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Virus Could Have Arrived To U.S. Earlier Than Thought; Drug Touted By Trump Proving Ineffective Against COVID-19; GA Governor Gets Pushback On Reopening State; Dr. Anne Rimoin Discusses GA Governor Reopening State Too Soon; Updated Model Has 10 Percent Increase In U.S. Deaths; Trump Plans To Sign Immigration Order After Officials Scramble To Draft His Proposal; Senate Passes $484 Billion Package To Help Small Businesses. Aired 11-11:30a ET

Aired April 22, 2020 - 11:00   ET



JIM SCIUTTO, CNN ANCHOR: That celebration to include fireworks. Of course, no details have been hashed out yet. De Blasio saying, quote, "This is a day we cannot miss. There's no day like the fourth of July. One way or another, the show will go on."

POPPY HARLOW, CNN ANCHOR: We're all looking forward to seeing that.

Thank you so much for being with us today. We'll see you back here tomorrow morning. I'm Poppy Harlow.

SCIUTTO: I'm Jim Sciutto.

"NEWSROOM" with John King starts right now.

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 it coronavirus pandemic.

And 2.6 million is where the global case count sits this hour. The city of northeastern China now outlawing inbound traffic to stop the coronavirus surge. Lebanon's government today confirming the first coronavirus case in a Palestinian refugee camp. And a United Nations monitor warns of widespread famines in countries forced to save people from the virus only to die of hunger.

And 45,000-plus have died here in the United States from the virus. That is a remarkable rise in just two weeks. And 32,000 American lives lost in the past 14 days.

Today, there's new evidence indicating the virus arrived on American shores earlier than we initially thought. A northern California county said an individual died from coronavirus back on February 6th, three weeks earlier than what was thought to be the first confirmed virus fatality in Kirkland, Washington. The disclosure adding to the growing stack of information suggesting the case count and the death toll could be far higher than the current count.

The president is having a scatter-shot morning. Threatening Iran in one tweet, wishing a gossip columnist a happy birthday in another.

On the pandemic, The president is again out ahead of the facts or trying to create alternative facts. He says states are safely coming back and reopening. Fact is, that process is just now beginning. And only in a few places.

Georgia and Florida do want a quick return to work. Texas also taking some first steps. Delaware's governor, though, says he wants to double the president's advice and log 28 days of declining cases before thinking about reopening his state.

Currently, no state meets the letter of the president's own reopen guidelines. And the president's own medical experts are advising caution.

The CDC director says a tandem flu and coronavirus assault next fall would, quote, "put unimaginable strain" on the health care system.

And this morning, the FDA commissioner echoes the giant concern about a second wave.


UNIDENTIFIED NEWS ANCHOR: Are you worried about that second wave?

DR. STEPHEN HAHN, FDA COMMISSIONER: I think that it's certainly a possibility, and the whole task force of doctors is concerned about the second wave.

UNIDENTIFIED NEWS ANCHOR: The timetable for a vaccine, which would be really a game changer, last we checked in with you was about a year off. That would be march of 2021. Is that still the case?

HAHN: Still the case that the estimate is march, but we're really trying to accelerate the efforts.


KING: Trying to accelerate the efforts. But perhaps a year or so or more even to get a vaccine to emerge, which puts a premium on finding therapeutic drugs that at least help with treatment.

Today, one study showing a drug repeatedly touted by President Trump is not effective in treating COVID-19. In fact, patients who took the drug had higher death rates than those who didn't take it.

This as the FDA approves the first at-home test for detecting coronavirus.

Meantime, a leading model upping its projected death toll to 10 percent in the United States up to 66,000 by August.

CNN Senior Medical Correspondent, Elizabeth Cohen, joins me now.

Elizabeth, what do we know and what does it mean, the fact there could have been two COVID-19 deaths in California back in early February? DR. ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: It tells us

that people were dying earlier than we thought, and also, it's very important, the coroner there saying these two folks did not travel. They had no link to Wuhan or any other hot spot, so they got it just out in the community. Community, it appears.

John, let's take a look at these dates. These autopsies were February 6th and 17th. No known travel history. The first case of unknown origin was February 26th, so it appears it was actually spreading in the community much earlier. February 29th, the CDC announces the first death.

So these two autopsies are significant for both reasons, an earlier death than we had thought and early community spread than we had thought.

KING: And, Elizabeth, also today, a lot of discussion about this new test, new study on Hydroxychloroquine. What does it tell us?

COHEN: Right. It's a study done by the Veterans Administration. It was over 350 people. So by comparison, this is quite a large study.

Let's take a look. The folks who were taking Hydroxychloroquine, they had a 27.8 percent death rate. The folks who weren't had an 11.4 percent death rate. And that's after the researchers adjusted for any differences between the two groups as far as how healthy they were or weren't. That was after statistical adjustment.

Now, John, I will say this was put up on a Web site that's called the Preprince Server. It's not peer-reviewed or published in a medical journal.


KING: We need more evidence but that one study tells you be cautious at a minimum there.

Elizabeth, a lot of talk about testing. A lot of people thinking if I go back to work, can I be tested first? Tell us about the new at-home test. Does it work?

COHEN: Yes, the folks who make it say it works and they have been allowed to mark it.

It's very interesting. It's very convenient to be able to do this at home. This could help a lot of people who don't know where to go to get tested.

Let's look at how it functions. You collect the sample yourself. You put what looks like a Q-Tip in your nose and you do a swab. And it costs about $119. And you mail in the results.

So that this can be something -- I have certainly talked to people who are thinking, gee, I don't know if I have COVID or not. They don't know where to get a test. They don't know if they want to go out and expose themselves in case they're not already infected. That takes care of a lot of those problems.

KING: Elizabeth Cohen, a lot of updates on important developments. Appreciate it very much. Thank you.

Now let's shift to the reopen debate here in the United States. States deciding on their own when they can reopen. The president hopes it's as soon as possible. But in Maryland, Oregon, West Virginia, restrictions now being extended indefinitely. Virginia's governor setting June 10th as the date to possibly reopen his state.

Meantime, Georgia's Republican governor, Brian Kemp, is going full speed ahead, reopening a variety of businesses in that state, even though, as you can see, the number of coronavirus cases not exactly on a steadily decline in Georgia.

CNN's Martin Savidge is outside Atlanta for us.

Martin, the governor getting pushback from local officials. Where are we right now?

MARTIN SAVIDGE, CNN CORRESPONDENT: From the very moment he announced his plan, which was on Monday, he's had a tremendous amount of pushback, And it's not all coming from just officials or those in the opposite party. It's also coming from some people who run the very businesses that could benefit.

We're at a strip mall here. There are at least a dozen businesses here that would under the guidelines of the executive order be allowed to open starting on Friday. But that's not to say they will.

The governor has been going on the defensive. He was on FOX News. He was also on a number of local interviews. And he's been doing a lot of tweeting. Here's one of them that he put out. It reads, "Due to favorable data and more testing, gyms, fitness centers, bowling alleys and a litany of all those businesses that will reopen."

But the first line, "due to favorable data and more testing?" We have another chart that shows you the number of coronavirus hospitalizations in the state of Georgia. They have actually gone up in the last week.

When he talks about testing, Georgia has ranked nearly at the bottom when it comes to all the other states where testing has been conducted on the general population. So it doesn't jibe with what the medical authorities are reporting here.

And remember, this is the governor who, famously, not that long ago, came out and said he wasn't aware that people who were asymptomatic could be spreading coronavirus, even though the CDC is literally around the corner from where he works and where he lives.

So a lot of this is being looked at skeptically by business owners who say look, I'm not sure I can actually open by Friday, and even if I do, I'm not sure that customers are going to walk through that door. I don't even know if my employees will show up.

There are so many questions. And Friday is not likely to be the end of them.

KING: Martin Savidge for us in Atlanta. Martin, appreciate it.

Whether you agree or disagree, they have the mayor pushing back, the businesses pushing back. Be nice if they could sort all this out.

A note, we have invited Governor Kemp to come here to visit us on CNN. He's been on FOX and other networks. The invitation is extended. He's so far declined.

Here to join me to share her insights on these major medical developments this morning is Dr. Malloy, a professor of epidemiology at UCLA.

Doctor, let me start with you.

This is a little mix of medicine and politics, but when you see hospitalizations in Georgia are up, the case counts on a bit of a roller coaster. You might be able to go back two weeks and say the trajectory is going down. That's what the president says, but you have some bumps.

If you were advising the Georgia governor, would you say go now or would you say wait a little bit?

DR. ANNE RIMOIN, PROFESSOR OF EPIDEMIOLOGY, UCLA: If I were providing advice to the governor, I would say that it's time to wait. We don't have the testing in place. We don't have the ability to do the contact tracing that we need to do. We just do not have all of the things that we need in place that meet all of the criteria that have been set forth of how to be able to reopen.

So I know that everybody is champing at the bit to get started again, get moving. But we really risk losing all of the gains that everybody has worked so hard to be able to achieve here.

KING: And when you look at the latest model out of IHME, the University of Washington, a model often cited by the White House, but they are now, as they have watched this play out, they have more and more U.S. data to put in their model.


Initially, it was based on what was happened in China and Italy. They have increased by August 1st the U.S. death toll will be up to 66,000. That's up 10 percent from the previous model.

And these numbers, on the right side of the screen, they're important. They're also depressing, 45,150. If we had the conversation today. What is changing that is leading them to think, OK, it's going to go up a little bit?

RIMOIN: Well, it seems that we have now gotten a lot more information here in the United States about how the virus is spreading, what the actual mortality rate is here. And that also, that has improved by going back and looking at some of

the nursing homes and really looking to see who had -- who could potentially have the virus and who didn't. They are now classifying presumptive cases or cases that were suspected to have met all of the clinical criteria but were not tested at the time, now as COVID. So that's increasing the number of deaths associated.

And so the more we understand the data here, the more we really know what's going on. We put that into the model, and the model then is adjusted.

Everybody has to remember that models are predictions. And they're only as good as the data that are in them. So that's why the IHME models are being constantly refined and getting better and better, because they're finetuned to the situation at hand right here.

KING: And help me and our viewers understand in this coverage, every day, if not every hour, there's a study about this, a controversy about testing here.

Testing is the big thing before us right now. You hear about the armies of contact tracing. You hear the president say, oh, states have enough. You hear governors saying no we do not. Maybe we have the labs, we don't have the supplies.

When you're looking at this every day, help our viewers since you understand it better than most, what is the most important thing you have seen in the last 24 hours on the testing question that you think needs to be looked at?

RIMOIN: Well, I think that some of the questions about how well these tests are identifying people who have COVID is coming into play now. It's something that we all know, no test is going to be perfect.

But we really need to be careful by making decisions on, you know, based on data that is not perfect. So we're still trying to sort out so much about this virus.

It is a novel virus. I know people hear that all the time. This is a novel virus, new to humanity. We're still trying to understand what's going on, but it's really true here.

It's really amazing how much work has been done and how much science is done on a daily basis, but many of these papers that are coming out are still in preprint, meaning they have not been peer reviewed and gone through the normal process of vetting and questions being asked by other experts.

And so I think that this is a really big issue in trying to digest everything in particular for the general public who is seeing the papers on preprint and not understanding that this is -- these papers are not the same as a paper that is already in a published -- that's in a journal that's gone through peer review. That's why so much is being refined over time.

KING: The world is seeing on an hourly basis the things that you get to see behind the curtain, but you understand them better. It's confusing for everyone else out here.

I just talked a little bit to Elizabeth Cohen from this. But from an epidemiology standpoint, if you're trying to understand the scope of all this, you have these two cases in California now that they say go back to early February.

What does it mean, how does it impact our study to figure out exactly when did it get here, how did it spread, that we could have cases back in early February, weeks ahead of what we thought was the first case at that senior center in Kirkland, Washington?

RIMOIN: Well, I can just amplify what Elizabeth said, which is that what it suggests is that this virus was circulating in the community much earlier than we knew. These cases that were identified had no direct link to another case. And so these -- and were not people who had been to China.

Therefore, it just suggests this was circulating in the community long before we knew that it was here.

KING: Fascinating as we look forward.

Dr. Anne Rimoin, I want to thank you so much. We'll continue the conversation in the days ahead.

Up next for us, pandemic policy making Trump style. A tweet that is scrambled by aides and, in the end, a retreat by the president on immigration.

Before we go to break, a doctor from Mt. Sinai Hospital in New York sharing one of the hardest parts of being on the front line.



UNIDENTIFIED PHYSICIAN: It's even more stressful when the young patients come in and they don't end up making it. It takes an emotional toll on everyone. It makes us realize that everyone can be affected. And actually kind of scares me a little bit because, if I get it, there's really no telling if I'm going to be a mild case or a serious case.



KING: Some new details today about the policy chaos the president causes with his tweets. Even in the middle of a pandemic. This morning, the president promising to sign a new immigration executive order today. That order is borne of another tweet sent late Monday promising to suspend immigration into the United States.

A declaration that caught the president's own aides by surprise. Sent them scrambling once again to write a plan to match a tweet. What the president will sign today falls considerably short of what he promised in that initial tweet.

CNN White House Correspondent, John Harwood, joins me now.

We have seen this play out before, president tweets, aides rush to write a policy to match it, but not in the middle of a pandemic.


JOHN HARWOOD, CNN WHITE HOUSE CORRESPONDENT: That's right. But this is a president who has been very consistent in his operational style. As you know, having covered the White House as I have for some time, the orderly policy making process of most White Houses is not consistent with somebody who operates on moment-to-moment impulses, much less moment-to-moment impulses at 10:00 at night.

The president, having felt the weight of blame from the public, from other politicians, from the media for his handling of coronavirus, was looking for something to change the storyline, give his base something to get enthused about. He talked about immigration since the outset of his political career, so he tweets he's going to ban immigration.

Now we know that the Agra business, which uses immigrant labor to keep the food supply going, is going to be exempted from this. That's the part of immigration that has the most immediate economic impact.

Remember, the president saying he was doing this in the name of protecting American jobs. This is applying mainly to green cards over the next 60 days.

And as you know, with 22 million Americans having filed for unemployment over the last couple weeks, the number of potential green card holders who would be affected by this is tiny, about 75,000 at the pace of 2019 green card applications.

So it's also the case that the bureaucratic activities surrounding green card holders, visa processing green card applications, has all been slowed. Travel has been slowed by the coronavirus.

So the practical impact of this, not very great. The message sending impact, that's what the president was looking for. His campaign has been putting this out, raising money off it. That's what this is all about.

KING: This is politics in the middle of a pandemic.

John Harwood, appreciate the fine reporting. We'll watch what the president does today.

Meanwhile, the president's attorney general, William Barr, is calling for an easing of social distancing. In a radio interview, Barr outlined ways he says the Justice Department could possibly take action against a governor if it believes the state's restrictions go too far.

The attorney general saying, quote, "These are unprecedented burdens of civil liberties right now. The idea that you have to stay in your house is disturbingly close to house arrest."

Barr added that, so far, he has not seen a need for Justice Department action.

More money to help small businesses stay afloat is on the way. The House plans to vote tomorrow on a $484 billion deal that cleared the Senate yesterday. It's the fourth coronavirus relief package. And there are some new tensions brewing as talk turns now to what will be needed in a fifth installment.

CNN Congressional Correspondent, Phil Mattingly, joins me now.

Phil, first, small businesses are desperate for this money. Tell us, what's in the current package?

PHIL MATTINGLY, CNN CONGRESSIONAL CORRESPONDENT: So this will be a replenishment of money that disappeared so quickly, just 13.5 days after the paycheck protection program set up by the small business administration, that program will get $310 billion more.

It had $349 billon to start with and now an additional $310 billion, which should be good news for the thousands of people who had applications who are essentially waiting in the queue if had got that far to this point. This will be voted on Thursday.

There are other key elements that are important. One, there are some restrictions put on the $310 billion for the small business program. $60 billion of that will be redirected toward smaller financial institutions, community financial institutions, institutions that are more minority-owned.

The effort here to try to get the money to the small businesses that weren't able to the first time around because they didn't have existing relationships with banks. They didn't have credit lines with banks. That will be something to keep an eye on as the money rolls out.

Also some other key elements. $75 billion for hospitals and health care providers. $25 billion for testing and national testing strategy, more language in terms of how the money would go to states. Testing is a huge issue on the national and state level. Money there as well, and another $60 billion for another small business loan program.

There's a lot in this package, John. That's one of the issues. You blink and, all of a sudden, there's another $500 billion about to go out the door from Congress, which underscores two things. One, just how deep this economic crisis in the economic pain is and, two, that lawmakers recognize they need to move quickly or at least as quickly as Congress can.

KING: States can't print money. You have the national government jumping in here. We're starting to hear rumblings from mitch McConnell, as we know there's going to be a round five. The president says infrastructure. Democrats say what about aid to big states and cities. Mitch McConnell seems a little weary of all this spending. HARWOOD: Yes, look, I think this is really important to pay attention

to. There's essentially been four legislative relief packages since coronavirus really kind of took hold here. Four legislative relief packages that equal close to $2.7, $2.8 trillion.

It was only a matter of time before both on the ideological front and the deficit front, you start to see divides in the partisanship.

Take a listen to what the Senate majority leader told Hugh Hewitt.



SEN. MITCH MCCONNELL (R-KY) (voice-over): What they wanted the most, I refused to go along with and the White House backed me up. That is we're not ready to just send a blank check down to states and local governments to spend any way they choose to.

We need to have a full debate, not only about if we do state and local, how will they spend it, but also we haven't had much discussion about adding $2.7 trillion to the national debt.


HARWOOD: So, John, a couple things there I want to pick out. First, state and local funding has been a huge issue for Democrats. They tried to get it in the package that will clear Congress tomorrow. They're stopped.

And McConnell tells you why. There are ideological differences in terms of how many should be doled out in the states between Democrats and Republicans. Even though the chair of the National Governors Association, the Maryland governor, Mr. Hogan himself, is the one asking for the money,

But the other issue is McConnell is reflecting where his confidence is. You talk to Republican Senators and Republican House members, they're not necessarily comfortable with all of the spending and even though the crisis is so deep, you're going to start to see that as they work through the next package -- John?

KING: The leader also has a good memory. It was 10 years ago the Tea Party was born of all the Republican and conservatives over the spending after the last financial crisis. The leader looks around the Senate sometimes and remembers that quite well.

Phil Mattingly, appreciate the details there.

Up next for us here, a CNN exclusive. We're returning to Wuhan, China, where the coronavirus pandemic began.