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U.S. Now Recording 67,000+ Cases on Average over Last Week; California Surpasses New York as State With Most COVID-19 Cases; Fauci on Pandemic: "We Do Not See Any Particular End in Sight"; Trump: I Think Coronavirus Testing is "Overrated"; U.S. Faces Major Hurdles for Vaccine Distribution Once Approved; Dr. Paul Offit Discusses U.S. Vaccine Development . Aired 11-11:30a ET

Aired July 23, 2020 - 11:00   ET




JOHN KING, CNN ANCHOR: Hello, everybody. I'm John King in Washington. Thanks for sharing your day with us.

Bad numbers today reinforce the everywhere-you-look challenge of a very bad coronavirus moment. Weekly unemployment claims are heading back up, meaning the summer case surge is taking a toll on the economy, as well as on hospitals, on test sites, and on your back-to- school planning.

The overall case count will hit the four million mark sometime today. And it's taken only 15 days to go from three million cases to four million.

To more numbers. Almost all of them sober. We're in the pandemic's worst month when you consider cases. Nearly 1.3 million added so far in July so far alone, and second-highest of new cases on Wednesday, 71,695.

The immediate challenge, of course, is to stop the surge. The national average of new cases over the last seven days, a record high, 67,429 new cases. Deaths, too, climbing. The United States reporting back-to- back days of 1,000-plus deaths for the first time since the end of May.

There's a pattern to much of this. The summer surge and then state after state re-imposing restrictions and then jobs lost. The first- time unemployment claims that I mentioned back up after a 15-week decline. That adds even more urgency negotiations now to negotiations up on Capitol Hill about more coronavirus relief. That's a Washington debate.

Where you live, out in the states, the immediate challenge is to slow the spread.

And let's take a look at how that works out. In some ways, this map is a bit more optimistic than it has been in recent days. And 23 states though still heading up. That's the orange. Texas the largest among them. That means more cases this week than last week.

If you look, Florida and California steady at the moment. And 22 states are holding steady right now. You'll take whatever progress you can get if you're in those states. Holding steady now. The challenge is, can you sustain that.

The 23 headed up and 22 holding steady. That's the yellow or the beige. And five states heading down, including Arizona, which had been part of the summer surge. The question is, can they keep that in the green and keep that to push it down.

Let's look at some of the other trends, including total cases. Exponential growth is what gets you. Back on April 28th, one million confirmed infections in the U.S. By June 10th, that doubled to two million. Then less than a month to July 8th, three million.

July 8th, that's earlier this month, from three million to four million we'll hit in a matter of 15 days. It's the exponential growth that tells you why you have to stop the surge.

The seven-day new case total, again, you can see the dip into May and then June starts and up the hill we go. And what a steep hill it is. A new record high recorded yesterday. Seven-day moving average of new cases 67,000- plus. That's a number you must shove down to stop the surge.

Where is it happening the most? In these states right here. Seven-day moving average in Florida, California, Texas and Arizona.

Florida, you hope that's coming down. Look how high it is. Starting from a high baseline. You hope it's starting to come down.

Texas trickling down a bit. Hope to flatten that. And California as well. These three big states California, Florida and Texas driving the numbers.

Arizona is down here. Again, it spiked, seemed to have plateaued a bit and heading down this week. And let's hope it stays that way.

You just look at the total cases, this is why we go from two million to three million to four million. When you have the big state like California, like Texas and like Florida, above 100,000 cases and climbing and above 4,000 cases in California. That's why the numbers start to go. Arizona coming up as well, of course, below the larger states.

California, our largest state, our most populous state, now the state passing New York with the most cases, 421,286 as of yesterday. The case count still coming in today. Again, look at the steepness of that hill. California's challenge now, flatten it and then push it down.

Stephanie Elam live for us in Los Angeles as California deals with this challenge.

Stephanie, the numbers are overwhelming. The question is, how do you fix it.

STEPHANIE ELAM, CNN CORRESPONDENT: That's right, John. You look at the overall amount of new cases that were announced in a day, yesterday hitting a new record there of 12,807. We're seeing that hospitalizations continued to rise. Yesterday, it went up by 79 new hospitalizations there.

But the positivity rate, you were mentioning that before. You look at that over the 14-day period and it's at 7.4 percent, down ever so slightly from the day before that. But when you look at the seven-day, it's at 7.6 percent. The state trying to keep that below 8 percent. But obviously a concern here.

Here in Los Angeles County, as we've discussed before, is the heart of the outbreak in the state of California, we are seeing here that, fourth day in a row, we've seen over 2,200 new cases announced -- I'm sorry, hospitalizations, I should say, announced in a day. So things not going the way you would like.

However, the mayor here, Eric Garcetti, saying we're not going to go into a further stay-at-home order right now because things have stabilized, even though at a higher number than they would like to see, at about 10 percent as far as positivity rate is concerned.

Listen to what the mayor had to say.



ERIC GARCETTI, (D), LOS ANGELES MAYOR: When you spread this lethal virus to a family member, it can kill them. So be smart. Don't gather. And please wear a mask. We need to assume that COVID-19 is everywhere right now. We need to be vigilant.


ELAM: And, John, I know, because you like stats and data, Los Angeles County is saying COVID-19 is killing twice as many people in six months as the flu did in eight months last year.

KING: Let's hope, Stephanie, that statistics get the attention and then people do what needs to be done to turn them around.

Stephanie Elam, live for us in California, the hottest of the hot spots at the moment, thank you.

Joining us to share his insights is our chief medical correspondent, Dr. Sanjay Gupta.

Sanjay, today, we'll hit a very tough mark, four million confirmed infections. That number alone might not mean much but the way we've gotten from three million to four million.

Listen to Dr. Fauci here. Where are we in this fight? He says not quite probably halfway. (BEGIN VIDEO CLIP)

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES: We're certainly not at the end of the game. I'm not even sure we're halfway through.

We are living right now through a historic pandemic outbreak, and we are right now in a situation where we do not see any particular end in sight.


KING: Help our viewers understand, Sanjay. What would it take so we could be having a conversation about containment?

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, you know, the same strategies apply here, John. Here's the big difference, though. When we look at numbers going up. We have to look at fact that they are going up but also the pace at which they are going up. You alluded to this a couple minutes ago.

But take a look at how long it took us to get from basically the new emergence of this infection to a million new cases. It's about 99 days. But the most recent million, from three million to four million, took about 15 days. So it's not just the -- the number of cases that's going up. It's the pace at which they are going up.

One of the metaphors used sometimes to describe this, John, think about it like this, a big cruise ship sort of moving through the ocean gaining speed. In the beginning, it would have been harder to slow down. But now that it's gained a lot of speed and is moving along, it has a lot of inertia. So even if you slam the brakes on, it would take a long time to slow down. It won't respond as quickly.

It's not to say that the same strategies can't work. They will have to be applied more aggressive and maybe need to be applied longer as well in order to make significant changes.

The longer you wait, it becomes harder to control, whatever metaphor you want to apply. It's not just the numbers but the pace we need to pay attention to -- John?

KING: The pace that we have to pay attention to.

I want you to listen to the president of the United States. He's back giving briefings, doing them solo. He's not inviting the experts in. He says he's talking to the experts.

I have to say, in the last couple of days, the president hasn't said anything nearly as outrageous as he said in the previous incarnations of briefings.

But he continues to say things that make the experts cringe a bit, including -- this is the president, not in the briefing room but in a FOX interview, on the subject of testing.


DONALD TRUMP, PRESIDENT OF THE UNITED STATES: To me it -- every time you test, you find a case and, you know, it gets reported in the news we found more cases. If instead of 50, we did 25, we'd have half the number of cases. So I think it's personally overrated but I'm totally willing to keep doing it.


KING: It's good that he's, quote, unquote, "totally willing to keep doing it." It's so misleading. If the we had half the testing, we would know of fewer cases but we would still have them.

GUPTA: Yes. Absolutely, John. Look, if you're doing testing right, ultimately, it should lead to a decline in the number of cases, because you would find people who have the infection, isolate them so they don't continue to spread it.

The fact that we lost all of February and some of march meant that the virus continued to spread. We weren't really testing then. And we need to do a lot more testing to eventually catch up.

John, I was talking to some sources a couple of days ago. And, you know, in the model that I just described, in an ideal scenario, you could get a test and, before you leave, you're told whether or not you are positive, and they start the process of contact tracing right there and then.

Right now, it can take days to get the results back. People forgot the contact and may not be isolating. And you can see the problem.

Testing is right now, because it's so lax, that we are using it to essentially signal where the hot spots are in the country. It's like here's a fire over there, go put it out. There's a fire over there, go put it out.

We won't be able to catch up if we're in fireman mode with regard to this pandemic. And that's because we're still not doing enough testing.

KING: That's a great way to put it.

On this point, our conversations in March and April and even into may were largely about New York or maybe Virginia to the north, if you will, the mid-Atlantic, up to the northeast.

Now we're watching -- and we can show some graphics. Seven-day moving average by region. It's the south and west that are driving the numbers right now in a dramatic way.


My question is, if you're the Midwest or the northeast, you're feeling a little bit better. You're trying to keep the numbers there. Can you, or is this an inevitable cycle? If you're having giant numbers in Texas and California, does it eventually cycle back or can the states in a better place keep it that way?

GUPTA: I don't think it's inevitable that they have to recycle. Although, a national strategy toward this would make it a lot easier to give them some confidence, you know, that they can keep the numbers down.

Two things jump out at me about that graph. One is you can look at Memorial Day weekend, that time frame, and sort of start to do the math and realize that that probably had a significant impact.

Countries sort of opened up again. People thought that this thing was gone, this pandemic, and, you know, I think they really let their guard down. We saw that where people congregate more, in the west and the south, during that time period. So that sort of makes sense in terms of what we're seeing there.

But the other thing, John, we're not really -- we're going to have this -- the model is going to be like, it gets really bad in a place and people start to say, oh, gosh, this is bad, let's wear masks. And hospitals are overflowing, so let's dial it back and stay home more and then they will improve.

And hopefully, they will stay low. But if they start to let their guard again, we're going to see these sorts of cycles in many places around the country.

KING: Got to get to a better way before we can have that part of the conversation of keeping it in place.

Dr. Sanjay Gupta, as always, appreciate your insights.

Remember, to our viewers, it's important. Dr. Sanjay Gupta will host an all-new coronavirus town hall tonight with Anderson Cooper and special guest Bill Gates. That starts at 8:00 p.m. Eastern right here on CNN. Don't want to miss that.

Coming up, once we do actually have a vaccine -- still a ways off -- but once we have one, who should be first in line to get it?



KING: The big summer case surge and the fact that the United States is on track to hit four million confirmed coronavirus infections today underscores just how critical it is to find a coronavirus vaccine.

The Trump administration, as we discussed yesterday, is spending billions to produce vaccine candidates, even before they are proven effective, so that if one gets the OK, they will be ready to ramp up production as quickly as possible. But who gets first access and who decides that?

CNN's Sara Murray joins us now.

It's a fascinating question, Sara. If this works out and if there's a viable vaccine, who gets it?

SARA MURRAY, CNN POLITICAL CORRESPONDENT: John, a great question, and one of many thorny questions that the administration is dealing with because it takes a lot to get this vaccine from a lab and into the arms of Americans. And the Trump administration is trying to prove that they are taking steps now to be ready when the vaccine is ready.


MURRAY (voice-over): After bungling everything from testing to personal protective equipment, the Trump administration is aiming to prove it can roll out a coronavirus vaccine to millions of Americans as soon as one is ready.

TRUMP: Operation Warp Speed.

MURRAY: The debate is already underway over who should get the first doses.

FRANCIS COLLINS, NIH DIRECTOR: I think the people are a little uneasy about the government calling the shots here.

MURRAY: To reassure a skeptical public this decision will be apolitical, the NIH director called the National Academy of Medicine, an esteem nongovernmental organization, and asked them to advise who should be first in line.

A second group of CDC advisers are also asking who counts as an essential worker. Should race and ethnicity factor in? And where do teachers fall on the priority list?

DR. ROBERT REDFIELD, CDC DIRECTOR: But, clearly, the vulnerable are going to be, if not the top priority, one of the top priorities.

MURRAY: The Trump administration is tapping top health officials and industry experts to lead vaccine plans rather than politicians.

But the administration's vaccine effort, Operation Warp Speed, is shrouded in secrecy.

DR. MATT HEPBURN, SUBJECT MATTER EXPERT, OPERATION WARP SPEED (voice- over): Certainly ask for both your latitude a little bit in terms of my lack of ability to provide a lot of specifics about what we're doing.

MURRAY: Vaccine developers already have contracts with the government to stockpile their product. And the administration hopes to have 300 million doses available early next year, a timeline vaccine experts believe is overly optimistic.

VIJAY SAMANT, BOARD MEMBER, BRICKELL BIOTECH, INC & VACCINE EXPERT: This is a big task. Even if you have a vaccine, getting these people vaccinated is a humungous step, humungous because you need to convince people you can get an optimistic message that the vaccine is going to be out in December, come December, you don't have a vaccine, people are wondering what happened. MURRAY: The distribution alone is a monumental challenge.

ALEX AZAR, HEALTH & HUMAN SERVICES SECRETARY: We're right at the beginning of Operation Warp Speed, work to lock down fill-finish capacity, as well as syringes, needles, and glassware. So, we've secured that to be able to ensure we're able to vaccinate the American people.

MURRAY: The federal government has shelled out hundreds of millions of dollars to companies like Corning for glass vials needed to transport the vaccine.

BRENDAN MOSHER, VIE PRESIDENT & GENERAL MANAGER, CORNING INCORPORATED: I think the U.S. is going to set a bar. Glass won't be the critical bottleneck and there will be a plenty to go around at the point a vaccine is ready.

MURRAY: Hundreds of millions of syringes are on order too, from companies like BD. Though contracts and industry experts suggest the government may come up short.

ELIZABETH WOODY, VICE PRESIDENT FOR PUBLIC AFFAIRS, BECTON, DICKINSON AND COMPANY: It is, I think, the beginning of the process. The U.S. government is preparing for two shots of the vaccine. And so, you know, assuming a population of approximately 350 million people, we're looking at, you know, a total of 750 million -- or excuse me, 700 million syringes, at least.

MURRAY: Once the vaccine is available, it could take a year to inoculate enough Americans to slow the spread. And that's if Americans agree to get the vaccine at all.

Safety concerns, politics, and fears among minority communities that they may be exploited or left out are all contributing to Americans' hesitation.


MURRAY: Now I talked to a senior Health and Human Services official who said they know they have a transparency issue around Operation Warp Speed. They know they need to win over the American public if they want people to actually get vaccinated.

And they are planning a big P.R. campaign. They are planning a number of television ads and they will feature the doctors, John, we're used to seeing in the briefing room, Dr. Fauci, Dr. Redfield from the CDC, and the surgeon general. Those should be coming soon.


KING: Fascinating questions you raised. We'll see if they can get this done on their timeline and who gets it. That's fascinating.

Sara Murray, very much appreciate the reporting.

Let's continue the conversation with Dr. Paul Offit. He's the director of the Vaccine Education Center at Children's Hospital of Philadelphia.

Dr. Offit, good to see you again.

Let me start with the process and then the substance. When you see Operation Warp Speed and Pfizer and other companies getting billions of dollars, where they say produce your candidate in mass quantities and then if it gets the OK, we'll have it ready to distribute.

Do you think, given the scope of the problem and that we'll hit four million confirmed infections today, that that's the right approach, or do you have questions about that?

DR. PAUL OFFIT, DIRECTOR, VACCINE EDUCATION CENTER, CHILDREN'S HOSPITAL OF PHILADELPHIA: I certainly think it's right to prepare, that when we find out that these vaccines are safe and we find out that they are effective, that we're in a position to distribute the vaccine.

What worries me in this is we're spending a lot of time about how many millions and millions of doses we can make when we haven't found out if they are safe and effective yet.

We don't know and we're not going to know that until we do a large phase three prospective, where 20,000 people get a vaccine, as has been recommended by the National Institutes of Health, and 10,000 people get a placebo.

If you look at all the hoopla that surrounds that U.K./Oxford vaccine, that paper that was published in "Lancet" last week or the past few days should never have been published.

I mean, it was billed as a 1,000-person study but roughly 543 people got the virus. The so-called replication defective simian adjutant. It's a monkey virus that causes colds, replication, meaning it can't reproduce itself.

And because it can't replicate itself, these people were inoculated with roughly 50 billion virus particles. The virus then would enter your cells and make that protein that sits on top of the coronavirus, the so-called spike - OK, you make the spike proteins and antibodies.

And you think, 543 people, that's a lot. But when you look at the number of people they tested to see if they had neutralizing antibodies, they only tested 35. Where were the only 508 people? I'm sure that they obtained blood on those people. Why didn't they test them?

And when they looked at their dosed 35 people, they found, in fact, they didn't have a great neutralizing antibody response when compared to people just convalescing from natural infection.

And then what they did was they took 10 people out, non-randomly, and gave them a second dose and found the immune response much better. That was a 10-person study.

And I'm amazed that we talk, on the one hand, about this kind of a paper, which is a 10-person study, in essence, because AstraZeneca said it was going to be a two-dose vaccine, which can be tested.

And now we're talking, as they have talked about, making hundreds of billions of doses. What I ask for in all this is, please, wait for a phase three trial to make sure that we can mitigate the risks regarding safety and mitigate the risk regarding its efficacy.

It just makes me very nervous, John.

KING: And that's why we bring you back, sir. I want our viewers to know you're not somebody who just criticizes. You have decades and decades of experience on this yourself, including the patience to successfully vaccines over time. So that's why we bring back your expertise.

I'm assuming -- I know part of the answer already. Part of this deal yesterday with Pfizer. Pfizer is about to start a phase three trial, which you say is absolutely essential. October, they may be able to seek regulatory review.

And they're hoping to have 100 million doses and the OK available by the end of the year. That's their process and what they are doing. We should all wish them well.

But the president of the United States yesterday says I think we have a winner. Let's listen.


TRUMP: We think we have a winner there. We also think we have other companies right behind that are doing very well on the vaccines, long ahead of schedule.


KING: That's the part that I know concerns you. Let's do the research. Maybe more of it should be less public, more private until we have a bigger sample.

Do we know if we have a winner there?

OFFIT: No, we don't.

And what worries me the most in this is, as an election is coming up and we move toward the end of October, the administration would be tempted, since there are millions or tens of millions of doses by then -- it would be available in Warp Speed -- to reach their hand in and pull out Pfizer's vaccine, Moderna's vaccine or the U.K. vaccine.

And say, look, we tested it in several thousand people and it appears to be safe. These vaccines produce excellence immune responses. Therefore, we're going to roll it out to the American public.

When you don't know whether or not those immune responses are associated with protection. You're only going to know that by doing phase three trials.

And I just worry that the pressure of the upcoming election will cause us to do something that we may request.

Now, we may get lucky with the vaccine when it's in tens of thousands or , hundreds of thousand or tens of billions of people ends up being safe and it ends up being highly effective for a long period of time. But you want to mitigate the risk of not knowing those things exactly, at least by doing a phase three trial.

And I think -- you only have one chance to make a first impression here. And if the first vaccines we roll out are much less than what people hope for, you're going to lose what is a fragile vaccine confidence in this country.


KING: That's an important point.

Dr. Offit, we'll keep bringing you back and continue this conversation as we go through it. Appreciate your time and your insights today, sir.

Up next for us, another big factor in the coronavirus debate, positivity rates. We'll break down how one stat can help you figure out where your state stands in this very important fight.