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United States Cases Near 1.6 Million, Deaths Approach 95,000; Study: Drug Trump Touted Made Coronavirus Patients More Likely To Die; Defense Chief Mark Esper: "Completely Confident" Vaccine Delivered By January; Businesses Seeing Increased Foot Traffic As States Reopen; Schools Make Reopening Plans Ahead Of New Year. Aired 12-12:30p ET

Aired May 22, 2020 - 12:00   ET




JOHN KING, CNN HOST: Hello, everybody, top of the hour. I'm John King in Washington. This is CNN continuing coverage of the Coronavirus pandemic. All 50 states now open in some way this holiday weekend.

The President's take is they should stay open even if Coronavirus cases begin to explode in the fall. In the here and now there are more states trending in the wrong direction. At least one of them Alabama worries of a possible shortage of critical care hospital beds.

But we begin with another violent collision between what the President Thinks and say and the more disciplined world of science and data. For two months now President Trump has told that hydroxychloroquine is a game changer. He says it is a drug that saves lives.

The President himself says he is finishing up a round of hydroxychloroquine treatment. Sales of the drug had doubled driven by the President's praise. But a new study published in the medical journal "The Lancet" today says the drug did not help hospitalized Coronavirus patients.

Instead, that study says it made them more likely to die and it also increased the likelihood patients would develop an irregular heart rhythm that puts them at sudden risk the cardiac arrest. Let's get straight to CNN's Senior Medical Correspondent Elizabeth Cohen. Elizabeth, 96,000 patients across 6 continents hospital data studied, take us inside the study.

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: John, let's take a look at these numbers. The study that was done and published in "The Lancet" today looked at patients in 671 hospitals with Coronavirus on six continents, nearly 15,000 hospitalized patients who received hydroxychloroquine or chloroquine, sometimes in combination with other drugs as well as patients who were in a controlled group.

And what they found is that those who took those drugs or some combination of them, 33 percent to 45 percent more likely to die, and that is even after adjusting for the fact that there were some differences between the groups in terms of how healthy the patients were also patients who took the drug, 2.4 to 5 times more likely to develop heart arrhythmias.

Point, I want to make here these are hospitalized patients. Trump said he is taking this preventatively. Those are two different things and we don't know what it does preventatively. Could it work?

It's possible, but doctors I've been talking to say when you see these kinds of results that it actually hurt patients who were in the hospital and this is not the first study that's found this. There are other published studies that say the same thing. They wonder is it even worth studying as a preventative agent against COVID-19.

KING: Elizabeth Cohen, thank you so much a very important study. Let's continue to discuss it now with one of its lead author Dr. Mandeep Mehra is also Executive Director of Brigham Center for Advanced Heart Disease in Boston. Doctor thank you for being with us today.

You looked through the study and I want to read you a principal finding from it. We were unable to find a benefit hydroxychloroquine or chloroquine when used alone or with -- on in hospital outcomes for COVID-19. Each of these drug regimens was associated with a decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment for COVID-19. Based on this should hospitals around the country and around the world just stop using this as a treatment?

DR. MANDEEP R. MEHRA, EXECUTIVE DIRECTOR, CENTER FOR ADVANCED HEART DISEASE AT BRIGHAM AND WOMEN'S HOSPITAL: Yes, that would be our strong recommendation, John. Our data has very convincingly shown that across the world in the real-world population that this drug combination, whichever way you slice or dice it, does not show any evidence of benefit, and in fact, is -- showing a signal of grave harm.

KING: So, there is a distinction in the sense that you are looking at hospitalizations of patients. This is not a live, clinical trial, right? That would be the gold standard of research. So, for anyone out there now, for the hydroxychloroquine promoters, who are going to say oh, wait a minute. Its elitist doctors trying to say the President of the United States is wrong.

Make the distinction for me between your research and some of the clinical trials that are under way right now about the same drug?

DR. MEHRA: Yes. So, we looked at a very specific cohered of patients who were hospitalized with COVID-19. Now we all know that when you get hospitalized with COVID-19 it's a very chaotic situation with the lots of uncertainty.

We know that patients who have underlying cardiovascular disease and underlying lung disease are particularly vulnerable to bad side effect of any medicine that's used in these patients at that time, and what our data is showing is in that chaotic circumstance of the hospitalized patients of COVID-19.

And there's no question that there is a very clear signal of harm with these drug regimens. Now caution is advised in interpreting these findings for people who have not yet had COVID and are actually looking at trying to prevent COVID.


DR. MEHRA: It's in that group of patients that clinical trials are to be conducted and we would endorse conducting clinical trials in those patients. But even in those patients, the use of this drug regimen in an off-label capacity should be shunned and avoided notably because of these observed risks particularly in patients who have underlying cardiovascular illness and this is a very, very critical distinction to keep in mind.

KING: Well, so let's close on that point because the President of the United States is one of those people you just mentioned. He's outside he is not hospitalized. He says he wants to use this as a prophylactic. He says he keeps hearing despite studies like this from other people, as he likes to put it lots of people as he likes to say that this actually works.

Here's one of the things you say in your research and your write-up of this. Nevertheless, a cause and effect relationship between drug therapy and survival should not be inferred. These data do not apply to use of any treatment regimen used in the ambulatory out of hospital setting. Randomized clinical trials will be required before any conclusion can be reached regarding benefit or harm of these agents in COVID-19 patients.

That's where the President is, he is in an out of hospital setting, but from what you learned inside the hospital do you believe this drug should be restricted to only disciplined, protected clinical trials and not the kind of use the President of the United States says he just went through?

DR. MEHRA: I do agree with that statement, John. And in fact, when I finished medical school one of the most important principles that I kept in mind was what I was taught at the time I was graduating which was -- first do no harm. And when you see evidence of harm, you've got to be really, really careful using anything in any circumstance without a controlled clinical trial setting.

KING: But what would you say, sir, to someone who says I believe the President?

DR. MEHRA: Well, it's their belief, and I would personally disagree with that individual, but we all have a choice to make in our lives, and we can't push choice.

KING: Doctor Mehra, I really appreciate you joining us today. And of course, this as the article in "The Lancet" here is very detailed it is very thorough. It is worth a read, no matter what you view on this issue. Sir, I really appreciate your time.

DR. MEHRA: Thank you.

KING: Thank you. Let's bring in our CNN White House Correspondent, Kaitlan Collins. Kaitlan, you've been there at the White House most days through this. And the President let's listen from the very beginning has been a fan.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: I had a two-week regimen of hydroxychloroquine.

A lot of doctors are taking it. A lot of people swear by it.

I get a lot of tremendously positive news on the Hydroxy.

I really think it's a great thing to try.

What do you have to lose? Take it. I really think they should take it.

The hydroxychloroquine try it.


KING: Kaitlan, repeatedly promoting a drug that this new study says is harmful, it doesn't help with COVID and it is potentially harmful for people in the hospital. You heard the lead author there saying he doesn't think it is very helpful or at least until we get clinical study it should not be taken by people out of the hospital like the President any reaction at all from the White House?

KAITLAN COLLINS, CNN WHITE HOUSE CORRESPONDENT: No reaction yet, but we know that this is a journal they quoted before. They quoted just last week when the President was threatening to withhold funding from the World Health Organization. So, they're well aware of what they've been publishing.

But I think it is that sentiment that you heard there from the President at the end that has been the most concerning for medical experts. And that's the President not just taking it himself they say that's between the President and his doctor of course. But that he is pushing other people to take it and he's saying you know the sentiment of what do you have to lose?

Well, based on this study people could have a lot to lose, so I think that's been the concern. And of course this study doesn't at all touch as Elizabeth noted on how the President is using it which he believes as a preventative even though the FDA says there is no evidence that it actually works to prevent you from getting Coronavirus.

But we know that what the President has said matters? People like Senator Rubio have said they don't believe people are taking prescriptions based on what the President is pushing, but we actually know after the President started pushing hydroxychloroquine in March there was an uptick in prescriptions written for it because people were asking their private pharmacies and retail pharmacies were actually seeing a higher interest of request to use hydroxychloroquine.

So, that's the question there. Is he encouraging other people to where they feel more comfortable using it? And so far they haven't responded. We should note, John that today is the last day for the President to be taking his own prescription of hydroxychloroquine according what he told us about two days ago.

KING: Kaitlan Collins live for us at the White House. Come back if you hear anymore from the White House or any of those people about this new study. Kaitlan, I appreciate it, thank you.

And a big promise today from the Defense Secretary Mark Esper in the race for a vaccine, on NBC Secretary Esper says, come the New Year, every American will be able to get a vaccination.


MARK ESPER, U.S. DEFENSE SECRETARY: Absolutely it's possible and I've spoken to our medical experts about this. We are completely confident that we can get this done. We've been ahead of the curve and in the fight from day one and this is the next phase of this battle. And we will deliver on time the vaccines. I'm confident we'll get it.


ESPER: DOD has the expertise and the capability, of course, to get the manufacturing done and the logistics and I am confident that we will deliver.


KING: You heard a couple of confidence and a completely confident there but that would be a remarkable achievement in well ahead of what most scientists believe is probable. Even the former big Pharma Executive now leading President Trump's vaccine effort told "The New York Times" just last week 12 to 18 months for a viable vaccine "Is already a very aggressive timeline". A quick break when we come back as states reopen, as states drop more restrictions you're getting out of the house and moving about. We'll show you just how.


KING: This weekend Memorial Day meets the new normal. Fewer Americans will be hitting the road and there are crowd limits for those who hope to gather for the traditional ceremonies and the parades or may be just to escape to the beach.


KING: CNN's Pete Muntean recently went out on a road trip on his own. Pete, you're up in Annapolis. What can Americans do to stay safe while out in about this weekend?

PETE MUNTEAN, CNN AVIATION CORRESPONDENT: John, I want to talk about those tips but I also want to talk about the traffic. You know, here at the Chesapeake Bay Bridge, typically one of the busiest spots, a gateway to beaches in Maryland and Delaware usually things would be backed up for miles.

Things actually moving pretty smoothly here right now even still people are traveling this weekend and we found out that if you do travel this weekend, you're going to have to get creative. We did a bit of a road trip of our own putting some of these tips from AAA into action and it says that you have to plan your pit stops especially carefully this time around.

You know many rest stops are not open this does vary though state to state. We were able to find rest stops in Virginia that are opening that are being cleaned every hour. But if you're looking for that all- important bathroom AAA underscores that you may want to gravitate to a gas station because those are essential businesses still open right now.

Gas prices are the lowest this weekend in more than 15 years, but AAA cautions that if you do try and fill up be especially mindful of all of the things that you touch that other people touch like the nozzle or the buttons on the pump, maybe use your knuckle instead of your fingertip.

Also, researchers underscore to me that you might want to use gloves or may be a paper towel as you do that. They do underscore that driving, being in your car is actually one of the safest places to be, but it's the door-to-door experience where things get more risky.

Whether or not to go is a very personal decision and that's why there's a bit of a void of research of exactly how many people will drive this weekend? AAA not doing its typical Memorial Day weekend driving forecast for the first time in more than 20 years researchers telling me they'll be looking into Smartphone data to see how many people travel this weekend and exactly where they're going. John?

KING: Pete Muntean thanks very much for that. I'm distracted by the scene behind you. I've live here for 30 years, I've never, never on the Friday before Memorial Day weekend have I seen that the traffic moving like that behind you. Pete, thank you very much.

As Pete noted many of you already are moving around more to get back to work maybe or to take advantage of things that are reopening from gyms, restaurants, to hair and nail salons. Let's take a peek at some data here from SafeGraph which is trafficking social distancing and foot traffic, using anonymous cell phone data.

Number one, let's just look up at the map here, this is shelter in place as of May 18th. The darker means more people are staying at home and the lighter parts of the country and you see it's lighter especially if you've been with us for the last several weeks, we could show you this before it was darker.

People are starting to get out and move about, more so in the south and more so in the west than up here in New York City or in the Washington D.C. area or in the big cities in California. But you see white that means people are beginning to move around.

Look at the foot traffic here this is in Alabama and Mississippi. This is back on the 15th restrictions are lifted in both states people moving around more than 45 percent -- 45 percent here, 40 percent here. Look at the places that are sheltering the least.

They're all in the south. South Carolina, Arkansas, Oklahoma, Alabama and Mississippi, places where people are sheltering the least meaning they're getting out they're getting more active, they're interacting as this economy starts to reopen.

Alabama versus Mississippi, these are the cases. You see more activity and be careful, you can't directly correlate these things, but this is what you have to watch? As people get out and start to move about more the cases in both states climbing. The question is earlier, we were talking in Alabama, some stress especially in Montgomery of the hospital system.

We need to watch this. You look at the seven-day track here and if you look at Mississippi is the lighter line its flat, may be trending up a little bit Alabama has had a bit of a spike off late in cases.

And so, the scientist will look at the cases and then the mobility and try to make a connection. Are we pushing it as more people get out in about or are states finding a way even if this is slight increase in cases to manage it? That's the challenge of weeks and week ahead.

Joining us now to talk about these data trends Ryan Fox Squire he is a data scientist at SafeGraph. Ryan, when you're looking at all this data, you can look at and you can get overwhelmed there is so much of it. What jumped out at you the most when you're seeing the big changes from when we talk say weeks ago to now as the states reopened? What jumped out most?

RYAN FOX SQUIRE, DATA SCIENTIST, SAFEGRAPH: Yes. Hi. Thanks for having me back, John. As you know, the focus right now is all about how to save as many lives as possible without killing the economy? Every state and local government is working to figure out those policies and we're seeing different states try different strategies.

However, the important point is that you can't figure out these best policies if you can't measure physical distancing. You need to be able to measure how much people are leaving home, moving around and visiting businesses? And that's why SafeGraph data is turning out be a valuable piece of the puzzle.

We are seeing that thousands of individuals from governments, industry and academia are using this including the CDC to try to figure out the right policies to reopen. So, you mentioned earlier data -- yes?

KING: I just want to go through some of it with you. Let's take a look at urban versus rural in terms of getting about. The urban line is the green line here and so people in urban areas tended to be staying home more and even now as they get about more so than in rural areas and the blue is little distracting here.


KING: So, let me come out with this. You see in rural areas they weren't staying home as much to begin with and they're out and about now. Is this in conservative areas of the country this is just because there is more space in rural? Can we answer those questions?

SQUIRE: Yes, exactly. So, here we're using SafeGraph data to show how much people are staying home comparing the 25 percent most urban and 25 percent more rural counties? And as you see what we're seeing as urban counties are staying home at a much higher rate than people living in rural counties that's generally been the trend throughout the pandemic.

Urban counties are staying home closely around 35 percent, while rural counties are down around 27 percent. And there are number of reasons to explain the difference. First is that urban centers were hit first and hardest by COVID-19 so the policies and urgency around stay at home have been higher there.

Second, I think urban centers lend themselves easier to shelter in place because they have more infrastructures around delivery and things like that.

KING: Let's look at something else. This is foot traffic. So, you can monitor not only are more people getting out and about, but what are they doing? This is just Mississippi foot traffic from May 9th through the 17th. And you see a heavy increase in people going to the gym.

Now the yellow line here is music stores, then you have department stores, shoe stores and then beauty salons. So, people getting supplies may be they couldn't get, when you look at department stores, shoe stores and music stores things that they might have wanted when they couldn't get out of the house and then gyms and salons some people are deciding it's time to get back to a more normal life, if you will, things that are more important to them personally?

SQUIRE: Yes. I think that's one of the most important takeaways that we're seeing from the data that not all businesses have been affected equally and how they're being impacted by the pandemic? Like you just showed we're seeing that certain types of categories are surging up fast as economies start to reopen.

I think the category on the list that jumps out the most to me is gyms and fitness centers those include things like exercise classes. Public health official tells us that places like gyms are particularly dangerous when it comes to spreading COVID. Exercise are super important, and the data shows that people are eager to get back to their gyms, but hopefully everyone is staying safe and trying to maintaining physical distancing.

KING: And so, this last one I want to show you here is states with the biggest increase, the foot traffic increase since May 1. And there are some states in the northeast here, you see New Hampshire jumping off the charts in recent days.

Particularly though New Jersey and Rhode Island if you look at them these are among the states hardest hit New Jersey and Rhode Island. New Hampshire hasn't had as many cases. When you see that jump there again there's cabin fever involved or it is just the beginning of the reopening but those are states that are just coming sort of out of the tunnel, if you will. And if you look at that data and you think well, I need to keep an eye on that.

SQUIRE: I think that's right. I think we're seeing whether or not states are changing their policies about stay at home all states are increasing the amount of foot traffic that they're having to businesses. So, everyone is leaving their home more and more.

I think the states that have been hit hardest have the most space to recover. So, there is more growth happening there. But overall people are eager to get out and I think that's a struggle that public policy will have to deal with.

KING: Ryan Fox Square I really appreciate you coming and sharing that with us. And let's keep in touch as we go through this for weeks and weeks ahead as we learn more and more. Hopefully the counts stay down but that data is very helpful to us. Thank you, Ryan.

SQUIRE: Thank you.

KING: Not a lot of time for administrators to figure out how and whether to reopen school across the country? So, how do you do that safely?



KING: A message to students from the First Lady. In a taped message provided to last night's CNN Town Hall Melania Trump called the pandemic a defining moment and she thanks students for adapting to the country's new normal.


MELANIA TRUMP, U.S. FIRST LADY: The determination to get through this will define your generation for years to come, so thank you for helping your families, your friends, your communities and our country to stay healthy and safe during these unusual times.


KING: As of today here's where states stand on when and how to reopen schools? States in red say they're leaving it up to each individual school district to determine their own start dates. States in yellow don't have a final plan just yet.

Joining me now is Tony Thurmond he is the California State Superintendent of Public Instruction. Good to see you again, Mr. Thurmond. If there's any state that proves we cannot have a one size fit all approach to this, it would be your state our most populist state 10,000 schools, 1000 districts, 6.2 million students and more than 360,000 teachers. So, you are a leader of a monumental task. Where are you today?

TONY THURMOND, CALIFORNIA STATE SUPERINTENDENT OF PUBLIC INSTRUCTION: Thanks for having us on. What we're doing is having guidance to provide to those 1,000 school districts but working with them as we know that most of our districts are making their own plans.

You know, obviously no one knows exactly what the future holds but we know that when the school reopens in late August and early September for most of our schools that students will have to come back to temperature checks and wearing a mask and sanitizing our classrooms and maintaining social distance.

So, we're having those conversations to guide our thousand school districts about how to approach opening with social distancing conditions?

KING: So, every piece of this is complicated. Let me pick up on one of the pieces you just mentioned. You have 6.2 million students, 360,000 teachers, masks. School districts provide the masks. These are children. Masks are going to get lost. Masks are going to get soiled. What are you talking about? You're now essentially -- you're in the hospital business, right? You are in the PPE business as you try to reopen schools?