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Dr. Tanira Ferreira & Dr. David Lang Discuss Florida Hospitals Running Out Of Room As Cases Climb; NY Governor Cuomo Gives Update On Coronavirus Response. Aired 11:30a-12p ET

Aired July 6, 2020 - 11:30   ET



KATE BOLDUAN, CNN ANCHOR: These are shocking numbers in and of themselves. But it's one thing to talk about the numbers, but what does that look like and feel like for doctors on the front lines in this fight right now?

With me right now is Dr. Tanira Ferreira, chief medical officer at the University of Miami Hospital, and Dr. David Lang, who is medical director of emergency medicine at the University of Miami Hospital.

A point of personal privilege, Dr. Lang helped lead the team that saved my mother's life two weeks ago.

So, Dr. Lang, it's fantastic to see you again. Thank you very much for being here.

Let me start with you, Dr. Lang.

Can you take us inside the E.R. right now, what you and your teams are seeing?

DR. DAVID LANG, MEDICAL DIRECTOR OF EMERGENCY MEDICINE, UNIVERSITY OF MIAMI HOSPITAL: We've been seeing an increase in patients coming in all ages with COVID symptoMs. We do not see many pediatric patients. So let's take out anyone under the age of 18 for us.

But our COVID patients are ranging usually 20s to late '90s now. Many of them are getting sicker. And our admissions have gone up.

But the testing overall, as you mentioned early in the show, the positive rate of testing has also increased.

BOLDUAN: Yes. Which is a scary, scary thought of exactly what all of that means.

Dr. Ferreira, what kind of changes have you seen in the last two weeks? Because when I speak with local officials on the ground, it's different, things are changing, and it's all heading in the right direction.

DR. TANIRA FERREIRA, CHIEF MEDICAL OFFICER, UNIVERSITY OF MIAMI HOSPITAL: Yes. Thank you, Kate, for having me. What we've seen is the number of cases hospitalized has almost doubled

to our COVID units. We have seen a younger population, but that's not to say that we've seen the range that Dr. Lang has described.

Obviously, we have been preparing since January. We have not stopped preparing. The plan is very comprehensive and fluid plan and we have been able to adapt.

At our hospitals, we test every single patient coming into the system. We test for COVID. And we sort of create the units that we isolate the COVIDs from the non-COVIDs. And we're able to adapt.

But certainly, we have seen an increase in the number of hospitalizations with COVID disease.

BOLDUAN: You know, off the top I listed off, Dr. Lang, kind of the latest numbers from Miami-Dade. Everything is up. Everything is the wrong direction?

We talk about numbers a lot, but what does that feel like? What does that feel like for the -- for you, the nurses, other lab techs, everyone in the hospital when you see these numbers jump, and what they are seeing and what they know is also going to continue coming their way?


LANG: Right, I think it puts a pressure --


BOLDUAN: Both of you can take a stab at it. Go ahead.

FERREIRA: Lang first.

LANG: I'll defer to my chief medical officer.

FERREIRA: Thank you, Dr. Lang.

Well, I think we have different stages of a surge plan. And our plan is comprehensive to the point that every single number of patients will go up a step, we'll go up a step. So we have a long preparation on that. But certainly it does stress the system.

But kudos to the staff. We've not stopped working. The staff continues to work, works nights, days, weekends. Yes, it all comes into preparation.

Dr. Lang?

LANG: I think it puts some stress on the system. We have been able to flex up and down over the past few of months as needed to see all the patients.

Look, our system luckily, as Dr. Ferreira said, prepared in January for this. We have daily meetings with administration, including our CEO, about, do we have what we need to manage our cases.

Our staff is working 24/7. Sometimes we flex up shift, we flex down shifts to try to get everybody seen and try to explain to the patient what is going on, what their diagnosis is, having to call them back with their diagnosis if they are COVID positive or negative, because the test isn't immediate. It will take several hours.


LANG: Depending on the day of the week, we can have a significant surge of patients coming in. And at least at this point, our system is -- they have been able to handle it pretty well.

BOLDUAN: Looking ahead, Dr. Ferreira, finally, you've seen these images from around the country, local folks in Florida are very nervous about what the Fourth of July meant in terms of the spread.

How worried are you, what you can be seeing coming through your doors in a couple of weeks, mark it from holiday weekend plus two weeks?

FERREIRA: Look, I think going back to the surge plan, I think it's not only staffing, the number of beds and number of ventilator capacity and number of medications can and obviously PPE.


As far as suppression, the key is people need to adhere. The scientific message has not changed, OK? And that message is social distance, wear a mask, you wash your hand, and if you're sick please go and get tests. That message has not changed.

What needs to happen, people need to adhere and follow that message.

Of course, we're concerned. We're monitoring the situation closely with authorities and local authorities working very closely. And we're trying to get that message out.

But you're seeing some increase in the numbers. And I think there's some local measures when you try to flatten to some extent the curve. And the flattening of the curve would require people to adhere to the safety measures for sure.

BOLDUAN: That's exactly right.

Doctors, thank you so much for your time.

We'll jump over to New York City right now where Governor Andrew Cuomo is speaking, making an announcement.

GOV. ANDREW CUOMO (D-NY): Our numbers are all good. So that's good.

Best news, a number of lives lost. And we're down to nine. It's unimaginable at one time that we would be this low. Obviously, you don't want to even see nine. You don't want eight, seven, six, five, four, three, two, one. But this is great, great news. The rolling average for number of lives lost is nine yesterday. We did 54,000 tests yesterday. On average, we do about 60,000 tests

per day. It's the highest testing rate in the nation, .95 positive. We normally run about 1.1, 1.2, somewhere in that range. So that's all good.

So what does this mean? What it means is, since we started reopening, which was May 15th we started our phased reopenings. The numbers have actually declined since we started reopening. You see the gold line under May 15th. That's where we were when we started reopening.

Every expert warned us, on the reopening, that you could see the numbers start to go up, right, because you were increasing activity. Our premise was you could moderate the activity so you could start the reopening but monitor the number of cases and control the phased reopening to keep the number of cases down. And that's just what we've done for the past seven weeks.

We're actually down from where we were when we started reopening, which, as you'll remember, no one predicted. The question was, when you start reopening, activity will go up, the number of cases will go up. Can you control the increase? That was the question.

We haven't needed to control the increase. We've actually had a slight decline. And now we're basically running flat. And that is great news. That is really great news.

And it's what we said from day one, with my great graphic that nobody liked at the time I originally did it, and nobody still likes, but I like it, so sometimes it's nice to be governor.

You have a valve. Control the activity and watch, monitor the valves to see if the infection rate is going up, the hospitalization rate is going up, and keep your hand on the valve. And if you see it start to go up, slow down the valve. If you don't see the numbers going up, then you can open up the economic activity valve. And that's what we've been doing.

That's what you see with these little corrections. So New York City goes into phase three but no indoor dining, right? So we have the phases, and then we have certain adjustments that we make to the phases. But the numbers show you that we're right where we want to be.

New York City goes into phase three today. No indoor dining. But there are rules on phase three, right? It doesn't mean go out and have a party. We have 50 percent occupancy for personal care services. You have to wear face coverings. The customers will wear face coverings, six-foot distance.

Prohibited services that require removal of face coverings such as facials. You can't get a facial. I did that against my own self- interest. I was supposed to get a facial today.

Close the waiting rooms. Employees providing services must be tested every 14 days. So there are rules.

[11:40:00] Tomorrow is phase four. Four was just in Westchester, Rockland and Hudson Valley. Long Island is on track for phase four on Wednesday. Their numbers are all good.

School reopenings. Just to make sure there's no confusion, there are 700 school districts this the state. The state has directed all seven school districts to come up with a plan on how they would reopen.

Because there's two levels of discussion. Should they reopen, and if they reopen, what does a reopened school look like in the, quote, unquote, "new normal," right?

So we've asked every school district to come up with a plan on what reopening would look like in your district. New York City is coming up with a plan pursuant to that question on what it would look like to reopen the New York City school system in September.

But there has been no decision yet as to whether or not we're reopening schools. We obviously very much would like to. Nobody even knows the effect that have going to have on students, socialization of young students, et cetera. We want kids back in school for a number of reasons.

But we're not going to say that children should go back to school until we know it's safe, right? And we have some time. This is a very fluid situation. And when we get the data, we will make a decision.

In the meantime, I'm telling all school districts to come up with a reopening plan. But we don't yet know if we're going to reopen. And we'll follow the data and we'll make a decision on data. The Department of Health is also working on this.

So every school district is coming up with a plan to reopen. That doesn't mean they are reopening, OK? Nuance sometimes is important. Not often but sometimes it is.

The -- on casinos and movie theaters, we're still looking at the data, but for now, they are going to be closed.

We are not going to open the state fair in Syracuse. This is a really tough one. Fairs all across the nation are not reopening.

We have a fantastic state fair in Syracuse. We've invested a lot of money. We've had record attendance, 1.3 million people last year. We broke the attendance record.

We invested money. We redid the whole state fair. We built a new expo center, 110,000 feet. It's really been amazing. It's been an economic boon for the whole region.

But this year, we're going to have to cancel it. And that makes me personally very unhappy, but that is where we are.

On the COVID transmission, following the facts, the facts are changing as they learn more about this virus. There's less concern about surface area transmission. More data that it is primarily an airborne transmission.

That then raising the question of, what can we do with air filtration technology. You hear this in an air-conditioned building. It brings air up into the HVAC system and runs through the HVAC system and gets recirculated.

What kind of filtration can you have on the HVAC system that may be capable of catching the virus as it's attached to the droplets? There are filters that systems install. HEPA filters are one of them.

And then a series of filters that are rated by the minimum efficiency reporting value, MER value. And the most-dense filters can actually filter out the virus, which is remarkable and interesting.

Nothing is simple with this virus. It depends on air conditioning system you have whether or not it can take one of these higher filters and still operate. And different systems take different filters. And we're working through this now.

We're spending time on it because I think there's a real possibility that we could actually have a positive contribution here. And different HVAC systems have different capacities. But we're working through this now.


Because, if there's a way to filter the air and a way to get COVID out of air, then we want to do that. And if we can do that without an exorbitant expense for existing HVAC systems, it's something that we have to look at.

So we're in the midst of that now. And as soon as we know something, we will make it public.

New Yorkers did the impossible. We went from the worst infection rate in the United States to the best infection rate in the United States. I like to say that we crossed the mountain. There's the mountain. We don't want the challenge of crossing a mountain range, right?

One mountain was enough. The last thing we need is to see this virus spike again. And there are two threats in that area. One, New Yorkers getting complacent. This is great. New York is doing great. The numbers are down. I heard the governor, he said everything is great.

We get complacent. We get cocky. And we get a little arrogant. That is a real threat. And it's a threat that I'm concerned about.

You look at the festivities over July Fourth. You see gatherings that are not socially distanced. They are not wearing masks. You see it in Manhattan. You see it on Fire Island. There are reports upstate of gatherings where people aren't socially distanced and people aren't wearing masks.

You know, I don't know how else to say it. Actions have consequences. Our success was a function of our action. You change your action, you change your behavior, you're going to change the outcome. It is that simple.

That curve was purely a function of what we did. If we change what we're doing, you're going to change the trajectory of the virus.

I understand people are fatigued. We've been doing this for 128 days. I get it. But it doesn't change the facts. And we have to stay smart.

We -- I need, we need every person in the state needs the local governments enforce the law. I talk to local governments all the time, mayors, county executives, et cetera. And I'm going to have another round of conversations today.

I understand that it is not politically pleasant to enforce the mask law or the gathering law or the socially distanced law. I get it. I get that politically it's difficult for the local governments to do it. But it is the law. And if we don't do it, there's going to be a serious problem.

It's not a local government law. It's a state law. So I get the politics. And I've said to them, I have no problem taking responsibility. Mr. Mayor, tell your police, when they go out to enforce the law, they can say don't blame the mayor, it's the governor, blame Governor Cuomo.

County executive, tell your police, don't -- when they hand out a summons, say this is not a county law, it's a state law, blame the governor. I don't have a problem with that. But they have to enforce the law.

We do not have a state police department that is large enough to enforce the law in the entire state of New York. That's why we have local police agencies. But they have to do their job and they have to enforce the law. And the law is clear.

And I don't want to be difficult or unnecessarily difficult, but I'm telling you, if we don't follow these behaviors, the numbers are going to go up. It's that simple.

The second threat is you now have 38 states in this country with an increasing virus rate of infection. It's getting worse. It's not getting better. You look at states like Texas, likes as and we've seen those curves. We've been there, done that. This is a frightening situation across this country.


Look at California. Look at the curve on California. We have been here. We have seen this. Deja vu all over again. A.J. Parkinson said that. No? Will Rogers said that? Just seeing if you're paying attention. I know it's a Monday morning. You're a little sleepy. Will Rogers didn't say it. Yogi Berra said it. Two points. But it's deja vu all over again.

This is how the virus came to New York in the first place. It got on a plane in Europe and it landed at JFK and Newark and that's why we had the spike. Nobody knew it at the time. Everybody was saying China virus. The

China virus had gotten on a plane, went to Europe, and it came here from Europe. Three million people got on planes, landed in New York, January, February, march. That's how we had the problem we had.

Now you're going to see people getting on planes from the 38 states in this nation where the virus is going up. They're now going to land at JFK, Newark, et cetera. You know, an outbreak anywhere is an outbreak everywhere. That's the new mentality we have to have.

We can't protect ourselves as an island because we're not. We have people coming in and out all day long. And when you have these spikes, in China and Europe, that's how it happened the first time, and now people can come from Florida, anywhere else.

We are already seeing it. We have had significant clusters where people came from out of state, attended a function, bang, the next day, we have an increase in the infections.

We're doing so many tests and so many tracings that we can trace it back to patient zero and they're very often from out of state. We have it down state. We have it upstate. It is inevitable.

So, yes, New Yorkers have to be smart. But we also have a problem that, if the virus is increasing anywhere, it is going to travel here and then we will have a problem.

Denying COVID is really advancing the COVID virus. And I know this is a politically charged environment right now. And somehow COVID has become a political issue, which I have never heard of a virus becoming political. But in this environment, it has.

But if you deny the problem, then you will never solve it. We're not the United States of denial. We have never been a nation that has excelled because we refuse to admit the problem. We admit the problem. And then we overcome the problem.

If we do not, as a nation, acknowledge the COVID viral increase, it is going to continue. Those upward numbers don't change on their own. They only change when you change them.

That number keeps going up unless you bend the curve. The bend doesn't happen naturally. The bend happens when people change their behavior and reduce the transmission rate.

So you look at those numbers in those states, those upticks are just going to continue.

That mountain, that didn't just plateau because God said plateau. It plateaued because we did masks and social distancing and closed down and all those activities and testing and tracing. That's how we bent the curve.

If we are in a state of denial, you will see that curve continue to go up. Now, how do you bend the curve? We know how to bend the curve because

we did it. You have to be aware of it, admit it, you have to take action and be committed to it. And it starts at the top with leadership. ]

The president said over this weekend, if we didn't test so much and so successfully, we would have very few cases. OK? Think about that for a second. What he is really saying is, if we didn't test, we wouldn't find the cases, and if we didn't find the cases, we wouldn't have a problem. That's incredible. But that's what he is saying.


OK, so let's just extend that logic. If we don't test, then we won't know. And if you don't know, then you have no problem. It's a great way to go through life, isn't it?

So on that theory, let's do no more cancer tests and that will solve the problem with cancer. No more mammograms because we don't want to know and that will solve breast cancer. No more prostate checks to solve prostate cancer. No more T.B. checks, that will end T.B. No more HIV tests, and that solves the AIDSs issue.

No! Not knowing doesn't mean you don't have a problem. And in this case, if you do not admit it and if you don't confront it, it's only going to increase.

We know it has to be done because we lived it here and we did it here. To bend the curve, yes, you have to test. Yes, you have to trace. Yes, you have to isolate. Yes, you have to phase the reopening. And you have to socially distance.

By the way, phasing the reopening is better than reopening recklessly, where you have the states, OK, we are reopening, everybody comes out, the virus goes up, the stock market goes down, and now the states are saying we have to close again.

A phased reopening is better than reopening and closing. That is not just a premise. It's been proven by the past experience. Look at the states that reopened recklessly and are now closing again. Who did that help? It actually set us back.

So, Mr. President, don't be a co-conspirator of COVID. Do one simple thing. Acknowledge to the American people that COVID exists, it is a major problem, it's going to continue until we admit it and each of us stands up to do our part.

If he does not acknowledge that, then he is facilitating the virus. He is enabling the virus.

How did this become a political statement? This is common sense.

And let the president start by sending that signal very simply, just wear the mask. I've been asking him to do it for weeks. Just wear the mask. And say to the American people, this is real, and it's a problem and we have to do our part. We started masks April 15th. First state in the nation to start masks.

They make a difference.

July Fourth, true patriots wear masks. True patriots are New York tough and smart and united and disciplined and loving.

UNIDENTIFIED REPORTER: Governor, one of the things the president said in recent days is that the virus is no longer as lethal as it was when it started in New York. He's made the case that 99.9 percent of the people that get it are fine and you basically just need to live with it.

I wonder what your response is.

CUOMO: Yes. I know what the president says. The president says a lot of things. Right? They're not necessarily facts or true, 99.9 percent. They then had the FDA commissioner on the television saying is the president right, and he wouldn't say the president is right.

He makes up facts. He makes up science. He wants to deny the COVID virus. He has from day one. Well, just like the flu. Well, it is going to be gone by Easter. It will get warm and then disappear like a miracle. He said all those things. None of them were true.

And now we have a problem in 38 states because some people believed him. He won't wear a mask. Vice President Pence says wear a mask. All the health officials say wear the mask. He won't wear a mask because he doesn't want to admit that there's a COVID virus. Why? I have no idea.


But his denial of the problem and his making statements like that, 99.9 percent don't have to worry about it, OK, then there's no issue.