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The Lead with Jake Tapper

Are Hospitals Prepared For Coronavirus Outbreak?. Aired 4-4:30p ET

Aired March 19, 2020 - 16:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

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NICK WATT, CNN CORRESPONDENT (voice-over): Carnival Cruise Lines now offering up its fleet.

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: If we should need ships with lots of rooms, they will be docked at New York and Los Angeles and San Francisco, different places.

WATT: A field hospital also now on U.S. soil, Washington state. Around 10 million Californians told to shelter in place, clusters cropping up, at least 46 positives now at this one Illinois care home, three dead, four others infected in just one extended New Jersey family.

DR. SEJAL HATHI, MASSACHUSETTS GENERAL HOSPITAL: Hospitals across the country are rapidly running out of masks, gowns, protective eyewear that they desperately need. We are being asked to reuse and recycle single-use respirators and surgical masks when we go see patients.

WATT: The CDC now advising, use homemade masks, e.g., bandana, scarf, for care of patients with COVID-19 as a last resort. And in areas with community spread, consider allowing asymptomatic take exposed providers to work while wearing a face mask.

Here is one face of this growing pandemic.

KEVIN HARRIS, CORONAVIRUS PATIENT: You choke. You throw up. The pain. The headache.

WATT: Because even if you don't suffer much, you can give this to others, although up to 20 percent of coronavirus hospitalizations in the U.S. are between 20 and 44, according to a new federal study.

DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: People need to pay attention, no matter your age.

WATT: Some U.S. congressmen have not confirmed they have the virus. Georgia's entire legislature told to self-quarantine for two weeks after a state senator tested positive.

GOV. ANDREW CUOMO (D-NY): I am not going to imprison anyone in the state of New York. I am not going to do martial law in the state of New York.

WATT: But they are considering converting New York City's hotels into hospitals. They are giving people a three-month break from mortgage payments. And?

CUOMO: Seventy-five percent of the work force must stay at home and work from home.

WATT: Netflix now reducing the bit rate on streaming in Europe, so we don't all actually break the Internet while we hunker down.

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WATT: And another fact that just bears out how we're changing the way we live our lives, Domino's Pizza is advertising for 10,000 new employees, pizza delivery one of the very, very few boom industries right now.

And how long is this all going to last? Well, nobody really knows. Today, the president was asked what happens after the 15 days that we have been told to do this social distancing? His answer? We will know on day 14 -- Jake.

JAKE TAPPER, CNN HOST: Yes. And it's probably going to last a lot longer.

Nick Watt, thank you so much.

Joining me now is CNN chief medical correspondent Dr. Sanjay Gupta.

Sanjay, masks are in short supply. We have been covering this now for weeks. You have health care workers making their own masks, reusing expired masks. We talked to an E.R. doctor in the last block -- in the last hour talking about how they're using the same mask more than once now.

The CDC even issued guidelines saying medical personnel might have to use bandanas or scarves as a -- quote -- "last resort." How fraught is this?

GUPTA: Well, I mean, obviously, that was very jarring, I think, for a lot of people to read who are health care providers who would be in that situation.

I mean, look, not only do these bandanas or scarves not work to protect someone from the virus. I mean, we're told that it really has to be an N95 mask. Even surgical masks don't provide a lot of benefit.

So this is a very different sort of tone that people are hearing. And, look, I just interviewed this couple. Husband is an E.R. doctor. Wife's at home with their kids. And they're not at that point yet at the hospital where he works.

But if they get to that point, she's also worried that he can then bring that back to the family. So it's the doctors themselves, the nurses themselves. It's their patients and then the families. I mean, that's the nature of what's happening here.

TAPPER: I interviewed a couple like that as well, and the husband was sleeping in the garage, and basically not spending any time with his wife or their three kids, one of whom is like 3 weeks old.

The CDC also issued some new guidance, this also must have been jarring for health care professionals, saying health care workers showing slight symptoms can keep treating patients. How did you read that?

GUPTA: Yes.

I mean, look, so the specific guidance was, if you have been exposed, and even if you're showing symptoms, you can continue to take care of patients as long as you wear a mask. That is, if you have a mask, again, right, not a bandana or a scarf?

Let me tell you something, Jake. The problem is that, first of all, that's a very different guidance than just a few days ago. A few days ago, people were told to go quarantine themselves for 14 days. And now they're saying, look, even if you have symptoms, not just an exposure, it's OK to keep taking care of patients if you're wearing a mask, which you may not be able to get.

It gives you a sense of the fact that they really recognize how short on staff they're likely to be at some of these hospitals. I mean, I don't fault the CDC. That's where this guidance came from.

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I mean, I think I fault the overall planning. The CDC is just trying to keep up now, I think, with coming up with any contingency plan possible. The problem is, they -- those doctors or nurses can then become vectors and infect other patients and other colleagues, whatever.

TAPPER: Yes.

My sister is a doctor in Western Massachusetts. And her hospital, Berkshire Hospital, sent home 160 employees because of possible exposure to a coronavirus patient. They had to hire like four dozen nurses to take their places, obviously still not sufficient.

And now that advice is completely changed.

GUPTA: Yes.

I mean, and if you -- look, I mean, we get to talk about this right now. But for these -- these health care providers on the front line, I mean, they're living that, like the couple that you have interviewed, like people that I have interviewed. They're living that.

So now it's OK if I'm sick and have been exposed to keep taking care of patients. And, by the way, I might not get a mask. I might have to use a bandana or a scarf. Look, I wish I was making this up, Jake, but that is what they're

hearing. And, I mean, many of them may say, look, is it worth the risk? I'm worried about taking this back home to my family. I'm worried about spreading this to other patients. I mean, health care providers are doing incredible work here.

They have got to be given the resources. And right now -- in many places, they have the resources. But, as you know, Jake, in some places, they don't.

TAPPER: Too many places, they don't.

So, coronavirus cases in the United States have now topped 11,000. That's up from 1,000 this time a week ago. Some of that is attributable to the fact that there's more testing out there, but some of it is also attributable to the fact that it's spreading.

Now, the White House Coronavirus Task Force coordinator, Dr. Deborah Birx, said today that they think that more than 50 percent of the confirmed cases originate from 10 counties in just three states.

That's obviously New York, Washington state and California, and, more specifically, it's the San Francisco area of California. For the sake of stopping the spread, for the sake of flattening the curve, should these counties consider at least ordering residents to shelter in place, which doesn't mean imprisoning? You're allowed to maybe get out and get some fresh air, as long as you stay six feet away, but, generally speaking, keeping people inside?

Should that be considered?

GUPTA: Well, look, Jake, I mean, maybe I'm going to get some angry e- mail about this, but I would take it even a step further.

We have identified these places where the virus is clearly spreading substantially. But I'm still -- like, because we have been so undertesting here, I think there are many more places where the virus is spreading, and we just don't know yet.

If you look at what has worked in places where they have really seemed to make some impact on this coronavirus, there have been sort of substantial, call it shelter in place, which is sort of a weird term, frankly, for this, because I don't really think of shelter. I think of that like school shootings or storms or something, but stay inside your house, almost always, except for essential things.

I think that needs to be sort of a blanket thing right now across the nation, and, look, not just those communities, but everywhere, because if you're not doing it for yourself, you're helping keep other people protected as well.

The way you break the cycle of transmission is to really, truly do this for a while.

If we don't do this for a while now, Jake, we're going to be doing it a lot longer, and with larger numbers later. So we have got to do this, and I think everywhere.

TAPPER: Everywhere.

And, look, obviously, the Chinese government was not honest and open about this. And, obviously, there are some serious planning problems when it comes to the U.S. government, not to mention how much certain leaders in the U.S. government, starting with the president, belittled this.

But this is where we are. This is where we are. And it really is up to the population of the United States, young people, old people, and Gen X'ers, whatever, to take this step to try to take it into our own hands, because we really can't rely necessarily on the government solving this problem for us.

GUPTA: Absolutely, Jake.

And we know that this can work, OK? I don't -- people aren't just making this up. And people may say, how do that this even works, this physical distancing? Because it's been done throughout history where you see significant impact of this physical distancing from one another.

We have seen it even more recently in other countries around this particular outbreak. So I think it's -- I think it's very important to remember, according to recent data, that four out of five people who have contracted the coronavirus infection in China got it from people who didn't know they were infected.

Let me just say that once more. Four out of five people who were confirmed to have the coronavirus infection got that infection from people who didn't know they were infected. Everyone has to behave like they have the virus.

That's not to scare you. That's the change the way you behave and make it so that you don't transmit this to others and are less likely to get it yourself.

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TAPPER: I think it was a week ago when somebody died, a 72-year-old man, right outside Kansas City that a lot of us internally at CNN were saying, oh my God, it's -- it must be everywhere, because this guy had not traveled anywhere. They didn't know who he had had contact with it that he got it from.

But this poor guy, this 72-year-old right outside Kansas City got it. Then it's everywhere.

GUPTA: I think there's plenty of evidence of that, even if you go back to Washington state, Jake.

The first patient diagnosed in this country in Washington state in January, when they looked at the genetic sequence of the virus and tried to compare it the viruses that were infecting people six weeks later, it was very similar, suggesting that, basically, that the virus had been circulating in that community for a month-and-a-half.

I think, especially in places where you have had a lot of international travel, I think it's pretty clear the virus has been circulating for some time. But now, I mean, you look at the map, I think the map, that this virus is here, so much so, Jake, that as much as we focus on testing, which I think continues to be important, the testing really was to try and determine, how widespread is this?

I think we're starting to know the answer to that question, even without the testing, because it's clearly here.

TAPPER: And it's not just killing old people, not -- which is to say nothing about the people that are belittling the deaths of people over the age of 60. But it's everywhere. And anyone can get it.

Dr. Sanjay Gupta, thanks, as always.

And, of course, you can see more of Dr. Sanjay Gupta tonight. He will be co-hosting the CNN global town hall, in partnership with Facebook, along with CNN's Anderson Cooper. The two will be working to bring you answers about the coronavirus pandemic. That's 10:00 p.m. Eastern, only on CNN.

I believe Dr. Fauci will be with them as well.

Coming up, the State Department telling Americans abroad to return home immediately, unless you're prepared to stay outside of the country indefinitely -- the new advisory next.

And ahead, many businesses in America may never be the same again -- how some major corporations are trying to adapt to this new reality.

Stay with us.

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TAPPER: Breaking news, the State Department in the U.S. now telling Americans not to travel abroad because of the threat of coronavirus. Just moments ago, the State Department raised the travel advisory to the highest level. It's a level 4.

CNN's Kylie Atwood joins me now from the State Department to explain.

Kylie, does this mean if you go abroad for any reason, not listening to the U.S. government, you might not be able to get back into the U.S.?

KYLIE ATWOOD, CNN NATIONAL SECURITY CORRESPONDENT: It's possible. So, this is the highest level of advisory regarding the U.S. travel that the State Department can issue. They are telling Americans don't travel internationally. They shouldn't take this lightly, because I want to give you a little context, Jake, this is a level of advisory that the State Department usually uses for places like Syria, Afghanistan, where the Americans could travel and face situations that would lead to death.

So this is very serious, if Americans do choose to travel abroad, I want to read to you what the advisory says. It warns, quote, if you choose to travel internationally, your plans may be severely disrupted and you may be forced to remain outside of the U.S. for an indefinite time frame, essentially saying that we cannot assure you will get back to the U.S. in a quick amount of time here, telling them to stay home.

TAPPER: I don't have to tell you or our viewers, it was just a few days ago President Trump was belittling the threat of this virus. He's thankfully in the last three days been on a completely different page in acknowledging the great threat. But there are Americans traveling or who travelled around the world and what might this advisory mine for those who are stranded in places like Peru or Morocco where the government said shut down all commercial flights?

ATWOOD: Yes, well, that's the reality here, Jake. There are many Americans who are in countries that can get on flights. The State Department is saying if you have commercial travel available to you right now. If you can find flights back to the U.S., get on those flights.

But there are thousands of Americans in countries where they have shut down their borders, where they have shut down their international airspace, which means these Americans can't find ways back to the U.S. And so, President Trump was asked about this today. He said the administration is working on this, we could see some U.S. flights into these places, but this is something we know the State Department is working on around the clock. And people are frustrated in countries where they want to get back into the U.S. -- Jake.

TAPPER: A lot of hard working government employees trying to make sure that these Americans get back home safely. Thanks so much, Kylie Atwood.

As doctors and hospitals sound the alarm of a lack of medical equipment, President Trump said today it's up to the governors of each state, not him to find those supplies. But as CNN's Boris Sanchez reports now from the White House, President Trump does have the authority to expand production of medical supplies. But for now, he is not using that authority.

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BORIS SANCHEZ, CNN WHITE HOUSE CORRESPONDENT (voice-over): President Trump today deflecting blame for the coronavirus pandemic and lashing out over reports that hospitals are facing shortages of medical supplies.

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: The governors are supposed to be doing a lot of this work, and they are doing a lot of this work. The federal government is not supposed to be out there buying vast amounts of items and then shipping. You know, we're not a shipping clerk.

SANCHEZ: The president causing confusion after signing the Defense Production Act to boost manufacturing, but then tweeting that he didn't plan to use it.

TRUMP: You don't know what we've done. You don't know whether or not we've ordered. You don't know if we've invoked it. You don't know what's been ordered, what's not been ordered.

SANCHEZ: While Trump insists the administration was prepared for the outbreak, he couldn't explain alarming reports from emergency rooms about a lack of personal protective equipment. Instead, blaming the media for reporting their stories.

TRUMP: I cannot explain the gap. I'm hearing very good things on the ground.

We were very prepared. The only thing we weren't prepared for was the media.

SANCHEZ: Trump also placing some responsibility on China for suppressing critical information about the virus as the outbreak unfolded.

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TRUMP: It could have been contained to that one area in China where it started. And, certainly, the world is paying a big price for what they did.

SANCHEZ: Though a few days after the first COVID-19 case was discovered in the U.S., Trump tweeted that he, quote, greatly appreciates their efforts and transparency. It will all work out well, offering a direct thank you to President Xi Jinping from the American people.

As Congress finalizes a trillion dollar economic rescue package, Trump touting bipartisanship.

TRUMP: I think there is a great spirit of the Democrats and Republicans are getting together and they're trying to get things done.

SANCHEZ: Though Trump's own campaign launching false accusations at Democratic front runner Joe Biden, misrepresenting Biden's statement in a press release claiming the former vice president is siding with the Chinese during the outbreak.

Biden's camp saying Trump is grasping for distractions, quote: Instead of obvious and frankly lame efforts to deflect responsibility, why doesn't President Trump do his job?

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SANCHEZ: And, Jake, President Trump and vice president Mike Pence wrapped up a teleconference with some of the nation's governors, many of those governors voicing concerns over a lack of concern for swabs for testing and overall capacity in many of their hospitals. The vice president simply telling them, we are with you every step of the way, Jake. TAPPER: Yes, I heard about that the question of swabs was going to be

next.

SANCHEZ: Yes.

TAPPER: Terrifying.

Boris Sanchez, thanks so much.

We're going to talk to an emergency medical physician next. Are the supplies that are supposedly being sped up and expanded, are they making them to the hospitals that need them?

Stay with us.

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TAPPER: Welcome back.

Hospitals throughout the world continue to sound the alarm about the anticipated rush of patients, saying they do not have the manpower, the beds, the masks, the ventilators to handle the surge. Business leaders here in the U.S. say they want to help but they don't seem to know how.

Tesla and SpaceX CEO Elon Musk went on Twitter and said, we will make ventilators if there is a shortage. Ventilators are not difficult but cannot be produced instantly. Which hospital versus these shortages? He asked that question of Nate Silver.

As CNN's Athena Jones reports, the worry is that soon, most hospitals could be facing these very shortages.

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ATHENA JONES, CNN CORRESPONDENT (voice-over): It's a warning authorities are sounding across the country.

GOVERNOR ANDREW CUOMO (D-NY): This is a crisis for our healthcare system management.

JONES: The coronavirus pandemic could overwhelm hospitals, particularly in and around big cities, leaving them without enough beds, equipment or staff to treat patients effectively. In New York, the state with the most COVID-19 cases in the country, Governor Andrew Cuomo issued an executive order to increase hospital capacity to make sure they're prepared for a potential flood of sick patients.

KENNETH RASKE, PRESIDENT, GREATER NEW YORK HOSPITAL ASSOCIATION: Nothing has been as large as this, this is huge.

JONES: Kenneth Raske, president of the Greater New York Hospital Association, is helping lead the state's effort. RASKE: We've asked every hospital throughout the metropolitan area,

New York to come up with a plan to add to their intensive care unit beds, because those are the ones most in demand.

JONES: New York's healthcare system has 53,000 hospital beds and 3,000 intensive care unit beds, according to Governor Andrew Cuomo and at the virus' peak, the state could need between 55,000 and 110,000 hospital beds and 18,000 to 37,000 ICU beds.

Both New York and New Jersey had been pleading with the army core of engineers to go temporary medical facilities, with the defense secretary says once deployed could help civilian hospitals by taking non-coronavirus patients off their hands.

MARK ESPER, DEFENSE SECRETARY: We could take care of your trauma patients so you can make up more rooms for patients with COVID-19.

JONES (on camera): And in a worst case scenario, large venues like this one, the Javits Center, a 760,000 square foot convention hall here in Manhattan could also be used to house patients.

(voice-over): But it's not just about patients. It's also about doctors and nurses.

JEAN ROSS, PRESIDENT, NATIONAL NURSES UNITED: We are not at all afraid to take care of the COVID-19 patients. It's what we do.

JONES: Shortages of personal protective equipment like masks could put healthcare workers at risk.

ROSS: Our complaint, our requests are begging for proper protective equipment is going on deaf ears. If you lose us, look what happens to the patients and the health of the community.

JONES: Machines like ventilators that save lives could cost lives in a shortage. Manufacturers are ramping up production but are struggling to keep up with the demand.

The administration is invoking the Defense Protection Act to expand production of protected gear. The defense says it will help with the ventilator supply.

ESPER: We are prepared to distribute to HHS up to 2,000 operational deployable ventilators for use as needed.

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JONES: Now, we've been focused on big cities, but rural hospitals could also be overwhelmed as this crisis worsens. We are talking much lower numbers here. Still, a representative for rural hospitals told me they serve communities that often have a high proportion of low income and elderly people, and people with high health needs and they often have much smaller facilities, 25 beds or fewer and have little to no surge capacity -- Jake.

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