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Health Professionals Offer Opinions on Efficacy of Hydroxychloroquine as Treatment for COVID-19; White House Coronavirus Task Force Warns of Possible New Phase of Coronavirus Pandemic; Tropical Storm/Hurricane Threatens Carolinas. Aired 8-8:30a ET
Aired August 3, 2020 - 08:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. HARVEY RISCH, YALE SCHOOL OF PUBLIC HEALTH: Below that it says that it only has data for use in inpatients, which is a totally different disease. So the FDA has no data on outpatient use, and yet it put a black letter warning against it. That, to me, is just unconscionable that they could do that and allow 45,000 deaths in the months of July alone because of blocking a medication that they had no data on.
JOHN BERMAN, CNN ANCHOR: The data is random placebo-controlled trials --
RISCH: We're talking about data of harm, data of harm.
BERMAN: -- which showed no benefit. And what they say is because there is proven benefit, the possibility of harm is not worth the risk.
RISCH: They have no evidence of harm, and, aside from the seven studies of about 1,500 patients have shown handfuls of death, two or three deaths out of some 1,500 patients in which these medication haves been used, there are two clinical trials, not randomized, but they are still clinical trials with adjustments for all possible confounding that you or I or epidemiologists can think of, all showing benefit. There's studies in the state of Brazil showing when they introduced 75,000 doses of azithromycin and 90,000 doses of hydroxychloroquine on April 6th, about five weeks later, after the medication began to dispersed, the exponential growth of mortality plummeted to an eighth the level of the peak because those medications were given out in large force. That's the evidence that shows these medications work.
BERMAN: Dr. Harvey Risch, we do appreciate your time. Thanks for coming on and discussing this. Be well.
RISCH: Thank you.
BERMAN: NEW DAY continues right now.
Good morning, everyone. Welcome to our viewers in the United States and all around the world. This is NEW DAY. Alisyn is off. Erica Hill joins me this morning. We've been discussing hydroxychloroquine. Joining us now, Dr. Jeanne Marrazzo, director of the Division of Infectious Diseases at the University of Alabama at Birmingham, and Dr. Frank LoVecchio, and emergency room physician and a professor at the University of Arizona College of Medicine. Dr. Marrazzo, I want to put this to you. I am not an epidemiologist. Dr. Risch is. My understanding based on speaking to many doctors and listening to Dr. Anthony Fauci is that these randomized placebo-controlled trials are the gold standard, and there is a reason we lean on them. Dr. Risch seemed to dismiss that.
DR. JEANNE MARRAZZO, INFECTIOUS DISEASE DIRECTOR, UNIVERSITY OF ALABAMA AT BIRMINGHAM: John, you were masterful in that discussion. You clearly have read what we consider to be the gold standard for evidence regarding hydroxychloroquine. And indeed, that is the randomized placebo-controlled trials.
Now, sometimes see a gap in what those trials show and what happens in the real world. And we call that distinction the perfect effectiveness that you would see in a randomized controlled standards and real world efficacy. That said, it doesn't mean that what you show in those trials should not be held as the truth. And in fact, those are the date that that really we respect.
Unfortunately, one thing we're seeing in this epidemic is that people don't really trust the experts who are really committed to figuring out what's going on here. And as I mentioned before, when you have infectious disease physicians with decades of experience using these drugs, treating viral infections, you really should, I think personally, like Dr. Fauci, go ahead and pay attention to what they're telling us as opposed to someone who I don't believe sees patients or has actually run a large randomized controlled trial.
BERMAN: Let me just jump in and ask Dr. LoVecchio one question here. My understanding of Dr. Risch, he is a Yale epidemiologist respected in his field, which is cancer research in epidemiology. And I'm not questioning that he's coming from a place of good faith or bad faith here. But Dr. LoVecchio, again, he's suggesting that something that I understand to be the standard in terms of mass use of a drug like hydroxychloroquine is the randomized trial, and he seems to be dismissing it out of hand. And I'm concerned -- I frankly am very concerned that people are going to hear him and say, oh, this Yale doctor says it's OK, so it's OK. The overwhelming feeling in the medical community is no.
DR. FRANK LOVECCHIO, EMERGENCY PHYSICIAN: I appreciate you having me on. I'm also an epidemiologist, and I also have a fellowship in medical toxicology. And I will tell you that you need to stop talking about hydroxychloroquine. There's no benefit. You have randomized controlled trials, sure. What he's talking about is other evidence. And when you don't have that other evidence, such as randomized trials, sure, you go by other studies. But in this case we have good evidence that it doesn't work. We talk all the time how toxic this drug is. One or two pills can kill a child.
[08:05:00] So if you have it at home and you thought you needed it and you have a child at home, please get rid of it. It is harmful. If taken six or seven tabs maybe by accident or if you have a heart condition, it can lead to death in adults. We need to stop talking about this and move on.
ERICA HILL, CNN ANCHOR: It's such an important point, too, which is why we are continuing to fact check all of this. The concerns about misinformation and mixed messaging are legitimate and they are real, and we are seeing more and more that that concern is growing.
That said, we're also hearing a little more now from the administration, Dr. Deborah Birx telling our Dana Bash yesterday that she's concerned about what she calls a new phase. I want to play that moment.
(BEGIN VIDEO CLIP)
DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR: We are in a new phase. And that's why I really wanted to make clear to the American people. It's why we started putting out governor reports directly to health officials and the governors in every single state, because we could see that each thing had to be tailored. This epidemic is different, and it's more widespread, and it's both rural and urban.
(END VIDEO CLIP)
HILL: Dr. Marrazzo, I know that doesn't come as a surprise to you, that it's more widespread, that it's rural and it's urban. Is that enough, though, in terms of the messaging at this point?
MARRAZZO: Well, Erica, I appreciate Dr. Birx being so forthright. That is the most, I would say, potent messaging she has really had around the extend of this pandemic and the epidemic in many states. Is it enough? It's a big shift in tone from someone who is the primary spokesperson about COVID for this administration. And I think it goes a long way for many people in restoring our faith that the truth is actually finally getting out there, and we really can start acting on it.
The only way we're going to get this under control, as I've said many times, is to recognize the data for what it is and collectively respond as a complete community as opposed to state by state, town by town, jurisdiction by jurisdiction.
BERMAN: Dr. LoVecchio, I was struck by the fact that Dr. Birx said people should start wearing masks at home. She was specifically talking about people who live with someone who may have a comorbidity or be in a vulnerable population, but still, wear masks at home, she warned, is something that we need to consider doing, which is a whole different level of behavior than we've heard from members of the task force. And I'm wondering how that struck you?
LOVECCHIO: I appreciate that comment of wearing a mask at home. I think it's a good idea, especially if you have somebody who is vulnerable, i.e. older folks, especially if the kids go back to school and are likely to come home and give the disease, give COVID-19 to someone in the household. Having masks is a great idea at home. Remember, when we talk about these benefits, having a mass decreases the incidence of transmission by about 40 percent or so. So I think it's very important, if you can do that. Always be outside -- do that, also.
HILL: As we look forward, there's so much hope for a vaccine. As we know, Dr. Marrazzo, this new reporting in "The New York Times" about just how much concern there is among scientists that the politics will seep through here. They even note a senior White House official who discussed the matter on the condition of anonymity said it would be unethical to withhold a vaccine for three or four months while more people died just to check the boxes of a more routine trial process. Which brings us back to where we started the discussion, in that there are certain measures in place for safety and for efficacy, and they are there to protect people as we hopefully get them a vaccine. Would it be unethical to hold something while we wait for some of that information?
MARRAZZO: That's an excellent question. And what you're seeing here is a really bipolar response to the possibility of a vaccine, right. On the one hand, you're seeing people who really are understandably desperate for some measure of prevention. People don't want to wear a mask at home. We can come back to that. But that is a whole other level, and I think that deserves more discussion.
But yes, people really desperately want a vaccine. The challenge is that those boxes that you mention that we check off in the clinical trials are not just for our comfort. They are for your safety as a research participant and as a citizen to whom we would like to get the vaccine eventually. Those boxes are critically important. So you've got people who really want it now, and then on the other hand, you say it's going too fast already and it's been politicized to try to rush it. We want to be somewhere solidly on the middle, on all four tires, taking our time but driving fast in order to get this out in a way that is responsible and effective. And that's what's being done for sure.
BERMAN: Dr. LoVecchio, I've had a chance to speak with you a couple times over the last month, some of those times when Arizona was in a really bad, bad place. Some of the metrics in your state now improving. What are you seeing on the ground?
LOVECCHIO: On the ground we are seeing improvement in the emergency department, and we think that after that hospital admissions hopefully are going down, and intensive care unit admissions are going down. It does not mean we need to let up. Last month we saw 60,000 new cases in the U.S., which is double what we saw the month before. So we're not where we want to be yet, but we went from about 25 percent positive for our COVID-19 tests to about 12 percent this last week. The trend is favorable, and we have to keep fighting this.
BERMAN: All right, Doctor, thank you for the work you're doing there. I know you've been fighting it hard for weeks and weeks now. Hope you can get some rest soon. So Dr. LoVecchio, Dr. Marrazzo, always a pleasure to have you on.
LOVECCHIO: Thanks, appreciate it.
HILL: Breaking overnight. Tropical storm Isaias is strengthening now as it approaching landfall in the Carolinas, landfall expected tonight. There has just been an update in the forecast. Meteorologist Chad Myers is tracking the system. What is the latest update, Chad?
CHAD MYERS, CNN METEOROLOGIST: The hurricane hunters in the storm right now finding the exact same pressure than when they left at 1:00 this morning. So things aren't really shaping up for this to get to be a big storm. The forecast is for it to get a hurricane, but a 70-mile- per-hour T.S. or a 75-mile-per-hour hurricane, the damage will be almost identical. The power outages will be identical, the surge will be almost identical. So don't put your focus on that T.S. word, tropical storm word, because it's still be 70 to 75 miles per hour.
The problem is that we've had dry air in here. We talked about this weeks and weeks about the Saharan air layer. Remember that dust layer that we had? It wasn't dusty this time, but the air was certainly drier than came off the Sahara and into this storm, and that didn't allow the storm to develop like some computers models said it would.
It is going to make landfall in the Carolinas, either South Carolina or North Carolina tonight. If it's farther to the left, let's say Murrells Inlet, you're going to be 8:00 p.m. If it's farther to the right, almost on up towards Myrtle or farther to the northeast, maybe as close as 12:00 tonight, just because the hypotenuse is bigger. But the threat is storm surge. We have high tides because of the full moon, already two to three feet higher than they should be, or could be, and then another two to three to maybe four feet on top of that. So you're going to push that surge into Charleston, you're going to push that surge into any estuary or bay along the Atlantic Ocean, and then you're going to put down six inches of fresh water rainfall trying to get back down those rivers. So that's where the threat could be.
And even on up toward the northeast, this is going to make power outages because our winds up here are going to be 50, 60-mile-per-hour gusts and the trees are going to be saturated with all that rain. Those trees are going to fall down, some branches will, and we'll have power outages as the week goes on. Not a widespread cat three storm. We watch it because there will be localized damage, Erica, but for now we're doing OK. We're going to keep watching it, though.
HILL: We'll focus on the OK, but we will not stop watching and being vigilant for all of that that is to come, as you point out. Chad, thank you.
There's little chance the 2020 election will be delayed. The result of the vote, however, could come a little bit later than expected, certainly not what you're used to. The Ohio secretary of state is with us next to explain.
BERMAN: New this morning, the President levying fresh attacks on mail-in voting, despite the fact that some states do it perfectly safety and reliably.
Let's bring in Frank LaRose, he is Ohio's Secretary of State and a top election official for the state. Mr. Secretary, thank you so much for being with us this morning. You can mail in ballots in Ohio. In fact, you're sending absentee applications, I think to everyone in the state, correct?
FRANK LAROSE, SECRETARY OF STATE, OHIO: That's correct, 7.8 million registered voters in the state are going to be receiving their absentee ballot request from us right around Labor Day weekend, and your right to say for close to 20 years, Ohioans from both parties have trusted absentee voting. It's a safe and secure process here in the Buckeye State.
BERMAN: All right, so nothing inherently flawed with the process as far as you see it.
LAROSE: You know, the biggest thing that we're watching for this year is we expect the highest volume ever. We normally see 20 to 25 percent of our ballots come in by mail. I'm telling our Boards of Elections to expect that number potentially to double, and so we're adding extra equipment, adding extra staff and reminding voters do not delay. Get your absentee ballot in right away.
BERMAN: That's the great message. That's a great message to send to people as a kind of public message that will help if people get in their ballots early, it will make the process easier.
Now, there is something and I think that you are issuing a warning that people need to be prepared for. If everyone sends in mail-in ballots or more people send in mail-in ballots, it's going to be hard to count them election eve, correct?
LAROSE: You're right to say and we're also, of course, making sure that Ohioans have the choice if they want to, to come and vote in- person on Election Day. We also have four weeks of early voting at the County Board of Elections with evening and weekend hours.
But if everybody waits until the last minute and mails in their ballot, let's say, the weekend before the election, yes, we will have a challenge with getting all of those processed on time.
Our Boards of Elections will rise to the occasion, but as you know, we may not see all the results on election night because of that.
BERMAN: Well, you say on time. In fact, there is no official on-time here. Everyone wants to know the results of an election on election eve, but the election is over when you count the ballots, and it may be that people need to be patient and learn to wait a little bit, correct?
LAROSE: Patience is going to be important this year. Of course, life has changed so much in the last few months and that includes the way that the ballots are going to be counted on election night.
It could take a while longer, you're right to mention. And with us relying so much more on absentee balloting this year, we could see a lot of ballots come in after Election Day.
We'll receive ballots for ten days at the Boards of Elections as long as they're postmarked before Election Day and those count. Every vote counts and we will make sure that every vote is tabulated. We will never sacrifice speed for accuracy.
BERMAN: Yes. Look, those ballots that are postmarked before Election Day that arrive up to ten days late are absolutely legal and there's nothing inherently wrong with it, although it might be frustrating.
People may need to be patient is what I'm trying to say and I know you're trying to say as well.
LAROSE: Absolutely. Patience is important. Accuracy is what we're going to focus on at our Boards of Elections, and every ballot that comes in deserves to be counted as long as it's legally cast, and that means that the results that we report on election night are going to be unofficial results and the results that we report in the official tally weeks later could change.
That doesn't mean there's something nefarious is happening. That's the manifestation of every vote actually counted and the system working as it should.
BERMAN: It's democracy, in other words. We have a word for that, counting every ballot.
Now, the Post Office, the Postal Service, what are your concerns in terms of what they can handle?
LAROSE: Well, the Postal Service isn't running at peak efficiency. I think that's an understatement. We saw this in the primary here in Ohio. I partnered with the Postal Service to try to make some last- minute changes. They were willing to implement a thing called an all- clear procedure, for example, where they go through their facilities every night.
And even with that, we saw some really more-than-expected delays. That's again why procrastination is such a bad idea in this context, and any voter should get their absentee ballot request in, and then as soon as they receive their ballot, they should send it in as well.
We don't want people waiting until the last minute because the mail isn't moving as fast as we expect it to normally.
BERMAN: What would be helpful public messaging from leaders in this scenario and/or beyond messaging, helpful public action? I don't know if giving the Post Office more money would help.
LAROSE: Well, of course, funding is more important. I know that the men and women of the Postal Service are working hard and they have got a difficult scenario, a very complex logistics.
But you know, the message is that I'm sharing with every Ohioan every chance I get is get registered to vote. Make sure your voter registration is up to date. That means if you've moved, you need to fix that.
And also, we need poll workers. We need 35,000 Ohioans staffing the polls to run Election Day smoothly, and so that's the other thing and then of course, if you are going to vote by mail and we encourage that, don't delay. Get your absentee ballot in right away.
BERMAN: Frank LaRose, Secretary of State from Ohio, thank you so much for having, I think, this very upfront conversation about what you've done in the past, what you are doing and what people need to be prepared for, maybe not election eve, but election week.
LAROSE: Thank you, John.
BERMAN: Take care. Erica?
ERICA HILL, CNN ANCHOR: Well, as we look at what's happening with coronavirus and this increase in cases, there's a growing concern about Midwestern states. We will be hearing a lot about this, specifically Ohio and Indiana. Could they become the next Florida? We are going to talk to two doctors from those states. They join us next.
HILL: Coronavirus cases is spiking across the Midwest which has epidemiologists concerned that the region could turn into a hot spot in a matter of weeks.
Dr. James Porter is President of the Deaconess Health System in Evansville, Indiana; and Dr. Andrew Thomas, Chief Clinical Officer for the Ohio State University Wexner Medical Center joining us from Columbus.
Gentlemen, good to have both of you with us. As we look at this, this rise in cases, the virus and the infection rate shifting up from the south. We know this has been a concern for some time.
But Dr. Porter, as I understand it, you're actually starting to see this on the ground. You've seen cases rising and you say it's not just the number of tests, but the positivity rate is also up.
DR. JAMES PORTER, President, DEACONESS HEALTH SYSTEM, EVANSVILLE, INDIANA: Yes, that's correct. We saw the lowest positivity rate and the lowest number of cases around the first to second week of June, and since then, we've been seeing a rise.
We got down within our health system to a positive rate of right around three percent and an increase to a high of about 10 percent and seem to be running eight to 10 percent at this point. HILL: That's still very high especially as we're hearing, too, from
Dr. Birx there is more concern now about smaller rural areas. You're saying you're starting to see more outbreaks in those communities. Can you get it under control, do you think?
PORTER: Well, we certainly hope so. We are -- our mayor in our city here implemented a mandatory mask order around the middle of July and, of course, the Governor of Indiana implemented that for the whole state around the end of July.
And as you know, there is always a lag between an intervention that's taken and when we see the actual effect occur. So, we're certainly hoping that mandatory masking is going to make a difference.
We've definitely seen the number of people wearing masks out in public in our community increase pretty dramatically as a result of those orders.
HILL: You know, Dr. Thomas, one of the other things that we've been hearing about is how travel is impacting the spread of this virus that could also be contributing to what we're seeing in the Midwest as more people head south, maybe head to the coast and then make their way back. Is that a factor in what you think you're seeing in the Columbus area?
DR. ANDREW THOMAS, CHIEF CLINICAL OFFICER, OHIO STATE UNIVERSITY, WEXNER MEDICAL CENTER: First of all, thanks for having me this morning. I think travel is an important issue, but I think even more important than where someone goes is what they do when they go there, much like even when you're at home.
If you are essentially controlling your environment, not going into public places with large crowds, you're wearing a face mask, you're washing your hands, you can go on vacation safely. But you need to be paying attention to the exact same things you've been paying attention to at home while you're on the road.
I think certainly flying on planes is a little less safe than driving. But if you're wearing a mask, washing your hands, going on vacation in and of itself is not unsafe. Certainly, there are parts of the country with higher number of cases, but it's what you do when you go there.
If you're going to bars and restaurants not wearing a mask, going out with large crowds to hear bands, and those sorts of things, you're going to potentially come home with a virus.
HILL: Are you worried that Columbus could become a hot spot?
THOMAS: Certainly, we were at the tipping point a few weeks ago. As was stated earlier, less than five percent is really the target for the C.D.C. in terms of a pandemic being under good control.
What we saw was our positivity rate ticking up in early July. It got to seven percent and I think we were really at a tipping point. It could have gone one way or the other. Now, the good news is, the Governor has put in some new orders around
face masking. We have developed a new public health advisory system that is county based which gives warnings to people in local communities about what the risk is in their community.
And what we've seen over the last two to three weeks is a slow decrease to the point where our seven-day rolling average, the positivity is back down to under five percent.
So we think this is something that the citizens of Ohio can handle. We've handled it before, we've bent the curve back in the spring and we think they can do it again if they just pay attention to those key things -- wearing a mask, keeping your social distance, washing your hands and washing high touch surfaces.