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When Will Country Have Enough Testing?; Problems With Small Business Loan Program?; Interview With National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci. Aired 4:30-5p ET

Aired April 28, 2020 - 16:30   ET



JAKE TAPPER, CNN HOST: Welcome back.

The U.S. now has a million confirmed coronavirus cases, with the death toll in the United States approaching 60,000, this as the White House says the federal government will begin to ramp up efforts to help states take charge of testing, allowing for a testing of a minimum of 2 percent of the state's population every month.

Joining me now, Dr. Anthony Fauci. He's director of the National Institute of Allergy and Infectious Diseases. He's a critical member of the White House task force.

Dr. Fauci, thanks for joining us, as always.

So, let's talk about this. The federal government is helping states and six to eight million tests a month. I believe you would like that number to be closer to 12 million tests a month, right?


Well, what we're doing right now, it's very clear from the guidelines that came out, the blueprint for testing, clearly indicates something that we really have to do. There has to be a partnership between the federal government and the states, that the federal government has to -- has to provide strategic guidance, as well as technical assistance.

We had a phone call with the governors where that was explained, that, I mean, obviously, when you say you put tests out there, Jake, one of the problems has been is the test getting to the people who need them, or are the tests out there, and we're not connecting the dots?

And what we're trying to do -- and I believe that was pretty -- pretty well-articulated to the governors -- was, if that's not happening, if we're not connecting those dots, we need to help them to do that. We can't just leave them on their own on the one hand, and the federal government can't do it by itself on the other hand.

So, we really -- we have really got to be having a productive partnership. And I believe that most of the governors have resonated with that. We haven't gotten it perfect yet, for sure. I mean, we know that.

I mean, obviously, you call around, and a lot of people feel OK about what's going on, but others still need to connect those dots. And that's what we're working on.

The issue about tests is that, as we get into the next weeks to several weeks to a month, as we get into May and June, from what we're hearing, and I'm telling you, Jake, what we're hearing, from the people in the task force who deal directly with the companies, namely, the major firms that make the tests -- this is predominantly Admiral Brett Giroir is telling us that we will have a very, very increased production, so that, by the time we get to those months, we should have what we need.

But I'm always the skeptic in the group. And I always say, OK, I hear you...

TAPPER: Right.

FAUCI: ... I believe you, but let's see what happens. Let's see what happens.

TAPPER: And as -- and, as you know -- and you and I have talked about this -- the issue is, it's more than just the tests themselves. It's also about the testing supplies, the swabs, the reagents that hold the sample, the lab employees, the lab equipment.

I want you to take a listen to these governors, reflecting both Democrats and Republicans.


GOV. CHARLIE BAKER (R-MA): Broad antibody testing needs the federal government, and especially the FDA, to step up and give states and providers a lot more guidance than we have now.

GOV. NED LAMONT (D-CT): We keep asking for masks. We keep asking for gowns. We keep asking for the reagents. And I'm tired of asking.


TAPPER: So, that was Charlie Baker from Massachusetts, a Republican, and Ned Lamont from Connecticut, a Democrat.

They're begging for federal help because they say, governors in general say, they don't have the ability, unlike President Trump, to force companies...

FAUCI: Right.

TAPPER: ... to manufacture reagents or PPE or more.

What do you say to them?

FAUCI: No, I mean, listen, when people like that, who, in good faith, are calling out for help, I tend to believe them and resonate with them.

So the thing we have to do, Jake, we have to help them. And, you know, at the last meeting, when we did speak to the governors, what -- what Admiral Giroir had in front of him was literally a flow sheet of all the different states, the tests they have, the tests they need.

And the point was made to them that if, in fact, you still don't have either the tests or the material to do it, we will call you up, and we will try and connect you with the pathway to get that. So there's going to be more of a reaching out.

And the fact that we have to do that means that what you're hearing is true in some respects. It isn't perfect yet, by any means. But, as every day and week goes by, and we have more tests, and we try to get the people who are making these other materials, these swabs, these extraction material, these media, I mean, obviously, if they don't have it, we have to get it to them.


But I believe, Jake, that we are going strongly in the right direction.

I think what gets confused is that, when they say that, when you hear Admiral Giroir talk about the numbers of tests that are out there, that the people who don't have them say, wait a minute, what's going on, and what's the truth there?

The truth is that we're going in the right direction, but we need to continue to partner in a very active, collaborative way with the states. We need to help them, the same way they need to do the execution. And we're going to get there, but it's -- as I have said before -- and, every time I do, it gets taken a little bit out of context, not by you, but by some -- that say, it isn't perfect, and we're not there yet.

And we're not. But we're going to get there. We're going to get there soon, I hope.

TAPPER: When do you think? I mean, when will it all be up to speed? When will everybody who needs to get a test be able to get one?

FAUCI: Yes, and I like the word you used, Jake, when you said need, because, a lot of times, people say, I want a test...

TAPPER: Right.

FAUCI: ... and it's not part of the strategic approach.

But needing is important. Everyone who needs a test, according to the way we're approaching the identification, isolation, contact tracing, keeping the country safe and healthy, that, hopefully, we should see that as we get towards the end of May, the beginning of June.

Jake, that's what I'm being told by the people who are responsible for the testing. I take them for their word. If that doesn't happen, I'm going to go to them and say, what happened

here? Why didn't it happen? And how can we fix it?

TAPPER: It seems like there's so much about this virus that we don't know.

And, in fact, the CDC just added a whole bunch of new symptoms to the description. We're also seeing, I think, some accounts of young people.

First of all, we're hearing doctors share stories of increased blood clotting in patients, especially young people, more prone to strokes, neurological impairment.

Tell us about the uncovering, the discovery, the mystery of this coronavirus...


TAPPER: ... and when we're going to know enough about it to be able to solve and come up with a vaccine.

FAUCI: You know, that's a great question, Jake.

And as you were describing that, it was reminding me of the early years of HIV/AIDS, when we were trying to figure out what I would call -- in fact, that's the name of my group. The pathogenic -- immunopathogenic section in my laboratory is trying to look at what the pathogenesis -- and that's a big word, to mean, how does the virus do its damage, and what are the primary and secondary effects of infection?

And it took us a while to delineate that completely in HIV/AIDS. And we're having the same experiency now. We're seeing things that weren't quite noticed in the big chaos of the explosion of cases, first in China, then Europe, and now in the United States.

But now we're starting to see things that, on the one hand, are puzzling, but, on the other hand, are enlightening. And I say they're enlightening because they can inform us and open up maybe more modalities of treatment.

So, there are two major buckets of treatment. You directly treat the virus by an antiviral agent, by an antibody, by whatever it is that you put in there to block the virus. But then the virus triggers things in the body that, as we see more of it now, we say, wait a minute, maybe there's another avenue of treatment of being able to block the secondary, often deadly effects of the virus.

And one of them, you mentioned quite clearly. When you look at autopsies now, we're seeing things that we didn't expect. We thought it was all primary viral pneumonia, because people would have ground- glass appearance in their chest X-ray, which is indicative of a diffuse involvement of the lung.

Then, when you look at what's in there, they're a thing called microthrombi, which means platelets aggregate and thromboses form. When that happens, the diffusion of oxygen back and forth to the blood doesn't work.

And that may be why people who are in that situation seem to be doing well and then, all of a sudden, they rapidly and dramatically deteriorate.

You know, as a physician who's taken care of acutely ill patients for a good proportion of my career, when you see somebody sitting around looking well, and immediately drops, that's probably a cardiac arrest.

But if someone deteriorates very, very rapidly, there are only a couple of things that can do that. One of them is, you're bleeding out. The other one is, you're having thrombi, or blocking of blood vessels. And that's one thing that I think we really need to pursue.


The reason I say that, Jake, is because there's treatment for that that's above and beyond the treatment of just antiviral. And, right now, together with the National Heart, Lung, and Blood Institute, the Neurological Institute at the NIH, we're putting together protocols, and others -- we're not the only ones that are doing it -- to determine if that's the cause of the deterioration, in addition to the virus.

We got to aim at two goals. We got to block the virus, but we got to do something about those secondary effects. And these are the things that are emerging right now that are both fascinating and informative.

So, we have a lot to learn, but it's opening up the door, I believe, to some interventions that might be helpful.

TAPPER: That's fascinating.

Dr. Fauci, as always, thank you so much for your time. We hope to have you on again soon. It's always an -- always an honor. Thank you so much.

FAUCI: It's always a pleasure to be with you, Jake.

Thank you.

TAPPER: Back with me now is CNN chief medical correspondent Dr. Sanjay Gupta.

Sanjay, I want to get reaction to what Dr. Fauci just said. First of all, very interesting riff he had there at the end about this -- the mystery that they're uncovering when it comes to this virus and why it is it's not just about the lungs. It's also about microthrombi, I think he referred to them.

Explain to people what they just heard and why that's significant.

DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: I think the significant thing was that we think of a respiratory virus like this as something that primarily is going to affect the lungs, primarily cause a pneumonia.

And that's what the expectation was, I think, for a lot of doctors, understandably, respiratory therapists who were trying to treat these patients.

Different things started to emerge. I remember one of the first clues was people were losing their sense of smell as a first symptom. And a lot of people thought, well, why would that be? Why would a respiratory virus cause that?

What Dr. Fauci was just talking about -- and there was a few reports on this, this week -- that it seems to also, as a first symptom, again, cause people to have increased blood clots, blood clots that may form in their legs and go to their lungs -- it's called a pulmonary embolism -- go from elsewhere in their body to their carotid arteries, their brain, causing strokes as a first symptom.

It almost reminds me -- I was writing about this last night, Jake -- that -- like what we first called the car. People first called it the horseless carriage, right, because everything was done in the context of horses still.

It's almost like this virus, we're trying to put it in a box, a respiratory virus box. And we're learning every day that this virus is behaving unlike a lot of other viruses.

So, it is a coronavirus. It is a respiratory virus in terms of how it spreads, but how it behaves in the body, it may not even be the lungs that it first effects. It could be the blood. It could be the clotting mechanism. It could be these other organs.

So I think that that's what Dr. Fauci was talking about. And he said that there's a lot that we still have to figure out. Why are young people -- mostly, it's rare, rare for young people to get very sick and die. But it happens. Why? What's happening in their bodies that's different in some ways?

So, I think that's what he was referring to, Jake.

TAPPER: It was very interesting.

He also acknowledged that testing isn't where it needs to be in this country, which, of course, is obvious. He thinks that we, as a country, are going to be able to get to a place where everybody who needs a test, not the same thing as everybody who wants a test, but everybody who needs a test will be ramped up, and he hopes, by the end of May, early June.

What do you make of that?

GUPTA: I think a lot of people are going to need a test.

I mean, I mean, I'm not sure the need/want sort of differentiation ends up being that critical here, because, in order to do the -- there's people who don't know if they need to test or want a test, but they're going to have to have a test if they're going to go back to out in public places where they are not going to be able to physically distance and have the confidence to do that.

I mean, there was a report that just came out, another one, from the Harvard School of Public Health, that is now saying that we may need by June to be at five million tests a day, and that, by the end of summer, or mid the end of summer, we may need to be at 20 million tests a day.

If you look carefully at the White House plan in terms of what they were saying, they were saying that they're sort of looking at 2 percent -- I'm sorry -- yes, 2 percent of the country being tested a month.

So that's roughly six to seven million tests a month, whereas you're hearing we may need to be at 20 million a day by the end of summer.

So, I mean, yes, Dr. Fauci is right. We have certainly improved. And I think a lot of people are focused on the absolute numbers here. But the reason the Harvard School of Public Health and others have said we need to be testing at that level is to basically get an idea of just how many people out there are infected, and to start to get an idea of what sorts of industries, businesses can be reopened.


We're not anywhere near that right now, Jake, in most places.


The admiral in the Coronavirus Task Force, Admiral Giroir, talked about how they don't agree with that Harvard study, not surprisingly.

Dr. Sanjay Gupta, thank you so much.

And be sure to tune in to CNN this Thursday for a CNN town hall with Dr. Sanjay Gupta and Bill Gates, who has been talking about pandemics for years now. It's at 8:00 p.m. Eastern on Thursday.

Coming up: One researcher says it's a disgrace the government is prioritizing larger labs to test for coronavirus, as opposed to hospitals, medical centers and smaller ones.

Up next, a CNN investigation -- why many hospitals and doctor's offices say they're getting shortchanged on testing supplies.

Stay with us.



TAPPER: President Trump says he's confident the United States has enough testing to reopen the country.

But a new CNN investigation finds that not only is there a critical shortage of testing supplies at smaller labs, hospitals and states across the country, but many of the supplies that do exist are being handed over to big commercial laboratories before going to hospitals, clinics and small labs.

And, as CNN's Drew Griffin reports for us now, now hospital groups and medical associations are begging the White House task force for help.


DREW GRIFFIN, CNN INVESTIGATIVE CORRESPONDENT (voice-over): What the president says that his briefings...

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: Confident that we have enough testing to begin reopening and the reopening process.

GRIFFIN: ... is not the reality at labs across the country.


GRIFFIN: A CNN investigation finds a critical shortage of COVID-19 testing supplies at many labs is delaying and halting testing. And the supplies that are available are often distributed unevenly, leaving big commercial labs with everything they need, while some hospitals, clinics and other medical centers don't have enough.

MARY BOOSALIS, CEO, PREMIER HEALTH: I knew we needed capability to do 1,000 tests a day, and we didn't have that.

GRIFFIN: Mary Boosalis is CEO of Premier Health Hospital System, who sent a letter earlier this month to Ohio's governor, saying, inequitable distribution of reagents, the chemicals needed to perform tests, was impacting patient care standards.

BOOSALIS: We have kept running into anecdotal information from vendors that said they had a reagent, but they couldn't sell it to us. And so that was of concern to me.

GRIFFIN: Different labs need different supplies. For some, it's swabs, others pipettes or reagent. Multiple health care facilities tell CNN supplies they order either don't arrive or they only get a fraction of what they need.

BUTLER-WU: It's not unusual for us to place an order and to be told that the order is going to be canceled and it can't be filled, or that we only get 10 percent of what we order.

GRIFFIN: Meanwhile, the biggest commercial labs, like Quest and LabCorp, tell CNN they have the supplies they need. The White House task force even shared plans to prioritize supplies for commercial labs.

The big labs make up more than half of all testing in the United States, more than three million tests so far, though experts say the inequity is leading critical health care facilities, where sick patients go to get tested, without necessary supplies.

BUTLER-WU: I think is a disgrace. So to prioritize testing to be sent out away from a hospital that may have the capacity to do in-house testing is basically contrary to all the principles of optimal patient care.

GRIFFIN: The heads of major lab associations have been writing directly to the task force asking for help, like Carmen Wiley with the American Association for Clinical Chemistry, describing significant barriers to testing because of shortage of necessary supplies.

DR. CARMEN L. WILEY, PRESIDENT, AMERICAN ASSOCIATION FOR CLINICAL CHEMISTRY: We feel there's a disconnect between the theoretical capacity and what we're actually able to do.

GRIFFIN: Some state governments also complaining about lack of supplies. Washington, D.C.'s health director says the district is only able to do half the number of tests it could if it had proper supplies.

And it's clear the task force knows. This document shared with governors obtained by CNN shows the federal government discussing barriers to testing, including insufficient laboratory personnel, funding and supplies.

TRUMP: Today, we're releasing additional guidance on testing to inform the states.

GRIFFIN: Monday, the White House released a blueprint for change that critics say changes little.

States and local labs fend for themselves for precious supplies, adding to confusion, scarcity, and lack of tests where they are needed most.

Overall, testing numbers are inching up, when experts say we need leaps. Harvard estimates 500,000 tests a day at minimum are needed to reopen the country. Current averages are less than half that amount.


GRIFFIN: And, Jake, Vice President Pence again promising millions of tests a week very soon, a promise he's made before and not kept -- Jake.

TAPPER: Drew Griffin, thank you so much.

Moments ago from the White House, President Trump praise the federal loan program helping many small businesses try to stay afloat, but the program is not without problems, as we have been covering for weeks.

The latest development, the NBA's Los Angeles Lakers are the latest big money operation to dip into funds intended for small businesses without access to capital.


The L.A. Lakers have now returned the money.

Plus, more technical issues plagued the second round of loans.

I want to bring in CNN business anchor Julia Chatterley.

And, Julia, Treasury Secretary Steve Mnuchin called it outrageous that the Lakers took $4.6 million in a loan. There's also a multimillionaire Trump donor who owns a hotel chain in Texas. He also received small business loans.

These loans, I believe, correct me if I'm wrong, were meant for companies, smaller companies, having a difficult time getting access to capital to stay afloat. Were these larger businesses out of line to apply for these loans in the first place?

JULIA CHATTERLEY, CNN BUSINESS ANCHOR: Technically, to use the basketball analogy, Jake, there was no foul play here, but it's like two 20-foot basketball players walking onto the court and saying, hey, let's play.

Is it fair? No, it's not. And that's why the rules have changed here. To your point, the Lakers gave the money back. That hotel chain has not so far. They have got under a week to change their minds or face fierce scrutiny, as they should.

TAPPER: The Lakers, Shake Shack, Ruth's Chris Steak House, they're all among those giving back millions of dollars.

How much overall is being returned at this point?

CHATTERLEY: Yes, this is a great question.

The Small Business Administration tweeted yesterday that over $2 billion have been declined or returned from the first round. That's going to be added into the current pot. It's small in terms of the hole size, but it's big in terms of small businesses that are still desperately waiting for the money.

And I think that's the point here.

TAPPER: The second round of loans opened yesterday. Lenders worried the $310 billion could be gone in days. Does it appear that will be the case?

CHATTERLEY: It's guesswork.

The rules have changed. There was bulk submissions, and we're talking hundreds of thousands of applications. There's pacing going on in terms of the number of applications for the banks per hour.

The most consistent message I'm hearing, Jake, is a week. But I will reiterate it's guesswork right now.

TAPPER: Is there still an advantage for working relationships between lenders, companies, and the Small Business Administration, do you think?

CHATTERLEY: The best advantage, I think, is being advised by your lender not to take this PPP money and being found an alternative.

I think it's working better this time around.

TAPPER: And businesses can apply for as much as $10 million.

Mnuchin said today that SBA, the Small Business Administration, is going to review all loans over $2 million. Is that a lot of money for a so-called small business, $2 million?

CHATTERLEY: Never mind the $2 million, Jake. The cap on this lending program is $10 million, and it makes no sense to me.

What this means is, in order to get forgiveness, a small, small business has to be paying payrolls of $7.5 million over two months. How many mom-and-pop businesses do that spend that that kind of money paying their workers?

This cap should have been brought right down. Make it $2 million and make it applicable only to the smallest businesses in this country. I could have done that from the beginning, but no one's listening, Jake.

TAPPER: Julia Chatterley, thank you so much, as always.

We have been talking for weeks now with mental health experts who have been warning that front-line health care workers will no doubt be battling post-traumatic stress, dealing with this pandemic for years.

And now we have learned of a top Manhattan emergency room doctor who devoted her life to saving others who took her own life on Sunday, after working on the front lines of this horrific pandemic.

Dr. Lorna Breen, who worked in the Columbia University Irving Medical center in New York Presbyterian Hospital System, she had been treating patients with coronavirus in the heart of the epicenter of this pandemic worldwide.

Breen told her father that her colleagues were working 18-hour days, they were sleeping in the hallways, they were trying to care for the influx of COVID-19 patients. She described how ambulances had to be turned away at the hospital because the hospital was at capacity.

Dr. Breen herself contracted coronavirus, after tirelessly working in the emergency room for weeks. She took just a week-and-a-half off before returning to work to help save others while still battling symptoms.

Dr. Breen was admitted to the hospital and treated for exhaustion. Days later, she took her own life.

Her father, Philip, called her a hero, saying -- quote -- "She went down in the trenches and was killed by the enemy on the front line. She loved New York and wouldn't hear about living anywhere else. She loved her co-workers and did what she could for them" -- unquote.

May Dr. Breen's memory be a blessing and a reminder of the stress and trauma endured by all the medical heroes fighting against coronavirus. They will need to be taken care of as well. If you or someone is having any suicidal thoughts, please call the

National Suicide Prevention Lifeline at 1-800-273-8255. That's 800- 273-8255.

Our coverage on CNN continues right now.