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Texas to Start Reopening Stores Friday Despite Lack of Testing; Study Says No Benefits and a Higher Death Rate for Patients Taking Hydroxychloroquine for Coronavirus; Scientist Helped Develop Saliva Test Speaks to CNN; Virus Threatens Financial Survival of Rural Hospitals. Aired 3:30-4p ET

Aired April 21, 2020 - 15:30   ET

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

[15:30:00]

BRIANNA KEILAR, CNN HOST: Across the country there are new concerns about the U.S. food supply after coronavirus forces more processing plants to shut down. Plus, nursing homes report they are still not getting the supplies they need to keep residents safe.

We are our team of reporters covering those angles and more. We start with CNN's Ed Lavandera on how one of the largest states in the country is starting to reopen this week.

(BEGIN VIDEOTAPE)

ED LAVANDERA, CNN CORRESPONDENT: I'm Ed Lavandera in Dallas. State leaders here are rolling out what they describe as a phased approach to reopening the Texas economy.

State parks opened on Monday and on Friday what's being described as retail to-go will begin and that's essentially giving retail stores a chance to sell to customers on a drive-thru basis.

The Lieutenant Governor of Texas made the eyebrow raising comments of saying that there are more important things than living and that's saving this country. He says opening up the economy here is worth the risk of spreading the coronavirus. This in a state with a dismal testing record. Less than 1 percent of the population here has been tested for the coronavirus.

AMARA WALKER, CNN CORRESPONDENT: I'm Amara Walker in Atlanta. Nursing homes across the country are facing a catastrophic situation.

They are still struggling to get access to protective gear for their healthcare workers and unable to get testing done quickly enough. Now this as long-term care facilities are seeing coronavirus cases and deaths go up.

Now Genesis Health Care, one of the largest nursing home chains in the country, says its workers are reusing medical gowns when they are able to. An official says FEMA is working on a plan currently to get more supplies to these nursing homes. DIANNE GALLAGHER, CNN NATIONAL CORRESPONDENT: I'm Dianne Gallagher in

Atlanta. As the Trump administration talks about reopening the country, the food supply chain is concerned about additional closings. As more of the processing plants around the country begin to close due to coronavirus outbreaks, there are some senses that reopening is possible if they can get it under control.

Several large plants have since reopened. The concern now amongst union members and workers is whether those plants are going to be able to prevent additional outbreaks on these reduced lines.

(END VIDEOTAPE)

KEILAR: Thank you so much to all of our reporters across the country. And coming up, it is a drug touted by the President as a miracle for coronavirus. But a new study found it actually caused a higher death rate for patients. We'll have that next.

[15:35:00]

(COMMERCIAL BREAK)

KEILAR: Breaking news. A brand-new study of patients at the Veterans Health Administration medical centers finds there is no medical benefit for patients taking that anti-malaria drug hydroxychloroquine which has been touted by President Trump as a treatment for coronavirus.

Let's bring in senior medical correspondent, Elizabeth Cohen, who's joining me now. And just not only is there no medical benefit, Elizabeth, this study shows, and we should be clear other studies need to be done here, higher death rates among patients who took it?

ELIZABETH COHEN, CNN SENIOR MEDICAL CORRESPONDENT: Yes, much higher death rates. Actually, more than twice the death rate. And this was a lot of patients. This is a very large trial. Let's take a look at this.

This was done as you mentioned at Veterans Administration hospitals and they looked at 97 patients who took hydroxychloroquine, they looked backwards at medical records and found that almost 28 percent of them died when they looked at records. 158 patients who did not take it had a death rate of 11.4 percent.

Now, Brianna, I want to note caution just as you did, but in this particular case, this is a study on what is called a pre-print website. In other words, this study has not been reviewed by other doctors and it has not been printed in a medical journal. But it was done by respected doctors, University of Virginia and University Of South Carolina and a V.A. office in South Carolina.

KEILAR: Yes, I mean that number disparity is just -- it is so stunning though. And I want to ask you, Elizabeth, about the FDA now authorizing this first at home test for coronavirus. People would collect their own samples. This would be in the privacy of their own homes and then they would mail them into approved labs for results. Is that how it works?

COHEN: Yes. This is actually -- well, it's exactly how it works, and this is a really interesting step forward. People are given the test which includes kind of like a Q-tip and you swap the inside of your nose and then you mail it back to the lab.

Now, what's interesting about this is that I have personally have spoken to a couple of people who aren't feeling well, who want a test, but they don't know where to go to get a test or they're scared. You know, they don't want to get infected on their way to the test or infected by someone at the testing site. So, they don't really know what to do. I think they feel a little bit paralyzed. And if they could get a test at home, they would be more likely to take it.

And, Brianna, as we've talked about so many times, this is all about testing, testing, testing. The more people we can test, the better. If some people are more likely to do that test at home, it is great that they could do that now.

[15:40:00]

KEILAR: And Elizabeth, this antibody study that's out of L.A. County it found the actual infection rate could be 55 times higher and that 4.1 percent of adults in the count have or have had the virus. Tell us about that.

And also, we spoke with an expert yesterday who said be a little wary of these antibody tests because as we know the antibody tests have not been particularly reliable, but that that they also think that there are a ton of asymptomatic people out there.

COHEN: Yes, absolutely. All of those things are true.

So, let's take a look at numbers and then I'll go through those points one by one. So, we've been really relying on counties and cities to say how many people have coronavirus where they are. So L.A. County had thought they had about 8,000 cases of coronavirus but when they tested for antibodies and antibodies show if you had a past infection and got over it, they found it was more like between 221,000 and 442,000. That is obviously a gigantic difference.

Now, Brianna, to your point about antibody tests not being so great. The FDA really loosened their regulations. Hopefully L.A. County used one that's good. I would think that they validated it first. There are good ones out there. I would hope that L.A. County -- I would think that L.A. County used a good one.

KEILAR: OK because that's a very good point. Elizabeth, thank you so much. Live for us from Atlanta. We really appreciate it.

And let's talk now about this state of testing with Andrew Brooks. He is a molecular neuroscientist and genetics professor at Rutgers University. He actually helped develop a COVID-19 saliva test. Andrew, thank you for joining us.

ANDREW BROOKS, HELPED DEVELOP CORONAVIRUS SALIVA TEST (via Cisco Webex): Thanks for having me.

KEILAR: OK, so I want to get to your test here in just a moment. But first, what's your reaction to these stay-at-home tests. Because, you know, one of the big issues is there's currency in being someone who's immune. If you are someone who is presumed immune because you had it, you can possibly go to work. You can go out and do the things you need to do, whether it's for enjoyment or it's for your economic survival.

BROOKS: Yes, I know, it's a great point. And I think that at-home testing is going to have to take into consideration not just the actual tests, the safety, the stability of the sample and going to the lab that's going to run it. But also, how to identify and also properly medically manage patients.

So, I think that a real viable opportunity here is going to see a lot of telehealth companies step up in this process. Being able not just to make sure that the right person and you have the right questionnaire, but the right person is being collected through telehealth.

These capabilities exist. And then the appropriate, you know, reporting of results for a number of reasons. If you look at the EUA documentation with our test and others, is that just because also you test negative doesn't mean if there's clinical significance that you still need medical care.

Just because your COVID-19 negative doesn't mean that you might not be at risk in where you are in your infectious journey if you contract the virus later on or if you're asymptomatic.

KEILAR: No, it is a very good point. And let's talk about your test. Because it actually does not rely on nose and throat swabs which we've been talking about, they're in short supply, right. There are the tests but there aren't the swabs to do it. So, tell us about how this works and tell us about how that would save things like PPE for instant.

BROOKS: Sure. So, there are a number of factors. Like you had just talked about in the last segment, first off, why put medical professionals at risk or make people feel uncomfortable not knowing if the medical professional may, you know, be infected? So, keeping doctors and nurses, taking care of patients instead of administering tests is a huge priority.

Second, all of the PPE that's being used is tremendous. You could reduce and we've seen in New Jersey, in Middlesex County where they've quadrupled their collections moving from swab to saliva at drive- throughs -- a reduction of 90 percent of PPE.

You don't need to replace it with every patient that comes through. You hand them the saliva device, they roll up the window, they spit up to the line, they put the cap on, the preservation agent preserves that sample at different temperatures, through transit, transport until it's safely back in the lab and then it's tested.

And the third is when you look at saliva, as being a good source, when you sneeze on someone, the reason wearing masks, things are expelled from your lungs, from your respiratory pathway but a lot of what is aerosolized, it's what is in your saliva.

So, we looked at this as a tremendous source. We found a device in a solution from Spectrum in Utah that preserves this virus in a manner that allows it to be transported across temperatures, across states to be tested in any lab. And there is a huge savings in people and in PPE.

KEILAR: And if I could just ask you finally before we say good-bye, how accurate is it? Are you getting any false readings that are concerning?

[15:45:00]

BROOKS: So, in the study that we submitted to the FDA, we see 100 percent correlation between nasal pharyngeal or pharyngeal swabs and the saliva test.

KEILAR: OK.

BROOKS: So, I think the false data that's being reported is a function of the timing of testing and not necessarily the test. But saliva is robust and more sensitive.

KEILAR: All right, very interesting. We'll be tracking this. Thank you so much, Andrew Brooks.

BROOKS: Great. Thank you.

KEILAR: Some hospitals in the country were already struggling to survive. So why coronavirus is putting the future of badly needed rural hospitals in question.

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[15:50:00]

KEILAR: As hospitals and cities across the country are fighting for enough masks, gloves and ventilators to protect their staff and save patients. Rural hospitals are facing a different kind of crisis which is how to financially survive during the pandemic as they shut down elective surgeries out of an abundance of caution.

As CNN's Leyla Santiago reports, the result means that small town Americans may have a harder time getting the care they need without traveling for hours.

(BEGIN VIDEOTAPE)

LEYLA SANTIAGO, CNN CORRESPONDENT (voice-over): Among the rolling hills and the open fields, a laid-back community.

UNIDENTIFIED FEMALE: To me it's one of the best places to live.

SANTIAGO: Rural America has largely been able to avoid the worst coronaviruses. No packed ICUs or morgues filling up. But there are people with COVID-19. 80 percent of rural counties across the country have now reported cases. And though it is nowhere near the spike seen in metropolitan areas, for doctors like Dr. Donovan Beckett in West Virginia --

DR. DONOVAN BECKETT, PHYSICIAN, WILLIAMSON MEMORIAL HOSPITAL: It's devastating. I mean having COVID on top of it an already struggling health care system has been quite burdensome.

SANTIAGO: The presence of a pandemic is just one more financial burden on struggling rural hospitals, already trying to stay afloat. 19 rural hospitals closed last year, victims of cuts to Medicare and Medicaid funding and reduced populations.

DR. RANDY TOBLER, CEO AND PHYSICIAN, SCOTLAND COUNTY HOSPITAL: It's just a perfect storm for Armageddon.

SANTIAGO: Dr. Randy Tobler is an OB/GYN and the CEO of Scotland County Hospital in Missouri which serves about 5,000 people. When elective procedures came to a halt in response to the coronavirus, their revenues dropped by more than half.

TOBLER: When we were already in a tremendously fragile financial situation, it has really put a tremendous burden on our ability to meet payroll.

SANTIAGO: Last month the hospital furloughed some staff and reduced pay across the board, desperate to avoid running out of money and having to close, which would be devastating to the community.

TOBLER: Yes, these are the vulnerable populations. They're older and they're sicker. And they're therefore more vulnerable to the coronavirus menace.

DANIELLE BAIR, RECOVERING COVID-19 PATIENT: It is critical for our area to keep the hospital here.

SANTIAGO: Tobler's patients, Danielle and Jake Bair, are both recovering from COVID-19 and said having a hospital with familiar faces closer to home, made all the difference.

BAIR: We are about an hour from any other healthcare facility. And there are times when people need emergency care and we need it now.

SANTIAGO: Back in Mingo County, West Virginia, Williamson Memorial Hospital will likely shut down any day.

BECKETT: We've obviously had to do away with having elective procedures done, on an already struggling volume level. So that creates a perfect storm and makes it difficult.

SANTIAGO: After filing for bankruptcy late last year, the hospital was hoping a future partnership could save it. Then came COVID-19.

BECKETT: It was the last straw and the current owners decided that they would go ahead and pursue closing the hospital. SANTIAGO: The relief package Congress passed last month provided some

temporary relief to rural hospitals with a $100 billion fund for hospitals and other health care providers. It's not enough, Tobler says.

TOBLER: We were a vulnerable and remain a vulnerable and are probably now a more vulnerable rural hospital because there's no foundational change.

(END VIDEOTAPE)

SANTIAGO: And, Brianna, back here in Virginia, I spoke to a rural hospital in Bath County. They called the coronavirus crippling and they haven't even had a coronavirus case yet. But let's talk about those elective procedures. The decision of lifting the restrictions on that will be up to the state and the local governments. And I can tell you, some states are already having that conversation.

KEILAR: All right, Leyla, thank you so much for that report.

And coming up, Dr. Sanjay Gupta takes a new coronavirus antibody test. He'll look at his results, ahead.

[15:55:00]

(COMMERCIAL BREAK)

ANNOUNCER: This is CNN breaking news.

JAKE TAPPER, CNN HOST: Welcome to THE LEAD, I'm Jake Tapper.

We have some breaking news for you on a drug the President has been touting as a possible miracle treatment for coronavirus. It turns out one brand-new study shows that hydroxychloroquine might not be miraculous at all and in some cases could actually increase the chances of a coronavirus patient dying. We'll hit those details with Dr. Sanjay Gupta shortly.

But first, right now, the death toll in the United States from coronavirus is nearing 44,000. At this time last week there were about 25,000 deaths in the U.S. and despite that growing death toll, there is a deepening divide in the U.S. as some states begin to scale back measures in an effort to ease some of the economic pain of the pandemic.

You will soon be able to go to the gym in Georgia or to the beach or a department store in South Carolina. In Colorado, you will soon be able to visit a salon and visit the vast majority of businesses in Tennessee.

The White House suggested to states that in order to reopen, there must be a decline in the number of new cases reported each day for 14 days straight.