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Study Shows Hydroxychloroquine Has No Benefits to Coronavirus Patientsl New Report Suggests Coronavirus Killed Americans Weeks Earlier Than Previously Thought; Tyson Foods Shuts Down Waterloo, Iowa Plant Linked to Virus Outbreak; Nursing Homes Across the U.S. Become Ground Zero for Virus Spread. Aired 9-9:30a ET

Aired April 22, 2020 - 09:00   ET



POPPY HARLOW, CNN ANCHOR: Good morning, everyone. I'm Poppy Harlow.


It was here before we even knew it was here. This morning, we're learning that the coronavirus killed Americans weeks earlier than we first thought. Officials in Santa Clara County, California, say autopsies now show that two people who died in their homes in early February were infected with the virus. That is three weeks earlier than the first recorded death in Washington state.

Also today, a new warning of a second wave of the virus, and this one could be even more devastating. The CDC director says this winter we could be fighting two epidemics. The coronavirus and the normal flu at the same time, making for an even more difficult season ahead.

HARLOW: Yes, that is stunning. But we're not even through this season, of course, as you all know, and a leading U.S. model is upping its projected death toll by August to 66,000 people here in the United States. That is a 10 percent increase from their previous modeling. Still, states moving forward on their plans to loosen restrictions despite warnings from top experts and no clear treatment for this virus.

A new study this morning shows the anti-malarial drug that the president has consistently touted has no benefit in treating COVID and is linked to higher rates of death.

Let's begin there with our senior medical correspondent Elizabeth Cohen.

Elizabeth, we're going to get to that study on hydroxychloroquine in a minute. But let's start with this news out of California that deaths from COVID-19 in the U.S. were actually three weeks earlier than previously thought.


ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Yes, this is very interesting. And this is certainly something that I and other reporters brought up at the time. How do we know that people aren't dying of coronavirus? This was sort of in mid -- during pretty much the month of February because it was a bad flu season. And I remember asking a federal official how do we know that all of these deaths from flu aren't actually some of them aren't coronavirus? And I didn't really get a very satisfactory answer.

But to get to what the "New York Times" reported, they found that in Santa Clara County, that's northern California, that there were autopsies of two people who died in February before the first known U.S. death, who died actually of coronavirus or who had coronavirus when they looked at the autopsy. And the death -- the first known death in the U.S. wasn't until later.

This is really significant. This shows that people were dying or suggests that people were dying before we thought they were dying. Also, interesting to note, the coroner apparently said, you know what, these people who died, they had no known travel history. At this point instead of early to mid-February, the CDC was really focused on, oh, we're going to test you if you travelled to Wuhan or some other hotspot.

You know, it sounds like people were getting it even if they hadn't traveled.


SCIUTTO: Elizabeth, other news, a study of the effects of this anti- malarial drug that the president so publicly touted. What did it find? Effective or not effective?

COHEN: You know, it found that not only was it not effective but the people actually had a higher death rate. This was actually a relatively large study when you look at other hydroxychloroquine studies, 368 people.

Let's take a look at what they found in the two groups that we're going to focus on right now. Folks who took hydroxychloroquine had a 27.8 percent death rate. Folks who did not take hydroxychloroquine had an 11.4 percent death rate. That is a huge death rate and there are probably other things that may have contributed to that difference. That needs to be sort of worked out.

I will say that this was put on a preprint server, meaning it hasn't been peer reviewed by other doctors, it hasn't been published, but still the difference in that death rate is quite stunning.

And take a listen to what Dr. Stephen Hahn said. He's the commissioner of the FDA. He was asked about this at the White House briefing last night.


STEPHEN HAHN, COMMISSIONER, FDA: This is something that a doctor would need to consider as part of a decision in writing prescription for hydroxychloroquine. (END VIDEO CLIP)

COHEN: Now, it's interesting, Dr. Hahn said this was a small study. This was 368 people, far larger than the 20 person-study that his boss, President Trump, has been touting for weeks.

SCIUTTO: Yes. Listen, that's why you listen to the science. Don't listen to the politicians.

Elizabeth Cohen, thanks so much.

COHEN: That's right.

SCIUTTO: Despite all the warnings and resistance, some states are moving ahead, moving forward to reopen. In Colorado, the governor there says that he will not extend the stay-at-home orders set to expire at the end of this week.

HARLOW: Texas Governor Greg Abbott says elective surgeries will begin in that state today. In Georgia, Governor Brian Kemp is taking his plans to ease restrictions on some businesses this Friday.


Let's go to our Martin Savidge. He joins us just outside of Atlanta.

So this is what businesses can do. I think the question, Marty, is what will businesses do? Will they open?

MARTIN SAVIDGE, CNN CORRESPONDENT: And that's a really good question right now, Poppy, because many of the businesses are beginning to understand that despite the executive order from the governor, it just isn't so easy to reopen as taking that little sign on your door and flipping it from closed to open.

So much has to be taken into consideration, including, first of all, the personal protective equipment that has to be found. And, remember, it's for all the employees that you have to have it, and could you in getting it be taking it away from the medical community that still needs it because they're trying to battle with the coronavirus? Will you have product to sell? And will you, above all, have a public coming through the door?

There have been a lot of Democratic mayors that have been critical of the governor, but there are some Republicans who are now coming to the governor's support, but they too raised questions. Here is the mayor of Sandy Springs.


MAYOR RUDY PAUL (R) SANDY SPRINGS, GEORGIA: The market is going to determine whether this works or not because if customers don't show up, you can open your business all day long and nobody is going to be there.


SAVIDGE: That's the problem. You don't know if the public is going to show up. For instance, the movie theater here behind us, it can open up on Monday. Two of the movies that it is advertising right now are available for the public to stream at home. Not much of an incentive to turn out and go to the movies.


SAVIDGE: Poppy and Jim.


HARLOW: That for sure says it. Marty, thanks for the reporting.

Let's talk about the significant developments that we've had overnight. Dr. Kent Sepkowitz joins us again, an infectious disease specialist, serves as deputy physician chief of quality and safety at Memorial Sloan Kettering.

Dr. Sepkowitz, let's just begin on hydroxychloroquine. Elizabeth Cohen just laid out the new study and the findings and yes, it hasn't been peer reviewed yet, but they're startling that there is a higher death rate from patients with COVID treated with this than those without. And here's what the president said about this drug just on April 5th.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: We have purchased and we have stockpiled 29 million pills of the hydroxychloroquine, 29 million. We're sending them to various labs, our military, we're sending them to the hospitals, we're sending them all over.


HARLOW: Sending them all over and now this study, so what does this mean for anyone thinking about treating COVID with hydroxychloroquine?

DR. KENT SEPKOWITZ, INFECTIOUS DISEASE SPECIALIST: I think it's a preliminary study. I think that it has a major flaw, which is that it's retrospective. So probably the sicker people got the pill and they were destined to do poorly.

That said, we've used the hydroxychloroquine long before President Trump endorsed it. It never seemed to have a whole lot of kick to it. Maybe a few people a little bit of the time, but we were using it because desperate times called for desperate measures.

This study doesn't surprise me. If anything there is a tiny benefit in a few patients. I think we knew that all along. This doesn't change my mind. I hope we never have to use it. But --

SCIUTTO: Yes. You know, I know that doctors have difficult decisions in situations like this, where if there is nothing else that offers hope, they might take a risk that they wouldn't otherwise. But this is an unusual situation in that you have -- we might have lost the doctor there.


SCIUTTO: Dr. Sepkowitz, he hears as well. We're going to come back to him. In the age of social distancing, sometimes technology gets in the way. But we'll bring the doctor back.

HARLOW: Yes. There you go. But I hear what you're saying, Jim, and I think a lot of people are going to be interested in more details from this study. Exactly what it says. I think we have the doctor back.

SCIUTTO: Oh. He's back.

SEPKOWITZ: I'm back.

SCIUTTO: OK. Dr. Sepkowitz, you hear me OK? The point I was raising is I know doctors have difficult decisions here because there might be times when because there is no hope, they try something that's riskier.


SCIUTTO: But what's unusual here is you have politicians getting into the debate about treatments, the president, as Poppy mentioned, but also media friendly to the president. Just listen to the sound here and I want to get your reaction as to what value or damage this poses. Have a listen.


TRUMP: The FDA also gave emergency authorization for hydroxychloroquine. We're having some very good things happening with it. It's shown very encouraging -- very, very encouraging early results. There is some good signs. You've read the signs. I've read the signs. And I say it, what do you have to lose? I'll say it again, what do you have to lose? Take it.


BRIAN KILMEADE, FOX NEWS HOST: It seems South Dakota is going hydroxychloroquine crazy.

LAURA INGRAHAM, FOX NEWS HOST: This drug that you and I have talked about, hydroxychloroquine, talked about it with Dr. Grace, it's already being used and one patient was described as Lazarus, getting up after he was, like, on death's door, and they started getting a protocol of hydroxychloroquine at Lennox Hill and it's suddenly like Lazarus up from the grave. I mean, that's an actual case.

TUCKER CARLSON, FOX NEWS HOST: Watching people in the media talk down a potentially lifesaving medicine because a politician they don't like has endorsed it is probably the most shameful thing I as someone who's done this for 20 years have ever seen.

SEAN HANNITY, FOX NEWS HOST: Hydroxychloroquine is a very safe drug, it has been given to tens of millions of individuals in the world since its approval.

DR. MEHMET OZ, SURGEON AND TV PERSONALITY: In their protocols, doctors have protocols for doing certain things. They don't ever mention complications from hydroxychloroquine because they're so uncommon.

STEVE DOOCY, FOX NEWS HOST: On their Web page, the FDA is offering a generic guidance to manufacturers on how to produce hydroxychloroquine.

TRUMP: So we -- the hydroxychloroquine is something that I have been pushing very hard. I got the very early approval from the FDA.

If things don't go as planned, it's not going to kill anybody. It will be wonderful. It will be so beautiful. It will be a gift from heaven. And it works.

We have some other person putting forward that say, oh, let's go with it, you know. What do you have to lose?

UNIDENTIFIED FEMALE: Huge study that's going on, hydroxychloroquine.

INGRAHAM: I need to ask you about this brand-new study, and I know you're not an epidemiologist, but you just heard me talk about it. It's not controlled, but it is clear from this -- the renowned epidemiologist and his team in Marseille that this hydroxy-azithro combo seems to be working.

OZ: This study done by reputable center, double blind randomized trial showed that there was an improvement in outcomes in patients that took the hydroxychloroquine. It's not a panacea, but you have to respect data.

HANNITY: All right, thank you, Dr. Oz, appreciate the medical update tonight.

TRUMP: I've seen things that I sort of like. So what do I know? I'm not a doctor. I'm not a doctor. But I have common sense.


SCIUTTO: So, Dr. Sepkowitz, you of course are a doctor. Does that kind of pushing here from folks who are not experts -- does that help or hurt the treatment and the response to this?

SEPKOWITZ: It's very damaging. It puts false hopes into patients and their families. It I think deflects resource and attention to other better therapies. And it also turns up a discussion that's a pretty sober discussion into something resembling a political circus, which never helps.

HARLOW: Speaking of things that could potentially be very helpful, you have a whole piece where you talk about plasma treatments. And these are really just beginning. We don't even know the end result of a lot of them now. But you say this is the most promising treatment. Can you talk about why and also lay out any risks? SEPKOWITZ: Sure. There is always risks. I think right now we have two

plausible therapies that seem to have a signal in the medical literature for some of that. One is the antiviral Remdesivir, it's intravenous, It's in relatively short supply. And the studies are quite preliminary. Similarly giving convalescent plasma, taking it from someone who had the infection, recovered and altruistically donates it for the next person has been shown historically in SARS and even the great Spanish flu of 1918 to have some effect. How effective these are is a matter of things are relative.


SEPKOWITZ: I think for the convalescent plasma, getting people early, giving them a dose is to me probably going to be a very good intervention. Will it save lives? We're going to find out. But right now it is both scientifically and on the basis of the spotty data we've had, the most promising thing to me that we've got. Other experts who would perhaps endorse Remdesivir, but these are the two things we (INAUDIBLE).

SCIUTTO: Yes, you need data over time. Just very quickly before we go, studies showing that -- as Poppy mentioned earlier that people were infected with this earlier than we knew, a death in California weeks before the first recorded death in Washington state. What's the significance of that?

SEPKOWITZ: It's hard to know right now. We need to have a lot more information. Two cases in California, apparently with very solid evidence, this far in advance of what we thought we knew shakes me up a little bit.


That said, I think the peak of the curve is what we thought it was. In other words, all of the country monitors flu-like illness, generically over time. We did not see a spike that would have suggested trouble in February. We were still seeing flu and diagnosing flu. So, yes, I think that we're going to find out that there were some cases, but I don't think that we missed the story. I think the story was what we saw in March, not February.

SCIUTTO: OK, Dr. Sepkowitz, thanks so much, we had so much to run by you this morning and we appreciate it.

HARLOW: Thanks, doctor.

SEPKOWITZ: Thank you so much.

HARLOW: Still to come, clusters of cases still emerging in food plants and nursing homes across the country. Hundreds of people in some of these food plants contracting it. What is being done to stop the spread and why aren't some of them closing?

SCIUTTO: Plus, many small businesses missed out on the first $350 billion in government assistance. Will the second round help them out? And a CNN team goes inside the very epicenter of the outbreak, Wuhan, China. What is life like there now? We're going to be live.



SCIUTTO: Breaking news just in to CNN, we've just learned that Tyson is shutting down a pork processing plant in Waterloo, Iowa, this is a plant that's been linked to nearly 200 coronavirus cases. Protesters rallied outside that plant earlier this week, it's been linked now to nearly half of the known COVID-19 cases in that county there alone.

HARLOW: Our Dianne Gallagher has been following this story closely and joins us now. I mean, it was basically a plea from the mayor of Waterloo again last night saying, now 90 percent of the cases in his -- in his county are from this plant. They are finally shutting down. Why?

DIANNE GALLAGHER, CNN NATIONAL CORRESPONDENT: Yes, that was an announcement that literally just came down from Tyson within the past couple of minutes here that they are going to be suspending production at the Waterloo pork processing plant this week. That around midweek, they will stop production. Now, it wasn't just the mayor. It was almost all of the local and state-elected officials in that area for more than a week now have been asking, I want to read a portion of the statement that Tyson just sent out about this decision.

They said, quote, "protecting our team members is our top priority. And the reason we've implemented numerous safety measures during this challenging and unprecedented time. Despite our continued efforts to keep our people safe while fulfilling our critical role of feeding American families, the combination of worker absenteeism, COVID-19 cases and community concerns has resulted in our decision to stop production.

Now, look, there are 2,800 people who work at that plant. According to the county health department, 182 of the 374 cases within the county have been linked directly to the plant. At this point again, we're looking at production according to Tyson, stopping sometime this week, something that those local officials have been trying to get to happen for more than a week now.


SCIUTTO: So there is another plant, the Columbus Junction plant, where workers actually going back to work. What's being done to protect them?

GALLAGHER: Yes, and so we're starting to see this more across the country. These plants that shut down earlier due to coronavirus outbreaks, the one in Columbus Junction, Iowa, another Tyson plant was shut down for roughly two weeks, and during that time period, what they do is they add these mitigation efforts inside. They've added according to Tyson these barriers, these Plexiglas barriers, they're working on absentee policies and of course allow those employees to start getting tested in that area.

HARLOW: You know, it's just startling, reading about not just this company, so many of these meat processing plants across the --


HARLOW: Country and the amount of people that have gotten sick working there, and a refusal by many to close them. So I think this is welcome news for that community. Dianne, thanks for the updates. Next hour, we're going to be speaking with the mayor of Waterloo who has been sounding the alarm bell about this plant for a month now, he'll be next hour.

Ahead, a quarter of Florida's 867 coronavirus deaths have now been linked to nursing homes and long-term care --


HARLOW: Facilities, Jim.

SCIUTTO: Yes, it's been a case really in so many places across country. That state releasing new data showing that more than 2,000 residents and staff members have become infected, and more than 300 facilities across that state. CNN's Sara Sidner has the story.


UNIDENTIFIED MALE: Better same or work.

SARA SIDNER, CNN NATIONAL CORRESPONDENT (voice-over): Family members from across the country --

UNIDENTIFIED FEMALE: She was an amazing human being. She didn't deserve to die like this.

UNIDENTIFIED FEMALE: It was just so fast.

SIDNER: All experiencing the same tsunami of grief after their parents contracted COVID-19 in a nursing home.

DENEEN BARR, FATHER DIED FROM CORONAVIRUS: For my daddy to just die. But his stay off the -- that just hurts my heart.

SIDNER: Deneen Barr says her father was a retired fire captain who worked hard to help others, only to die alone at a hospital.

BARR: Even to start a fire lifeguard, and he couldn't breathe. It just -- it just hurts me to my heart, and I'll never see him here again.


SIDNER (on camera): I'm so sorry.

(voice-over): Nursing homes across America are taking the brunt of the outbreak. This is just a small sample of states that publicly report coronavirus cases at nursing homes. For more than 10,000 in New Jersey to 1,700 in California.


Now a federal agency that oversees nursing home says, they must report their coronavirus deaths and infections directly to the Centers for Disease Control and Prevention.

(on camera): What's causing the problem inside of nursing homes when it comes to COVID-19?

MICHAEL DARK, STAFF ATTORNEY, CALIFORNIA ADVOCATES FOR NURSING HOME REFORM: It's really two things, Sara, under-staffing and infection control. And the two things go hand-in-hand.

SIDNER (voice-over): In New Jersey, at Andover Subacute and Rehabilitation Center, police discovered 17 bodies piled in its morgue. Thirty six people have died from coronavirus there. In Richmond, Virginia, 45 residents dead from COVID-19 at this facility. In Massachusetts, Holyoke Soldier's Home, coronavirus killed 47 veterans including Patricia Cowden's husband of 38 years. She says she believes the administrator there may not have initially taken the virus seriously enough.

PATRICIA COWDEN, HUSBAND DIED FROM COVID-19: And you know, he's a military person, the commander-in-chief for saying it was nothing, you know.


SIDNER: So, look, you know, the very first major outbreak in all of America happened at a nursing home just outside of Seattle, 129 people linked to that facility got coronavirus, 35 people there died. But the facilities are saying, look, we need help, this happened to us, this was an unknown disease, there weren't a lot of the guidelines and the guidelines kept changing on how to deal with this virus, and they're having trouble with personal protection equipments, they also are not getting enough testing from government facilities.

And so, this has been a really horrible time for the staff there, and now, we're hearing from life care centers of America that there are actually some of their staff members and facilities are receiving threats including death threats, one of which has been investigated by police. Poppy and Jim?

SCIUTTO: Listening to those poor families, to lose --

SIDNER: Yes --

SCIUTTO: Relatives under those conditions. Sara Sidner, thanks very much. In Washington, Congress has moved closer to another huge round of funding for small businesses who are struggling to keep their doors open during this pandemic. Where is that money going? Will there be changes making it more available to many small business? We're going to dive into it.

HARLOW: We're also moments away from the opening bell on Wall Street. Futures pointing higher this morning, partly because of investor optimism on that news of a deal in Washington. They're also paying very close attention to the oil market, oil prices continuing their epic crash.

Today, the president says he's instructed the Energy and Treasury Departments to develop a plan to provide money for oil and gas companies. So far no deal, no details have been announced.