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Antibody Testing Ramping Up?; Some States Start Reopening. Aired 3-3:30p ET

Aired April 27, 2020 - 15:00   ET



KATE BOLDUAN, CNN HOST: Hello, everyone. I'm Kate Bolduan. Thank you so much for joining me today.

Steps to reopening are happening now, but are they reopening too soon? They say they are ready, but are they? These are the big questions today. And it seems each state is being left to answer them in their own way.

Governors across the country are outlining paths to reopening portions of their states. Today, more than a dozen states are allowing some form of business to restart, some retail, some restaurants, even some movie theaters.

But as the nationwide death toll now is past 55,000 and the number of confirmed cases is beginning to approach one million, are these states moving too fast and putting their neighbors at risk?

Here's why we ask that. Some health experts are warning still today states shouldn't consider loosening restrictions until testing is far more widespread and the ability to trace who the infected have been in contact with has been ramped up. And neither of those markers have been met anywhere.

And the White House seemed to acknowledge that just this morning.


PETER NAVARRO, DIRECTOR, WHITE HOUSE OFFICE OF TRADE AND MANUFACTURING POLICY: We will be able to ramp up rapidly in the testing, just as we did in ventilators. So we shouldn't get fixated on where we are now.

We should look to where the puck is going to be. And good things are going to happen on that as well.


BOLDUAN: So where does that leave millions of Americans, though, where the governors are starting to green-light reopening?

Let's start there. CNN's Martin Savidge, he's out -- he's in a restaurant in Atlanta, Georgia. It's the state with the most aggressive plan to reopen so far.

So, Martin, what are you seeing there?

MARTIN SAVIDGE, CNN CORRESPONDENT: Well, this is phase two. And phase two is really perhaps the riskiest, at least in the minds of medical professionals, and even some of those who run the businesses.

What I'm talking about is restaurants now being allowed to have customers dine in. It's been slow. In fact, it's been really slow. What is clear is that a lot of people are accustomed to dining or carrying out, and they seem to like that system.

Dining in, even though they can do it today, we hardly saw anybody who really took advantage of it.

Let's just refresh what businesses are open in the state of Georgia right now. It's, of course, restaurants. They have been doing carry- out, but the dine-in is new. Theaters -- movie theaters, we're talking about here -- and private social clubs.

As far as the restaurants, there are 39 guidelines they must adhere to that were outlined by the state of Georgia. And just to give you some of them, employees, of course, have to be screened for fever, for cough. They also have to implement staggered shifts, increased handwashing, use of hand sanitizers.

Employees have to wear a face mask. And then you won't be having a salad bar, there won't be any buffets, and you can't have customers sort of lingering in a waiting area. And, no, they're not going to be hanging out at the bar.

We talked to the manager of this place here. And he said, hey, it's day one.


BRIAN MANCUSO, MOE'S ORIGINAL BBQ: We didn't feel like there were going to be people lined up, beating down the door to get in here. We have had some good dining customers today. It's day one. And we're off to a good start.

My expectations for today were not very, very high in terms of numbers. I'm encouraged that we have had a couple people come in and sit down and enjoy their meal and say thank you and leave.


SAVIDGE: Kate, this was kind of a psychological starting point. And that's about all it really was.

What's clear is that you have a number of restaurants that are willing to open, but a majority of customers are not quite ready to dine in -- Kate. BOLDUAN: Great point. And that speaks to kind of that conversation that's been going on all along, which is, the president might want to try to reopen the economy, governors might want to try to reopen the economy

The only people who really going to reopen the economy are going to be customers, people, you, me and everyone, when they decide they're ready and comfortable enough to do it.

SAVIDGE: Exactly.

BOLDUAN: Thanks, Martin. Appreciate it.

So, in Washington, President Trump, he just wrapped up a meeting with governors from across the country. And the White House also just announced that the president will be holding a press conference in just a couple hours, not the typical task force briefing, if you will.

The White House says that he -- the president has new guidance on testing and also on opening up the economy that he might be laying out.

CNN's Kaitlan Collins joins me now with much more in this.

Kaitlan, what are you hearing about what the president could be announcing?

KAITLAN COLLINS, CNN WHITE HOUSE CORRESPONDENT: Well, Kate, it's not entirely clear, because we have really been back and forth all day on whether or not we're actually going to hear from the president in a press conference-type -- style setting.

Initially, they had it on his schedule this morning. Then they canceled it, citing that they weren't going to be doing that today, but they may be doing briefings like that later on in the week.


And then, of course, just a few hours later, the press secretary announced that there actually would be a news conference today, in which she said the president is going to make some announcements on testing and other factors, though we're still waiting to see what that is.

We do know that he did have a call with governors today. He had several other meetings as well.

And we know, behind the scenes, they have been working on guidance that they could issue for certain businesses on opening up, so there's not just this discombobulated move happening throughout the United States, as you're seeing stores open up, because they have got -- they believe that the executives and people who work at companies like child care centers, churches, other places like that need more guidance on what it's going to look like when they are reopening and when people do start feeling comfortable going back to restaurants, going back to churches and things of that nature. So that's what we're potentially expecting. That could be happening

today, though, of course, Kate, it's really anyone's guess right now, because it hasn't been totally clear on the guidance on what that's going to look like, given the fact that we have not heard the president take questions since Thursday, that briefing which, of course, where the president went off-script.

He made those suggestions about household disinfectants and potential ways to treat coronavirus. And, of course, we have not seen him at a press briefing since then. Well, he did appear on Friday, I should say, but he did not take questions from reporters that day.

BOLDUAN: All right. Well, more to come. Kaitlan, thank you so much.

All right, so later this hour, we are expecting to hear the reopening plans for another state Texas. Governor Greg Abbott, he's said that he will be laying out the next steps for really a wide range of businesses, like restaurants, hair salons and retailers.

This as the state is still reporting more new cases than the day before, as you can see.

So, what is reopening going to look like in the nation's second largest state by population?

Joining me right now is one of the experts who has been advising governor Abbott on this, Mark McClellan. He's former FDA commissioner under George W. Bush,

Doctor, it's good to have you here. Thank you so much.


BOLDUAN: What has been or is your advice for a state like Texas and the governor there? I mean, what the markers that should be met before opening up businesses like restaurants?

MCCLELLAN: Well, Kate, it is all about protecting the public while getting back to more economic activity. And it is going to be a new normal, and it's a new normal that we should get to gradually, just as you were describing.

For a state like Texas, it's very important to make sure that the health care system is secure, can not only handle a surgeon cases, but it can help people get the care that they need that many of have been deferring in recent weeks during these extreme distancing measures, also that businesses have very clear guidelines in place.

It's not going to be normal businesses, with much more distancing, like people are used to with grocery stores, seeing that on a more widespread basis, and having the capacity to test for the presence of the virus and then trace the contacts of people who are positive quickly.

I have one more piece on top of all this, and that's that special level of attention to people who are at higher risk of complications from COVID-19, so older Americans and people with chronic diseases. They need some extra help in protecting nursing homes and assisted living facilities in the like. And they need to take some extra precautions even as this -- these reopening steps are going on.

BOLDUAN: Absolutely.

I mean, can you give us a window into the conversations, as you have advised the governor and his team, of what his response has been to kind of your advice on what the new normal will look like?

MCCLELLAN: Well, Texas has taken a very comprehensive approach.

The state has set up advisory groups, including businesses, including experts on logistics, including health care advisers, really trying to represent all parts of the state that will have important things to do as reopening occurs.

And I think that kind of intensive look is a very good preparation. The conversations that I have had with the governor have focused on what the important public health considerations are, so making sure the state is thinking about all of these dimensions that I just described.

In the end, the governor has got to make a very challenging call between the cost and health harms of keeping the economy closed down tightly vs. the costs and health harms of opening back up.

And the way to balance that, I think, is to do as intensive work as possible on both sides, strengthening businesses, helping prepare for detecting and containing any new outbreaks on the one hand, and taking extra steps to help keep people safe who are especially at high risk from COVID-19 complications.

So I think, from my conversations with the governor, he's trying to do all of that. But it is a tough set of decisions to make.

BOLDUAN: And one that a lot of governors are making and making different -- reaching different conclusions with similar sets of data, right?

Because one key marker that a lot of folks are pointing to is the prevalence and the existence of testing. According to the COVID Tracking Project, the state, Texas' highest daily tally of tests has been just over 20,000 -- just over 20,000.


So do you think that is enough for the state to be able to handle -- to have a handle on tracing, tracking and containing the virus, if they see a spike once again once they start opening up? Is that enough?

MCCLELLAN: Kate, extrapolated to the nation -- remember, Texas is about 10 percent of the percent of the U.S. population -- that corresponds to something like close to a couple million tests per week, which is in line with some of the reports that are out there. I think it would be better for Texas to increase capacity. And I

think, as part of the plan that the state is announcing today, they have a plan to get to much higher levels of test capacity, and, again, not only the test, but having the ability to follow up quickly if there is a positive test.

So that means getting in place literally hundreds, if not thousands of contact tracers, so if someone does test positive, there's a quick ability to find out who they have been in close contact with and quarantine and test those individuals as well.

That's going to be really important for the next phase of containment in this pandemic.

BOLDUAN: Right. And, honestly, there's been really no evidence to date that any state is really ready in terms of having enough contact tracers on hand to be able to handle it.

I mean, and this is -- all in a perfect world would be in place before anyone would open anything up. I mean, just looking to the immediate future have a couple hours from now, the president is expected to announce something with regard to nationwide testing or -- and also how to -- maybe guidelines on safely opening states up.

What do you hope you hear from the federal government in terms of that?

MCCLELLAN: Kate, I think further steps to support increase test availability, increase federal support for the contact tracing.

Again, it's not just the testing, but what you do with that quickly. I think the federal government can play some important roles in helping states do this right, giving them technical assistance, giving them funding. We have made some recommendations on that through a program at Duke and with other collaborators around the country.

And I also hope that additional guidance to states will be forthcoming. As I mentioned, Texas has gone through a lot of work with all sectors of business to develop its very specific guidelines for a very limited reopening.

And I think the more that we can make this a gradual, slow process, one where we're checking it every step to make sure that outbreaks are not happening, even though the virus is still out there, and it's going to be with us for months to come -- yes, we're not living in a perfect world where we have got all this under control.

But these kinds of steps can help contain the virus going forward and also help people get back to work, meet their health care needs, and avoid some of the other very serious consequences of this pandemic.


Doctor, thanks for coming on. Really appreciate your perspective.

MCCLELLAN: Thank you. BOLDUAN: Coming up for us, could a popular heartburn drug help treat


Details on a new clinical trial coming up next.

Plus, as states invest heavily in testing for coronavirus antibodies, the World Health Organization has a new warning that those tests may not give the definitive answers that many are hoping for.

We will be back.



BOLDUAN: As the world is waiting for a treatment to the -- for the coronavirus, and scientists across the globe are searching for that very treatment, now a common over-the-counter medicine is being tested as a possible treatment.

In New York hospitals, they're testing the active ingredient in the heartburn drug commonly known as Pepcid.

CNN senior medical correspondent Elizabeth Cohen, she's joining me now. She's been looking into this.

This is fascinating, Elizabeth. What are you hearing about this?


Let's take a look at the -- some of the specifics of this trial. They're looking for 1,200 patients. This is now being done at Northwell Health, a large hospital chain in New York. About half of them are getting famotidine, which is the active ingredient in Pepcid. And half of them are not.

And they're expecting preliminary results in the next few weeks. And, Kate, it's interesting. They decided to do this because, one, there's some theoretical reasons, sort of molecular reasons why this might help.

And, also, a doctor in China started noticing that patients taking this drug seemed to have better survival rates. But, really, we're just not sure if this is going to work or not. Don't run out and buy heartburn medicine. The patients in the study are getting mega-doses, I.V. They are not taking tablets.

BOLDUAN: Yes, that is probably the most necessary consumer information at this moment. This isn't just going out and taking over the counter. These were high, high, high doses of Pepcid, of that active ingredient.

But there's another treatment I want to ask you about that's been being tested and been talked about quite a bit. It's remdesivir. This is an antiviral. And this morning, NIH said that preliminary results could be coming pretty soon?

COHEN: Right.

A doctor at the University of Nebraska who's involved in this trial said that there could be results in a week or two. This will be long anticipated. Kate, you and I have both been on the remdesivir roller coaster.

It was looking good. It wasn't looking good. The bottom line is that we need to see the results of the clinical trials, not what a doctor said or that doctor or this got posted online. We need to see the actual results, and that's what we're hoping to see soon.

BOLDUAN: And, again, preliminary results is not final conclusions, of course, as always.

But, at this point in this search quest and game, it's -- any preliminary anything is worth looking into.

COHEN: Right.


BOLDUAN: Thanks. Great to see you, Elizabeth. Thank you.

COHEN: Thanks.

BOLDUAN: So, that's the search for the treatment of the virus , right?

Another major part in all of this, as many have said over and over, is testing. In New York and Massachusetts, officials have announced that they are ramping up antibody testing in a big way. Starting tomorrow in Georgia, public health teams will be going door to door in two metro Atlanta counties conducting random antibody testing.

It sounds really significant. But this also comes -- and I guess this is adding to the complexity. This comes as the World Health Organization warned just this weekend that there's no evidence that people who have had COVID-19, that they will not get it a second time.

So, what does this mean then for testing and for everyone's understanding of when you can be safe from the virus?

Joining me right now is Dr. Mary Hayden. She's chief of Infectious Diseases Division at Rush University's medical school.

Doctor, thank you so much for joining us.

I want to get your reaction first to what the WHO is saying here, which is, essentially, that the existence of antibodies in someone does not mean immunity. What are your thoughts on this?

DR. MARY HAYDEN, RUSH MEDICAL COLLEGE: Yes. So, it's a complex question. My interpretation of the WHO statements

are as follows. So, we -- the evidence so far is that individuals who recover from COVID-19 usually have antibodies detectable in their blood, say, approximately 14 days or so after diagnosis.

We also expect, from information that we have about other coronavirus infections, that people who recover from COVID-19 will have some degree of -- at least some degree of protection from future infection.

What we don't know is how well the antibodies that are detected correlate with any sort of protection. Right now, we just don't have the information. And especially we don't know how well the antibody tests that are being sold in the United States, how well they correlate with any sort of protective immunity.

Those tests were produced very rapidly. Most have not undergone any sort of scrutiny or review by the FDA, which is usually the way that tests enter the market for diagnosis. And so there's just a lot of uncertainty right now.

And so I think the statement of the WHO just wants to be very conservative. If you have an antibody test that shows that you have an antibody to coronavirus, to COVID-19, you should not expect that you will be protected necessarily from infection. And you should take the usual sorts of precautions that we're recommending for everybody, social distancing, hand hygiene, et cetera.

BOLDUAN: And if there's so much that is still not known about what the presence of antibodies really means, do you think antibody testing is not worthwhile at this point?

HAYDEN: Well, I think it is worthwhile.

I think, in particular, the sorts of surveillance that you were describing is very valuable on a population level. So it gives us information, at least relative information. Assuming that the tests that are used are accurate, it gives us information about the proportion of a population who were infected.

It can give us information about groups that are particularly at high risk, so that we can potentially intervene in those groups and reduce their risk.

It gives us information that we can use to predict the course of the pandemic over time. So, it's very useful right now, I think, on a population level, but I don't see how it can be -- it's particularly useful today for guiding behavior of an individual.


And I think that maybe is where I want to leave it with you. I mean, for people who have had an antibody test, and it comes back positive in the realm of you have antibodies, should they be changing their behavior in any way?

I will say, a week ago, it almost -- it seemed like yes. But now it sounds like no.

HAYDEN: Yes, I would say today, I do not recommend that anybody changes their behavior.

I think we all have to remember that, four months ago, we didn't even know that this virus existed. We have learned a tremendous amount since then. But there's a lot we still don't know. We're learning more every day.

We may know in another month or in another two months the -- how protective the antibodies that are detected are. But, right now, we just don't know. And I think it's just safest to continue those safety precautions, even if you're -- even if you have evidence that you have antibodies in your blood.

BOLDUAN: Fascinating and, honestly, so important to hear that message today, I must say, with so much talk about all the different types of testing out there now, between antibody testing, diagnostic testing, and now -- and then antigen test.


Doctor, thank you very much.

HAYDEN: Thank you.

BOLDUAN: Coming up for us: Governors are calling the shots about when to restart the economies in their states, leaving mayors to interpret those orders.

I'm going to talk with two city leaders in two different states who both have big concerns about how their states are opening up -- next.