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Study: Virus Far More Widespread in New York Than Thought; Trump Proposes Light, Disinfectant as Possible Treatments; Oil Prices Rise After Historic Lows; Small Businesses Struggle as Wuhan Reopens; Singapore Seeing Dramatic Spike in Infections; COVID-19 Devastating Seniors in Long-Term Care Facilities; Oxford Starts Human Trials for Potential Vaccine; Observing Ramadan During the COVID-9 Pandemic; Money from Walls Helps Waiters & Waitresses. Aired 12-1a ET

Aired April 24, 2020 - 00:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


MICHAEL HOLMES, CNN INTERNATIONAL ANCHOR: -- hospital in the U.K. hit hard by coronavirus as they prepare to face a feared second wave.

[00:00:23]

Welcome everyone. The United States is now closing in on 50,000 deaths from COVID-19, according to Johns Hopkins University, an astonishing and troubling acceleration of death, considering just one month ago, the number was 500.

Infections and fatalities are expected to keep rising. New York's governor says new test results suggest the coronavirus could be far more widespread than previously believed.

Despite that, other U.S. states like Georgia are starting to fire up their economies, starting in the hours ahead. President Trump says he is not on board with that. Too soon, he says.

And a key data model often cited by the White House shows Georgia should wait another two months to start relaxing restrictions. Other governors and mayors facing some tough choices ahead.

CNN's Nick Watt begins our coverage.

(BEGIN VIDEOTAPE)

NICK WATT, CNN INTERNATIONAL CORRESPONDENT (voice-over): The number of people infected by this rampant virus in New York state, the global hot spot, might actually be a stunning 10 times higher than we thought.

DR. AMESH ADALJA, INFECTIOUS DISEASE EXPERT: It tells us that this virus is much more widespread.

WATT: Phase one of an antibody testing program suggests that as many as 2.7 million New Yorkers might have already been infected. But the state's current confirmed case count is just under 270,000.

GOV. ANDREW CUOMO (D-NY): Thirteen point nine percent tested positive for having the antibodies. They had the virus. They developed the antibodies. And they are now, quote unquote, "recovered."

WATT: New York's death toll of around 19 and a half thousand is almost certainly also too low.

CUOMO: That number is going to go up. Those deaths are only hospitalization or nursing home deaths. That does not have what are called at-home deaths.

WATT: Now, a higher infection rate could mean this virus is actually less deadly than we thought. It kills fewer of those who get it. And --

ADALJA: We are developing some immunity to this. There are people that have mild illness that don't even know that they're sick. And those individuals may be part of how we move forward, how we start to think about reopening.

WATT: But New York is not opening up. Not yet.

DR. RICHARD BESSER, FORMER ACTING DIRECTOR, CDC: We need to see how this is playing out in each community and have the ability to test thoroughly and protect citizens before we think about opening up.

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE FOR ALLERGY AND INFECTIOUS DISEASE: We absolutely need to significantly ramp up. I am not overly confident right now, at all.

WATT: Wherever, whenever we open, cases will likely rise.

CARLOS GIMENEZ, MIAMI-DADE COUNTY, FLORIDA MAYOR: We're never going to come up with something which is -- gives you a zero probability or possibility that you're going to spread the virus. But what we want to do is make sure that you reduce the possibility.

WATT: In Miami-Dade, despite a new case count that is not consistently coming down in accordance with those White House reopening guidelines, apparently, they're planning to reopen marinas, golf courses, and parks with twists.

GIMENEZ: You will be able to play tennis. Singles tennis but not doubles tennis. You have to jog in a certain direction. So there are a lot of differences.

WATT: And meatpacking plants still seeing outbreaks across the country. Tyson just closed its fourth facility, a beef processing plant in Washington state, to test all employees. This place usually produces enough beef every day to feed four million people. Not anymore.

Nick Watt, CNN, Los Angeles.

(END VIDEOTAPE)

HOLMES: Well, a few odd or you could say even dangerous moments at Thursday's White House coronavirus briefing. A Department of Homeland Security official who is not a scientist said sunlight, heat and humidity appear to have what he called a powerful effect on coronavirus particles in the air and on surfaces.

But that's not where it got dangerous. President Trump urging officials to figure out a way to use UV waves on human beings as a treatment. And that wasn't all. The president also touting the possibility -- the possibility -- there was a way to inject the body with a disinfectant to get rid of the virus.

Needless to say, real doctors say no, no, no.

And CNN medical analyst Dr. Celine Gounder joins me now. She's an infectious diseases specialist and an epidemiologist and host of the "EPIDEMIC" podcast.

Thanks for being with us, Doctor. I mean, I wanted to start by talking about this whole UV light idea. But -- but also the president's comments about it. Let's have a listen to him.

(BEGIN VIDEO CLIP)

[00:05:08]

DONALD TRUMP (R), PRESIDENT OF THE UNITED STATES: Supposing we hit the body with a tremendous -- whether it's ultraviolet or just very powerful light, and then I said, supposing you brought the light inside the body, which you can do either through the skin or in some other way.

And I think you said you're going to test that, too? It sounds interesting.

And then I see the disinfectant, where it knocks it out in a minute. One minute. And is there a way we can do something like that? By injection inside or almost a cleaning, because you see it gets in the lungs, and it does a tremendous number on the lungs. So it will be interesting to check that. So that you're going to have to use medical doctors. But it sounds -- it sounds interesting to me.

(END VIDEO CLIP)

HOLMES: OK. So, quote, "Supposing you brought the light inside the body." Also asking if there's a way to disinfect people via injection. I wanted to get your thoughts on light as some sort of potential therapy, but also the president's comments, which on the face of it do seem they could be interpreted as dangerous. I mean, what are your thoughts?

DR. CELINE GOUNDER, CNN POLITICAL ANALYST: Well, Michael, I mean, I think it's one thing to talk about treating an N-95 mask with UV light to try to disinfect that over a period of time, you know, say 20 minutes or so. But to do what he's suggesting to the human body, that's, like, very strong radiation that could be cancer causing. That's really quite concerning.

And in terms of injecting people or having people drink or however they choose to ingest detergents or other disinfecting products, that can be lethal. And we've already seen some patients or people die from taking

hydroxychloroquine that was not formulated as a medication, that was to be used for more industrial kinds of purposes. And so on. And so this is really quite concerning.

HOLMES: Would it be significant if more people had this than we previously knew? That it was more widespread in the community? What would that -- what would that tell us?

GOUNDER: Well, one, it might tell us that the case fatality rate, so the proportion of people who are infected with this, the proportion who actually die is much lower than we had feared. Which would be a good thing.

But the problem is that we're clearly, even with the numbers that we're seeing, who are having severe disease and dying. No matter how you do the math, there are too many people getting sick and dying.

HOLMES: Testing, the president keeps saying it's all fine, that there are plenty of tests out there, plenty of testing. I mean, he even said, I think, that some governors have said they don't need testing, which I haven't found one who actually did say that.

But how far behind is the U.S. still on testing, compared to where it needs to be? And again, how vital that testing is for a whole raft of reasons, from spread indication to antibody contact tracing and so on.

GOUNDER: Well, it's really impossible to contain something if you're flying blind. So it would be like saying we're going to try to control crime, but you can't take fingerprints. You can't pick up, you know, casings from a shooting site. You can't do, you know, any kind of interviews with people at the crime scene.

So how are you supposed to track down criminals in the absence of that kind of information? That's essentially what we're trying to do right now.

So, you know, this -- this is a situation where we really do need the testing in order to identify who has been infected, who currently is infected, who might be at risk for developing disease, because they have been exposed to somebody who's been infected. And so in a sense, it's about knowing where the disease has been and where it's going next.

HOLMES: I wanted to also ask you about, you know, there seems to be growing evidence of potential lingering effects, even if you do recover. I mean, lung damage, lung function, kidney issues, neurological issues. Are we likely to see impacts of this on the recovered patients for years to come?

GOUNDER: Well, we're still learning a lot about this, but one of the things that we've learned is that this is a virus that can infect the brain. This is a virus that is causing miniature blood clots in the tiny circulation of the lungs and the kidneys, which is part of the reason you see difficulty with breathing and oxygenation. And it's also part of the reason that many patients develop kidney

failure as a result of this infection. And there are probably many other consequences that we haven't fully appreciated yet or seen yet.

HOLMES: I also wanted to get your thoughts on other patients. I mean, are they getting the care they need: cancer patients, heart attacks, strokes? I mean, vital follow-up care for serious conditions? There was an M.D. tweeting today that some people with serious conditions were refusing to go to post-acute care facilities, given concern about contracting COVID.

[00:10:00]

GOUNDER: Well, those are really the secondary effects of all of this. Because you have a lot of people who've had to defer their care. Partly, it's their own fear about coming into the hospital. For example, pregnant women, we have pregnant women who are delivering at home, because they are so afraid of coming into the hospital and getting infected, getting their baby infected.

And then you have people who have been discouraged by doctors, such as myself, saying you know, this is probably something we can wait for now. Maybe it's elective. But you know, even, quote unquote, "elective" surgeries and so on are not -- they're not completely optional. It's more a question of timing. And the longer people are having to defer those kinds of treatments, the more they are becoming more and more urgent.

HOLMES: Yes. Good points. Dr. Celine Gounder, thank you so much. Great to have you on.

GOUNDER: My pleasure.

HOLMES: And do join us next hour for a replay of our special coronavirus global town hall. Alicia Keys will play her new song, dedicated to the everyday heroes on the front lines of this pandemic. That's coming up in the next hour, right here on CNN.

Now, Germany has become a textbook example during this pandemic for handling the crisis better than most. Small shops there are now allowed to reopen, but Chancellor Angela Merkel has a warning about moving too fast. She is joining other European leaders who are calling for a gradual easing of restrictions but says the gains her country has made in slowing the spread are fragile and that Germany is on, quote, "the thinnest ice." Take a listen.

(BEGIN VIDEO CLIP)

ANGELA MERKEL, GERMAN CHANCELLOR (through translator): Nobody likes to hear it, but it's the truth. We are not living in the final phase of the pandemic, but still at the beginning. We will have to live with the virus for a long time.

(END VIDEO CLIP)

HOLMES: Another European leader managing expectations, Scotland's first minister, Nicola Sturgeon. She says a full return to normal might not happen until next year. She's looking into how Scotland can come out of lockdown with a new framework.

That document says restrictions on outdoor activities may be eased before indoor ones, and that schools might reopen in phases. But public offense and gatherings in pubs and the like are likely to remain banned and restricted, at least, for some time to come.

Well, they've endured one of the strictest lockdowns of the pandemic. Now, as Wuhan begins to open, we take a look at how businesses are adjusting and the lessons other countries could learn.

Also, a country once praised for its containment measures now seeing a surge in coronavirus cases. We'll find out why when we come back.

(COMMERCIAL BREAK)

[00:15:17]

HOLMES: Welcome back. Oil's wild week continues with gains on Thursday, bouncing back from Monday's historic sub-zero prices. The WTI closed at just under $17 a barrel. Brent crude closed just shy of $22 a barrel.

A tweet by the U.S. president contributed to the comeback. For exactly how, let's bring in Kaori Enjoji in Tokyo.

Yes, price surge, but boy, was it off of a crazy low. What's been happening and what's the outlook?

KAORI ENJOJI, JOURNALIST: It's been a crazy week. And I think this rebound means that oil is trying to, you know, move into the mend. But it's still at very, very historically low levels. And as you pointed out, WTI is just still below the $18 mark.

There's an old saying in the oil markets that says if you want to push up the price of oil, say that there's a skirmish in the Strait of Hormuz. And this tweet by the U.S. president instructing the U.S. Navy seem to talk with the U.S. Navy to shoot down Iranian gunboats if they harass the U.S. was that trigger earlier on in this week.

But the -- everyone is still talking about the demand destruction. Planes are grounded. People are not getting into their cars during a lockdown. Factories, some are coming back on, but a lot of them are still closed, means the demand is going to be -- remain -- going to remain, excuse me, weak for the considerable time.

And that is the primary reason why we saw that massive sell-off earlier on in the week with people paying, literally, people to take oil off their hands. So I think that situation remains the same.

Today, we're seeing a bit of a steady trading session in the oil market in Asia. We're also seeing a little bit of a softer picture for the stock markets in Tokyo, Seoul, and Shanghai, as well, as we head into the weekend. As investors weigh the two factors that are conflicting the markets. One is the fact that infection rates are starting to subside in some parts of the world, but you also have the economic reality of a very, very bleak picture.

You have 26 million people in the U.S., unemployed during the lockdown. You have an economy in the eurozone that is at its weakest point in 20 years. And across Asia, as well, you have a similar picture of the corporations saying that they can't give any guidance for this year. And I think that is the quandary that's facing the markets right now.

People are also focused on the central bank here in Japan, which will likely issue some kind of new measure next week. And people are waiting to see whether it will match the U.S. Federal Reserve measures, which is basically do whatever it takes to help the economy and buy government bonds.

So that's where we stand right now. A little bit of a caution seeping in ahead of the weekend, Michael.

HOLMES: All right. Kaori Enjoji in Tokyo, appreciate it. Thanks so much.

Well, American workers are feeling the economic fallout of the virus as Kaori was just saying. The Labor Department says 4.4 million jobless claims were filed last week.

Now, this, as the debate to reopen the economy intensifies. Over the last five weeks, the U.S. has lost more than 26 million jobs. That means more than 16 percent of the entire U.S. labor force has been laid off.

While the number of workers filing for unemployment is going down each week, economists warn the damage is already done. CNN's Julia Chatterley weighing in on what this could mean, long term.

(BEGIN VIDEO CLIP)

JULIA CHATTERLEY, CNN INTERNATIONAL ANCHOR: We're now talking one in six American workers either having lost their job, having been furloughed, or just fearful about their jobs.

We don't know, and that is what is difficult to gauge here, to what extent this will translate into real job losses when we get the unemployment report. But the belief is that we are above 15 percent now. We could even be as high as 20 percent.

The critical questions now is what does reopening of this economy look like? How many of those jobs come back, and how quickly can that happen? And of course, at least, in the short term, what can be done to try and protect against further job losses with a lending program for small businesses, of course.

And getting money to people in the United States, too. Forty percent of households couldn't write a $500 check in an emergency, and that was before this crisis. Now look at these numbers and compare. That's terrifying.

(END VIDEO CLIP)

HOLMES: Julia Chatterley there.

Now, a study by Pew Research says half of low-income adults have either lost their job or taken a pay cut. Bleak times.

As U.S. businesses anxiously await the moment they can reopen their doors, many are closely watching how Wuhan, the original epicenter of the virus, works to get back to normal. Its harsh lockdown lasted 76 days, and, as CNN's David Culver reports, some small businesses are struggling to survive.

[00:20:16]

(BEGIN VIDEOTAPE)

DAVID CULVER, CNN INTERNATIONAL CORRESPONDENT (voice-over): Wuhan's mild spring weather, luring people outside. They do not need much convincing after enduring the most extreme of lockdowns.

CNN found folks enjoying the company of neighbors, or soaking in the stillness. All the while, still wearing face masks. A reminder that the original epicenter of the novel coronavirus outbreak is not in the clear.

Two weeks after Wuhan lifted its lockdown, a drive-through commercial street shows many storefronts still shuttered. The shops staying open finding a new way to serve customers.

(on camera): You can only go up to the box of front. They've had a little table set up. You order with somebody who either comes to the door, or you can do it through an app.

The idea is you are not to go into the store. All of this, still open business, but also, keep a social distance.

(voice-over): But for some small business owners, there is no reopening in sight.

UNIDENTIFIED MALE (through translator): For private businesses like us, there's almost no subsidies.

CULVER: We talked with Mr. Wong. CNN agreed not to use his full name, as he wanted to avoid any trouble with local officials.

After three months of sitting closed, the 35-year-old restaurant owner is struggling with rent. If a government relief check arrives, he says, the assistance will likely come too late, especially if there is another spike in infections here.

UNIDENTIFIED MALE: Considering the possibility of a second wave, very likely, we will leave this business and find another job.

CULVER: Mr. Wong opened up about the mental health struggles of living under lockdown, sealed inside his home.

UNIDENTIFIED MALE (through translator): I was actually very scared at that time. When I saw the news that the pandemic was gradually under control, I felt less nervous. When I got bored at home, I just watched TV. I played on my phone and slept.

CULVER: And yet, Mr. Wong, like many across the world, also had to deal with news that three of his loved ones contracted the virus. One of his extended family members passing away.

UNIDENTIFIED MALE (through translator): Of course, we were very sad. We couldn't see him for the last time when he died, or even give him a farewell ceremony. It was a big regret in our hearts. We would go to his grave after the pandemic to hold a simple ceremony for him.

CULVER: Likely, thousands of similarly delayed remembrances to take place here in Wuhan over the weeks ahead. As others cautiously move forward with living, these, the faces of those who endured a harsh lockdown, now navigating their way into an uncertain future.

(on camera): And here we are, more than three months after the lockdown initially took effect, and you can tell there that folks are still very hesitant to walk back into life as it was prior to the lockdown.

And businesses, the ones that will reopen, will do so, as you see, with very different modes of how they operate. The ones that remain closed, including fitness centers and cinemas, won't be doing so until they get formal approval to reopen.

And even once they reopen, many of them are still concerned that the customers will be very reluctant to come back, concerned that they will face that added exposure ahead of what could potentially be a second wave of this outbreak.

David Culver, CNN, Wuhan, China.

(END VIDEOTAPE)

HOLMES: Turning our attention now to Singapore, where that place is seeing a dramatic spike in coronavirus cases.

According to Johns Hopkins University, they've recorded more than 11,000 total infections. And for the past four days, they've been reporting more than 1,000 cases a day.

For more on what's behind the surge, I'm joined now by Manisha Tank in Singapore, a place once doing so well on control, now headed in the wrong direction. What's the plan there to deal with it, Manisha?

MANISHA TANK, JOURNALIST: Yes, it's incredible isn't it, Michael? Lots of questions being asked about that, what happens, next. And one of the things that has happened is we've had an extension of our lockdown measures, or they're being called, circuit breakers, here until June 1. The hope is that it can really get this virus under control. But as a resident, I can tell you, at the beginning, I felt so well

taken care of. We were given free masks. We were given free hand sanitizer. There was a great public information campaign, but it's like a virus. In just biological terms, it really hits you in your weak spot.

(BEGIN VIDEOTAPE)

TANK (voice-over): Just enough personal space for a bed and some belongings. This is just one dorm, like many in Singapore, these construction workers call home. Under lockdown, with nowhere to go, they find themselves quarantined, isolated, fearful of a deadly virus.

UNIDENTIFIED MALE: I'm scared of this coronavirus. Because there are so many people dead.

[06:20:01]

TANK: Leaving their families behind, they flock here from India, Bangladesh, and other parts of Asia in search of better pay and economic opportunity.

UNIDENTIFIED MALE: If I catch it, I can't take care of my family.

TANK: Despite Singapore's early accolades for coronavirus control and prevention, the city state has a surge in cases in foreign worker dormitories.

As the government pursues aggressive testing, some are asking if this situation could have been avoided, especially in a community that normally lives tight-knit in crowded, shared facilities.

New social distancing measures are now in place, but so-called stringent circuit-breaker measures to control the spread of the coronavirus have been extended until June. The threat of asymptomatic infection lingers.

LEE HSIEN LOONG, SINGAPORE PRIME MINISTER: Unfortunately, that number of unlinked cases has not come down. And this suggests that there is a larger, hidden, reservoir of COVID-19 cases in the community.

TANK: Coronavirus cases in Singapore have gone from fewer than 1,000, to more than 10,000 in less than a month. The economic cost from the pandemic, and efforts to control it, has led to three bouts of economic stimulus in as many months. It also sounds a warning for other countries with density-packed populations.

TEO YIK YING, NATIONAL UNIVERSITY OF SINGAPORE SAW SEE SCHOOL OF PUBLIC HEALTH: What we see in Singapore can and will happen in other countries.

TANK: Despite the challenges, many workers who spoke to us remain positive. Like Jasin, who gave us a tour of his room, and the adjoining block.

UNIDENTIFIED MALE: Actually, Singapore government has made a very good step for the migrant workers who stay in dorms. Especially, they like to take care of us.

TANK: Government agencies and charities have stepped up support. Some workers in good health are still performing the essential services that keep Singapore running and are being put up elsewhere.

(on camera): So this is the view from my apartment here in Singapore. It's midmorning. Normally this time of day, I would hear the whirr of grass being cut, or maybe the roar of a neighbor's renovation going on. And often, in those construction and maintenance teams, you'll find lots of migrant workers. Along with the extended lockdown, things around here at the moment are eerily quiet.

(voice-over): But even with lockdown measures, experts warn of yet more cases to come.

YING: Our models in Singapore project we are looking at possible case numbers of an additional 10 to 20,000 more.

TANK: For now, migrants like Jasin wait in limbo, away from their families, unsure when this will end.

JASIN: My family was worried. They always call. My mom call, my dad call. My wife calls, and they are all worried about us.

(END VIDEOTAPE)

TANK: So you see, Michael, this is the issue. It is the migrant worker community that's been hit the hardest here, really being seen as a vulnerable spot. Because many of them normally live in very tight- packed spaces, even though now, the government is ensuring that social distancing is going on in those dormitories.

But there's another track of cases that we are concerned about here, and that's the asymptomatic ones. The local press describing it as the blind spots.

So they're saying beware, especially when you're talking about places where people congregate: malls, crowded spaces. This is very much a story which is a warning for the rest of the world, I'd say, Michael.

HOLMES: Yes. Testing, testing, testing, as everywhere. Manisha, thank you. Manisha Tank there in Singapore.

Long -- long-term care residents are some of the most vulnerable to COVID-19, as we have seen. Just ahead, I'll be talking with a doctor about what can perhaps be done to better care for seniors and what lessons have been learned here.

Also, CNN was able to spend 48 hours on the front line in one of the hardest hit hospitals in the U.K. The message doctors and nurses there have for all of us.

(COMMERCIAL BREAK)

[00:31:16] HOLMES: A grim statistic from the World Health Organization. As many as half of the people who have died from coronavirus in Europe were nursing home residents, long-term care facilities.

The regional director for the WHO Europe addressed the problem on Wednesday, saying operations in these long-term care facilities need to change.

(BEGIN VIDEO CLIP)

HANS KLUGE, REGIONAL DIRECTOR, WHO EUROPE: This isn't an imaginable human strategy. There is immediate and urgent need to rethink and adjust how long-term care facilities operate today and in the months to come. This means striking a balance between the requirements of residents and their families and ensuring that services are run safely and staff are protected and well-supported.

(END VIDEO CLIP)

HOLMES: In Canada, the prime minister, Justin Trudeau, says he is sending thousands of military personnel into nursing homes to help shore up care and carry out testing, as well.

Earlier, I spoke to the director of one facility in the U.S. about what needs to be done.

(BEGIN VIDEOTAPE)

HOLMES: Dr. Jim Wright joins me now. He's the medical director of Canterbury Rehabilitation and Health Care Center in Richmond, Virginia.

Doctor, it's great to get your input on this very important subject. You're the medical director of a nursing home where, when this started, there were 166 residents.

DR. JIM WRIGHT, MEDICAL DIRECTOR, CANTERBURY REHABILITATION AND HEALTH CARE CENTER: Right.

HOLMES: A hundred and thirty tested positive; 49 died. That is just terrible news.

But the thing is, it's similar to what is playing out in other places around the country and even the world.

Why isn't more being done on a state or federal level to address this? You would think with these kinds of numbers, it would be a major priority.

WRIGHT: Right. Well, it is. And we are meeting regularly with state and federal officials on how to address the ongoing problem.

When we were beset with our crisis, unfortunately, it was at the beginning, and little was known. And we had less resources than we do now. I think the state and federal agencies have really stepped up and have actually been very helpful and very willing to listen. HOLMES: Yes. I mean, you'd think you'd want to test everyone in a

nursing home in the country at the moment, and hopefully, that -- that sort of attention is going to be paid.

I wanted to ask you, because one of the things that strikes me in the coverage of this and COVID in general is, so often these deaths are reduced to numbers. I just reeled some of then, when of course, they are individuals. They have families and lives, and that is so sad, the dehumanizing aspect of this.

I know you formed close bonds with many residents. Tell us about having those relationships. And then you basically -- and you've written about this, having to see those people just die before your eyes.

WRIGHT: Well, it's been the worst experience of my professional life, that's for sure. I've been with this facility for 10 years, medical director for eight. And for many of the residents, I am their first and only primary care physician they've ever had.

Here in the United States, you have to pay to get into the healthcare system. If you can't pay, you really have no access to primary care. You go to the emergency room. So for many of my patients in this publicly-funded nursing home, they were too poor to access the American healthcare system. So I was their first trusted primary care physician.

And for 10 years, most of my patients have been -- you know, had been treated by me, had come to me with problems. I'd been able to address those problems.

And then, almost overnight, 49 of my patients died, rather suddenly. You know, they expected me to be able to help. I was able to do what I could, but certainly not cure this virus. All I was able to offer was good palliative care and comfort and sometimes handholding. But unfortunately, it was not enough. So it's been hard.

[00:35:25]

HOLMES: I'm so sorry. And I can't imagine, because again, these are people.

And you -- I mean, you said something that was interesting. You said, quote, "A publicly funded nursing home is a virus's dream."

I guess my question is, has this exposed issues and shortfalls that existed well before and need to be acted on, regardless of COVID and this awful death toll?

WRIGHT: Right, right.

HOLMES: That this should be a springboard for fundamental, systemic change?

WRIGHT: Exactly, Michael. I mean, I -- I've been in this business for 25 years, working with people in nursing homes. If you do this, if you're a CNA, a nurse, an administrator, you can't help but being angry and ashamed of how we treat our elders in the United States.

But something like this is something we all should be ashamed about, because we're all responsible. You know, the knee-jerk reaction, I think, to a lot of people is to look at nursing homes as the cause of problems like this and find them, punish them, sue them.

But when you think about it, we're really only in existence. We are providing the kind of care that our society determines is just and appropriate for our elders.

So we're chronically underfunded by Medicaid. We are existing in the most punitive environment that any industry exists in. And we are supposed to provide a high level of care to people who are frail, have multiple illnesses, and are -- are some of the most complicated patients in -- in medical history.

So we don't have the resources. We never have had the resources. And this did not have to happen. Had we simply devoted enough resources to our elders to give them a private room, for example. People could have been isolated much more easily.

HOLMES: Yes. It's shameful in many ways, and also staff who -- who are not as well-trained as they might be, and grossly underpaid, in many cases.

WRIGHT: Exactly.

HOLMES: Working multiple jobs. Very briefly, because we're almost out of time, I know that you have a vision of what an age facility should look like. We've only got a minute. Give us a synopsis, briefly. What should it be?

WRIGHT: Thank you for asking, Michael. My -- my group is called Homecoming Group. And we have a vision of a new type of community for elders that maximizes their free access to outdoor space, community reintegration, and recognizing the value of all life. No matter how old, no matter how cognitively impaired you are, we believe everyone deserves the same resources. And we're going to do it.

HOLMES: Well, good, and I hope -- I hope you are able to. It really is shameful what has happened in nursing homes in the U.S. And around the world. And as you say, some systemic change needs to be made.

I -- I appreciate you being with us, Doctor. Thank you so much.

WRIGHT: Thank you. Thank you so much for having me. I appreciate it.

HOLMES: Well, British doctors say they're having a tough time getting the personal protective equipment they need to take care of their coronavirus patients.

Doctors Association U.K. found 38 percent report they do not have proper eye protection. The same percentage say they don't have top quality face masks when they most need them. Six out of 10 say the masks they do where have not been tested to ensure that they fit properly. And 75 percent say they don't have the necessary long- sleeved gowns.

So, how are doctors their handling such a terrible crisis?

CNN's Nick Paton Walsh spent 48 hours with those fighting coronavirus in the U.K., where despite the lockdown, so many are dying each day.

(BEGIN VIDEOTAPE)

NICK PATON WALSH, CNN INTERNATIONAL CORRESPONDENT (voice-over): When, if ever, does it end? This vast hospital, it's in the U.K.'s second worst hot spot, the midlands, and has no easy answers.

So while London mends, here the living and the dying keep coming, and they fear the second wave may be near.

We look to numbers for comfort, but in this ICU, the odds are about even with COVID, doctors say. During the 24 hours we were here, two patients died and two got out of the ICU.

As the virus rages through our ordinary world outside, in here, its power is in the quiet it imposes.

[00:40:08]

(on camera): Standing here, you don't only see the ferocity of the disease, but the silence with which it kills and also the helplessness of the people suffering.

(voice-over): One doctor wore a body cam during the life-saving procedure of proning, turning a patient on their front to ease breathing.

UNIDENTIFIED MALE: We don't 100 percent understand why it works. Essentially, what it does is it changes the distribution of air within the chest, but also changes the way blood is distributed within the chest.

UNIDENTIFIED MALE: You keep going, yes? You're going to have some ice cream when that tube comes out.

UNIDENTIFIED MALE: If people pass away, it's more often because we've come to the conclusion that they're not going to survive, whatever we do, rather than them dying suddenly.

WALSH: The hardest for staff, that isolation means patients die here without their family nearby. Masked doctors and nurses are the last people they see alive.

DR. ROGER TOWNSEND, CONSULTANT, UNIVERSITY HOSPITAL COVENTRY: I've held a telephone to the ear of a gentleman who was dying so that his wife could speak to him. He was sedated, but we would always assume someone can hear you.

Even the nurses looking after the patient will sit and hold the hand as they pass away. So they're always with someone. When my colleagues confessed that they were scared, I confessed. I

said, I'm scared, too. Now this has gone on, I think the best we can do is wear the PPE, keep our fingers crossed that we don't get it.

Yes. So am I scared? No. Not scared like I was when I started.

NERISSA CIFRA MANALAD, NURSE, UNIVERSITY HOSPITAL COVENTRY: There's been really difficult shifts where I just cried in the shower. I cry in the shower. I cry at night. I'm going to cry again. It's just very -- it's just very -- I'm scared. I'm just scared. And I'm -- you know, I'm just basically like, when am I going to catch this? You know, because, you know, we're here. We're dealing with patients who are infected.

At this point, having all the PPE, you still don't know, isn't it? Even if you're -- if you go by the book, people still get infected. So it's just really -- I'm just so scared.

WALSH: This is not over, and it's not even clear if this is the beginning of the end or a lull before another wave.

TOWNSEND: We need to continue with the lockdown that we have to stop it spreading. So for the next six weeks, we're on standby.

WALSH (on camera): For another wave?

TOWNSEND: For another wave, yes.

WALSH (voice-over): Still, the sick come, worsening and improving.

Jacqueline, who delayed coming to hospital because she feared catching there the virus she already had, is improving.

UNIDENTIFIED FEMALE: They called the ambulance three times and I kept refusing to come in. I was scared to come in. Oh, my goodness. It's so tight. You've got somebody sitting on your chest. And you're trying to breathe, and you're not getting anywhere. It's -- it's really frightening.

WALSH: This hospital has had over 170 patients die from COVID. It now has about 170 who have it, or possibly have it. A toll leaving them both ready and cautious about a second wave in a pandemic so riddled with unknowns it leaves us certain only of how much we need each other.

Nick Paton Walsh, Coventry, the United Kingdom.

(END VIDEOTAPE)

HOLMES: It's hard to watch, isn't it?

Scientists in Britain are hopeful about new research that could go a long way to fighting the coronavirus pandemic. CNN's Bianca Nobilo with those details.

(BEGIN VIDEOTAPE) BIANCA NOBILO, CNN INTERNATIONAL CORRESPONDENT: Scientists at the

University of Oxford began human trials of a potential coronavirus vaccine Thursday.

(voice-over): This comes as the British government has warned that social distancing measures could stay in place until next year in the absence of an effective treatment or a vaccine being found.

A vaccine is key to the world's road back to normal life. The government has given an extra $25 million to Oxford University this week as the clock is ticking.

The experimental vaccine is made from a weaker version of a harmless virus that causes an infection in chimpanzees that's been engineered to carry part of the coronavirus.

Health Secretary Matt Hancock has praised the progress being made but cautioned that there are no guarantees.

MATT HANCOCK, U.K. HEALTH SECRETARY: In normal times, reaching this stage would take years. And I'm very proud of the work taken so far.

At the same time, we'll invest in manufacturing capability so that, if either of these vaccines safely works, then we can make it available for the British people as soon as humanly possible.

Nothing about this process is certain. Vaccine development is a process of trial and error, and trial again. That's the nature of how vaccines are developed.

NOBILO: Sarah Gilbert, professor of vaccinology at Oxford University, has told "The Times" newspaper that she's 80 percent confident that the vaccine will work.

[00:45:13]

SARAH GILBERT, PROFESSOR OF VACCINOLOGY, OXFORD UNIVERSITY: Personally, I'm very optimistic it's going to work. Formally, we are testing it in an efficacy setting, and we have to find out if it works. There's absolutely no suggestion that we're going to start using this vaccine in a wider population before it demonstrated that it actually works.

NOBILO (on camera): Participants in the study are hopeful that it could bring an end to the crippling outbreak.

UNIDENTIFIED FEMALE: I'm so excited that it's finally happening. Yes. And I didn't feel anything, so this is nothing. It's really cool.

UNIDENTIFIED MALE: I think you can never fully exclude any sort of potential risk. But I think you have to, I guess, walk in faith in these things.

NOBILO: If successful, it's hoped that about a million doses could be ready by September. That's why there's already a big push to get manufacturing capacity up, as Oxford University has warned that producing large doses of a vaccine could present a big technical hurdle.

Bianca Nobilo, CNN, outside London.

(END VIDEOTAPE)

HOLMES: (AUDIO GAP) across the globe, and this year, activists marking the Muslim holy month is much subdued. Some of Islam's holiest sites -- Mecca, Medina, and Jerusalem's al-Aqsa Mosque -- will be empty because of coronavirus restrictions.

Sam Kiley with more on how the new normal is affecting this year's observance.

(BEGIN VIDEOTAPE)

SAM KILEY, CNN CORRESPONDENT (voice-over): Lanterns for sale in Cairo, traditional decorations to mark the month-long fast of Ramadan. Spiritual reflection in the time of corona, inevitable.

And the tradition of nighttime feasting and celebration is now tarnished by social isolation and a ban on collective prayer.

He says, "(UNINTELLIGIBLE) prayers, they're what one misses the most. People wait for it year after year in the gatherings. But now, most people are afraid of visiting each other. You don't know what people's circumstances are.

Across the Islamic world of 1.9 billion souls, Pakistan is an outlier, defying advice to close mosques to prevent contamination. Its prime minister refusing to ban congregations.

"Ramadan is a time of prayer. The nation wants to go to the mosques. It's a time of prayer when people want to move closer to God, and they have made up their minds to pray," the prime minister said.

KILEY: In the United Arab Emirates, a nationwide lockdown has shuttered mosques for weeks. The murmur of prayer, silenced for now.

Lonely Ramadan decorations try to lift spirits on near deserted streets.

On most Ramadan nights, Salem's home would be filled with guests to break their fast at Iftar. Not this year.

SALEM AL-MENHALI, ABU DHABI RESIDENT: Iftar will not be big like the previous years. It will be very little, including our presents, family, which is sitting at home until this COVID-19 is over.

KILEY (on camera): Are the children complaining about that?

AL-MENHALI: They are a little bit bored, but they understand.

KILEY (voice-over): From Baghdad to Beirut, Ramadan shopping is tinged with anxiety. Lockdown has led to an increase in poverty. He says the stuff you're buying, you're searching for cheaper things to buy at a lower price. And overall, it's harder than ever to be able to put the same food

during Ramadan on the table. It's harder.

But across the Islamic world, religious authorities have vowed to help out. A glimmer of hope at this special but now difficult time of year.

Sam Kiley, CNN, Abu Dhabi.

(END VIDEOTAPE)

HOLMES: Time for a short break here on the program. When we come back, Spanish students teaming up with firefighters to ease the pain in Madrid. How their special deliveries are helping families make ends meet. We'll be right back.

(COMMERCIAL BREAK)

[00:51:12]

HOLMES: When the coronavirus pandemic hit Spain, the country's economy was still struggling to recover from the 2008 financial crisis. Well, now lockdowns have worsened the situation, of course, for many, leaving some unsure of their next meal.

One group of hospitality students are trying to keep hunger at bay. CNN's Scott McLean reports.

(BEGIN VIDEOTAPE)

SCOTT MCLEAN, CNN INTERNATIONAL CORRESPONDENT (voice-over): Inside this kitchen, volunteers are preparing food for Madrid's most needy. The funding comes from World Central Kitchen, a charity started by celebrity chef Jose Andres, better known for its work in the aftermaths of floods, fires and hurricanes.

"This is the closest we've lived to a natural disaster. A fractured economy, the consequence is the same," he says.

The meals are delivered by the Madrid fire department, used to responding to disasters, just not the kind that Spain is facing right now.

The coronavirus crisis that's killed well over 21,000 people in Spain has also torched a huge swath of the national economy. For many families, it's reduced their income down to zero.

Loaded up with food, the Bomberos go out to deliver. Five weeks into the lockdown, the firefighters have gotten familiar with the people they serve, many who, until now, had been unfamiliar with the inside of a food bank.

Daisy Ribeiro (ph) lives with her autistic son and works full-time at a daycare center. She's been out of work for almost six weeks now.

"He doesn't understand why we can't leave. I tell him, son, at least we have food now," she says. The last financial crisis sent Spain into a long, painful recession.

Twelve years later, before COVID-19, it was still finding its economic feet, still struggling with 13 percent unemployment and one of the highest debt burdens in Europe.

Elizabeth Sanchez is a mother of two with a third on the way. Her husband, who works in construction, has been forced to stay home since the lockdown began.

"It was already difficult before. Now, it's even tougher. I pray to the Lord this ends soon," she says.

So far, her prayers have gone unanswered. While Prime Minister Pedro Sanchez has promised the largest stimulus package in Spanish history, he's also promised to extend the lockdown for at least another two weeks.

Scott McLean, CNN, Madrid.

(END VIDEOTAPE)

HOLMES: And to find out how you can help others and how you can get help during this coronavirus pandemic, do log on to CNN.com/impact. Plenty of resources there for you.

And CNN NEWSROOM will be right back.

(COMMERCIAL BREAK)

[00:55:27]

HOLMES: Well, you know that old saying, money doesn't grow on trees. Well, what about walls? CNN's Jeanne Moos explains.

(BEGIN VIDEOTAPE)

JEANNE MOOS, CNN CORRESPONDENT (voice-over): Laid-off workers are getting a little something to line their pockets, thanks to money they used to line the walls.

UNIDENTIFIED FEMALE: Taking dollars down!

MOOS: Dollars plastered with messages and then slapped on the walls of places like The Sand Bar in Georgia, Hot Leggz in Fort Lauderdale, and Hamburger Joe's in North Myrtle Beach, where the slogan is "Bite my buns."

When coronavirus took a bite out of business, owners raised the bar.

UNIDENTIFIED FEMALE: We literally had money on the walls and time on our hands.

MOOS: So they put their hands to work, prying off all that cash to give to laid-off employees. It took the establishments anywhere from a few days to a couple of weeks to take down the bills. RICHARD BROOKS, GENERAL MANAGER, HAMBURGER JOE'S: Some of the money is

in not the best condition. And some of it had been up for 30 years of hamburger grease and dust and good memories.

MOOS: But it was good money, around $6,000 at Hamburger Joe's.

KY NOVAK, CO-OWNER, HOT LEGGZ: When you tear them off, you've got to tape them back together. You've got to keep serial numbers together.

MOOS: Hot Leggz retrieved as much as 10,000 bucks to take to the bank.

NOVAK: I don't think the bank likes dealing with us. We've had bills that had over 20 staples in them.

MOOS: At the Sand Bar, they peeled off over $3,700. Then an anonymous donor doubled it. One bartender said she was OK financially and gave her 600 bucks to this bartender --

UNIDENTIFIED FEMALE: What?

MOOS: -- who works elsewhere.

UNIDENTIFIED FEMALE: Oh, my God. That will pay my rent.

MOOS: The mermaid once surrounded by bills is looking a little lonely without them. At Hot Leggz, the co-owner says --

NOVAK: The bar looks too clean right now.

MOOS: -- he'll be happy when customers start attaching money again.

(on camera): Everybody knows money doesn't grow on trees.

(voice-over): Money grows on archways and ceilings and corners. It sprouts from the rafters.

Jeanne Moos, CNN --

UNIDENTIFIED FEMALE: Dollar, dollar bills, yo.

MOOS: -- New York.

(END VIDEOTAPE)

HOLMES: Thanks for watching. I'm Michael Holmes. The CNN global town hall is up next.

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END