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More Than 2.3 Million People Globally Known To Be Infected; New York City Mayor Says, Rise In Hospital Patients Admitted For Suspected COVID-19; Police Says, At Least 10 Dead In Nova Scotia Shooting Rampage; Around 12,000 Coronavirus Testing Kits Recalled In Washington; Inside A Busy Intensive Care Unit In Israel; Navajo Nation Struggles To Battle Coronavirus With Limited Resources. Aired 6-7p ET

Aired April 19, 2020 - 18:00   ET




WOLF BLITZER, CNN HOST: Welcome to our viewers here in the United States and all around the world. I'm Wolf Blitzer in Washington. This is a special edition of THE SITUATION ROOM.

Right now, globally, more than 2.3 million people have been infected by coronavirus, and those are just the numbers that are known, reported from countries able to conduct testing. The actual number is, no doubt, much, much higher.

Around the world, more than 165,000 people are confirmed dead from the virus, and the United States has now reached another horrible milestone, surpassing 40,000 deaths. That's how many people have died just in the United States in the weeks since the pandemic started to spread.

This is truly shocking. When I was reporting to you exactly one week ago tonight, exactly one week ago, the death toll was half that, just over 20,000. It's now more than 41,000, and that, once again, is just in a week.

Despite that grim statistic, some states are now taking steps to reopen outdoor activities. South Carolina will soon start lifting restrictions on beaches. And over in Texas, the governor reopened state parks but insisted people cover their faces in public and avoid groups of people. Texas, by the way, reports more than 18,000 people infected with the coronavirus.

Protesters in several states, Indiana, Maryland, Wisconsin and Ohio, they're demanding their governors end the emergency stay-at-home orders. The loudest message coming from the protesters, people need to get back to work.

And news for millions of Americans out of a job or struggling to keep their businesses afloat. The treasury secretary says he's hopeful they're close to a second round of small business loans. After all, the initial relief money in the program ran out at the worst possible time. President Trump is focusing in on reopening the economy. And in fact, he's now encouraging people to protest their state's social distancing guidelines, guidelines the president himself recommended last month. But medical experts are warning that reopening will require an increased testing capacity, which several governors say they simply don't have right now.

The president has attacked several of those governors, blaming them for the shortages. Now, a growing number of governors from both parties, they are pushing back.

Jeremy Diamond is joining us from the White House right now. So, Jeremy, what's behind the disconnect between the White House and several of the states when it comes to testing?

JEREMY DIAMOND, CNN WHITE HOUSE CORRESPONDENT: Well, Wolf, President Trump has insisted that there is sufficient national capacity as far as testing is concerned for some states to begin to reopen their economies. He's even accused some governors of simply being unwilling to fully use that capacity. But, Wolf, governors are pushing back today, governors both Republicans and Democrats, insisting they need more help from the federal government.


GOV. LARRY HOGAN (R-MD): To try to push this off to say that the governors have plenty of testing and they should just get to work on testing, somehow, we aren't doing our job, is just absolutely false.

GOV. RALPH NORTHAN (D-VA): That's just delusional to be making statements like that. We have been fighting every day for PPE, and we've got some supplies now coming in. We've been fighting for testing.

GOV. GRETCHEN WHITMER (D-MI): It would be nice if we had a national strategy that was working with the state so every state knew precisely what was coming in.


DIAMOND: And, Wolf, as you could hear, those governors all offering the very same message, that they do indeed need help from the federal government on testing and that it still remains an issue. But the president, as we have seen, continuing to deflect blame and responsibility onto those governors, even though in the past, Wolf, we know that he's been willing and really wanted to claim credit for progress that has been made on the testing front in the past. Wolf?

BLITZER: You know, Jeremy, after a week of deadlock, the treasury secretary, Steve Mnuchin, and the speaker, Nancy Pelosi, they are both indicating that a deal to fund small businesses and hospitals appears to be, they say, imminent. Where exactly does it stand?

DIAMOND: That's right, Wolf. Well, our understanding is that those negotiations are still continuing, but we have heard optimistic notes, both from the treasury secretary, Steve Mnuchin, who has been leading those negotiations for the White House, as well as house speaker, Nancy Pelosi, and the Senate minority leader, Chuck Schumer.

Democrats, of course, have been asking for more funding for other projects beyond the small business program. That is what has held up the negotiations over the last week. But now, Democrats are going to be getting, in addition to the $310 billion for the PPP loan program. They're also getting $75 billion for hospitals and $25 billion for testing. Those are the latest figures that we have. But, of course, they could shift.

However, Republicans and the White House have been adamant that they are not going to be budging on this notion of additional funding for state and local governments.


That was an additional sticking point for some Democrats. We will see whether or not they can relent on that point and a deal can be made. But the treasury secretary, Wolf, saying that he believes that a deal can be reached very soon and that this can be on the president's desk for signature within a few days.


STEVE MNUCHIN, TREASURY SECRETARY: I'm hopeful that we can reach an agreement, that the Senate can pass this tomorrow and that the house can take it up on Tuesday, and Wednesday we'd be back up and running.


DIAMOND: And as you can hear there, the treasury secretary's optimism about how quickly they can get this done, Wolf, we will see whether or not the president has an announcement on that front as he is set to arrive in the briefing room in just moments. Wolf?

BLITZER: I know you're already there getting ready to ask your questions. All right, Jeremy, thank you very much for that report.

Joining us now to discuss all of the above and more, the chief of the Division of Infectious Diseases at Massachusetts General Hospital, Dr. Rochelle Walensky, and former acting Director of the CDC, Dr. Richard Besser.

Dr. Besser, some states have begun to ease restrictions already, including Florida, for example, reopening some of the beaches in the Jacksonville area, for example. What sort of risk, potentially, does this pose to public health?

DR. RICHARD BESSER, FORMER ACTING DIRECTOR, CDC: Well, you know, Wolf, I think it's way too soon to be taking these steps. We need to be able to do testing in a wholly different way than it's currently done.

Right now, the people who are being tested are people who have severe illness, people who may be admitted to the hospital. If we're switching from the lockdown strategy we're in now, which has slowed the spread of this disease, we need the ability to test people who have even mild symptoms. And the reason for that is that with the new strategy, public health has to be able to do their work. We need to increase the public health workforce so that every single case of COVID-19 can be investigated, people who are sick can be isolated and everyone they've had contact with can be put in quarantine so that they don't spread this and we don't see increases in the rate of infection.

Those things aren't in place right now. We don't have the testing capability. We don't have the personal protective equipment ability. And we have a lot of communities, in particular, communities of color, where we don't have a clear picture of what's going on and how to protect people from this disease.

BLITZER: Yes, those are really important points there. So, Dr. Walensky, the president says there's more than enough testing around the country. We know that that's not true. What are the biggest hurdles right now to conducting enough tests?

DR. ROCHELLE WALENSKY, CHIEF, DIVISION OF INFECTIOUS DISEASES, MASSACHUSETTS GENERAL HOSPITAL: Good evening, Wolf. Well, so, I think there are numerous things that are a challenge. One is we don't have the tests themselves. We have a certain allocation of the number of tests that we can do in a given day, and we do as many as we can, but then we run out of tests. So there's that.

There's the swabs that are needed to conduct the tests. There's the media that's needed to transport those swabs into the lab, and then there's the assays that are needed in the lab to do in order to get the test ready to conduct.

So, I think there are many steps along the way. I think PPE, we are stable here with some PPE, but we certainly need N95s in order to conduct those tests. So I think there are numerous challenges in that space.

One thing I really want to reiterate is that the -- we at Mass General in Massachusetts, we are testing people, just as Dr. Besser said, who come into the hospital, who need to be admitted, who have severe symptoms.

We are still not at a capacity where we can test people even with mild symptoms, people who want to stay home. And we're certainly not at a place that we're testing asymptomatic people. So, really, right now, we are not in a place that I believe testing is sufficient.

The other marker that I think is really important to understand is you can kind of tell how you're doing with your volume of tests based on your fraction of number of people positive, given all the people you've tested.

We here in the United States and in Massachusetts, we're at about 20 percent to 25 percent. One in four, one in five people who are we are testing has disease. That means we're testing people with very high probability of disease, like the sick people coming into the hospital.

In countries like Germany or in countries like South Korea, who have really done a great job with testing, their positive rate is around 7 percent in Germany and 3 percent in South Korea. We really need to push that positive rate down to less than 10 percent to feel comfortable that we're doing an adequate amount of testing.

BLITZER: Yes, that's an important point as well.

Dr. Besser, you're helping advise, I understand, New Jersey, some of the other northeast states, on when to reopen. How many tests do you need to conduct a day to safely start that kind of reopening across the country?

BESSER: You know, Wolf, I don't think about it in terms of the number of tests. I think about it as having sufficient capacity to be able to test anybody who may potentially have symptoms and to do the public health work to track them and isolate them.

In addition, we need to look and see, where are the tests being done?


Are we getting enough testing in community clinics where low-income individuals, people without health insurance, are more likely to be seen?

Many states have implemented drive-through testing as the way to keep people safe. Well, for people who don't have a car, for people who don't have the ability to get there and don't have a doctor to refer them, we need to make sure that testing is available there.

You know, I think Dr. Walensky is correct that if you can keep track of the percent positive, that would give you some sense of whether you're getting there. And I think also, Wolf, once we have the ability to do serologic testing, which is blood testing to look for immune protective factors in the community, that will give us a better sense of how much disease has already come through, what percentage of people may have no symptoms whatsoever, and hopefully be protected, and how safe it will be to slowly, gradually, carefully start to reopen society.

BLITZER: Yes, all right. I want both of you stand by, Dr. Besser and Dr. Walensky. We have more to discuss later this hour. Stick around, please.

The epicenter of the coronavirus in the United States is seeing a glimmer of hope in its fight against the deadly disease. We'll take you live to New York City. That's coming up next.



BLITZER: All right. This just coming into THE SITUATION ROOM. Chicago's coronavirus death toll has now surpassed the city's homicide total for all of 2019. The city's health department just announced an additional 12 deaths tonight, bringing the total death toll in Chicago from the virus to up to 500. By comparison, there were 492 homicides back in 2019, the majority of those from gun violence.

A potential ray of hope for the state hardest hit by the coronavirus pandemic, Governor Cuomo says if the data holds, New York State may be past the high point and on the descent. But as of today, the number of people admitted to hospitals in New York who are suspected of having COVID-19 is actually up, especially across New York City.

Right now, there are at least 849 patients getting treatment in the city's ICUs, this as the state's death toll continues to rise with the number of cases nearly quarter of a million.

CNN's Evan McMorris-Santoro is joining us now. Evan, Governor Cuomo says the state will begin antibody testing, so tell us what that will look like.

EVAN MCMORRIS-SANTORO, CNN CORRESPONDENT: Well, Wolf, this state doesn't yet have the capacity it needs to do the kind of massive testing required to reopen things, Governor Cuomo said today, but he says it does have enough to launch this antibody study, which essentially will be thousands of randomized antibody tests run by the state department of health to create a picture of who has these antibodies, where they are, and try to develop an understanding of how far this disease has spread and how far these antibodies have spread, Wolf?

BLITZER: Mayor de Blasio of New York, he had some pretty sharp words for the president today. What was his message?

MCMORRIS-SANTORO: Well, look, we've been hearing for weeks from the leaders of New York City and New York State that the budget shortfall caused by the revenue decline caused by the coronavirus is going to have a huge impact on the future of this area and its ability to reopen and just what it looks like when it does reopen.

Mayor de Blasio has spoken of having to cut back on sanitation and other kinds of essential services. The governor this morning said that there might be cuts to hospitals, kind of a tough cut at a time when the state's still dealing with the coronavirus.

De Blasio likened this moment to a moment from New York's past, the '70s, when the city went bankrupt and the federal government didn't really step in to help. And he didn't mince words at all, as you say, when he spoke about it in his own press conference this morning.


MAYO BILL DE BLASIO (D), NEW YORK CITY, NY: President Trump, what's going on? Cat got your tongue? You're usually really talkative. You're usually having an opinion on everything. How on earth do you not have an opinion on aid to America's cities and states?

Mr. President, are you going to save New York City or are you telling New York City to drop dead? Which one is it? But you have to speak up now.

(END VIDEO CLIP) MCMORRIS-SANTORO: So, look, this is really teeing up what is going to be the next big battle in this pandemic conversation, which is, state and local leaders like de Blasio, like Cuomo, they're not the only ones, asking Congress and asking the president to send some federal dollars their way to help to fund the activities needed to get things reopened.

We learned today from some reporting from Jeremy that you had on earlier that that's not going to be in the current bill that's up for debate in Washington right now that may pass this week. States and localities are going to have to wait. And the local leaders here are saying that waiting can have a real damage to the future of New York City and New York State. Wolf?

BLITZER: All right. Evan McMorris-Santoro in New York City for us. Evan, thank you very much.

We're following all the late-breaking developments in the coronavirus pandemic. Much more of our special coverage coming up right here in The Situation Room.



BLITZER: All right, there's breaking news coming from Canada. I want to get to that right now. Police now confirmed that at least ten people are dead after a Saturday night rampage in Nova Scotia. Authorities say a gunman opened fire inside a home late last night, then went on a shooting spree with multiple crime scenes.

CNN's Paula Newton is joining us right now. Paula, so, update our viewers. What do we know so far about this deadly shooting?

PAULA NEWTON, CNN CNN CORRESPONDENT: We do know that, in fact, police are saying at least ten people. An incredibly crazy, chaotic evening there in rural Nova Scotia, on Canada's east coast, multiple 911 calls coming in late Saturday evening. When police got there, they say that there were multiple casualties inside and outside.

Right now, they are saying that at least one RCMP officer, Wolf, is dead. That is a mother of two, an RCMP veteran, and at least ten people. The good news is that at this point in time, police do believe that they have the suspected gunman, who they arrested, then he died, apparently. They're not saying exactly how he died, but a terrifying night, Wolf.

And can you imagine, they are saying it was so chaotic with so many fires even raging right through that community, spread across dozens of miles, that they still have to go into each individual crime scene and determine whether or not there are more victims.


You can imagine, Wolf, like the rest of us, those people in those rural communities, locked down in their homes, then had the terrifying news, go to your basements, lock down further. We don't know what's going on. And finally, late Sunday morning, this gunman, suspected gunman, apparently now deceased, but along with that RCMP officer, and so chilling for the entire community to think they do not know how many people have died in this shooting rampage. Wolf?

BLITZER: You know, Paula, tell us a little bit about that part of Nova Scotia, that part of the country. Is that a place with a history of gun violence? How shocking is this to the people of nova scotia?

NEWTON: Not only is it shocking for that community, it's, of course, shocking for all of Canada. Obviously, we're not used to these kinds of shootings here. It would be one of the most horrific, unfortunately, crime sprees and murder sprees in Canada in several years.

But this community, Wolf, I started my reporting career there, so quiet, very rural, neighbors know each other, and, in fact, even the suspected gunman here, Gabriel Wortman, people knew him and say he was a nice guy, a guy who had a denture business throughout the community.

It is beautiful. It is stunning. As I said, people are here, Wolf, it's a cliche to say, but there are still people there that really have their doors open, and especially during this lockdown. A lot of people in the rural community trying to reach out to each other and reach out to the elderly, because as you know, Wolf, it's a period of high anxiety for everyone.

So to be told in the middle of the night, really, lock your doors, if you see this suspect, do not approach him. And then to hear that so many people that you know in this close-knit community have now lost their lives, stunning.

And you could tell from RCMP press conference, Wolf, I mean, this is an entire community that is completely shaken, including the law enforcement community, having lost one of their own, and losing so many people that they they know throughout the community.

It's stunning to me, Wolf, that the police won't even venture a guess as to how many more than ten, how high the actual murder count will go. Wolf?

BLITZER: Really disturbing information. All right, Paula Newton reporting from Canada for us, Paula, thank you very much.

Coming up, we'll get to all the late-breaking developments in the coronavirus pandemic.

We also have a troubling story out of Washington. Thousands -- get this, thousands of coronavirus testing kits have now been recalled due to possible contamination.

Much more of our special coverage. Stay with us. You're in the situation room.



BLITZER: We're back with our special coverage of the coronavirus pandemic. Also back with me right now, the chief of the Division of Infectious Diseases at Massachusetts General Hospital, Dr. Rochelle Walensky, and the former acting director of the CDC, Dr. Richard Besser.

Dr. Besser, we're just learning something very disturbing right now that some 12,000, 12,000 testing kits distributed by Washington State Department of Health were actually recalled due to contamination. What's your reaction to this?

BESSER: Well, you know, it's going to happen. 12,000 should not put you out of business. It kind of is a good example of how fragile the testing system is right now. We need millions of tests. And with millions of tests, if they're working, 12,000 wouldn't be a problem. It points to the importance of quality control to make sure that the results of the tests are results that we can believe. You know, many of the tests that are being used, they have to be applied and done properly.

And we're hearing reports that there are many communities, communities of color, where people are not getting adequately tested. And that's a real concern for us at the Robert Wood Johnson Foundation.

BLITZER: Because we're hearing, you know, Dr. Besser, all sorts of reports that there are some false positives, false negatives. Is that normal? How concerned should we be about that?

BESSER: Well, all tests will have some rate of false positive and false negative. You know, this test is not as simple as a pregnancy test where you take a sample of urine and you put it in a dipstick. Here, how you do this test, how you administer that swab in someone's nose, and it's an uncomfortable procedure, can determine whether or not your result is negative or is a good sample and can test positive. Very important.

BLITZER: Certainly is. You know, Dr. Walensky, there's a new study that's out. The study is using antibody blood tests, found that between 50 and 85 times more people may have been infected with COVID- 19 than have actually been confirmed by health officials out there in Santa Clara County, California.

Does that indicate that the majority of coronavirus cases may, in fact, be asymptomatic? People are walking around feeling fine, but they have the virus, and potentially they could spread the virus.

WALENSKY: I think it's a really important point. We are still learning a lot about these antibody tests. I think we have seen estimates that demonstrate somewhere between 4 percent and 94 percent of cases have been detected. So, we have a wide range listed there that we really have to uncover.

The other thing to note is the opposite has happened. So, we do know from some studies that perhaps a third of people who had a documented case of coronavirus did not actually produce antibodies. So, I think if these tests can go in both directions, it can find people who we might not have found previously, but it also might not detect people who we know have disease.

BLITZER: Dr. Besser, does it mean more people may have immunity to this virus than we originally thought?

BESSER: Well, you know, a lot of work has to be done around antibody testing to determine, is there a particular level of antibodies that will provide protection for somebody?


Is somebody who has that particular level of antibodies safe to go out in the community? Can they spread coronavirus to someone else? Those are really important questions that scientists are looking at right now.

Once you have that information, being able to look across a population, making sure that all segments of your population are being tested, will be very useful information to give you a sense of what's called herd immunity, how many people in your community have this and could actually provide a buffer to the people who are at the greatest risk of severe disease. Because that's what it's really all about. Most people who get this are going to have mild infection. It's about protecting the people who are vulnerable in our communities so that they don't get sick and aren't at risk for severe disease.

BLITZER: And you know, there's another question, Dr. Besser, I want you to weigh in on. There's talk of potential treatments or therapies, a lot of potential out there, key word, potential. But the one the president keeps talking about is the hydroxychloroquine. The actress, Rita Wilson, who had contracted the virus, says she experienced extreme side effects from the drug. What have we learned so far about the effectiveness of this drug, hydroxychloroquine?

BESSER: Well, you know, I ran emergency preparedness at CDC for four years, and during that time, in every outbreak, with every new disease, there were therapies that were put forward that people knew anecdotally, had experience in a clinic. It seems like this is doing something. It seems it's helping. You have to put those drugs through clinical trials to see, are they truly working? Are the benefits of the drug outweighing potential risks?

This is one of those examples where the studies are just being done to be able to let us know what drugs might be effective, which ones are not, what are the side effects, and how do you balance that? There's so much misinformation that's out there on the internet. People should really make sure that they're turning to trusted sources and that their health care providers are the ones who are guiding the treatments that they're going forward with.

BLITZER: And Dr. Walensky, I'm curious about this other drug that's getting a lot of mentions right now, Remdesivir. Is that a serious drug? Is it not serious? What kind of clinical testing has it gone through with people who have coronavirus? WALENSKY: So, importantly, unlike hydroxychloroquine, which you can

write for because it's FDA approved for other indications, Remdesivir is in fact not. It is not FDA approved for any indication. It's an antiviral drug in the lab. It has some activity against numerous viruses, including Ebola. People were thinking at one point it would be a good Ebola drug, but those clinical trials didn't pan out.

So, we are just testing it now in patients with coronavirus. There was a study last week in the "New England Journal" that demonstrated what happens when people with COVID-19 got Remdesivir in a compassionate use basis, and some people did get better. But just like Dr. Besser comments, we don't know what would have happened if they hadn't gotten the drug. And this is really where the randomized, controlled, clinical trials are essential to understand the drug's efficacy.

BLITZER: Well, Dr. Besser, what do you think of this drug, Remdesivir?

BESSER: You know, I agree with Dr. Walensky. The other piece of it is, as therapies are developed, we need to make sure they're getting to all patients. You know, we're seeing extremely high rates of death in black Americans, in Latinos.

I mean, is it because of differences in treatment? Clearly, there's issues in terms of exposure, in terms of the percentage of African- Americans and Latinos who fit into the essential worker group, who are unable to work remotely, yet don't have sufficient access to protective equipment.

We need to look at the risk. And then when there's treatments available, we need to make sure that they're distributed fairly to all communities.

BLITZER: Dr. Walensky, can life go back to some semblance of normality here in the United States? It's going to be at least a year, everybody says, including Dr. Fauci, for an effective vaccine to go through clinical trials, to be approved and then -- and go out there in huge numbers. But treatments, they say, may be much sooner, a month, two months, three months down the road, that would presumably prevent death, which would be a game changer right now as far as coronavirus is concerned.

Can life really go back to normal without at least some effective treatments?

WALENSKY: Yes, I think until we have a vaccine, life is going to be different. Now, I'm not saying that we can't think about what life would be like in the next phase, but I think that if we all think that we're going to Mardi Gras and baseball games in the next few months, we may be really disappointed. And I think we really have to recognize that.

I think once our hospitals are compensated and have fewer patients and have the capacity to take care of more patients, once testing is more widely available, as we previously discussed, then I think we can talk about what life might look like.


Whether restaurants might open at half capacity, whether there might be some return to be some return to work but with some employees working one week and other employees working another. I think we really have to decrease the density of the people who are around one another, really until we have real containment of this disease, lots of testing, and really, then a vaccine.

BLITZER: It's going to be a while until that kind of testing, you know, Dr. Besser, is really available, right?

BESSER: It will. And I think it's really important as we talk about vaccines that we talk about the hope for a vaccine. There's no guarantee that there will be a vaccine. There are many viral infections for which there's been efforts to make vaccines that have been unsuccessful. So as we're planning, it can't be, well, in a year we will have a vaccine.

Our strategies have to incorporate the possibility that there won't be a vaccine, that as we will gradually, carefully, reopen society, doing it based on the best available public health science, that there will be changes to the way we interact that go on for quite some time, until there's enough herd immunity, protection in the community so that people who are at the greatest risk can go about their lives in a safe way.

BLITZER: All right. Dr. Besser, thank you. Dr. Walensky, thanks to you as well. We'll continue these conversations down the road.

Meanwhile, there's more news we're following right now. Israel has one of the lowest coronavirus death rates in the world and also has one of the best health care systems in the world, but that doesn't necessarily mean Israel's doctors and nurses aren't being hit very hard with the grim reality of this pandemic.

CNN's Oren Liebermann takes us inside a critical care unit in Tel Aviv.


OREN LIEBERMANN, CNN CORRESPONDENT (voice-over): Deep inside Tel Aviv's Sourasky Medical Center, even the simple answers are hard to find.

DR. ADI NIMROD, ICU DIRECTOR: It's something else, it's another disease that we are learning all the time more and more about it.

LIEBERMANN: This is an intensive care unit for COVID-19. The toughest coronavirus cases come here.

Before we were allowed in, we had to dress like the medical staff for protection. My blood sugar monitor for type 1 diabetes required an extra wrapping. I've stood under rockets from Gaza, near artillery and sniper fire and more. And yet a part of me was more nervous here.

As we step inside, I meet Dr. Adi Nimrod, who shows us around the 16- bed unit. Most of the patients here are sedated, many on ventilators. Here patients get individualized attention around the clock. The risk of anything less is too great. There is no set treatment for coronavirus.

NIMROD: You have to sense them and to see them every day, to check them, to see their faces, to check all the parameters. There is the atmosphere around the patient.

LIEBERMANN: An external control room allows remote monitoring of every bed and a place to breathe. Part of head nurse Iris Berman's job is to keep everyone positive.

IRIS BERMAN, ICU CHIEF NURSE: It's very tough. Sometimes I'm not so positive. But I think if I won't be positive, no one will be.

LIEBERMANN (on camera): One day at a time in there?

BERMAN: Yes, one hour at a time.


LIEBERMANN: Within a few minutes of putting on all this protective equipment and walking into the intensive care unit here, I started sweating, my mask, as you can see I think, fogged over. But I have the luxury of being able to take this off in a few minutes when I step outside. The doctors and nurses will wear this hour after hour, treating the patients who need intensive care. They'll take their quick break, they'll step outside and then they'll do it all over again.

(Voice-over): Israel's mortality rate has hovered around 1 percent, among the lowest in the world. Israel instituted restrictions on travel and public gatherings very early. And the country's health care system is among the most advanced, which has helped lower the mortality rate. But that number soars for the critical care patients who need to be ventilated. Like many here, sometimes the outcome is measured very differently.

NIMROD: You try, you do your best. You're just a doctor, just a human being, as they are. And if you cannot succeed, be compassionate.

LIEBERMANN: Dr. Nimrod's treatment is guided by the latest science and also his experience. He was in the army during the 2006 Lebanon War. That's him treating the soldier on the stretcher. This, he says, is a different fight, one he calls much more complicated.

NIMROD: The virus taught us to be more modest, more humble. And a lot of compassion for legions of families. And it's just a virus. But not just a virus. It's something much bigger.


LIEBERMANN: The doctors and nurses are tested every week for the coronavirus. The hospital says everyone has so far tested negative. In this most sterile of environments, families are only allowed in if it's to say goodbye. Otherwise messages are recorded and sent through the nurses. And prayers must penetrate the layers of protection around the ICU. The patients see only the unit's staff. There is solidarity here through a common vulnerability.

(On camera): The closer you get to the patient as a doctor, does that make it harder and more personal as a human?

NIMROD: It's all personal. We are human. We are fragile just like they are. Now he is in this bed, tomorrow I might be here, or my family. We are very fragile.

LIEBERMANN (voice-over): Oren Liebermann, CNN, Tel Aviv.


BLITZER: Thank you, Oren, for that report.

Meanwhile, the Navajo Nation in New Mexico is seeing an alarming number of coronavirus cases. Why is that community so vulnerable to the virus? That's ahead.

Stay with us. You're in THE SITUATION ROOM.



BLITZER: The Navajo Nation in New Mexico is continuing to see rapid growth of coronavirus cases. On several days last week, it accounted for 75 percent of the new cases reported in the state.

CNN's Gary Tuchman reports on the impact of the virus there and how frontline workers are responding.


GARY TUCHMAN, CNN NATIONAL CORRESPONDENT (voice-over): Take a look at the nurse in the yellow being suited up. The protective mask she is wearing is a welder's mask. Personal protective equipment is at such a premium that this hospital has bought 60 masks from a welding company. This one of the many challenges for the Gallup New Mexico Indian Medical Center, which is adjacent to the remote splendor of America's Navajo Nation.

DR. JONATHAN IRALU, INDIAN HEALTH SERVICE: This is the largest ICU in Navajo Nation.

TUCHMAN: An infectious disease expert for the Federal Indian Health Service takes me inside the intensive care unit.

IRALU: We've transformed this kind of regular ICU into a COVID unit. We're doing things we never would have thought were proper, like put the IV pulse out here on the doorway were so much a problem. This is the best way for the nurse to be able to manage the medications without having to put on PPE every time the nurse goes in the rooms.

TUCHMAN: In that room a very sick woman who has been on a ventilator for about a week. And a nearby room --

UNIDENTIFIED FEMALE: Run it down and squeeze it. Like toothpaste. Squeeze it in. Yes. Just be careful with the one that's got the thing missing because like I said it will squirt your face.

TUCHMAN: A woman who appears to be in even more dire shape, about to get what's known as a fresh frozen plasma transfusion.

IRALU: It's an FFP transfusion to prevent breathing problems at this time. So it's part of a resuscitation.

TUCHMAN (on camera): How seriously ill?

IRALU: That's a very critically ill person right now.

UNIDENTIFIED FEMALE: She went in there. There was a patient in there.

UNIDENTIFIED MALE: OK. So we'll just go ahead.

TUCHMAN (voice-over): While this is the largest ICU of the four Indian Health Service hospitals in the Navajo area, it is much smaller than you would likely think.

(On camera): There are six rooms. Right now they're all full. And what happens when people come in and have to go into the intensive care unit and there are no rooms, often they have to be flown 130 miles to Albuquerque. It's very upsetting for members of the Navajo Nation to leave their nation to go to Albuquerque. But unfortunately, that's becoming a necessity.

(Voice-over): It also happens when people with COVID-19 already in the ICU needs special surgeries or procedures that aren't able to be done in such a rural area.

IRALU: The Navajo people live between four sacred mountains. And in general people prefer to stay in this area basically their homeland.

UNIDENTIFIED FEMALE: Many of our staffs live in Navajo. So it's very comfortable for them to be here with us here in Navajo Nation.

TUCHMAN: When members of the Navajo Nation fear they might have COVID- 19, they are initially seen outside this hospital, in tents that have been set up.

UNIDENTIFIED FEMALE: Any body aches, muscle aches?


TUCHMAN: And then --

(On camera): This is where suspected COVID patients are first brought. The emergency room.

(Voice-over): Patients are evaluated here and then they might go to a coronavirus ward where there is some good news today.

UNIDENTIFIED MALE: We're going to get some tests in the lab. I think likely we'll be able to get her out of here.

IRALU: Super. Thank you.

TUCHMAN: The Navajo Nation with about 175,000 people who live here has more cases of COVID-19 than nine entire states, more deaths than 13 states, and according to the chief medical officer of the Navajo Area Indian Health Service --

UNIDENTIFIED FEMALE: I do not believe we have hit our peak yet.

TUCHMAN: -- there are believed to be enough ventilators here, but the PPE shortage is very concerning.

IRALU: I tried to tell them to be strong, to rinse off their PPE, and try to get some rest so that they stay healthy.

TUCHMAN (on camera): (INAUDIBLE).

IRALU: It does.

TUCHMAN (voice-over): Before we leave the hospital, a decision was made. The woman in this room who needed the transfusion needs critical care she could only get in a bigger city. So she is brought out on a stretcher and will be taken by ambulance to a plane for a flight to a bigger city hospital where doctors will try to save her life.

CNN, Gary Tuchman, CNN, Gallup, New Mexico.


BLITZER: Very disturbing. Thanks, Gary, for that report.

We're going to bring in the latest developments on the global coronavirus pandemic in the next hour of our special SITUATION ROOM coverage.


We'll take a quick break, we'll be right back.


ANNOUNCER: This is CNN breaking news.

BLITZER: Welcome to our viewers here in the United States and around the world. I'm Wolf Blitzer in Washington. This is a special edition of THE SITUATION ROOM.