play out, for example, Wisconsin Governor Tony Evers already pushing back their stay-at-home order through past Memorial Day, which is a step that other Midwestern states have yet to take. And as you mentioned, this is a form of regional solidarity that is not just playing out in the Midwest, it's playing out across seven states in the northeast and then California, Oregon and Washington on the west coast.

An important context in all of this is that all of these announcements came in the wake of some in Washington saying -- or I should say, questioning the powers the governors do have in reopening their state economies (ph), Poppy.

HARLOW: It's up to them. Omar, thanks for that reporting out of Chicago this morning. Jim?

SCIUTTO: All right. Let's go to another state, Pennsylvania. Lawmakers there pushed through a bill that would allow some businesses to reopen. However, the governor, Tom Wolf, is not expected to sign it.


I'm joined now by Pennsylvania Secretary of Health Rachel Levine. Secretary, thank you for takin the time this morning.


SCIUTTO: So, in the midst of this, you sent a letter to the state of senators warning them of the potentially devastating impacts of opening more businesses now. What do you need to see before you can recommend such, even partial, reopening?

LEVINE: Well, there are a number of factors that we need to see to even suggest any type of phase reopening. We need to see a sustained decrease in the number of new cases of COVID-19. We also need to see a decrease in the percentage of cases that are positive. We also want to make sure that we have the public health workforce and resources available to test patients, to be able to do contact tracing with appropriate isolation in quarantine in any area that might be reopened.

SCIUTTO: Do you have those testing resources? Because every day, multiple times a day, we ask state and local officials around country, Republican or Democrat, and they all say, no, they don't have the capacity yet. Do you expect to get it? Can you build it yourself?

LEVINE: Well, we are working on expanding testing as much as possible. But you are correct. There have been significant challenges getting the reagents and the chemicals and the other materials that are necessary to do testing. And we're working on that every day. We hope to have increased capacity to do testing in our state lab in Exton.

And we have learned that a number of health systems, such as University of Pittsburgh Medical Center or UPMC, as well as Lehigh Valley Health Network plan to increase their testing capacity, hopefully, over the next couple weeks.

SCIUTTO: Well, we hope to see it. I wonder on the flipside, because I know that states, local communities, they have a balancing act to perform here because there are, of course, enormous economic consequences to individuals, to families, to businesses by social distancing. Are you concerned at all that the state went too far to some degree with social distancing? And are you prepared to toggle some back?

LEVINE: Well, we don't feel that we went too far at all. The governor has taken, you know, the necessary steps to do mitigation and prevention with the stay-at-home orders, which went in a progressive way through the state, as well as closing schools now through the rest of the year, as well as the closure of non-life-sustaining, non- essential businesses. We have those efforts. We have been able to bend the curve.

But now is the time to start to look at what would be necessary to have a phase reopening. And, in fact, Governor Wolf will be giving a major speech about this at 2:00 P.M. today.

SCIUTTO: And in that speech, I know a lot of families are listening, not just in Pennsylvania but around the country. They're wondering, are their kids going back to school this year? If they own a restaurant, are they going to be able to open up to some degree? What kinds of steps and how soon should residents of Pennsylvania expect?

LEVINE: Well, so we're not going to put out a specific timeline right now. As Dr. Fauci says, the virus determines the timeline, we don't determine the timeline. But now is the time to start to make those plans.

Now, the governor has closed schools for the rest of the year, although online education continues, and then we will be concentrating on the economy and on businesses, but it will have to be in a very careful, progressive, phased way to avoid significant outbreaks of COVID-19.

SCIUTTO: Are you getting the help you need from Washington, and is the State of Pennsylvania getting the leadership that they need from the president?

LEVINE: Well, so the governor has regular phone calls with the vice president about resources that we might need. For example, we have had two shipments of personal protective equipment with N95 masks, which are essential, of course, for the care of patients with COVID-19, and we have pushed those out to the hospitals, the healthcare systems and long-term care living facilities.

While we still are lacking, as we said before, are some of the reagents and chemicals and resources to expand greatly our testing.

SCIUTTO: Well, I hope you get them. I know the people and the doctors and healthcare workers of Pennsylvania need them and we wish you all the best of luck, Rachel Levine.

LEVINE: Thank you so much.


HARLOW: All right. Nearly four new clinical trials to try to find a treatment for coronavirus registered in one day, joining several others already underway, the latest on a promising -- potentially promising treatment is ahead.



HARLOW: Right now in the race to try to find a treatment for COVID- 19, there are dozens of clinical trials underway in the U.S., many around the world in the past 24 hours. Several more were registered with the government.

SCIUTTO: Yes. And they all need time to get established results. CNN's Elizabeth Cohen though, she's been looking at these. Elizabeth, we're hearing a lot more about one particular drug this morning, remdesivir.

[10:30:01] What more can you tell us and how along are the tests here, the trials?