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Smerconish

Scenes Of Hope In America's Coronavirus Crisis; Why Calculating COVID-19 Death Rate Is Complicated; Doctors Could Change Approach To Life-And-Death Decisions; Should Virus Shutdown Be Modified To Prevent Other Fallout?; Will Trump Put His Signature On Relief Checks?; Can Biden Compete With Trump's Coronavirus Platform? Aired 9-10a ET

Aired March 28, 2020 - 09:00   ET

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

MICHAEL SMERCONISH, CNN HOST: You don't need me to tell you that it's been a tough week, but let's not forget that while we're witnessing a 21st century test of American ingenuity, in many ways we are proving our resiliency. Just consider a few examples.

The state of New York has been hit hard with more than 44,000 confirmed cases of coronavirus and at least 500 deaths, but in response, more than 62,000 medical professionals have volunteered their services according to New York Governor Andrew Cuomo. That number includes practitioners who are coming out of retirement to put themselves in harm's way.

PPE is now an acronym that's part of our lexicon, personal protective equipment, and as healthcare workers struggle to protect themselves, there's some good news. A company called Fanatics normally manufactures major league baseball jerseys at this time of year, but they just halted production and instead are making safety masks and gowns for healthcare workers in their 360,000 square foot plant in Easton, Pennsylvania.

The executive chairman, Michael Rubin, explained, quote, "The COVID-19 crisis has compelled our country to be more collaborative, innovative and strategic than ever before. As the demand for masks and gowns have surged, we're fortunate to have teamed up with MLB to find a unique way to support our frontline workers in this fight to stem the virus who are in dire need of essential resources."

The pandemic has closed schools across the country, but in my house, like many of yours, three sons are still getting instruction, one in grad school even taking finals. They've been using the same video calling app that enabled their sister to have a virtual birthday party this week, Zoom. The company based in San Jose, California saw their iOS app become a top free download in Apple's App Store and not only is Zoom being used to keep educations on track, it's also uniting families literally around the globe.

Here's more ingenuity. "Victory Gardens" have historically been the stuff of wartime conflict. They earned their name after springing up in World War I and underwent revival in World War II. In the latter, according to "The New York Times," so many people took to the movement that at one point it's estimated that home school and community gardeners produced close to 40 percent of the country's fresh vegetables from about 20 million gardens. Well, today, according to various gardening metrics, Americans, worried that routine grocery shopping will increase exposure to coronavirus, are toiling again in their own backyards.

And then there are entertainers, too many musical performers to name them all, offering virtual concerts to boost the spirits of their fans. Miley Cyrus, John Legend, the Dropkick Murphys, Coldplay's Chris Martin among them. The Boss, Bruce Springsteen shared his Live in Hyde Park show for the first time.

Keith Urban did a half-hour set at his Nashville warehouse and streamed it on Instagram. Tomorrow night, Sir Elton John will host a living room concert benefiting Feeding America and First Responders Children's Foundation. Disney even brought "Frozen II" to its streaming platform three months early.

And public volunteerism on the rise. "Vox" reports that Google Docs, Google Forms and other spreadsheets are circulating online with the words "mutual aid" in the title. That's a fancy way of saying we should all help each other get through this pandemic giving what we can to neighbors and strangers alike. In these shared documents, thousands of people are jotting down their contact information and offering to do just that.

But perhaps my favorite celebration of American ingenuity comes from Neil Diamond. Sadly, there's no baseball being played at Fenway, but we still have this appropriate take on "Sweet Caroline"

(BEGIN VIDEO CLIP)

NEIL DIAMOND, MUSICIAN: Hands, washing hands, reaching out, don't touch me, I won't touch you. Sweet Carolina.

(END VIDEO CLIP)

SMERCONISH: Bum, bum, bum. The U.S. now has the most known cases of the coronavirus worldwide, surpassing China and Italy. So how deadly is coronavirus? Well, that's complicated. Earlier this month, the World Health Organization estimated the virus' rough mortality rate at about 3.4 percent, but they note there's a catch. We can't rely on simple math to tell us a mortality rate when we don't have an accurate number of how many people have coronavirus to begin with.

There are unlikely far more infections around the world than we've identified, meaning that the true death rate could be lower than what we've seen reported. Some areas such as New York City are even telling doctors not to test sick patients unless they're hospitalized. This is just one factor that makes projecting the long-term consequences of the virus very difficult. Some worst case scenario estimates say that without a stay at home order or quarantines, the virus could kill millions in the U.S..

[09:05:02]

But two Stanford University professors are challenging that premise, saying the evidence isn't there. They co-wrote an opinion piece for "The Wall Street Journal" titled "Is the Coronavirus as Deadly as They Say?" Joining me now is one of those authors, Dr. Jay Bhattacharya, a professor of medicine at Stanford University. Doctor, let's say this at the outset. Nobody should misinterpret your opinion as one saying COVID-19 is a non-issue. That's not where you're coming from, right?

JAY BHATTACHARYA, PROFESSOR OF MEDICINE, STANFORD UNIVERSITY: You are absolutely right. COVID-19 is potentially a deadly disease and we should be very, very concerned and taking precautions and, you know, I think -- I don't want my piece to say that we should not worry about it. That's absolutely not the intention.

SMERCONISH: OK. So with that as our starting point, here's my question. Is the virus widespread, but not relatively lethal or deadly, but not relatively widespread?

BHATTACHARYA: I mean, those are the two poles, right? So either it's a widespread virus that's, you know, deadly in some proportion of cases or it's very, very lethal and it's relatively narrow. That's the two poles in the scientific community. The main purpose of our op-ed is to say we don't know how widespread it is and the reason is that we don't have a population level testing that's been done of how many people have been infected and recovered with the virus as yet.

SMERCONISH: Why might the NBA of all things be instructive?

BHATTACHARYA: So if you -- if you want to try to understand selection bias and testing, and that's really what we're talking about there, you need to look for populations where they've looked at everybody or a relatively large fraction of the population or at least some population representative sample. Ironically, the NBA is one of the very few in the United States thus far that's tried to do testing on a relatively broad set of a, you know, well defined population.

The things that we highlight in the -- in that op-ed that you mentioned are places where we could find where they tried to do much more broad testing and in many of those places, first, there were more people infected than people thought that, including with people with very few symptoms and then second, the death rate that you get from those places where there's more broad population testing look lower than the death rates you get if you just do the simple math which I think is very -- the simple math is very misleading. What we really, really need --

SMERCONISH: You remind me --

BHATTACHARYA: -- is a population level study. I'm sorry.

SMERCONISH: I was going to say you remind me of Dr. Jeremy Faust from Harvard who was my guest here two weeks ago who said that the Diamond Princess cruise ship is a laboratory experiment of sorts and suggests a mortality rate of closer to 0.85 percent.

BHATTACHARYA: Yes. I mean, I think it's -- I think it's much lower. The problem is all of these numbers are based on tests. If you have -- if you will, there's a numerator and denominator. The denominator is the number -- the numerator is the number of deaths and the denominator is the number of people who've actually been infected. What we really need to know is the number of people who have been infected and recovered.

In order to do that, you have to do antibody testing in a broad population. Actually this is something that I'm actively working on trying to develop antibody tests -- develop a population level survey with using antibody tests that have just recently come out in the last week and -- week and so, you know, first recently approved for the U.S. -- approved for use in the U.S. by the FDA.

So I think -- I think we will know the answer soon enough, but until we know that answer, I don't -- I mean, I feel uncomfortable telling people there's a 3 percent mortality rate when it could be much, much, much lower than that. It panics people in a way that is likely not appropriate.

SMERCONISH: Dr. Bhattacharya, I want to put on the screen one paragraph, one graph from your op-ed that you co-authored in "The Wall Street Journal" and have you explain it. It says this. "A universal quarantine may not be worth the costs it imposes on the economy, community and individual mental and physical health. We should undertake immediate steps to evaluate the empirical basis of the current lockdowns." Explain.

BHATTACHARYA: Yes. So there's two things to that. One is that the -- we don't know that denominator, so we need to run tests, population surveys of the the antibody response to the -- to the virus. That's the thing I told you just right now. The second thing is a global economic depression will kill many people, especially in poorer countries. You know, if you're on -- $2 a day is your income and you have a global economic depression and you go down to $1 a day, that has deadly consequences.

A universal -- a universal quarantine will -- I mean, as you see -- as we've seen, is likely to have catastrophic economic effects which will be -- which will have deaths.

[09:10:03]

I mean, the key thing is there's deaths on both sides of that policy, deaths from COVID if you don't do it, deaths from economic collapse if you do do it. It's a complicated question how much -- how to balance those, but we need good information on understanding sort of both sides of that equation in addition to the population --

SMERCONISH: I --

BHATTACHARYA: -- survey levels (ph).

SMERCONISH: I appreciate your time. I encourage people to get a broader picture of your analysis in that "Wall Street Journal" op-ed. I'm putting it in my Twitter feed so that it'll be easily accessible. Thank you.

BHATTACHARYA: Thank you. It's a great pleasure to talk with you. SMERCONISH: What are your thoughts? Tweet me @Smerconish or go to my Facebook page. I'll read some throughout the course of the program. This comes, I think, from Twitter. "This is not worthy of debate. People are dying. More are going to die. The headline should be universal quarantine will be costly to our economy, but we have -- please do better than this."

I don't know how we can do better than bringing to you the educated perspective of a Stanford PhD and physician who simply wants to rely on data and draw the public's attention to the fact that we really don't know the proper denominator and therefore, we really don't know the fatality rate. And you heard my first question, comment to him which was to say no one should misinterpret this conversation as being ignorant of the damage of COVID-19. Can't do better than that. Not junk science, real science.

I want to know what you think. Go to my website at Smerconish.com. This is the survey question this hour. Comes right from the doctor's perspective in "The Wall Street Journal." Is a universal quarantine worth the costs it imposes on the economy, community and individual mental and physical health?

Up ahead, hospitals battling COVID-19 are beginning to prepare for grim scenarios. If rationing supplies comes into play, they have to be able to answer this question, who should be saved first? I'll speak to someone who helped design the system for rationing organs in the U.S..

And a prediction I made 10 days ago may be coming true. How the politics of coronavirus are playing out and how the president wants to make sure you are aware of it.

[09:15:00]

(COMMERCIAL BREAK)

SMERCONISH: As the coronavirus pandemic continues to swamp the U.S. healthcare system, some hospitals could soon be making difficule decisions that healthcare workers in Italy have been facing -- which patients should get life-saving treatment and which do not? Hospitals in the U.S. are required to have some guidelines for addressing ethical issues like this. The overall goal is to save the most lives, so hospitals may consider a number of factors.

Geisinger Health System, which includes 13 hospitals in New Jersey and Pennsylvania, confirmed to CNN in a written statement that such conversations are taking place within its hospitals, but are still in development. Quote, "We do not plan to override patient or family wishes, but rather our goal is to have these conversations proactively with families early on during the treatment so there is uniform understanding of care that is safe and compassionate for patients, families and staff alike."

The discussions were first reported by "The Washington Post." Several other large hospital systems are also discussing issues around DNR orders according to "The Post." Joining me now is Art Caplan. He helped design the system for rationing organs in the U.S. which has been in place since 1985. Dr. Caplan is the director for the Division of Medical Ethics at the NYU Langone Medical Center. Dr. Caplan, I should say at the outset that Dr. Deborah Birx, with whom we're all now very familiar, throws shade on our even having this dialogue. Let's watch.

(BEGIN VIDEO CLIP)

DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR: There is no situation in the United States right now that warrants that kind of discussion. You can be thinking about it in a hospital, certainly many hospitals talk about this on a daily basis, but to say that to the American people, to make the implication that when they need a hospital bed, it's not going to be there or when they need that ventilator, it's not going to be there, we don't have an evidence of that right now and it's our job collectively to assure the American people that -- it's our collective job to make sure that doesn't happen.

(END VIDEO CLIP)

SMERCONISH: Dr. Caplan, are these conversations taking place in hospitals across the country?

ARTHUR CAPLAN, DIRECTOR, MEDICAL ETHICS DIVISION, NYU LANGONE MEDICAL CENTER: Absolutely. And they should and I disagree with Dr. Birx on this. It's not that we have to go out and say to people, you know, the time has come for rationing today, but you can look at hospitals in New York City and in northern New Jersey, they're getting close to capacity in a number of them.

People are worried in New Orleans and Detroit, other major metropolitan areas where they think the virus is headed next. So discussions are taking place. I have about 60 policies for institutions around the country that are being debated and they should. You have to be prepared, you have to get ready.

SMERCONISH: Are these the sort of protocols that are reduced to writing at hospitals across the country and are they uniform?

CAPLAN: Well, we don't know how uniform they are. Part of the reason I've been trying to collect them is to compare them. Excuse me, Michael. So you're trying to figure out consistency, why might there be differences. There could be differences between a small rural hospital with two beds and a gigantic health system like NYU with many, many hospitals and many beds. So not every inconsistency makes a difference.

[09:20:01]

But the core of your question, Michael, is, look, we have to have principles in place. A first one is that everybody gets an equal opportunity. We have to remind people that it doesn't matter if you're rich or poor, it doesn't matter if you're male or female or what race or ethnicity or disability you are. We have to consider you even in a crunch on an equal footing. So I think that's something I'm looking for in every policy and I want to say to people making those policies, that's where we start.

SMERCONISH: It sounds to me like the sort of theoretical conversation you've been leading in classrooms for more than three decades is now in reality, at least from a planning perspective.

CAPLAN: Well, here's the difference. We've been rationing organs in the United States, sadly we don't have enough organ donors, for decades. People die every day because they don't get a heart or a liver. We have a system, we have rules. I think they work pretty well. They basically aim at maximizing the chance that a person who gets an organ is going to live and do well with it.

However, this is the first time in my memory where every American, everyone in the world potentially, could face rationing. It's one thing to be a transplant candidate and know within that world it's a tough system and maybe you will and maybe you won't get an organ, but where we are now is I think everyone's worried will there be a bed, will there be a ventilator, will there be healthcare personnel if things really surge?

SMERCONISH: What factors might be taken into consideration? Is it physiology? Is it age? Is it, quote-unquote, "social usefulness?"

CAPLAN: So the discussions go somewhat like this. Let's be sure that we are letting everyone have a shot. Start out with equal opportunity. Don't penalize anyone. Then let's make sure that we use the resources, if they gets strained, prudently and wisely.

Let's make sure that we give access to beds or ventilators or personnel if they're in short supply where we think people are going to do best. That's physiology, Michael. That's basically trying to make a prediction. Does someone have four or five underlying diseases? Have they had five heart attacks before they got here? That could disqualify or lower the priority of someone relative to someone else.

Then you start to look at things like age. Children are certainly going to get priority on almost every policy I've seen relative to somebody else if they're physiologically capable of benefit. Then you might even look towards saying what about healthcare workers? You want them back on the job, you want people to be able to care for others. Presuming physiology doesn't sort it out, you might look to something like that.

And at the other end, Michael, you're starting to think when would I stop care. If I'm really crunch, if someone isn't doing well, we've had them on a vent eight or nine days, they're not responding, they're frail, they appear to be dying and you're pushed, you may decide that you're going to move somebody out sooner than you might have under normal circumstances to make resources available to another.

SMERCONISH: A final thought. I can only imagine how the Twitter mob will react to this kind of a conversation, probably by saying that it's ghoulish or worse. My own view, it's planning and it's preparation for a worst-case scenario, what many people think was not done before this pandemic. My own view, and you can have a quick final retort, is that hospital systems would be derelict in their duty if they weren't having this kind of dialogue.

CAPLAN: Absolutely agree. It would be irresponsible not to plan. You don't want to start to plan in the middle of a crisis. We want to get ahead of it. I think most institutions are having the conversations, getting ready and I hope it never happens and I hope Dr. Birx is right that we don't get there, but if we do, we better be ready with our policies and our explanations to patients and families.

SMERCONISH: Dr. Caplan from NYU Langone, thanks so much for being here.

CAPLAN: Thanks, Michael.

SMERCONISH: Let's see what you're saying via my Twitter and Facebook pages. What do we got? "Begs the question whose life is more important -- those who will die from COVID-19 versus poor people who will die from an economic depression." Soccerdad, you know, I'm sure that Dr. Caplan has, for three decades in his classroom setting teaching ethics to medical students, probably evaluated questions like dueling beds between a 30-year-old who's a drug addict and an 80-year-old who has lived a very healthy and productive and non-addicted life.

The theoretical potentially could move into the reality. Hasn't gotten there, we all hope it doesn't, but hospitals need to be planning for such circumstances just so we always know what the plan will be. I want to remind you, answer today's survey question at Smerconish.com. Is a universal quarantine worth the costs it imposes on the economy, community and individual mental and physical health?

[09:25:02]

That comes, by the way, from an op-ed penned by two physicians at Stanford published in "The Wall Street Journal."

Up ahead, the president raised a huge ruckus by suggesting the national shut down cure might be worse than the virus itself, but there will be long-term fallout that isn't just economic. Meet the doctor, in a moment, advocating an approach he calls a surgical strike.

And prevented from holding rallies, the president has turned his daily coronavirus briefings into a sort of Trump TV show. His popularity ratings are going up. Trying to compete during a national quarantine, Joe Biden is doing virtual town halls, Facebook live and talk shows. I'll ask David Axelrod, is that enough?

(COMMERCIAL BREAK)

[09:30:01]

SMERCONISH: When the coronavirus shutdown began to crater the economy, the president tweeted in all caps, "We cannot let the cure be worse than the problem itself." Critics saw this as him only caring about the stock market and re-election but is there in fact a third path a way to keep people safe and keep some of the economy going.

My next guest a physician suggests that if the fight against the virus is a war as many have said, there's a way to do a surgical strike to protect the most vulnerable patients instead of a carpet bomb that disrupts the entire nation. Dr. David Katz joins me now. He's the founding director of Yale University's CDC-funded Yale-Griffin Prevention Research Center. He's also president of the True Health Initiative, an expert in public health and preventive medicine.

He also got tested this week for the virus. Am I right, Dr. Katz, that you're still awaiting your results? How are you doing?

DR. DAVID KATZ, FOUNDING DIRECTOR, YALE-GRIFFIN PREVENTION RESEARCH CENTER: Thank you, Michael. And, by the way, before we get to that, we're past the point of easy answers here and you are having the necessary hard conversations.

I've been listening to your programming while waiting to talk to you. Good job. And I thank you for that.

Yes, I'm still awaiting test results. They're taking far too long. I assume I have it. I've got all the symptoms of this infection in the middle of a pandemic. So, it's a case of if it flaps like a duck, it quacks like a duck.

But for public health purposes we need a much faster turnaround so we know what's going on in the population. So my way is disturbing me not so much about me, because I know what to do in the meantime, but it's disturbing me about what it means for our ability to respond to what's going on nationally.

SMERCONISH: We wish you good things with regard to your health.

KATZ: Thank you

SMERCONISH: I should also tell the audience, this is a pretty sophisticated audience. You are the guy, you're the physician that Tom Friedman has been relying on to a great extent.

I want to put on the screen something that you wrote this week -- quote -- "I think authorities could align and announce now a commitment to both immediate interdiction efforts that are on-going, and data analysis. That data analysis will inform a major public update on or by some date a week, or two, or three. It would give people a lot of hope to know there are policies in the works, and a proximal timeline for hearing about them, that address prospects for restoring any semblance of life as we knew it before the pandemic disfigured it all."

Please explain.

KATZ: Well to be clear, Michael, you mentioned the president's tweet and sort of a 180 from lock everybody down to indiscriminate largess was never what I was talking about. Everything we do needs to be data informed, but all of the data from around the world suggests that the risk of severe coronavirus infection, hospitalization, needing a ventilator and death is not uniform. There are massive differentials.

We don't fully understand them yet in the United States. And one of the things we have to do is understand them as quickly as possible. And, by the way, even as we speak this morning, I'm trying to collaborate with colleagues to connect money with boots on ground with test kits to see if we can do representative random sampling of populations in Connecticut, in New York, other parts of the country.

Who has this and doesn't know? Who has it and has mild symptoms? Who is likely to need a hospital bed? Who is likely to need a ventilator and who is at a risk of dying?

If there are all of these massive differentials, if all of the risks is mostly concentrated in elderly people, people with serious chronic disease then all of the interdiction efforts should be concentrated there as well. That group needs more than they're getting.

They need hotlines. They need services. They need people tested negative to deliver groceries to their homes. They need everything we can do to keep them away from this bug. But it may be that a major portion of the population needs a whole lot less because they are massively more likely to get a fairly mild infection, recover, and become immune which then makes them essentially part of a workforce that can service everybody.

I'm hoping that's the case with me. I want to get over this thing. I want to donate blood so someone else can use the antibodies I make. And then I want to volunteer clinical services because I won't have to wear an N95 mask, I won't be able to get this. At least we hope.

Another thing we need to know when you get over this are you reliably immune. There are anecdotal reports that people getting it twice. Is that true? Are those ladders? All of this needs to be sorted out and we need to be doing this right now.

And one of the things we could be doing right now to comfort the public is telling them this is what we're doing right now with data. These are the questions we're posing. These are the questions we're answering. Here's how we intend to use the answers.

So stay put, social distance shelter in place but rest assured this is not an indefinite period we are working on in the next space. What comfort there would be in knowing from our national leadership that's what's going on.

SMERCONISH: Dr. Katz, Bill Gates participated in a town hall here at CNN this week. Here's a short snippet of something that he said to Anderson Cooper.

[09:35:00]

Roll it.

(BEGIN VIDEO CLIP)

BILL GATES, CO-CHAIR, BILL AND MELINDA GATES FOUNDATION: So, we're entering to a tough period that if we do it right we'll only have to do it once for six to 10 weeks, but we have to do it. It has to be the whole country.

(END VIDEO CLIP)

SMERCONISH: What's your reaction to what you just heard?

KATZ: So, when I -- here's the interesting thing, Michael, when I wrote op-ed about a more surgical strike I wrote it 10 days before it ran in the "The New York Times," because it had to get the attention of editors at "The New York Times" and then be edited and fact-checked and then rewritten and the whole thing again and again, again.

When I first was proposing it, I was still looking at data from abroad and thinking we could look at risks tiers and maybe shelter the most vulnerable. And that ship had already sailed. So right now first of all to be clear, I agree. Our only option right now is for everybody to stay away from everybody because we don't even know where the virus is.

But let me explain what I was thinking. We sent young mostly healthy adults home from college campuses and big cities all around the country because they were laid off and universities closed down. We sent them home to their parents. So these 20 somethings were sent home to 40 something, 50 something parents many of whom have heart disease or diabetes or hypertension, and in many instances they're multi generational homes so their grandparents are there too. So now we're talking about the 70 somethings who absolutely can't afford to be exposed.

Did we test these kids? Of course not.

SMERCONISH: Right.

KATZ: Did we even take their temperature? No. That was the opportunity to say, wait a minute, deep breath. It looks like they are these major risk tiers. We may be sending people who can afford to get this and are most likely to just get over it, home to infect people who can't afford to get it and who are going to overwhelm our hospital systems. So that's what I was talking about.

But, again, that ship has sailed. Everything moves really fast in a pandemic. Right now, I totally agree with Bill Gates. I totally agree with everyone who is saying our only immediate option is social distancing, interdiction everywhere we can, prevent spread, minimize the acute demands on the medical system. I don't want us to face the ethical dilemmas that Dr. Caplan was talking about. I totally agree we have to prepare for them but I don't want us to find ourselves there.

But then let us do the data analysis right now. And, again, I'm working on it. I hope many others are as well. The public deserves to hear about it to answer questions about risk tiers and see can we in fact do a better job allocating more resources to protect those who really can least afford to get this thing, because they're most likely to get severely sick and die, and can we invite a portion of the population back to the world earlier because they're least likely to get severe infection. And for them, this is much more like seasonal flu. And can we into the bargain start getting intel about herd immunity, who has antibodies. Because people with antibodies are a valuable asset.

SMERCONISH: Dr. Katz, Godspeed. Thanks for your expertise. We wish you good health.

KATZ: Thank you, Michael. Thank you for having me.

SMERCONISH: Social media, I think, Catherine, this comes from Facebook? What do we got?

"It troubles me that you, Michael, seem to be more concerned with your wallet than the health of your brothers and sisters. How much is a human life worth?"

Grackle Green, it occurs to me that you don't want to have a conversation that's based on data. You couldn't be more incorrect in your assessment. I have brought to you so far today, let's just see, Dr. Katz from Yale, Dr. Caplan from NYU, Dr. Bhattacharya from Stanford. These are the best minds with the most expertise.

I'm not a physician, and I don't play one on TV. I'm just bringing you well-informed bright perspectives that you apparently don't want to hear.

I want to remind to you answer the survey question at Smerconish.com.

"Is a universal quarantine worth the costs it imposes on the economy, community and individual mental and physical health?"

Still to come, as we inch closer to the 2020 election the coronavirus pandemic has forced Democratic front-runner Joe Biden to throw out the normal campaign playbook. I'll ask David Axelrod how Biden can change course to compete with the president's megaphone.

And my prediction from 10 days ago appears to be prescient. Remember when I tweeted that President Trump would want his signature on all of the checks sent to Americans if a coronavirus relief bill was passed. Well, it passed and now guess who wants to add his John Hancock to the checks?

(COMMERCIAL BREAK)

[09:43:32]

SMERCONISH: With his usual gusto, President Trump relished the opportunity to sign into law a historic $2 trillion stimulus package as the American public and the U.S. economy fight the spread of COVID- 19. One key element of the package includes sending checks directly to individuals and families.

Look, 10 days ago, I tweeted that President Trump would want his signature on all the checks sent to Americans if a coronavirus relief bill passed. And then I doubled down on my prediction a couple days ago when I opened my mailbox and I got, yes, that postcard which had CDC guidelines on one side, and on the other side, it was described as President Trump's coronavirus guidelines for America.

Now, that the relief package has passed, "The Wall Street Journal" is reporting this -- quote -- "Mr. Trump has told people he wants his signature to appear on the direct payment checks that will go out to many Americans in the coming weeks, according to an administration official. The White House didn't comment."

Here to discuss on the phone is David Axelrod, former senior adviser to President Obama. David, it occurs to me that if a check shows up in the mailbox of a family of four, it could be $3,400. $1,200 for the husband, $1,200 for the wife, $500 in my hypothetical, for each of two kids to have the president's signatures on the bottom of a $3,400 check could be impactful politically speaking?

[09:45:06]

DAVID AXELROD, CNN SENIOR POLITICAL COMMENTATOR (on the phone): Yes, I suspect it occurred to him as well, Michael. And you were prescient but, I think, well-founded when you predicted this 10 days ago. Donald Trump is a promoter and this is a huge promotional opportunity for him in the midst of a reelection campaign. He wants Americans to believe that he did this for them. That he is giving them this money.

So it's -- it was axiomatic that he was going to -- that he was going to want to sign the checks. I don't know what the statutory restrictions are. I'm sure they're exploring the propriety of that. But I would be shocked if he didn't take advantage of this opportunity.

SMERCONISH: Doesn't it also heighten what you and I were intending to discuss before "The Wall Street Journal" published what they published? And that is the difficulty faced by former Vice President Joe Biden, there's just no blueprint for him to try and compete with a pandemic and a president who is taking all of the oxygen out of the room.

AXELROD: Yes, there is not. And I said on the primary night which was just 10 days ago it seems like a millennia ago. But I said that he -- that one of the great difficulties is going to be the president now had a platform, and he was going to use that platform to the fullest. And it was going to be very hard for Biden to break through and that has been the case.

He did a town hall last night I thought he used it to good effect on CNN because the contrast with the president was quite vivid. He was -- Biden was empathetic. He drew on his experience in crisis management. He talked a lot about relying on the science and was a very reassuring figure. But he doesn't get that many opportunities to do that.

And they're going to have to work hard to break through. So, yes, this is an advantage but it's also true that the president is the leader of this country in the midst of a great crisis. And how that crisis turns out and how he behaves overall is also going to impact on him.

And, you know, we've seen, the best and the worst of Trump at those pressers and including -- the best thing he knows how to use that platform better than anybody. The worst is that it's full of self- puffery and half truths and misleading information, and claims that this thing is going to go better than it may. And so, how this works out is very much -- will very much have impact on what happens to both Trump and Biden. And neither of them have much control over that.

SMERCONISH: Hey, David, a quick final comment. A radio listener of mine said that Biden may -- may as well stay in the rec room in Wilmington, because in the end this election will rise and fall based on how President Trump responds to the virus. And, frankly, it's therefore out of Biden's control.

AXELROD: Yes.

SMERCONISH: In what you said, it sounds like you buy into a bit of that.

AXELROD: I do. I mean, I think that Biden needs to be more visible than he was at the beginning of last week and through last week, he's been much better lately. But it's just there's a limit to what he can do. And that, you know, you just have to accept that.

This is going to be very much about how Trump handles the crisis and how the crisis evolves here. And, you know, Biden is a little bit at the mercy of events. And, you know, we shall see where that leads. But he's in uncharted waters here, and they're choppy waters.

SMERCONISH: David, stay safe. And thanks for your time.

AXELROD: Same to you, Michael. Thank you.

SMERCONISH: Let's check in on your tweets and Facebook comments. From Facebook, I think.

"Signing the check is another disgraceful display of caring more about himself and his campaign than he does about American health and lives."

Laurie, you may feel that way, if you were a political strategist on his team, which clearly you are not. Would you be saying to him, Mr. President, it's political genius. People are going to open up their mailbox and there will be a check and your signature. In fact, I'll bet some in that base of his might think twice about even cashing it.

Still to come, your best and worst tweets and Facebook comments. And we will give you the final results of the survey question. Go vote right now at Smerconish.com.

"Is a universal quarantine worth the costs it imposes on the economy, community and individual mental and physical health?"

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[09:54:31]

SMERCONISH: Time to see how you responded to the survey question this week at Smerconish.com. Question was, "Is a universal quarantine worth the costs it imposes on the economy, community and individual mental and physical health?"

Survey says -- 84 percent yes, it's worth it. Wow. With nearly 16,000 casting their ballots. I'll leave the question up for the duration of the weekend.

Catherine, what do we have from social media? We've got limited time unfortunately.

"What a 1984 question to ask.

[09:55:01]

My God, this is a disturbing question that only a sick twisted society would ask."

Man, you guys are rough. No, it's a question put forth by two Stanford physicians and professors who said we don't know the denominator and we need more empirical study as we approach what policy is in the best interest of the United States and around the globe. Read what they wrote at "The Wall Street Journal." I'll put it in my Twitter feed.

Thank you for watching. Stay safe. See you next week.

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