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Fears of Second Wave; Help for Small Businesses; Impact on U.S. Nursing Homes. Aired 5-5:30a ET

Aired April 22, 2020 - 05:00   ET



ROBYN CURNOW, CNN ANCHOR: Hi. Welcome to our viewers here in the U.S. and all around the world. Thank you very much for joining me.

This is CNN. I'm Robyn Curnow.

So, just ahead:

A grim warning. Fears over a second coronavirus wave expected to hit this winter. Many question how long we may have to live under the threat of COVID-19.

Also, help is on the way. Small businesses devastated by the pandemic could see relief in the U.S., but there are concerns about how far the money will actually go.


DENEEN BARR, FATHER DIED FROM COVID-19: For my daddy to just die by himself, it just hurts my heart.


CURNOW: Nursing homes are bearing the brunt of this outbreak. We'll hear about new measures that should help tackle the virus' spread. That's also next.


CURNOW: So, we now know that more than 2.5 million infections of coronavirus have been reported around the world. There have been almost 178,000 deaths, 45,000 of them in the U.S. So that means more people have died here in the U.S. than any other country in the world.

As the death toll continues to grow, the head of the CDC says the situation could still worsen. He warned of another wave this winter during the flu season, which could further overwhelm hospitals.

But Dr. Deborah Birx from the White House Corona Task Force disagrees.


DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS TASK FORCE: I don't know if it will be worse. I think this has been pretty bad. When you see what has happened in New York, that was very bad. I believe that we'll have early warning signals, both from our surveillance that we've been talking about on the vulnerable populations. We're going to continue that surveillance from now all the way through the fall to be able to give us that early warning signal.


CURNOW: Meantime, the governor of Georgia is defending his decision to reopen certain businesses in just a couple of days' time, even though the number of new cases in the state isn't decreasing.


GOV. BRIAN KEMP (R), GEORGIA: We're seeing more patients in our trauma centers in our state, because people are just, you know, they're tired of it. I would tell you that I imagine there will be people in gyms that will be a lot safer than they would be going to the grocery store or some of the other places of business that are part of the critical infrastructure that's been designated at the federal level.


CURNOW: Well, Dr. Birx also reacted to the governor's move and tried to offer some advice.


BIRX: I believe people in Atlanta would understand that if their cases are not going down, that they need to continue to do everything that we said -- social distancing, washing your hands, wearing a mask in public. So, if there's a way that people can social distance and do those things, then they can do those things. I don't know how, but people are very creative.

I mean, we've been very clear in the guidelines, and I think it's up to the governors and mayors to ensure that they're following the best they can each of those phases to make sure that both the public is completely protected.


CURNOW: A lot of mixed messages there.

Well, Nick Watt has more on all of this.


NICK WATT, CNN CORRESPONDENT (voice over): The virus has killed more than 44,000 Americans and it will return this winter and it might be even worse so the CDC director tells "The Washington Post" because it could coincide with regular flu season and two respiratory outbreaks at once would hammer our health systems.

Meanwhile, our leaders are trying to agree on how to reopen from round one. Take Dallas County, they extended stay home through mid May, setting up a possible showdown with the governor.

GOV. GREG ABBOTT (R) TEXAS: To the extent that my executive order has statewide application, it would overrule any local jurisdiction.

WATT: In Iowa, Democratic lawmakers want a pork processing plant closed after an outbreak. The governor won't do it.

The governor in Georgia says barbershops, nail salons, gyms can all reopen Friday but SoulCycle says it won't. Congregations can gather, but one bishop is telling his flock not to and other governors are wary.

GOV. NED LAMONT (D) CONNECTICUT: I'm glad I'm not an immediate neighbor of Georgia because I think all you're doing is potentially throwing some gas on the flames there.

WATT: Testing, of course, is required to keep track of the virus as we reopen.


MAYOR JIM KENNEY (D) PHILADELPHIA: If we don't have the data, we don't know what we're up against.

WATT: The continued lack of testing partly what's making some in Georgia so anxious about reopening.

MAYOR KELLY GIRTZ (D) ATHENS-CLARKE COUNTY, GEORGIA: We need testing. We certainly need work on treatment and we need contact tracing of the sort that we just don't have in this state yet.

WATT: The White House guidelines say you should start reopening only after among other things a downward trajectory of documented cases within a 14-day period.

GOV. BRIAN KEMP (R) GEORGIA: We are on track to meet the gating criteria for phase one.

WATT: Not really. Monday, April 6th, 1,099 new cases. Fourteen days later, yesterday, just one less.

Not so in Tennessee, but they plan to reopen some businesses Monday. Not so in South Carolina, but they opened beaches and retail stores today.

MAYOR STEPHEN BENJAMIN (D) COLUMBIA, SOUTH CAROLINA: And the reality is that South Carolina has not peaked yet, according to our own professionals.

WATT: Myrtle Beach, defying the Governor, will keep beach parking closed.

(on camera): So, hair salons open in Georgia on Friday while maintaining social distancing. How does that work? We don't know.

Dr. Birx was asked at the White House press conference, and she said, I don't know how, but people are very creative.

Nick Watt, CNN, Los Angeles.


CURNOW: Well, thanks, Nick, for that.

So, for weeks now, the U.S. president has been touting a drug for malaria as a possible treatment for coronavirus, but a new study of patients at Veterans Health Administration medical centers is casting doubt on his theory. It found that coronavirus patients who took hydroxychloroquine did not benefit from the drug. In fact, they had higher death rates than those who didn't take it. President Trump still isn't convinced by the results, but he says he'll review the study after he spent weeks recommending the drug.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: What do you have to lose? Take it. I really think they should take it.

Hydroxychloroquine, try it.

Hydroxychloroquine, which I think, as you know, it's a great malaria drug. It's worked unbelievably.


CURNOW: Well, joining me now is Keith Neal. He's a professor emeritus in the field of epidemiology of infectious diseases at Nottingham University and joins me now.

We have quite a lot to talk about. Good to see you, sir.


CURNOW: Good morning.

I want your reaction to the fact that this anti-malarial drug doesn't work. And apparently, there's a higher death rate, despite the political pressure on the fact that this works. I mean, no matter what, this is another reminder that there are no quick fixes out there.

NEAL: I think the thing is, had it worked, there might have been a quick fix, because we're now actually getting ourselves organized across the world and doing proper large trials to actually address the questions. Do we know of any drugs that work?

Hydroxychloroquine was pushed for various reasons, I think from France and this side of the Atlantic, but at trial, I have not seen any convincing evidence that it does any good, and the evidence suggests it does harm. We know that the drug is potentially toxic at high levels, and when people are seriously ill, drug excretion routes often get compromised. I think the message here is the importance of doing trials. And one of

the big criticisms you could easily make of China was that the proper trials were not done and lots of drugs were given, often with and without Chinese medicine, to various patients in the thousands they had, and we still haven't got any answers.

In the United Kingdom, we've recruited now over 5,000 people to a small number of trials, and it's important that we have a small number of trials answering the key questions so we can get answers as quickly as possible. And if a drug works, introduce it, and if it doesn't work, move on to another one.

Clearly, the anecdotal reports of hydroxychloroquine working have not been borne out and are now being shown to be harmful, which is proven with anecdotal science.

CURNOW: And as you say, I mean, this is also perhaps another example of where China has dropped the ball on this, because if they had followed protocols in terms of testing drugs in those early few weeks and months, we wouldn't have lost so much time now in trying to figure out where we were and what worked and what didn't.

NEAL: I don't think there are any set protocols as such in the sense there is no --

CURNOW: But documenting what worked and what didn't work.

NEAL: It needs a proper randomized control trial, because I have seen a number of papers where they base, some from Europe, where they gave it to ten patients and then compared it to what happened to the ten patients the week before. That really isn't very good science.

I was speaking to some colleagues across the world on a different topic last week, and they were saying they've entered people in various countries in Europe have entered people into very small trials.


That is one advantage of having a centralized health care system that we have in the United Kingdom, that where you can set up networks of hospitals to actually coordinate multicenter trials very quickly.

CURNOW: Yes, I understand. Imperial College, I know Cambridge and Oxford are all working, and I think even human trials for a vaccine are starting on humans this week in the U.K. So, certainly a coordinated effort where you are.

I want to talk about -- I mean, clearly, this is -- there's patches and there are different stages around the world. We're here in Georgia, the U.S. state of Georgia, in Atlanta. You've been hearing how it's been opened upcoming up on Friday.

If this is done too soon in many places, say, for example, Georgia, and there is a spike again and hospitals are overwhelmed, do you think we're going to be seeing a lot of places closing down then again? And so, instead of these graphs in a year's time, we're going to be seeing sort of a rollercoaster of the world stopping and starting?

That's pretty much what happened in the Spanish flu, isn't it? Is that what you think is going to happen now? Because this is the 1918 flu pandemic.

NEAL: I think the Spanish flu -- we need to accept that, A, flu itself has slightly different transmission dynamics. There is a much shorter incubation period than COVID-19. And the second spike of Spanish flu occurred at the end of World War II, when the troops were sent back around the world. So -- and also, there were completely different criteria going on.

And trying to base COVID-19's multi-phased responses on what happened with Spanish flu I think is a recipe for disaster, because it's a study of any cause one. It's just an anecdotal report. It's like we gave hydroxychloroquine to a few patients and they got better, therefore it works.

I think the issues about releasing the lockdown situation is being done in much more phased way in Europe. And I think the sense that people are trying to open up small shops and socially distance -- but maintaining social distancing within the stores.

One of the more interesting aspects in Europe is Sweden itself, which is actually almost -- it's had not extreme social distancing, but has relied on specific factors in Sweden to allow them to actually not shut down as much of the economy.

I think -- I'm not familiar with what's going on in all of the 50 different United States, but I think whichever country releases a lockdown in too big a phase, then you are actually risking a re- emergence of new cases at a level that can't be managed.

Of course, one thing that we know works is the current measures of lockdown will stop the transmission. I suspect some of the strategy is to drive the cases very low. So -- and I think people -- what the government in this country has been worried about exponential increase. Well, we will get an exponential increase. It depends whether it's from one case a week to two cases a week or from 1,000 a week to 2,000 a weak.


NEAL: When it doubled.

So, if you can drive it down to a very low level, we can reduce various lockdown measures, see what works and see what allows spread to be controllable. And, clearly, from countries like Sweden, they're not having rampant rates of infection, but with less lockdown. It's quite likely that some of the lockdown measures are probably more than we needed, but we're in a completely new situation.

So we can't -- and we therefore had to take a precautionary principle to start with, basically to knock this on the head before hospital services got overloaded. CURNOW: So, it's certainly -- I mean, it's certainly patchy. It's

going to be interesting to see which strategies worked, but either way, the death toll continues to rise, and that is concerning, no matter where you are in the world.

Professor Keith Neal, thank you for your expertise. Appreciate you joining us. Have a lovely day, sir.

NEAL: Thank you. Good morning.

CURNOW: We're going to the world, so it's one of all of those. So, thank you.

So, more help is on the way for many U.S. businesses hit hard by the pandemic. This is good news for folks in the U.S. the U.S. Senate has passed a fourth relief package on Tuesday that includes another $310 billion for loans in the Paycheck Protection Program. Money is also set aside to help struggling hospitals and to expand testing for the coronavirus. The bill now heads to the House for votes, for a vote, and then the president is expected to sign it.

Now, you'll recall that initial loan program ran out of money last week, leaving many, many businesses without a much-needed lifeline.

Christine Romans and I have been talking about this. She joins me now from New York.

So, hopefully, this is good news. I mean, is there a sense that small business owners, people who own restaurants or hairdressers or a bakery will be able to access this in the way that they should have been access -- been able to access the first one?


CHRISTINE ROMANS, CNN CHIEF BUSINESS CORRESPONDENT: Well, that's the real test here. I mean, they filled up this fund again with another $310 billion. Absolutely a huge chunk of money and absolutely needed right away by these small businesses.

And there had been some real outrage that bigger companies, companies that had access to public markets, have been able to get these PPP loans, and small mom-and-pop organizations, real main street companies, had not been able to. Their applications were received and then they never heard anything back.

This particular pot of money, $60 billion of it, has been set aside for small lenders, and I guess that's intended to make sure that those smaller lenders with maybe smaller customers will have access to that money. But a lot of the complaints I have heard are from small businesses with bank accounts at big banks who just were shuffled out of the picture.

So, this money is definitely needed. Experts are telling me it's going to last maybe ten days, best-case scenario, but a lot of these people have already put their paperwork in, so hopefully, hopefully, you're going to get money into the hands of these small businesses. It can't come soon enough. Most of these companies only have a few

weeks of operating expenses in their rainy day funds, and this is a month into the crisis.

CURNOW: Yes, it certainly is. And as we said, the big boys came in and gobbled up all the cash in the first place. So, hopefully, they let the little guys at the front of the line this time around. So, fingers crossed.

Christine Romans, good to see you. Speak again soon. Bye.

So, you're watching CNN NEWSROOM. I'm Robyn Curnow.

Much more ahead, including this. Nursing homes are being hard hit by the coronavirus pandemic in the U.S. Well, now, new measures are going into place to help officials track the virus' spread. That's next.




BIRX: We are continuing to see outbreaks in nursing homes and in confined spaces, and I think as Americans, we want to stop that, and we have the ability to do that by really paying attention to the guidelines that were to be in all three phases. So, I'm calling on the states again to note that an informed community and knowledgeable community is a protected community.


CURNOW: That is Dr. Deborah Birx there, again, the White House Coronavirus Response coordinator, with a sort of cautious warning to states planning to reopen soon. Of course, she's mentioning nursing homes. We know that thousands of senior citizens across the U.S. have died from the coronavirus in nursing homes and care facilities.

One official tells CNN nursing homes are being, quote, ground zero for COVID-19. As CNN's Sara Sidner now reports, officials are hoping new rules on actually reporting cases will help track the virus' spread.

Here's Sara.


SARA SIDNER, CNN NATIONAL CORRESPONDENT: Nursing homes across the country are taking the brunt of coronavirus outbreaks.

UNIDENTIFIED MALE: Better, same, or worse.

SIDNER (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 COVID-19: For my daddy to just die by himself, it 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: He was a certified 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 am 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 in nursing homes, from more than 10,000 in New Jersey to 1,700 in California. Now, a federal agency that oversees nursing homes 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, ATTORNEY, CALIFORNIA ADVOCATES FOR NURSING HOME REFORM: It's really two things, Sara -- understaffing and infection control, and the two things go hand in hand.

SIDNER: In New Jersey, at Andover Subacute and Rehabilitation Center, police discovered 17 bodies piled at its morgue. Thirty-six people have died from coronavirus there.

In Richmond, Virginia, 45 residents dead from COVID-19 at this facility.

In Massachusetts, Holy Oaks Soldiers 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.

UNIDENTIFIED FEMALE: And, you know, he's a military person. The commander in chief was saying it was nothing, you know?

SIDNER: The very first major outbreak in all of America happened at a nursing home just outside Seattle. A hundred twenty-nine people linked to the facility infected with COVID-19, 35 people died.

UNIDENTIFIED FEMALE: All of a sudden, there were so many patients. Everybody needed medications. Everybody needed treatment.

SIDNER: Their facility was fined in part for not doing proper infection control. But watchdog groups say that is one of the most common citations for many facilities. Life care centers disputes the finding.

TIM KILLIAN, LIFE CARE CETERS OF AMERICA MEDIA LIASON: What went wrong? An unprecedented viral outbreak, which we did not know enough about entered our country. And because we have a vulnerable population, it entered our population. That's what went wrong.

SIDNER: He stands by the frontline workers, saying they were the first in America to heroically battle a new and invisible enemy. Representatives of many nursing homes warn, the government's failure to provide enough testing and the scarcity of personal protection equipment can be a lethal combination.

(on camera): What is the nursing staff having to do? I mean, can they even self-distance from the patients? Don't they have to clean them and lift them and help them rehabilitate?

DARK: That's exactly right, Sara. That is the problem. Many of these patients have to be fed. So, nurses are touching and handling patients all the time.


They can't avoid it. They have literally no way of protecting themselves.

SIDNER: Case in point, what happened here in Riverside, California, at the nursing home behind me where 83 patients had to be evacuated because officials say more than a dozen staff members simply didn't show up to work for a couple of days. Some of them had coronavirus. Some of the others were simply too afraid to come to work.

And then there is one more thing that patient advocates are very concerned about, and that are new rules by health departments in both New York and New Jersey, saying that nursing homes cannot deny patients, even if they have tested positive for coronavirus after they've been released by the hospital. Patient advocates say if they're forced to take in coronavirus-positive patients, they will be putting them right in the midst of the most vulnerable population.

Guys, back to you.


CURNOW: Thanks, Sara, for that.

And with many nursing homes banning visitors amid this pandemic, it is incredibly isolating time for many of their residents, but some staff are going above and beyond to make them feel more at ease. I want you to take a look at this tender moment. You might have seen it, but boy, you can see it again.


UNIDENTIFIED MALE: What's up, darling? Ha! Oh! Oh! Ha!

(END VIDEO CLIP) CURNOWE: It was just so precious.

That's 94-year-old Ken Bender receiving a pillow covered with a picture of his late wife. His care worker who gave it to him says she noticed he went to sleep with his wife's photograph every night, so she decided to surprise him with this gift. Ken and his wife, Ada, were married for 71 years before she passed away last August. It's beautiful.

So, there's still more ahead here on CNN. Coming up, there is new data showing the death toll from the coronavirus could be much, much higher in the U.K. than the government's official count. So, what's behind the discrepancy? We'll go to London live for answers, next.