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Job Crisis Worsens As Calls Grow For Widespread Testing; Doctor Calls Search For Treatments Complete Chaos. Aired 7-7:30a ET

Aired April 16, 2020 - 07:00   ET

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

JOHN BERMAN, CNN NEW DAY: Needs to be dramatically increase before people can go back to work.

[07:00:02]

Polls show that a vast majority of Americans are not comfortable returning to old routines right now. The U.S. is still testing at a far lower rate than many other countries.

ALISYN CAMEROTA, CNN NEW DAY: John, there's a brand new study that indicates that people may be most infectious two days before they show any symptoms. So what does that mean for getting people back to work?

We are 90 minutes away from what is expected to be another devastating jobs report. Economists are forecasting another 4 to 8 million Americans filed for unemployment claims last week.

So let's begin there with CNN's Julia Chatterley on the economic toll of this pandemic. What should we expect today, Julia?

JULIA CHATTERLEY, CNN BUSINESS ANCHOR: More devastating numbers, Alisyn. This is a reality check, an economic reality check of what we're doing purposefully to fight the virus. As you said, we could see anywhere between 3.8, even as high as 8 million people filing for first-time unemployment benefits just in the last week alone. You can see the estimates there. They're all over the place, relaxed certainty on just how many people are getting through. We've known this for a while.

If I add this to the millions of other people over the past three weeks that have also been asking for help, we could be talking up to 23 million people in the space of four weeks filing for first-time benefits. We are looking potentially at an unemployment rate in the United States of 17 percent.

Just imagine what we're seeing just in the space of four weeks, and what that means for the people involved. And the worst part of this, Alisyn, is that we're not done yet. We know states are struggling to process these claims.

Just as I spoke to you in the last hour, I've had a number of freelancers contact me and say, in my state, I still can't get through. And that could be a further 23 million people. We've got another hour-and-a-half or so to wait until we get these numbers, but devastating, again, for everyone involved is the message.

BERMAN: Julia Chatterley for us. Please keep us posted throughout the morning.

Joining us now is Dr. Paul Goepfert, he is the Director of Vaccine Research Clinic at University of Alabama at Birmingham, and Dr. Rochelle Walensky, the Chief of Infectious Diseases Division at Massachusetts General Hospital.

It's interesting, we just got an economic report. But it is so directly tied to the medical reality in this country this morning, so much so that business leaders, Dr. Walensky yesterday told the president that they need to see more testing before they're comfortable reopening at the levels that the president seems to want to right now. More than 60 percent of Americans say they are not comfortable returning to old routines just yet.

Why is testing, in your mind, so important to reopen an office?

DR. ROCHELLE WALENSKY, INFECTIOUS DISEASE CHIEF, MASSACHUSETTS GENERAL HOSPITAL: Good morning, John. Good morning, Alisyn. I think there are two kinds of testing that we're talking about. We need to understand how much antibody is out there, how many people might have been exposed, presuming that that antibody gives us protection against being exposed quickly again. So before a new vaccine were to become available, we need to understand how many might, in fact, be immune. That helps us understand how crowded we can be, how much protection is out there in the population.

We then another test. That's the viral swab, the N.P. swab that everybody has been talking about to understand how many might have the disease right now. And because of these data that, in fact, people might be able to transmit before they have symptoms or maybe they might get no symptoms at all, we really need to understand how many people might be transmitting asymptomatically. And for that, we need a lot of tests. Meaning, I might test today because I don't have symptoms. I might test tomorrow and not have symptoms. So we're talking about millions of tests.

CAMEROTA: Dr. Goepfert, let's talk about that. Because this new study published in Nature of Medicine has gotten a lot of people's attention. The idea that the highest viral load a patient exhibits from throat swabs is two days before they exhibit any symptoms. Okay. That sounds to me -- I mean, you're the medical expert, but that sounds to me like a game changer in terms of how could we ever know who has the virus if it's before they have symptoms. And, by the way, why were people being tested two days before they showed any symptoms? How do we have this information?

DR. PAUL GOEPFERT, VACCINE RESEARCH DIRECTOR, UNIVERSITY OF ALABAMA AT BIRMINGHAM: Yes, thank you, Alisyn. Those are all great points. So this is an interesting study that was done in China, published in Nature of Medicine. And it did show that the majority of virus seems to be shedding prior to the onset of symptoms which would explain a lot. That really explains why -- it goes a long way in explaining why this has become a pandemic. [07:05:00]

And how they got them to test before had to do with context, so there were context of people who were sick and came down with the infection and then they started testing these context on a regular basis and then found out that they were actually shedding virus before they developed symptoms.

So that really explains why there's so many infections that a lot of people I talked to will -- who have gotten infected, they tell me, I got infected. I don't know anybody who was sick, and that happens a lot. And this explains that.

BERMAN: Well, is the answer to the question that Alisyn asked, Dr. Walensky, how can we know who has it if you're not seeing symptoms? You have to start testing who aren't symptomatic. Which means that in my office, right, the person in the cubicle next to me, in this case, it's Alisyn Camerota, does she need to be tested even though she's not symptomatic for me to feel comfortable coming back to work?

WALENSKY: I think that that's what we're getting at. When you start thinking about people who work in crowded places, who might be in the restaurant industry, who might be teachers, who might be working sporting events, that's the kind of testing we're talking. And we're not just talking once a month. We're talking potentially once every other day to really be able to detect this really early, isolate those folks, contact trace the people who they might have exposed and quarantine them. And so when you're talking about that level of intervention that we need, you need a lot of tests.

CAMEROTA: I find this conversation to be frustrating because -- I don't mean our exact one at this moment, I mean, the one we've been having for weeks because we don't have enough testing. So, yes, we all need testing to feel comfortable to go back. We don't have it. We don't have the capacity for it. We don't have the capacity to even manufacture it right now.

And to that's why I always veer, Dr. Goepfert to treatments and to a vaccine, because somehow that feels as though we're fast tracking that even more than the capacity for testing. I know your finger is on the pulse of not only the vaccine. First, let's just talk about the treatments you, also your colleagues are also working on the remdesivir. I hope I'm saying it right. But that -- we've heard about that drug and that may be being able to be employed. Is that our best hope?

GOEPFERT: Well, remdesivir is our hope right now. We're testing it for people who are hospitalized. That's just a fraction, as you know, of the people that are out there with the disease. So I don't think remdesivir is going to be much helpful, at least the way we're using it now to sort of get us back to work.

However, remdesivir could potentially be a useful drug to help people survive. And we should -- because the trial has been enrolling throughout this country and other parts of the world, we should have an answer to that question within a month or so. The vaccine development -- and let me also mention that vaccines are going to be a little bit longer off, unfortunately. I think we can gear up testing much more rapidly than we can get a vaccine. And remember, antibody testing, as Dr. Walensky mentioned, is also extremely important. We don't have that right now. We don't have a reliable antibody test right now. Although that's coming on board too and I think that would be tremendously helpful in getting us back to work to get off this quarantine stuff.

But vaccines take a while. There're several vaccines now, about five, that are being tested in phase one, which is just safety. And we'll know the results of that in a couple months, a month or two maybe. And after that, you have to do another phase of testing, which takes a couple months. And then, finally, you have to test for efficacy and you have to have enough cases that are still going around to be able to test a vaccine for efficacy.

And so --

BERMAN: Can I just ask very quickly, Dr. Goepfert? What have your preliminary results show in your test of remdesivir?

GOEPFERT: I mean, there is no way to know preliminarily. It's randomized control study. So half the patients get placebo, half the patients get the remdesivir active drug and I don't know who gets what. So there's no way I can tell exactly what's going on. And that's the way we've enrolled internationally over 700 patients, close to 800 patients now.

BERMAN: That's the way you do testing. It is so interesting for people, I think, to see it in real-time. You're agreeing, you're nodding, Dr. Walensky.

WALENSKY: Well, I want to just reiterate that we're in a point right now where the virus is winning, right? And so we need a multipronged plan of attack and none of them can we let off the gas. We need antibody testing, we need virologic testing, we need treatment, we need a vaccine. And I think we need to kind of go full steam ahead on all of them because right now we're losing the battle.

CAMEROTA: Yes. I mean, that is discouraging, obviously, to hear, that the virus is winning, but we can see that with our own eyes from the people that we all know and interview who are getting sick.

[07:10:00]

And the governors saying how hard it's going to be to restart the economy and let people go outside.

But, I mean, again, Dr. Walensky, don't you get discouraged by saying the vast, widespread testing we'll need but then knowing that we're nowhere close to it?

WALENSKY: Well, yes and no. You know, here is sort of the way I see it. We didn't know about this virus until January 1. When you look at the extraordinary scientific discovery that has happened, the tests that we have already, the treatments that we're testing in multi-site clinical trials, the fact that we have a vaccine, numerous vaccines already in phase 1, I mean, nobody would have predicted that was even possible.

When you look at somebody who might have diabetes, for example, they test their blood sugars at home four times a day. We know that those kinds of tests, we know that testing at a massive scale is possible in other situations. So I think we have the potential to get there. I don't think that that's -- that we've lost that potential. But I do think we have to, if not get there immediately, really understand that we need to sort of have the social distancing in place until we get there and be patient with that.

BERMAN: Dr. Walensky, I wonder if you can weigh in on a new bit of information we received overnight, and that comes from medical officials in South Korea, that 114 people there who had recovered from coronavirus, from COVID-19, they were sick and got better or at least they had it and got better, or recovered, have now tested positive again for the virus. Can you explain exactly what that means? Because, obviously, one of the things we're concerned about is the question of whether you can get it again once you've had it.

WALENSKY: Right. It's really interesting and I think we're going to be following this carefully. We know from relatively small animal studies that if you re-challenge animals who've had it before, they didn't get it. They were small studies in animals.

I think there are a couple of things that could be happening with this South Korean study. One is, did they document the fact that people cleared virus to begin with? So we know people can be shedding virus on average about three weeks and sometimes over a month after they have been infected. So is it the case that they actually did completely clear their virus and are now shedding it again, or is it the case that they've been re-infected or is it the case that they cleared but didn't fully clear? I think we really need to understand where in their disease course and whether this truly represents reinfection or persistent infection.

CAMEROTA: Yes, that would be helpful, Dr. Goepfert, because, obviously, that changes the alarm bells. Because if these are just traces of the virus that they are still shedding, then that's one story, and that's different than them not having immunity and getting re-infected.

GOEPFERT: Yes. I think it's also important to point out that in any type of viral infection, not everybody can develop protective immunity. And that's why we need things like vaccines and the community protection. And I don't know the details of this study, but it is possible, another possibility is that these individuals didn't develop the type of antibody protection that's necessary to protect them from a subsequent infection. And it's still possible that the majority of people are developing those antibodies. We just don't know.

And I think Dr. Walensky rightly pointed out that this is such a new pandemic. It's been January 1. But we're learning a lot very quickly and I feel confident that we'll get ahead of this virus.

BERMAN: we're learning a lot thanks to doctors like the both of you. So thank you so much for being with us this morning. Dr. Goepfert, Dr. Walensky, we really appreciate it.

GOEPFERT: Thank you.

WALENSKY: Thank you so much.

BERMAN: And be sure to join Anderson Cooper and Dr. Sanjay Gupta for a CNN coronavirus town hall tonight at 8:00 P.M. Joe Biden will join them, as well as Facebook founder and CEO Mark Zuckerberg and Dr. Priscilla Chan, on how Facebook and the Chan/Zuckerberg initiative are working to fight the coronavirus.

This virus is hitting the underserved communities in this country so hard. What is being done to ensure that help gets where it's needed most? That's next.

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[07:15:00]

BERMAN: This morning, doctors and drug companies worldwide are racing to develop effective coronavirus treatments. But experts say the efforts here in the United States are disorganized and chaotic and the lack of a centralized national strategy is undermining the search. One doctor told The Washington Post, it's cacophony, it's not an orchestra. There is no conductor. My heart aches over complete the chaos in the response.

That doctor, Derek Angus, joins me now. He's a chair of the Department of Critical Care Medicine at University of Pittsburgh School of Medicine. And he's leading a COVID-19 trial that is testing multiple therapies. Dr. Angus, thanks so much for being with us this morning. Just explain to me what you mean by chaos.

DR. DEREK ANGUS, CHAIR OF CRITICAL CARE, UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE AND UPMC: Sure, John. So, first of all, it's not just at the national level, it's at the international level. So as you and everyone knows, we have no active treatment for COVID-19. We've got plenty of ideas about what drugs might work, but we need to test these drugs in trials. Otherwise, we're bungling along not knowing what works.

The drug you hear about a lot is hydroxychloroquine. Hydroxychloroquine is a synthetic version of quinine, a malarial drug. We thought this was a good idea for the Spanish flu. 100 years later, we still don't know if it works.

We have three problems with trying to do trials. The first is these trials themselves are hard, but then when we try to do them, hundreds of people are having ideas about trials, but they're all in competition with each other rather than collaborating with each other.

And then, finally, we're using trial designs that make people uncomfortable a lot of time at the bedside.

[07:20:05]

No one wants to be 50/50 to get either an active treatment or just being placebo group.

BERMAN: And no one wants to be the placebo, for sure, if they think there's any hope of the treatment working.

In terms of who is running it, there is a notion that it's supposed to be the National Institutes of Health. The director, Francis Collins, says, I think we have the necessary clout to steer this whole complicated ecosystem. I want to know what works and I want to have it answered by June or July. Is that not where the direction is coming from?

ANGUS: I can't -- it would be fantastic. I think they could have the clout. But that's certainly not what's happening right now. What's happening right now at university centers all over the country is physicians are being asked to participate in hundreds of different trials. And they can't even choose which one to enroll in.

There are 94 trials registered for the testing hydroxychloroquine. I've never heard of any drug needing 94 separate trials in the same disease.

BERMAN: Do you think -- that's interesting because I hadn't heard that. Do you think there's an overemphasis at the national, perhaps non-medical level on hydroxychloroquine and have you seen any evidence in these some 94 trials that you're talking about that it works?

ANGUS: We have no evidence at this point. And the problem is, if you're trying to do lots of little trials, that's not as efficient or as useful as trying to do large, coordinated trials.

We've had over 2 million confirmed cases of COVID-19, mainly in North America and Europe. and yet, barely more than a few thousands of these 2 million patients have been enrolled in clinical trials.

BERMAN: Talk to me about what you're doing. Talk to me about the testing you're involved in right now.

ANGUS: So we have tried to join in within international effort to design called a remap effort. And remap trials are adaptive platform trials that test multiple therapies simultaneously and try to give as many patients as possible at least one potentially active treatment, so that there's hardly anyone in the so-called placebo group. This trial then also learns as it goes, getting rid of therapies or combinations of therapies that don't do too well and favoring over time those therapies that are doing better.

We feel this is an easier trial design for patients and doctors to get involved in. And what we've been doing in Pittsburgh is trying to put it right inside the electronic health record so that the whole thing takes place across our entire system, not just in our big teaching hospitals, but in our small community hospitals so that any patient with COVID-19 can potentially participate in these therapies.

BERMAN: Do you have any early signs? And I know the way trials are conducted. You often don't. And I know you're smiling already because you have layperson, I'm sure, that you get asked this question a lot. Any sense of what has been working in any of these trials?

ANGUS: No. Look, that sounds depressing to say I don't know. We can find out -- as I mentioned before, there are 2 million people already who have this disease. If even one in ten had been able to participate in a trial, we could have gone through about 100 different drugs by now and known definitively which ones worked or not. But as it is, at this point, we could be excited about the potential of some but we can't tell among the hundreds of ideas, we have no idea which ones will be best.

BERMAN: If you could answer one question right now, if you could ring a magic bell and get the answer to one question about coronavirus this morning, what would it be?

ANGUS: You mean other than how can we have lots of tests for everyone?

BERMAN: Other than that.

ANGUS: For treatment, it would still be great to have a safe, easy to take antiviral that patients could take as soon as they have symptoms to avoid getting sick in the first place. That would still be an incredible --

BERMAN: I take it from your other comment, you still don't think there's enough tests in the country?

ANGUS: There's not enough tests in the country or anywhere in most of the world to effectively engage in smart or precision public health.

[07:25:04]

BERMAN: Dr. Derek Angus, this has been an education. I really appreciate your time this morning and helping us understand. It's been really, really enlightening.

ANGUS: You're most welcome, John. Thanks.

BERMAN: All right. So what did China know about coronavirus and when did they tell their citizens, if not, the world? A live report from China with the facts, next.

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CAMEROTA: We are expecting another devastating weekly jobless report in the next hour that could wipe out all the job gains of the past several years. Economists are forecasting 4 to 8 million Americans will have filed for unemployment in the last week. Many of the newly unemployed are small business owners. And CNN's Vanessa Yurkevich tells us about their stories. What did you learn, Vanessa? VANESSA YURKEVICH, CNN BUSINESS AND POLITICS CORRESPONDENT: Good morning, Alisyn. That's right, those numbers that are coming out in about an hour now are going to be in the millions from the Department of Labor. And many of them small business owners who are trying to figure out, one, how to save their business, but also how to save their personal livelihood.

[07:30:01]

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UNIDENTIFIED FEMALE: Everything was just prospering and just growing.

UNIDENTIFIED MALE: Everything was actually really good.

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