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Fauci Predicts Coronavirus Spikes as States Reopen; Gilead CEO Says Remdesivir Has Positive Impact on COVID-19 Patients; Retail, Restaurants, Theaters Allowed to Reopen in Texas; Dr. Hilary Fairbrother Discusses Risks of Texas Opening Too Soon; WHO: 102 Potential COVID-19 Vaccines in the Works Worldwide; Dr. Frederick Nolte Discusses Scientists Questioning Reliability of Antigen Tests for COVID-19. Aired 11-11:30a ET

Aired May 1, 2020 - 11:00   ET



JOHN KING, CNN ANCHOR: Hello to our viewers in the United States and around the world. I'm John King in Washington. This is CNN's continuing coverage of the coronavirus pandemic.

The global case count quickly closing in on 3.3 million this hour. Russia records its biggest surge in cases, 8,000. And its prime minister says he is now affected. London's mayor does not see pubs opening any time soon. But Malaysia says it will start reopening businesses on Monday. Australia also set to reopen, in its case, earlier than anticipated.

Here in the United States, the federal social distancing guidelines are no more. Decisions of how and when to reopen are now with states and they are taking wildly different approaches.

Michigan's governor ignoring protests and the state's legislature and extending the stay-at-home order there in Michigan through May 28th.

The president takes issue. His morning tweet at the Michigan governor prods her to, quote, "give a little. People want their lives back again," he says.

More than two dozen states now relaxing restrictions and letting some sectors get back in business.

Georgia led the way on reopening. This explanation from the governor does sound more about politics than science.


GOV. BRIAN KEMP (R-GA) (voice-over): I'm trusting people, I think, would be the way I've been saying it. I mean, look, government policies are only good as long as they're reasonable and people will follow them.

I can tell you, after people being sheltered at home for a long time, on the verge of losing everything they've got, not being able to work, you know, not being able to get their kids out of the house, people are at wit's end. You can't have policies that cause our citizens to revolt.


KING: The national numbers, well, they tell us the coronavirus is quite stubborn. Take a look. This is the five-day rolling average of cases over the past two weeks. That is not a steady, much less, a consecutive nationwide decline.

As we begin the month of May, this scale of deaths is telling and chilling. One in February, nearly 4,000 in March and nearly 60,000 in April.

The nation's top expert says governors do have a choice here, but he recommends caution.


DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: Discretion is given to the governors. They know their states. The mayors know their cities. So you want to give them a little wiggle room. But my recommendation is don't wiggle too much.


KING: Here to share his expertise and his insights, our chief medical correspondent, Dr. Sanjay Gupta.

Sanjay, you heard Dr. Fauci there. Again, this is all up to the governors now and he's trying to coach them to take a cautious approach.

I want you to listen to something else from your townhall conversation with him last night, where, Tony Fauci says, yes, as people get back to work, you're going to see spikes. The question is how big. Let's listen.


FAUCI: What I think you'll see is these spikes, like in certain areas, nursing homes, plants where workers congregate, prisons and places like that.

The thing you'll really get into trouble is if it spills over into the general community the way it did in New York City. Because if you can't stop that from happening, then I think you're really going to see the sharp peak.


KING: I was struck. His tone is, we have no choice here, I guess, states are going to reopen. But he sounds so cautious.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Yes, I mean, that is forceful for Dr. Anthony Fauci. He's basically saying, we made these guidelines as easy to understand and follow as possible. The gating criteria for 14 days of downward trend. It's clear we're going to see these spikes.

I think to be fair, John, no matter when we reopen, there's going to be an increase in infections but it's a question of how big these spikes are. And there are certain places that will just be more vulnerable.

The key thing, John, I think people fundamentally understand this, is people can decide to take a risk for themselves. On a personal level, you can say, I'm going to eat healthy, exercise and not engage in bad behaviors, whatever it may be.

That's not what this is about right now. It's about personal risk, but it's the idea that people can harbor the virus inside their bodies. They may not get sick at all but then be the sources of illness for other people. I think that's the point he's been making for some time.

And this is a virus that can have exponential growth. So a few cases that may start up as a result of these re-openings three to four weeks from now could result in exponential growth, as you just showed in that chart from March to April.

KING: I think as we go through the next couple weeks and we test this experiment in terms of what happens with the case count, what happens with the hospitalizations, we shall see.

I want your take on this, Sanjay. The CEO of Gilead, a company that makes Remdesivir, we've learned in recent days they think it has some impact on people who have COVID. It's not a cure, but it has some positive impact.


Listen to the CEO who says we're using it to treat patients with harsh symptoMs. Let's see if we can do it on some others. Listen.


DANIEL O'DAY, CEO, GILEAD SCIENCES, INC: This is a medicine that's really for the most-severe patients.

Our scientists are hard at work to see, now that we know this medicine has an impact on patients, if we can bring it earlier into the disease.


KING: Explain, A, how that would work, and, B, the significance.

GUPTA: Yes, so, you know, in these early trials on any of these medications, John, typically, they're going to be used on the most- severe patients because those are patients at the highest risk for getting even more critically ill and even dying. I think what has been known sort of all along is that an antiviral

medication like this, ultimately, the best-use scenario would be earlier in the disease. If it stops entry of the virus into the cells or slows down replication of the virus, you would like to use that as early as possible.

The idea that now possibly this medication is used within a defined population of people who are earlier in their disease but are at high risk. So people who have underlying medical conditions who have recently been diagnosed with the COVID infection, could this now prevent them from becoming more severely or critically ill.

That's going to be the big question. And as he said, and as Dr. Fauci has said, there's some inclination of that.

The other thing Dr. Fauci said is it reminded him of the early days of HIV/AIDS. And when I talked to him about that, he said, in the beginning there was nothing, then AZT came along. AZT was not the cure-all, but it was the first thing that worked, so you built on that. You added other medications to the mix.

Might Remdesivir be a larger cocktail of medications, using it early and then using something to decrease the cytokine storm or the load on people's bodies which seems to cause so much illness? Perhaps. You might have a cocktail of medications.

But this is the first thing that's shown any efficacy at all towards this virus. And that's, I think, why people are so enthusiastic about it. It's not a knockout punch or a home run or whatever sports metaphor you want to insert, but it is something, and it's an important start.

KING: An important start. We'll take it after the last several weeks of tough news. An important start is something to build on.

Sanjay, as always, appreciate your thoughts and insights.

Today, Texas begins phase one of its reopening plan. Businesses like retail stores, malls, restaurants, and theaters can operate with a 25 percent occupancy limit. Texans can now go to libraries and museums or play an outdoor sport as long as there's no more than four people involved.

Governor Greg Abbott says phase two of his plan could come in mid-May. That would include re-opening barber shops, gyms and bars.

CNN's Ed Lavandera is Dallas for us live today.

Ed, as this experiment starts to play out in Texas, what are you seeing?

ED LAVANDERA, CNN CORRESPONDENT: We're at an outdoor shopping area known as The Shops at Park Lane here in Dallas. This is a popular area, a wide array of stores, some 50 types of stores here. It's still early so we haven't seen a whole lot of people come out. But it is going to be very limited. John, quite frankly, there are a number of people who simply just

won't -- or a number of businesses that simply just won't reopen yet. They feel either it's not worth the financial cost or it's not worth the risk.

And that's really what we're seeing across the state in talking to all sorts of different types of business owners here, is that trepidation and the uncertainty of reopening in the midst of this pandemic.

What is interesting to point out here, John, here in Texas, here in Dallas County, there's the largest spike of this pandemic in the number of new coronavirus cases, and that is raising real concerns here.

But here on the ground, we spoke with the general manager of this shopping center, who said this is -- he talked to us about the kinds of things that businesses are doing to protect themselves and their customers.


NEISHA VITELLO, SENIOR GENERAL MANAGER, NORTHWOOD RETAIL: We want to make sure that we can protect everyone in those guidelines, including offering face masks to guests on request, as well as hand sanitizer.

We've also put up a collateral in signage just as a reminder to walk six feet apart and practice social distancing.

Additionally, there are other directives inside the retail stores which includes offering hand sanitizer at the door and protective masks for all the employees.


LAVANDERA: So, John, as I mentioned, the numbers here in Texas kind of a mixed bag, and because of that, there are a great number of people here who are saying Texas is just reopening too soon, especially because the effects of reopening will take several weeks to really fully grasp and get a full sense of what this has done to the spread of this virus -- John?

KING: It will be the middle of the month before we see the numbers where we can say, hey, it worked, or hey, the case count is going way up.

Ed Lavandera, I appreciate your reporting on the ground there in Texas. Appreciate it. Thanks, Ed.


Joining me now, Dr. Hilary Fairbrother. She is an emergency medicine physician in Houston, Texas' largest city.

Doctor, thank you for being with us.

So about 1 percent of the state of Texas, if I have the numbers right, have been tested so far, which I think leads you to believe this is a gamble.

DR. HILARY FAIRBROTHER, EMERGENCY MEDICINE SPECIALIST: Yes. We're reopening today, and it does feel like a bit of a gamble.

In Texas, we never saw the number of cases that they anticipated. Our curve was really quite flat. We saw a small increase of cases until about April, early April, April 10th, and our cases have been somewhat constant since then. So we never saw the rapid rate of climb. And we're not seeing the rapid rate of descent that everyone recommends before reopening.

With all of that in mind, it's not -- it's understandable why people are talking about reopening, despite the fact that we haven't seen a decline. We don't appear to be on a similar curve as the rest of the country and maybe that's because we flattened it. But I honestly don't think we have enough information and data points to know.

KING: Right, and it's a great point. Testing is the way you get the data to understand. Sometimes I use the term, it's not a medical term, but flying blind. You don't know how many people are out there, who are asymptomatic or have COVID because they haven't been tested.

Just want to put some numbers up there to make your point and just to get your insight.

First, we have Harris County, where you are. Houston is in Harris County, a sprawling county, very diverse, it's spread out. The count there, if you look at the numbers, it's up, it's down, it's up. It's down from where it was days ago, but you see -- the spikes back and forth, I think, is what concerns you. It's not completely under control.

I'll just show you the Texas, the statewide 14-day trend. And Ed Lavandera was also talking about this when he was talking about this. If you look at the 14-day trend in Texas, it starts to go down on the left side of your screen there but then it seems to be coming up a bit.

Again, it's not a giant spike, but you look at this -- and I keep using the term stubborn, that the coronavirus, COVID-19, is stubborn.

You think that the social distancing flattened it, but you're not pushing it down. Is that fair?

FAIRBROTHER: I'd love to think that all of this social distancing really flattened our curve. But the reality is all of our testing has a delay to it, right? Patients get sick but they don't have symptoms right away. And even when they have symptoms, they don't get very, very sick right away and present to the hospital for care.

So the numbers we do know are the numbers of people who are hospitalized with COVID. And that's a very delayed data point when you're trying to collect real-time data about what's happening with the virus on the ground.

I think we just -- it's so hard to make broad, sweeping conclusions from the data that we do have. And we haven't seen cases going down. In fact, where I work in the medical center in Houston, cases are about -- our caseload is about 1.2 times what it was last week, which, essentially, it's the same as it was last week.

Certainly, right now, in Texas, we have the medical resources to take care of all the sick people. And we have enough ventilators, and we have protective equipment.

So, again, it's difficult to say, you know, don't reopen. I feel torn. But I do think that we are -- it is a bit of a gamble. We don't really know. And unfortunately, we won't know the effects of reopening until a little bit after the fact. There will always be a slight delay to whatever we do and the reaction to it.

KING: It might be 10 days, two weeks, I think, before we start to see if the numbers stay flat, start to go up at what rate.

Dr. Hilary Fairbrother, I want to bring you back then to talk about it. Thank you for your time today.

FAIRBROTHER: Thank you so much.

KING: But more important, thank you for all the work you do here, and your colleagues, every day here. Thank you. Appreciate it.


Ahead for us, the worldwide race to find a safe and effective COVID-19 vaccine.

But first, sobering words from a New Jersey paramedic.



ALEX STORZILLO, PARAMUS, NEW JERSEY PARAMEDIC (voice-over): The amount of people that we're pronouncing dead at home is astronomical. Anybody who says they're not scared during this is lying to you. This is what we signed up for. So ultimately, you have to do your job when it comes down to it.



KING: "Operation Warp Speed" is what the Trump administration is calling its accelerated push to find and then manufacture a coronavirus vaccine by the end of the year, he hopes. The president says he's in charge.

Officials say more than half a dozen vaccine programs are now in the clinical trial phase with at least 80 more in preliminary phases. The World Health Organization says there are at least 102 potential COVID- 19 vaccines in the works worldwide.

Joining me now, CNN chief medical correspondent, Elizabeth Cohen.

Elizabeth, the president sounds confident, a workable vaccine ready for mass production by early next year, January. Do the experts agree?

DR. ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: You know, it's interesting, John, because the people who run these vaccine companies, they all sound quite confident. But I think we should take that with a grain of salt. They are supposed to sound confident.

But let's take a listen to what Dr. Anthony Fauci has to say on this issue because he has been doing vaccine trials for decades.


FAUCI: Not every vaccine that we went after worked. So that's an assumption, that it's going to be safe, that it's going to be effective, and that we're going to be able to do it quickly. I think each of those are not only feasible but maybe likely. That's what I mean when I say, by January, we'll do it. But I can't guarantee it.



COHEN: Maybe likely, I can't guarantee it. I think when Dr. Fauci speaks, we need to listen to him and take him at his word.

He knows there are all sorts of things that can go wrong in vaccine trials. If you remember, John, decades ago we thought an HIV vaccine was on its way. We still don't have one. All sorts of strange things can happen.

He then went on to say, at last night's CNN coronavirus town hall, that you can have these safety signals. What he means by that is that, all of a sudden, instead of a vaccine helping people, it actually causes problems. That could also happen.

KING: We'll have to follow it as it plays out.

One wrinkle in this, two biotech companies, Moderna and a Swiss company are now teaming up to manufacture a possible vaccine. Is this big news or just companies here saying we have a jumping off point?

COHEN: Right. I would say the latter. Most of these teams that we've looked at are just that, they're teams. It's not one company. They're sort of joining forces to make this happen more quickly and more efficiently. That actually makes since. And it's happening very, very quickly.

Let's take a look at some World Health Organization numbers. On April 26th, on their Web site, they had 89 teams around the world pursuing a vaccine for COVID-19. April 30th, yesterday, four days later, 102 teams. So that's a lot more teams in just four days.

In addition, eight -- not in addition, but of these, eight have permission to do human trials. You can see there are a lot of people still in the lab. Eight have permission to do human trials.

But even eight is quite a few. And many of these are teams of, for example, Pfizer, with a smaller German biotech company. That's classically what we're seeing.

KING: I certainly wish them the best. But I think your words of caution are something to live by until we get more positive data.

Elizabeth Cohen, really appreciate it. Thanks so much.

Shifting now to new concern over antigen testing. Dr. Deborah Birx calls this type of test the breakthrough needed to screen large numbers of people. But many scientists are concerned it may not be reliable enough.

Here to talk about it, Frederick Nolte. He's a pathology professor, the head of coronavirus testing at the Medical University of South Carolina.

Sir, it's great to see you.

Antigen testing, Dr. Birx says a breakthrough. Do you believe that, or not reliable enough?


Antigen detection has been part of the diagnostic landscape for a number of years. And it has a number of appeals. It can be done relatively quickly, it's inexpensive, it can be deployed in a number of clinical settings outside of the laboratory near the patient.

But the chief concern with it has been the sensitivity. We have a lot of experience with antigen detection tests for the diagnosis of influenza. And we know, pretty confidently, that the sensitivity, the best sensitivity, compared to nucleic acid amplification tests for the diagnosis of influenza, is in the neighborhood of 80 percent.

KING: So 80 percent. So that's 15 to 20 percent you could be off?

NOLTE: False negatives, yes, sir.

KING: False negatives.

I want to show you the coronavirus testing total. The administration keeps talking about maybe we were slow in the beginning but we've ramped up to a point of 32.8 million is the cumulative amount of testing in the United States.

Is that the number you would focus on, cumulative, or is it more important to you, as you do this work in South Carolina, to what you have available today, tomorrow, and next week, especially as people go back to work and businesses have to make decisions, do we test everybody, do we test certain people once you have more and more people back to work, do you have routine and regular testing.

Where are we in that regard, do you think?

NOLTE: Our efforts have been -- we've been ramped up with local testing since the 23rd of March serving much of the state of South Carolina. We've tested somewhere in the neighborhood of 15,000 patients since March 23rd, identified about seven to eight hundred positive patients during that time.

We're moving toward more testing of asymptomatic patients, primarily to -- prior to operative procedures, so we can be assured that those patients are not asymptomatically infected with coronavirus.

So, yes, it's a combination of asymptomatic, pre-symptomatic and symptomatic patients that we're testing now.

KING: This has been a running debate, as you're well aware. People say things at the White House, governors, sometimes people in your position in the states say, not quite, or we need more supplies, or we need something.

I want you to listen to Dr. Fauci's take last night on where he thinks we are at the moment.



FAUCI: So you don't have to do every single person that comes in there and test every single person. It depends on the level of the risk. If you have enough tests, in a perfect world, then you would be testing more people. But when you're in a situation where you want to be realistic, you don't have to test every single person.


KING: I think a lot of people ask -- I get the realism, and Dr. Fauci is a realist. But I think a lot of people ask, you know, why months into this are we still not in the perfect world. Why can't there be a moon launch in the United States of America to get enough testing so that you can do anything you want, not have to be realistic?

NOLTE: Well, that's a good question, and it's a tough answer. It's not only about -- as you heard over and over again, it's not just about the availability of the reagents or the test kits. It's about getting those tests to the patients.

Patients with limited access to health care, we're setting up mobile test sites around the state to increase that access. You've heard, time and time again, about the shortage of the collection kits, the swabs, and the transport media. We've been lucky --

KING: I think we lost Rick Nolte's shot there in South Carolina.

Thank you very much. We'll circle back on another day and check in on you.

Up next, millions of Americans out work. Rent and other bills due today, first of the month.