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New Clues on Virus Spread, CDC Warns of Worse Second Wave; Study Raises Red Flags on Anti-Malaria Drug that Trump Hyped. Aired 6- 6:30a ET

Aired April 22, 2020 - 06:00   ET



UNIDENTIFIED MALE: The virus will return this winter, and it might be even worse.


UNIDENTIFIED FEMALE: I'm also worried about a second wave to come sooner, about those states who are relaxing some of these stay-at-home regulations.

UNIDENTIFIED MALE: This is just not handing them the keys back to go back to where we were. It was done based on the data.

UNIDENTIFIED MALE: We need to see a dramatic downward curve before we relax the provisions.

DONALD TRUMP (R), PRESIDENT OF THE UNITED STATES: We're going to do very significant testing. You know, not everybody wants to do such significant testing. You have governors that don't want to go all out in the testing, because they think they can do it in a different manner and do it better.

UNIDENTIFIED FEMALE: The supply chain issue is real. If you don't have the swabs and the reagents, you can't do a test.


ANNOUNCER: This is NEW DAY with Alisyn Camerota and John Berman.

ALISYN CAMEROTA, CNN ANCHOR: We want to welcome to our viewers in the United States and all around the world. This is NEW DAY. It is Wednesday, April 22, 6 a.m. here in New York. And we begin this morning with new reporting that shows coronavirus was spreading in the United States weeks earlier than previously known.

Officials in California say that autopsies now reveal that two residents who died in early and mid-February actually died from coronavirus. They become the earliest known casualties of the pandemic here.

So what does that mean for the rest of us. There's also a dire warning from the director of the CDC that a second wave of the pandemic this coming winter could be even worse than what we're battling now. This morning, we'll look into why it could be worse.

Also this morning, more southern states are looking to reopen, despite pushback from some of their own mayors and business leaders and residents who are wary of the danger.

JOHN BERMAN, CNN ANCHOR: So Alisyn, news this morning about one of the treatments that President Trump has been touting, oddly and notably above all others for coronavirus: hydroxychloroquine. His aide, Peter Navarro, talked about it, memorably, right here on this show.

A new study found that those who took hydroxychloroquine had higher death rates than those who did not. Now, it's a small study. It's not peer-reviewed. But still, as of this morning, the National Institutes of Health recommending against using it in combination with another drug that the president has been pushing.

Also of note, the Senate passed a $480 billion relief package for small businesses, hospitals and testing. The House is expected to vote on the measure tomorrow. More than 45,000 Americans have now died from this virus. Forty-five thousand. Nearly 3,000 dying just yesterday alone.

Our first report this morning from Martin Savidge, live in Atlanta. And Martin, word that coronavirus killed people in the United States much earlier than expected.

MARTIN SAVIDGE, CNN CORRESPONDENT: Staggering information, John. And the information comes just as the governor of Georgia continues to defend his controversial plan to reopen business in the state.

This despite the fact that the death toll here continues to rise. It's now above 800. And despite the fact that Georgia is woefully lagging behind other states when it comes to testing.


SAVIDGE (voice-over): Officials in Santa Clara County, California, say autopsies now confirm that two individuals died from coronavirus on February 6 and February 17, three weeks earlier than the first reported fatality in Kirkland, Washington.

The medical examiner says the people who died in February did not have any known travel histories and that it's presumed they contracted the virus from community spread.

It comes as Georgia's governor, Brian Kemp, is defending his decision to begin easing social-distancing measures in his state.

GOV. BRIAN KEMP (R-GA): This is not handing them the keys back to go back to where we were. This is a measured approach with a lot of different requirements that was done in conjunction with public health officials based on the data that we're seeing in our state.

SAVIDGE: By Friday, barber shops, hair and nail salons, bowling alleys, gyms and massage parlors are allowed to open again, and next Monday, so can restaurants and theaters. Some members of Kemp's coronavirus task force and local leaders say they were blindsided.

MAYOR KEISHA LANCE BOTTOMS, ATLANTA: I really am at a loss as to what the governor is basing this decision on, other than getting people back to work. And so I -- I am concerned that there was no local input.

SAVIDGE: President Trump's hinting he's eager for more states to follow Georgia's lead.

TRUMP: We have to build back our country. And I'm going to make our country bigger and better and stronger, and we have to get started.

SAVIDGE: But many governors suggest it's too soon. Instead, emphasizing how data shows social distancing is helping slow the spread.

GOV. GRETCHEN WHITMER (D-MI): I think that going too fast will be harder for businesses to have the confidence of the public to come in anyway. We've got to get this right so we don't have a second wave.

SAVIDGE: The CDC director warns the threat of a second coronavirus outbreak is very real, and it could happen during flu season. Dr. Robert Redfield telling "The Washington Post," quote, "There's a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through."

DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS TASK FORCE COORDINATOR: I don't know that it will be worse. I think this has been pretty bad.

SAVIDGE: Dr. Deborah Birx saying testing must be ramped up by fall.

BIRX: That we need to have testing in place to be able to separate and ensure those patients receive the best treatment.


SAVIDGE: Getting back to opening business here in the state of Georgia, many businesses say they're confused. They don't know if they've got the safety equipment for their employees. They don't even know if they have the products to offer.

For instance, the movie theater behind us here that's currently closed, when it opens Monday right now is advertising two films the public can already watch at home -- John.

CAMEROTA: Martin, I'll take it. And that does, I think, capture the challenge of whether the public will actually want to go out to movie theaters, et cetera.

Joining us now to dive into all of this, we have Dr. Ashish Jha, director of the Harvard Global Health Institute, and Dr. Colleen Kraft, associate chief officer at Emery University Hospital. Great to have both of you.

Dr. Jha, I want to start with you. Let me pull up this timeline. So this is what we previously knew about the origins in the United States of coronavirus and the new information this morning. OK?

January 7, Chinese authorities first identify this novel coronavirus. That's January 7. The first confirmed case that we knew of was January 21, and that was in Washington state. And that was a patient who had recently returned from Wuhan.

Here's the new information. February 6 and February 17, people died in California. Not Washington state, in California. Two people died. We didn't have confirmation of what they died from. We now know they died in California from coronavirus. We thought the first previous death, the first previous death was in Washington state on February 29.

So the fact that it was three weeks earlier, Doctor, and it was spreading in California from what we think is community spread, because these people who died in mid-February did not -- had not gone to China, they had not traveled, what does that tell us about where we are?

DR. ASHISH JHA, DIRECTOR, HARVARD GLOBAL HEALTH INSTITUTE: Yes, so good morning. Thanks for having me on.

This is a very significant finding and an update, because if you think about it, somebody who died on February 6, they probably contracted that virus early to mid-January. It takes -- it takes at least two to three weeks before -- between the time you contracted the virus and you die from it. Because it's a -- and so, therefore, that means there was community spread happening in California as early as mid-January, if not earlier than that.

So that's a very significant update. We really need to now go back and look at a lot more cases from January and even December and try to sort out when did we first really encounter this virus in the United States?

BERMAN: Dr. Kraft, it seems like a very big deal, that it was here obviously now. If this is true, weeks earlier, if not a month or more earlier than we previously thought. How does that reset the thinking on this?

DR. COLLEEN KRAFT, ASSOCIATE CHIEF OFFICER, EMERY UNIVERSITY HOSPITAL: Well, I think that it's something that we -- isn't a total surprise, given the fact that the community spread happened a lot more rapidly once we found it.

I do think that we've started to look back serologically at our patients that we took care of in February that had diseases that were confusing, doing that testing on previous patients.

So this is -- this isn't entirely surprising, but that also means that a lot more people have had this, probably, asymptomatically or with mild illness than we -- than we thought before.

CAMEROTA: And in fact, the chief medical officer of Santa Clara County, which is where these deaths have been reported, said that very same thing. I mean, she calls it the tip of the iceberg. This new revelation tells us that there was much more happening under the surface than we knew.

Here's what she has just said. This is Dr. Cody, who says, "Each one of those deaths is probably the tip of an iceberg of an unknown size. It feels quite significant. We had to ask the CDC every single time, does this person meet the case definition? May we send a sample? We had this very, very uncomfortable feeling that we were hearing about a lot of patients who really felt that they were cases, but we couldn't test."

So Dr. Jha, I mean, you know, I wish we were in a different place now than we were then. But we're not in terms of they couldn't test then, even though they had suspicions. And today, you know, we still can't test everybody.

JHA: Yes. So first of all, all of this is just a reminder of how we're going to learn new things and how much harder it's been to manage this pandemic, because our testing infrastructure has been so woeful.

BI think this is very helpful information. It also means that things like -- you know, the things we put into place in late January, like the travel ban, the virus was already here by then and probably circulating quite widely.

And so there's a lot of kind of recalibrating we have to do about what this tells us, but also reminds us that we really have to look forward and have -- be much more aggressive about testing going on.

BERMAN: Well, as we go forward, Doctor Kraft, the other bit of new information over the last 24 hours is Dr. Redfield of the CDC saying that a second wave from coronavirus could be worse, in some ways, than this first. He is looking forward to next fall and winter, the flu season, which begins roughly in October. Why could that be so bad?


KRAFT: Well, I think we just need to look back even to 2009, H1N1 pandemic. When, at that time, there was a spike in April, much sort of like we're going through now.

And then when schools resumed in August, at least in the southern states, we immediately saw, you know, with that cohorting of people and children all together, a huge spike in August of the pandemic H1N1 flu. That's -- that's in our recent history.

And so it's not surprising that we may even have a bump after these social distancing measures are relaxed in -- in areas, as well as, then, in the school year and the fall when people are together and the respiratory season starts in full.

So I expect there to be at least two bumps after our current flattening.

CAMEROTA: Yes. And Dr. Kraft and Dr. Jha, I -- I understand that there will be bumps. But Dr. Jha, I don't understand why it would be worse. By winter, we collectively and you researchers and doctors will know more about coronavirus than we did the first time around. We have done away with hand shaking. We no longer sneeze or cough into

our hands. How could the second wave be worse than what we're having right now?

JHA: Yes. So what -- I think what Dr. Redfield is saying is that we should expect it will be worse unless we make some very, very substantial changes. And so I think if we just go into the fall as though it were a normal fall, normal school, normal activity, we should absolutely expect it's going to come back; it's going to be much worse.

But I think if we do a lot of things proactively, some of which you've described, if we -- and we do a lot more social distancing and if we keep people apart, there's a much better chance that we can get through the fall and winter without a massive spike. But it's not guaranteed at all.

BERMAN: Dr. Kraft, you were talking about 2009. You can also go back to 1918 to look at how waves of pandemics kill.

This is the 1918 flu, which famously had three waves. It was the second wave that came in the fall that was by far -- by far -- the deadliest. So what can we do now to make sure that we don't have a deadlier second wave?

KRAFT: I THINK what you've already just said, which is we are farther ahead knowing about this virus. I mean, in 1918 they didn't even know what -- what it was. They didn't find out that it was a virus until the '30s.

And so we have, you know, antibiotic support, ventilatory support. You know, our testing will be -- they didn't have testing back then.

So I do think that -- I do hope that we, as a nation, as a world, will understand a lot more so that we can prevent the spread.

All of us have within our power the ability to do good hand hygiene, face hygiene and clean the surfaces around us. And so I am hopeful that some of these shifts that we've been making as a culture will actually hold. But that's going to be a lot of how we -- how we continue to hold this off as a severe disease and a severe outbreak.

CAMEROTA: And last, Dr. Jha, I mean, this week, some states are reopening, some states where they're actually still experiencing the peak. And so what do you think we're going to see as early as next week or the week after?

JHA: Yes. So two quick thoughts on that.

First of all, many of those states don't meet the president's own criteria. If you remember, the president laid out a set of criteria for when it would be OK for states to start opening up again. Georgia doesn't meet it. Florida doesn't meet it.

So I think one issue is that most states don't even meet those criteria, the president's criteria. Second is this is the most important part about this virus. Is that

when we act, we don't see any effects of it, positive or negative, for weeks. So I think they're going to open up. Nothing will look worse for several weeks.

It will be a month or six weeks down the road that we'll start seeing the increasing number of cases and then, unfortunately, probably increasing number of deaths.

So we'll have to be patient to see what the effects of these moves are.

CAMEROTA: Dr. Jha, Dr. Kraft, thank you both very much for all of the information this morning.

The nation's top scientists, meanwhile, John, are warning against using that drug combination that has been pushed often by President Trump and some of his media allies. We will tell you the latest study on hydroxychloroquine. Next.

BERMAN: Also, coming up in minutes, an exclusive live report inside the city of Wuhan in China where this pandemic began.


BERMAN: So we have news this morning about hydroxychloroquine, which is the treatment that the president and some of his allies have been touting as a treatment for coronavirus for months. This study, a government-funded study at the V.A., found that patients who took the drug were no less likely to need mechanical ventilation, and they had higher death rates than those who did not take it.

Back with us, Dr. Ashish Jha. Also joining us, Juliette Kayyem, a CNN national security analyst and former assistant secretary at the Department of Homeland Security.

Dr. Jha, I think we can say it more clearly. This study found no benefit from hydroxychloroquine and, in some cases, a much higher risk from taking it.

Let's put the numbers up on the screen here so people can see. Let me read them off the screen here. Ninety-seven patients took hydroxy. The death rate was 27.8 percent.

Of the 158 patients who did not take it, the death rate was 11.4 percent.

Now, this is a small study. It's not peer-reviewed. There was no control group. Like a lot of the things we've been discussing with hydroxy, we need to see much more data. We certainly wish it were effective. We all want to see a treatment here. But what does this study tell you?

JHA: Yes, so, first of all, I think you're absolutely right. We're all desperate for therapies that work. You know, I've always been puzzled by why we've made such a big deal

of hydroxychloroquine. The data supporting it was really weak and anecdotal. This study is also pretty weak and anecdotal.


And so I was not convinced it worked when I read the previous studies. I'm not convinced it doesn't work based on this. What I'd like to see is reasonable quality data, good science. And I want to let that drive our decision-making, not what people's guts are or what, you know, what they're feeling is about a drug. And this study just hasn't kind of definitively answered the question any more than previous studies have.

CAMEROTA: Yes. I mean, I think the reason that so many people were excited about is just what you talked about, which is that, anecdotally, I think we've all heard some miracle stories about it. And so that seemed promising in, you know, one -- one instance, you know, the anecdote that we had heard.

But with this study, do we know how old the patients were? Do we know at what stage they were in their fighting of the disease? Because maybe that affects their outcome, Dr. Jha?

JHA: Yes, those -- those things definitely outcomes. Remember, this setting is not prospective or randomized. And the reason why that's important is one of the reasons it's possible that there's higher mortality with hydroxychloroquine is doctors were choosing to give to some people and not to others.

And so this is a study that, again, if I were looking at this study as a peer reviewer, I would say, it's not very useful, I'm not sure it tells me very much.

And what I wanted to say to folks, politician in Washington, is stop politicizing this. Let the scientists figure out what's going to be the most effective therapy. We're all desperate for effective therapy. Let the science work. And we'll get you answers as soon as we can.

BERMAN: I do want to note the National Institutes of Health came out with a recommendation yesterday to not use hydroxychloroquine in combination with another drug that the president has been touting, using them together. He said don't do it. Don't do it.

Let me just -- Just so people know what we're talking about here and then I want to move on to a different discussion. You know, Alisyn was talking about anecdotal evidence, people telling stories. I don't even think that's the real reason people had hope for this. The real reason is because the president was talking about it with millions of people watching. Listen to this.


TRUMP: There's some good signs. You've read the sides, I've read the sides. And I say it. What do you have to lose? I'll say it again. What do you have to lose? Take it. If things don't go as planned, it's not going to kill anybody.


BERMAN: So he's gone silent on this for the last five days after touting it like that. And last night, wouldn't answer a question on it.

Juliette, I want to go back to the idea of this next wave that Dr. Redfield was talking about, of coronavirus coming back in the fall during flu season. Your job is preparedness.

KAYYEM: Right.

BERMAN: Your job is getting companies and states in the federal government ready. So what should people be doing now?

KAYYEM: Well, essentially, don't stop what we're doing now in terms of the social distancing and other behaviors that are going to stop the spread of the virus.

We are prematurely opening up in some states. That is going to lead to another wave or response in four -- four to six weeks, which we'll see in four to six weeks.

My fear is because it will take a while for, you know, people in Georgia to show symptoms or to show sickness, there will be incredible political pressure on other states to open up. And we're going to be looking at a bad summer and then a second wave in the fall.

So what would I want to do? I want to change behavior now. We are going to be living with some form of social distancing, changed behavior, adaptive behavior for a long time. And we have to begin that now.

Get employers to be smart about whether they're calling employees in. Stop things like mega events, sporting events until we have better treatments or, of course, a vaccine.

And then the most important thing is get our supply chain ready. If we know that there could be two, if not three -- a second or a third wave, I feel like the president still is sort of nickel-and-diming this. Even with Cuomo yesterday. Look, we need to just have a surplus. We need to have capacity ready for the summer and fall for tests, for ventilators, for gloves, for masks. Let's not stop now.

And so I would just keep assuming that we're going to have this for many, many months at a sort of semi-peak level. And we need to get our supply chain back up and running, because we are going to be getting requests from the states through the summer and fall.

CAMEROTA: Juliette Kayyem, Dr. Jha, thank you both very much.

KAYYEM: Thank you.

BERMAN: All right. We have an exciting, fascinating CNN exclusive. Our reporter has gone back to Wuhan in China where the coronavirus pandemic began. David Culver, back there three months after he left. He has his exclusive report, next.



BERMAN: New this morning, we have a CNN exclusive, back inside the city where the coronavirus pandemic began, Wuhan in China.

CNN's David Culver, he was there in January and got out just before a citywide lockdown was put in place. He is back for the first time this morning, three months later. You can see him right there. We'll talk to David in just a moment.

First, though, a look back at what it was like the last time he was in Wuhan, as word spread that the city was about to be locked down.


DAVID CULVER, CNN INTERNATIONAL CORRESPONDENT: So this is where authorities believe the source of the coronavirus is. It's the wildlife and seafood market. And you can perhaps see over there it's cordoned off. You've got police at all the corners.

(voice-over): It is so sensitive that within minutes of us arriving and recording, security asked us to stop filming.

(on camera): So police just asked us to leave the market area. They said we have to get official permission. And once we get that permission, we can come back. The reality is we won't be granted that permission. So instead, we're able to drive now through it. But you can see, they've closed off the entire market area. No shopping is going on. No business whatsoever.