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Study Finds Hydroxychloroquine Linked to Higher Risk of Death; Trump Demands Governors Reopen Churches. Aired 4-4:30p ET

Aired May 22, 2020 - 16:00   ET



ANNOUNCER: This is CNN breaking news.

DANA BASH, CNN HOST: Welcome to THE LEAD. I'm Dana Bash, in for Jake Tapper today.

This afternoon, President Trump is declaring all houses of worship essential, claiming he will override governors to allow churches and places of worship to open.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: Some governors have deemed liquor stores and abortion clinics as essential, but have left out churches and other how was worship. I call upon governors to allow our churches and places of worship to open right now.


BASH: But White House Press Secretary Kayleigh McEnany was unable to clarify what authority the president actually has to override governors on this, perhaps because that authority doesn't appear to exist.

Let's get straight to CNN White House correspondent Jeremy Diamond.

So, Jeremy, instead of answering the question, very important questions, the press secretary deflected by suggesting reporters want houses of worship to stay closed. And good for Jeff Mason of Reuters for pushing back on that. I know a lot of reporters, myself included, would like to go back if it's safe.

So what exactly happened in there?


Well, if there was any question about why the president is doing this, it became very clear in the White House press secretary's condescending comment there about reporters and faith.

The White House and the president are viewing this through a very political lens. This is the lens of the culture wars that so frequently animates the president's base. And this is the president throwing away the state-by-state playbook that he has relied on. For every other business, every other organization, other than places

of worship, the president has deferred to the states and said, we need to do this locally, you know, locality by locality, state by state.

But in this case, the president clearly throwing away that playbook. Now, it's not clear what authority the president would have to actually override the governors or order them to open these churches and other places of worship up. But that was what the White House press secretary really struggled to defend from the president. And instead what we got was a lot of mixed messages.


QUESTION: First, just to clarify, he came out and said, "I'm calling upon governors to allow churches and places of worship to open up right now."

Dr. Birx just said, in areas where they have high cases of COVID-19, maybe they should think about waiting a week. So, which is it, and why the mixed messaging?


QUESTION: The president said she's going to override the governors. Under what authority can he do that? And, to your point, he said several weeks ago this is all up to the governors.

MCENANY: Well, I think you're posing a hypothetical. And I think we can all hope that we see governors...

QUESTION: No, he said he would override the governors.

MCENANY: You're posing a hypothetical, though. We are assuming that governors are going to keep churches shut down and keep mosques shut down and keep synagogues shut down.

That is a hypothetical question. And we will leave it to these faith communities to reopen...


QUESTION: The president stood there and said, if governors don't...


MCENANY: We will leave it to faith communities to reopen.


QUESTION: What provision of federal law allows the president to override a governor's...


MCENANY: The president will strongly encourage every governor to allow their churches to reopen.

And, boy, it's interesting to be in a room that desperately wants to seem to see these churches and houses of worship stay closed.


DIAMOND: Now, beyond that last answer, Dana, what you heard there from the White House press secretary was a contradiction of what the president was saying.

She was saying, it's up to the governors, it's up to the faith community. So it's not clear exactly where the White House stands on this now, after the president said one thing, the White House press secretary said another.

Dr. Deborah Birx also was saying, let's rely on these faith communities to make these decisions. And most, interestedly, Dana, as the president is kind of putting aside these public health concerns in favor of a broad-based national reopening of places of worship, what you heard from Dr. Deborah Birx in the White House briefing today was concerns about rising case counts, continuing rising case counts in several metro areas, including in particular right here in Washington, D.C. -- Dana.

BASH: That's right. That was disturbing.

And if it is hypothetical, as Kayleigh McEnany was saying, then why did we hear the president come out and threaten the governors? That was really the fundamental question that went unanswered, Jeremy.

Thank you for that report.

The CDC has just issued the new recommendations for churches and places of worship that the White House and the president was referring to this afternoon.

Let's get straight to Nick Valencia live in Atlanta, who has been all over these issues at the CDC. Great reporting.

Nick, what do you see in here today? And how does that compare with what you saw, even though the public wasn't supposed to see, that the CDC had prepared beforehand?

NICK VALENCIA, CNN CORRESPONDENT: Yes, one of the more interesting points is just how it starts out, Dana, saying that this is nonbinding public health guidance.

It's language that we really haven't seen at all, and not the drafts that were leaked to the press or really any of the final products that have come out from the CDC. These recommendations were anticipated for weeks.

And just in the last 30 minutes, we got our hands on them first. And here's some of the details that are laid out in these recommendations, providing protections for high-risk staff and congregants, supplying soap, hand sanitizer, tissues, no-touch trash cans, encouraging cloth face coverings, intensifying cleaning and ventilation, and limiting shared prayer rugs, books, cups, et cetera.


I want to tell you a little bit about the backstory. It was earlier this week that we got a 60-page final draft document -- or final document, I should say, from the CDC on the recommendations of reopening America safely.

Noticeably absent from those recommendations were any reference to faith-based institutions. A part of the draft documents, it was initially 68 pages to account for those eight missing pages was the recommendations for faith-based institutions.

A very astute point by Jeremy Diamond, saying that this directly plays into the president's base. We're hearing from officials at the CDC there was a lot of debate over these recommendations between the office of HHS Civil Rights Division and senior leaders at the CDC.

Those members of the Civil Rights Division feeling as though that CDC officials were restricting religion. CDC officials pushed back in comments to us, saying that they weren't trying to restrict religion. They were simply trying to save lives, and they hope that these recommendations do just that -- Dana.

BASH: Because so many hot spots in so many places of worship, really, that was the beginning of a lot...

VALENCIA: That's right.

BASH: ... especially here in Washington, D.C., the beginning of the coronavirus outbreak.

Now, Nick, before I let you go, even before these CDC guidelines were released, or you got your hands on them, some church leaders were feeling pressure in their own communities to remain closed.

What are you hearing?

VALENCIA: Yes, well, look behind us here, we're having a viewing for a retired -- a former, I should say, leader of this congregation here in East Atlanta.

And there are members that we have seen going in and out. We asked them if they were fearful. Are they really open here? Are they worried about potentially the pushback that they get from the community? They said they're doing the best they can. They're following the -- what at the time they thought were draft recommendations from the CDC, wiping down those hymnal books, wiping down the pews, limiting 10 people at a time.

Social distancing is in place here. But, really, they are feeling the pressure from their congregation, this church specifically telling me, though, that there's a mixed reaction from their parishioners. Some people, the younger congregants, want them to open. Older congregants know that they have a little bit more health issues to be concerned about. In fact, we spoke to the senior leader here at the church who says

that he's not sure he wants to reopen, but, if he does, and when he does, he's going to make sure he follows the CDC guidelines -- Dana.

BASH: Nick, thank you so much for that excellent reporting. I appreciate it.

Now I want to bring in CNN chief legal analyst Jeffrey Toobin, as well as Dr. Peter Hotez, who is the dean of the School of Tropical Medicine at Baylor University and the co-director of the Center for Vaccine Development at Texas Children's Hospital.

Gentlemen, thank you so much, both of you.

Jeffrey, first on the legality of all this. The White House press secretary, who does have a law degree, she couldn't answer or didn't want to answer that.

So, let me ask you, is there any ability legally for the president to actually override any governor who does not want to open houses of worship in their states?

JEFFREY TOOBIN, CNN SENIOR LEGAL ANALYST: Absolutely not. The president doesn't have this authority.

And the reason Kayleigh McEnany didn't answer that question is because she couldn't. And the CDC is giving recommendations. They are, of course, free to issue recommendations. But it is up to the state.

This is a core state function. It's like the state has every right to tell a church or a synagogue, you have to have a fire alarm, your building, you have to have fire extinguishers. This is something that state governments do.

The federal government does not have the ability to override that or change it in any way, because the federal government's powers are limited under the Constitution. And this isn't one that they have.

BASH: So, no precedent that you know of for anything like this?

TOOBIN: No, this is a political act by the president to appeal to his base and make people who are looking like -- who are asking questions about it, like these reporters, like a bunch of heathens.

But all these people are doing, all the reporters are doing is pointing out what the president is saying, that he can require this sort of obedience from governors, is simply not true under the Constitution.

BASH: Well, let's look at the medical side of this.

Dr. Hotez, what do you make of the new guidance that our Nick Valencia got his hands on from the CDC for houses of worship?

DR. PETER HOTEZ, BAYLOR COLLEGE OF MEDICINE: Well, if you look at this with the CDC actually says, it's actually quite -- they're very respectful, first of all.

They -- there's a nice preamble explaining that they recognize that worship is central to American life and discuss this. And what they say is, what we really have to do is tailor this to what I think -- the words they used was practical, feasible and acceptable, and that was very important language.


The bottom line is, if there's a significant level of virus transmission going on in your community, this is not a time to assemble large gatherings in whether it's churches or anything else, because the virus doesn't recognize what's a house of worship and what's a basketball game.

So, it's really critical that any individual contemplating going to a religious service or a minister or someone who's making the decision about their church or synagogue or mosque have that situational awareness to know the level of transmission in their community, have a discussion with their public health authorities.

And then you can make a rational decision. But, otherwise, you could subject a lot of the congregants to serious illness.

BASH: Yes.

And, again, the point that you're making and Nick Valencia was making is that these religious leaders are not doctors. They want the guidance from the medical professionals on what to do as they begin to reopen.

And, Jeffrey, back to you. You heard Nick talking about this.

The CDC, the guidance is that places of worship should follow the directives of state and local authorities. Meanwhile, the president is warning, well, if they don't listen to me, I'm going to supersede, which I know you say is not legal.

But just in terms of a federal agency, like the CDC, giving a direct recommendation, listen to your state and local authorities, how do you square that?

TOOBIN: Well, you can't square them, because they're contradictory.

I mean, the CDC is doing what the federal government is supposed to do, using its enormous expertise and resources to provide guidance to the states about what's safe and what's not.

But the ultimate decision about what facilities are open and what facilities are not are up to the states. As the doctor said, the virus doesn't know what building it's in. The virus doesn't know if it's a barbershop or a grocery store.

And it's up to the local authorities judging from their local conditions, where there are outbreaks some places and not others, to make these judgments. But the idea that the president can override a governor on houses of worship is simply not true under the Constitution.

The president doesn't have that power. He can -- they -- he can make recommendations, as the CDC is doing. But this is a power of local government.

BASH: And, Dr. Hotez, I want you to listen to what Dr. Deborah Birx said this afternoon from the White House Briefing Room when she was asked specifically about the safety of churches reopening.


DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR: And I think what we're trying to say with the CDC guidance is, there is a way for us to work together to have some distancing and safety for people, so that we decrease the amount of exposure that anyone would have to an asymptomatic.

And I say it that way because I know all of you and all of Americans, if they didn't feel well, they wouldn't go to church that day.


BASH: So, of course, Doctor, the CDC released a report saying about 40 percent of all transmission of coronavirus is from people without symptoms.

In a different part of her press conference, Dr. Birx acknowledged that, and the dangers of asymptomatic people still spreading the virus.

So, are you surprised by Dr. Birx's answer specifically on the question of churches and other places of worship?

HOTEZ: Well, as we all have been talking about, Dr. Birx is in a tight spot.

She's trying to make the best medical and public health recommendations in a pretty volatile environment right now, and everything is heated right now. And it's going to get worse in the weeks going -- in the weeks going up to the election.

I think the really important point that I have been stressing is, this epidemic is not spread homogeneously across the country. There is tremendous variability, not only state by state, but town by town.

And, therefore, a situation in one -- in a town in the Panhandle of Texas might look very different from the Midwest or New York City or Philadelphia. So it's really important that we have detailed knowledge on this epidemic, again, through the -- through the testing, through hospital surveillance, contact tracing, syndromic surveillance.

And then we can make rational decisions on what to recommend in houses of worship and elsewhere.

BASH: OK, Dr. Hotez, thank you so much. Stick around for us.

Jeffrey Toobin, nice to see you again. We will get back to you, I'm sure.

TOOBIN: Indeed.

BASH: I'm sure. OK.

TOOBIN: Thank you, Dana.

BASH: Well, we're going to discuss a lot more on this, and, more broadly, a study out today that finds the possibility of real harm in the drug that the president has been touting and, he says, even taking.


It's now linked to a higher likelihood of death.

Plus, Facebook is now among the major companies considering working from home forever. Why it could change the future of your work life even if you don't work for a tech company.


BASH: For two months, President Trump has repeatedly pitched hydroxychloroquine as a safe and effective treatment for coronavirus. He's even said he's taking it.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: What do you have to lose? Take it. I really think they should take it. Hydroxychloroquine. Try it.


BASH: Turns out what you could lose is your life.


That's according to an observational study published in "The Lancet" today. Seriously ill patients who were treated with hydroxychloroquine were more likely to die or develop dangerous heart problems.

Dr. Peter Hotez is back with us, along with CNN's senior medical correspondent Elizabeth Cohen.

Elizabeth, let me start with you. What exactly does this study say and why is it so significant?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: All right. Dana, one of the reasons why this is so significant is this is by far the largest study that's looked at hospitalized patients sort of retrospectively to see how they did when they were given these drugs.

So, let's take a look at the numbers -- 671 hospitals, they looked at patients in 671 hospitals, in six different continents, nearly 15,000 patients who received hydroxychloroquine or chloroquine, sometimes in combination with other drugs.

And what they found is that the patients who got those drugs were 33 to 45 percent more likely to die even after they adjusted for the fact that the patients who got the drugs were sicker than the patients who didn't get the drugs to begin with. Also, they were between 2.4 and 5 times more likely to develop heart arrhythmias.

You know, according to every agency out there and every expert I talked to, they said, look, this means we should not be giving these drugs to hospitalized patients unless it's part of some study.

The question is, could these drugs prevent coronavirus? That's possible. Anything is possible. But, you know, there's a question, how much do we really -- how many resources do we want to expend on studying whether it can work preventively when we see these kinds of results when patients are sick -- Dana.

BASH: And that's, Elizabeth, exactly why the president says he's taking it, again, as you said, completely unconfirmed, to say the least, that that actually works.

Dr. Hotez, what's your reaction to this study on hydroxychloroquine?

DR. PETER HOTEZ, DEAN, SCHOOL OF TROPICAL MEDICINE, BAYLOR COLLEGE OF MEDICINE: Right. As Elizabeth says, this was a big study, 96,000 patients, 631 sites. And what concerned me also was, it wasn't just arrhythmias but what they call ventricular arrhythmias, which we know is a very serious arrhythmia that can be associated with progression to death very quickly, because the heart stops pumping effectively.

So, clearly, as a treatment this thing is -- we have to stop it. We have the first study out of Brazil that showed no benefit and serious heart disease, then two studies published last week in "The British Medical Journal", the BMJ, confirming this, and now this.

Even as prophylaxis, we had some evidence about a decade ago that this virus, in the test that works against influenza, it was then tried against influenza, as a preventive, as a prophylactic, and it also failed with that. So, with all that together, I would say at this point, there is really very little evidence that's worth considering continuing hydroxychloroquine.

BASH: Elizabeth, I want to go back to you on something else that was published in "The Lancet" today, and that was promising findings when it comes to a vaccine. What does it say?

COHEN: Well, I would say they were findings. I don't think we can -- well, Dr. Hotez will help us put sort of a value on these. This looked at 108 patients who received a vaccine that was developed by CanSino, which is a Chinese company. And what they found when they looked at these 108 patients, they gave them either a high dose of the vaccine, a medium, or a low.

So, two important findings. One relates to safety and one results to -- relates to the immune response that the vaccine elicited. So, when they looked at safely, about half of them developed fevers and other side effects, half of them, when you looked across all three doses. When you looked at the medium and low doses, half of them did not develop neutralizing antibodies.

So half of the patients at the medium and low dose didn't get the kind of immune response you look for. They're going to move forward with those medium and low doses. They're not going to do the high doses because there were so many side effect issues.

So they're moving forward with something that's shown not to elicit the right immune response in half the people. The experts that I've been speaking with have said that this is not impressive. One doctor, a vaccine developer himself, Dr. Paul Offit at the University of Pennsylvania, thinks they ought to abandon ship, these results show it's not worth continuing. Not everyone agrees with that, but certainly I haven't talked to anyone who is jumping up and down and saying that this is wonderful news.

BASH: OK, Doctor, this is your area of expertise, what say you?

HOTEZ: Yeah, I don't know that this kills the vaccine yet, but they are not really strong results in terms of immune response. You know, the study out of Harvard Medical School, that we talked about earlier this week, showed that protection seems to be -- with the COVID-19 vaccine, seems to be associated with the type of antibody known as neutralizing antibody. These are antibodies that bind to the surface of the viruses and prevent the virus from attaching to our -- to our human tissues.


And in this study, the level of neutralizing antibodies was pretty low, lower than what we've been seeing in the few reported studies in patients who have been infected with the virus and then survived. So that's concerning.

Potentially you could rescue this vaccine with another dose or another option is what's called a prime boost strategy. By this, you mean -- what you do is use this adenovirus vaccine as the immunizing dose and then you boost it with another type of vaccine, a recombinant protein vaccine. This has been tried with some success to boost antibody responses.

So, this may be a way to improve the performance of the vaccine. We'll also find out what happens with the two other adenovirus vaccines that are going to go into human trials in the United States. So, the AstraZeneca one at Oxford, that's also an adenovirus vaccine, and the J&J vaccine, and we'll see if there's similar types of results in humans.

BASH: Well, the point you made there at the end, people can rest assured, even if there are problems with this, there are lots of other vaccines in development certainly being fast tracked.

Thank you both for your expertise and for your reporting, I appreciate it.

And coming up, a holiday weekend during a pandemic. What you need to know about what's open and what is safe. That's next.