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Trump Invokes Defense Production Act to Increase Swab Production; Former CDC Director Frieden Says Testing "Absolutely the Federal Government's Responsibility"; Fight Brews as S.C. Governor Allowing Beaches & Retail Shops to Reopen; Harvard Study: U.S. Must Triple Testing to Safely Reopen; Trump Lashes Out at Others as U.S. Death Toll Passes 40,000; WAPO: Americans at WHO Gave Real-Time Info on Virus to Trump Administration; Meat Plants at Center of Iowa Spike in Cases. Aired 11-11:30a ET

Aired April 20, 2020 - 11:00   ET



JOHN KING, CNN ANCHOR: Hello to our viewers in the United States and around the world. I'm John King, in Washington. This is CNN's continuing coverage of the coronavirus pandemic.

Another global benchmark quickly approaching, 2.5 million confirmed cases worldwide. The French prime minister today saying his country will not return to normal for a long time.

Vladimir Putin says mitigation is working but the Russia coronavirus peak still lies ahead. And 100,000 defied lockdown orders in Bangladesh to mourn sparking fears of a devastating potential outbreak there.

The United States' case count now sits at just north of 760,000. See the numbers on the screen there. And 40,000 people have died in the United States. The numbers are harrowing but the White House says the data does show some promise and that early hot spots are on the other side, the downside of the curve.

Still, some new epicenters still forming. Hospitalizations and deaths in Chicago, Boston and Philadelphia are surging. Even in New York, where the virus is trending down, there's some cautions. The mayor today announcing all parades, concerts, rallies and large gatherings planned for June -- June -- are now canceled.

Looking across the nationwide landscape, zero states at this hour meet the president's criteria to reopen the country. Testing is a big piece of those White House reopen guidelines. Governors complain of a giant testing gap between capacity and capability. They say that means, until it is closed, they are just not ready for a reopening.

There are a few governors, though, easing restrictions, creating tension with local officials and public health experts. We also see this debate in protests. And the president keeps praising those pushing -- you see them right there -- to get their governors to open up. Yet, the president's top expert says just this morning a rush to reopen would be a giant mistake.


DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: But unless we get the virus under control, the real recovery economically is not going to happen. So what you do, if you jump the gun and go into a situation where you have a big spike, you're going to set yourself back. So as painful as it is to go by the careful guideline of gradually phasing into a reopening, it's going to backfire.


KING: The president, if you've been listening, for weeks. bragging about testing, insisting there are very few issues. Last night, though, the president did put the onus to test on governors, calling it a local problem.

Yet, at the same time, he also announced he's using the national Defense Production Act to propel a company to make more swabs used in that sensitive coronavirus diagnostics.

With me to share his expertise and insights, our chief medical correspondent Dr. Sanjay Gupta.

Sanjay, thank you for being here to start the hour with us.

I'm doing this 18 to 20 hours a day, just like you are, and it is so easy to get confused. The president says all is well, the governor says no, it's not. They say there's this test, that test, some of them are proven, some are not. Where are we?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: The practicality of someone who needs to be tested and that person being able to go through the process getting a test and getting the results of that test is still a holdup in places.

It doesn't mean that capacity to do these tests hasn't increased. It has increased in places. That means there's labs and in places technicians that are plentiful in order to be able to run the test.

The problem is there are many steps before you actually get to the capacity issue. You need to have the swabs, for example. People are learning more about swabs than they ever thought they would. You have to have the medium in which to transport the swab to the testing facility. You have to have certain reagents that then pull the genetic material off the swab, then the testing can take place.

The point is, every single step of the way, you have to make sure you have enough of these supplies. And some of those, John, are just in short supply.

When I talked to public health officials at the state level, that is the picture that some describe, where they say that, yes, we have public health labs, we have commercial labs, we have university labs, they've all really stepped up. But we don't have enough of X, Y or Z in order to get it done.

And that's why I think there's this conflict between the states and the feds. The states saying we can't compel this company out of a town of 1,500 people in Maine to make more swabs. We can't ask them to do that. We can't ask other companies to start making these swabs. We're a state. The federal government has to be able to step in and do that. I think that's the tension that I'm hearing -- John?

KING: That is the tension.

I just want to listen here to the former CDC director, Tom Frieden, who says, to your point, this is a national pandemic. We are in uncharted waters. Yes, states normally would pick up the slack here but, in this case, Tom Frieden says, no, Washington has to help.


TOM FRIEDEN, FORMER CDC DIRECTOR (voice-over): It is absolutely the federal government's responsibility. Currently, we're doing in this country less than 150,000 tests a day.

Earlier today, we released a report and we calculated quite simply, if we were just testing the highest-priority people and nobody else, we'd need about three times as many tests.


And since we're also testing some lower-priority people, we're going to need more than that. If we try to test really extensively, it would be 10, 20 times that.


KING: There's just no question, Sanjay, when you hear that that, look, there's been progress. We need to give people grace. There's human error. They're trying to ramp all this up. But if you listen to that, we're nowhere even close, as the president keeps nudging governors, reopen and reopen now.

GUPTA: Yes, I was really struck by that as well. So 150,000 tests a day a lot, but we need to be doing closer to 500 just to test the people who are health care workers, front-line workers, people who have symptoMs.

If we want to get to the point where we're doing surveillance out in the community, it could be a million, even more than that, tests a day that would really need to be done.

John, one way I thought about it recently with some of my medical colleagues is more along the lines of diabetes blood-sugar testing. This isn't a blood-borne thing. This is a respiratory thing. So you would be testing swabs, saliva, things like that.

But diabetics test their blood sugar many times throughout a day. They've gotten good at doing that. Might we, at least for a period of time in this country and around the world, have to test ourselves on some regular basis and have the facilities and the capacity to be able to do that even at home, John?

That's the sort of picture we should be angling for as opposed to where we are right now.

KING: Amen. But that's a conversation that the people who have the power to do something about it should have been having, I think, weeks and weeks and weeks ago. But it's being forced upon them now, a little late in the game, many would argue.

Dr. Gupta, thank you as always for your help and insights.

South Carolina today a test case in the big coronavirus reopen debate. The governor is giving some stores the green light to reopen business. There's a fight brewing between some mayors in South Carolina who think it's wrong to ease restrictions at the beaches right now.

This map shows one model suggesting when states should be ready to reopen given the best information available right now. For South Carolina, that date is late May, a month from now, not today.

CNN national correspondent, Natasha Chen, is in Columbia, South Carolina.

Natasha, Governor Henry McMaster deciding to push the envelope here.

NATASHA CHEN, CNN NATIONAL CORRESPONDENT: Yes, we're still waiting for official confirmation, John, from his office. But we know from the "Post and Courier" newspaper here in South Carolina that he is intending to announce today the reopening tomorrow of certain businesses that sell clothing, jewelry, furniture, but still limiting the number of people who can be in those stores at any given time.

We're also talking about the potential that he's going to reopen public access to beaches, rivers and lakes. Already on Friday, there was an order to reopen boat docks.

I just got off the phone with Representative Joe Cunningham's office. Joe Cunningham represents the district near Charleston with those beach towns. And they said that, over the weekend, since that order, there were a lot of people gathered trying to take their boats out.

And even before the beaches closed several weeks ago, they observed large crowds of people, from inland from the state or out of state, and so they're concerned about what would happen when those beaches reopen.

You mentioned those beach towns. Several of them got together and agreed that they're still going to restrict access, no matter what the governor says, to just residents on the beaches if those reopen.

And so there's concern right now to how the social distancing would be enforced without putting law enforcement at risk right now -- John?

KING: Natasha Chen for us in Columbia. Appreciate that live report.

This is one of the states as these governors go forward with this, like it or not, it will give us a test case. We'll watch and see how these things play out.

Natasha, thank you so much for that important reporting.

With me now to discuss, CNN medical analyst, Celine Gounder. She's an infectious disease specialist and epidemiologist, also host of the "Epidemic" podcast.

Dr. Gounder, thank you so much for being here.

I want to get, as an expert, when you see these things playing out, not every model is correct, but the model says end of May. The governor of South Carolina says I'm going to try this -- it's limited -- but I'm going to try this in the end of April. A, wise? And, B, I guess we will quickly learn, won't we?

DR. CELINE GOUNDER, CNN MEDICAL ANALYST: Yes, it does seem premature to be reopening. So there's two real metrics by which we can decide whether a state or other local region is really ready to reopen. And it's really about is there public health preparedness and is their health system preparedness.

On the health system side, can you do the contact tracing, can you do the testing of people that have symptoms, isolate people and test those who may have been exposed.

On the health care system side of things, as we saw before some of these social distancing measures were put into place, many hospitals in some of the hardest-hit areas were really overwhelmed. And that put not only patients at increased risk at dying from COVID but also health care workers at increased risk for contracting the disease.


So, really, that's what we're talking about, is making sure that we're ready on both fronts before we lift social distancing measures.

I think the other thing to remember is that, no matter what, we're going to see an increase in transmission when we lift social distancing measures. It's really a question of, how prepared are you to handle that resurgence in transmission.

KING: How prepared are you, how prepared is the psychology. People start to reopen again and you think, OK, my governor says I can go out. Then you see cases go up. There's a psychological impact.

You mentioned can the hospital system, can the health care system handle it? Are you at a point where you're stabilized so if you get more you can handle it?

The other question is, we don't really know -- this is the thing that fascinates me. We don't really know how bad it could be because we still don't have a sense of how many people are walking around asymptomatic, correct? Who still have or had, and we don't know if they had and processed it thinking they had a minor cold or something, whether they're immune for a month, six months, forever? GOUNDER: That's right. We still don't know what percentage of people

may have had it without knowing it. It's probably somewhere in the ballpark of 25 to 40 percent, but that's a big range.

And then there's been talk of these antibody tests. To be clear, antibody tests are not really about diagnosing somebody who is sick now. It's about looking backwards to see if they may have had it before.

Unfortunately, not all antibody tests are created equal. You have some that have been developed by state and public health labs, academic centers that seem to be performing pretty well.

But the FDA has really opened the floodgates to any number of tests, including some from China, that have already shown to have issues.

It's sort of like ordering something on Amazon. It looks great online when you order it, but when you receive it, how often do you find something made in China that you end up throwing in the trash because it's not what you thought you were getting.

Unfortunately, a lot of these new antibody tests that are coming out fall into that category of really not performing up to what the promises are.

KING: It's a great point because you hear -- and I think the president is way too casual when he talks about this at the White House briefing, saying the FDA approved this, I saw this study there, I saw this there.

Some of them we hope will bring us hope. A lot of them are in early stages or will turn out to be a dead end. And that gets lost in the conversation sometimes.

I want to get your view on this, because when I was talking to Dr. Sanjay Gupta, he had from his podcast him Tom Frieden, the former CDC director, saying we need to triple, maybe even more, but at least triple testing.

There's a new Harvard study out. I think we have a graphic we can show you. They say at least triple testing from where we are currently.

As you know, there are a lot of people out there what to say, well, New York didn't need all those beds. New York didn't need all those ventilators. The public health experts are grossly exaggerating. This is not such a threat.

As people start -- some are protesting, some are being told by their governor it's safe to go out and do a little more or to reopen. Help us understand why the testing piece is so critical.

GOUNDER: If you want to have accurate predictions about what the needs are, whether it's health care system needs or other needs, you really need to have a better handle on the actual numbers. So testing is really at the center of that. Testing is also what tells you where the disease has been, where the disease is going. We also need to get a better handle on whether these antibody tests

actually mean somebody is immune or not. And we don't have a firm answer to that yet. So it would be dangerous to say you're safe to go back to work and you don't have to mask up on the basis of an antibody test because we just don't know that's what that demonstrates right now.

You know, I think there's just a lot of unknowns, still.

KING: A lot of unknowns and some people try to fill that in with their own theories not necessarily based in science.

Dr. Celine Gounder, thank you very much. Appreciate the expertise helping guide people through this. A lot of questions. We're at that crossroads moment right now.


Up next for us, why the president is so focused on shifting the criticism to others.


KING: President Trump's go-to in this time of crisis is anger and confrontation. New attacks on House Speaker Nancy Pelosi, on Democratic governors, and on reporters who dare raise questions about his coronavirus response.

New numbers suggest most Americans are not impressed at the moment with their president. And 52 percent disapprove of how the president is handling this pandemic, 44 percent approve.

The latest NBC/"Wall Street Journal" polling also includes damning numbers for the president on the question of trust. Look here. Only 36 percent of Americans trust what they hear from the president. Only 36 percent. And 69 percent trust the CDC, 66 percent trust their governor, and 60 percent trust top infectious disease expert, Dr. Anthony Fauci.

The slipping poll numbers are part of the president's anger. He's also mad at even business and political allies who keep telling him the reopening process is going to take months.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: He said we did a phenomenal job. So report accurately because you are one of the most inaccurate reporters.

You don't have the brains you were born with. You should be praising the people who have done a good job.

I got here with the worst, most unfair press treatment, they say, in the history of the United States for a president. They did say Abraham Lincoln had bad treatment, too.

You just don't have the sense to understand what's going on.

I told you we inherited a lot of garbage. They had tests that were no good.

You and the Obama administration were duped for years because China was ripping off this country.

I'm not a fan of Mitt Romney. I don't really want his advice.



KING: CNN's John Harwood is with us today covering the White House.

John, you watched the president, especially over the weekend and in recent days. Yes, he's in a bit of a mood.

JOHN HARWOOD, CNN WHITE HOUSE CORRESPONDENT: He's in a mood, John. He's getting a very harsh judgment from governors who are criticizing his performance, from those of us in the press who are covering the president's performance, and from those poll numbers.

There's another one you didn't mention, which is the Pugh Research Center, last week, showed two-thirds of the American people think he's been too late on the coronavirus.

And I think he's struggling under the pressure of that harsh judgment. So he spent a long time at that briefing yesterday plaintively pleading with Americans to recognized that he's actually done a good job, reading a favorable column in the "Wall Street Journal," playing that byte from Andrew Cuomo.

He also decided to give some comfort to those protesters who were out in various states protesting against policies that he himself has called for.


UNIDENTIFIED REPORTER: Are you concerned that your talk about liberation in the Second Amendment


UNIDENTIFIED REPORTER: -- are you inciting violence among the people?

TRUMP: I've seen the people. I've seen the interviews. These are great people.

Look, they want to get -- they call it cabin fever. You've heard the term? They've got cabin fever. They want to get back. They want their life back. Their life was taken away from them.


HARWOOD: And think of the leadership contrast here, John. Andrew Cuomo, the governor of New York, who we're going to hear from in a few minutes, he said to the people, if you're mad about being shut down, blame me. I'm the one who is doing it for the greater good.

President Trump doesn't seem to have the internal strength and confidence to do that, so when he gets some heat from people who are impatient, he says, oh, blame the governor.

And people can see the difference in their judgment of leadership. Andrew Cuomo's ratings are in the high 70s, President Trump's in the mid-40s -- John?

KING: Blame the governor for putting in place the CDC and the president's stay-at-home social distancing guidelines.


KING: John Harwood, appreciate it, John. Thanks so much.

The president also has the World Health Organization in his crosshairs. He froze funding for the group after accusing them of failing to hold China to account.

But the "Washington Post" now reporting more than a dozen researchers, physicians and public health care experts, who were working at the WHO headquarters in Geneva when the coronavirus first emerged in China, "The Post" says those experts transmitted real-time information about the outbreak to the Trump administration.

CNN's Alex Marquardt is following this for us.

Alex, did the administration concede this happened or are they denying it?

ALEX MARQUARDT, CNN SENIOR NATIONAL CORRESPONDENT: They are disputing the characterization, John. They are admitting there were a number of Americans that were working at the WHO in Geneva.

In fact, the spokesman for the Department of Health and Human Services did confirm there were some 17 American medical experts working there, 16 of which, so all but one, working for the CDC detailed to the WHO as they have been for years.

What the administration, through the Department of Health and Human Services, is disputing is this notion that because they're American technical advisers, people offering technical assistant there, there would be some sort of communication from the WHO.

They're seeing the leadership of the WHO didn't include Americans. And the Americans there were not sending over the communication with transparency that the Trump administration has accused the WHO of not offering.

We should note, John, the "Washington Post" is also reporting there were a number of senior Trump-appointed health officials who were consulting with the WHO. So that does fly in the face of this notion that the president has been pushing that they weren't getting the communication they needed from the WHO and that they were covering up for China.

Now, Dr. Deborah Birx, who, as you know, is the coordinator for the Coronavirus Task Force, she was asked yesterday about the WHO and transparency. This is what she had to say.


DR. DEBORAH BIRX, COORDINATOR, WHITE HOUSE CORONAVIRUS TASK FORCE: You know, I think, early on, when you go back -- and again, I watch epidemics around the world, and the level of transparency and communication that you need, you have to overcommunicate. You have to communicate even the small nuances.


MARQUARDT: So Birx there saying that you have to overcommunicate. She did point the finger at China saying the onus is on the first country to be affected to report what is going on and be overly transparent.

But, John, she did say this notion of over-transparency and alerts is something that needs -- that should be dealt with down the road once the world has gotten thought this pandemic -- John?

KING: I'm not sure the president is patient enough to do that.

Alex Marquardt, appreciate that reporting. We'll stay on top of that story as well.

More concerns today as well over the food chain and the health of the workers who are its vital link. Take a look at this. Iowans saw their biggest one-day spike in new coronavirus cases. Two-thirds of those newly infected work in the meat packing and processing industry. Iowa is not alone, not by a long shot.


CNN's Dianne Gallagher has been following developments all across the country with incidences of coronavirus in key installations of the food supply.

Dianne, what do we know about these latest spikes across the country?

DIANNE GALLAGHER, CNN CORRESPONDENT: And that's it, John, it happens across the entire country here.

In Iowa, some of that spike may be attributed to an increase of targeted testing of these meat packing plant workers. Some of it is simply the length of time that it takes this virus to sometimes move through these large groups of people who, up until very recently, were working shoulder to shoulder, long, hard hours in these meat processing plants.

If you take a look, there are roughly a dozen plants across the country that have been shut down as a direct result of the coronavirus.

Four of them were in Pennsylvania. Now, one of those, CTI, reopened and is moving at a slower pace with a smaller staff as of today.

I spoke with the union leaders and they think that the other three plants are set to begin their reopening process today. This is after a deep cleaning, having to meet certain standards, implementing different safety features and things like that.

There's also the concern, John, of the plants that are continuing to operate even with some of these outbreaks. Waterloo, Iowa, where local officials, John, have requested Tyson shut down. At this point, Tyson says it is simply adding features and safety measures to mitigate the spread of the virus.

KING: Dianne Gallagher, thanks again. It's critical to be on top of this. You're doing a great job.

We're watching this not only for the food chain issues, but the people who are working now are getting sick. As the president says, it's time to send people back to work, safety needs to be paramount.

Coming up for us, more relief underway for hard-hit small businesses but still a few glitches as White House and Congress try to cut a deal.