Italy tops China TRANSCRIPT: 3/19/20, All In w/ Chris Hayes
STEVE KORNACKI, MSNBC HOST: That is going to be tonight 10:00 Eastern on
NBC and MSNBC. Thanks for being with us here tonight. Don`t go anywhere.
“ALL IN” with Chris Hayes is up next.
CHRIS HAYES, MSNBC HOST: Good evening from New York, I`m Chris Hayes. A
grim milestone today in the spread of the global coronavirus pandemic.
Italy recording over 41,000 total cases and another 427 deaths just since
yesterday. This was a scene in Bergamo, Italy where hospitals are so
overwhelmed with deaths that a convoy of military trucks would use to
transport bodies out of the city.
The death toll in Italy is now more than 3,400 passing China for the most
recorded deaths. Obviously, that`s enormously more deaths per capita than
China. Italy`s case-fatality rate now is just over eight percent, which is
very, very high. And this is all happening in one of the richest regions in
the E.U. a region with incredibly good health care, high-quality doctors,
and higher hospital per capita than the United States.
What we are desperately trying to avoid here is their fate. The grim
dispatch there is very possibly a look into our own future. We`ve already
seen health care workers in this country infected, hospitals starting to
run low on space and running out of supplies. We are many epidemiologist
estimate, probably 10 days to two weeks behind where Italy is.
And there are health care workers in Washington state right now that are
making their own protective masks. The American Red Cross warns that the
Red Cross is facing a severe blood shortage due to an unprecedented number
of blood drive cancellations, even though they say it is still safe to
donate blood, but it is an example of a problem that probably requires some
federal mobilization and coordination.
Also, as you no doubt know, our cases continue to climb as testing ramps up
though we still lag in testing capacity. Photojournalists with the Houston
Chronicle posted this video today, where she reports is a person who drove
up to be tested a drive-by site that had symptoms so severe that the person
was pulled aside and placed on a stretcher with medical workers and
personal protective equipment and rushed into an isolation area inside the
adjacent Medical Center.
As New York State ramps up testing capacity becomes clearer and clearer how
much New York City is and has been an epicenter. The total this afternoon
was over 3,600 cases up from just over 2,000 just last night in just New
York City. Today, in a letter to the President, requesting federal
assistance, California Governor Gavin Newsom explained the severity of that
state situation. We project that roughly 56 percent of our population, 25.5
million people will be infected with the virus over an eight-week period.
25.5 million people.
This virus did not appear in America out of nowhere. We saw the havoc it
wreaked on China and then more recently, we see the havoc it is wreaking in
Italy. And our leaders, the federal level particularly should have been
preparing, and some really did understand what was coming. NPR obtained a
secret recording of Republican Senate Intelligence chair Richard Burr, who
they say “warned a small group of well-connected constituents three weeks
ago to prepare for dire economic and societal effects of the coronavirus.
(BEGIN VIDEO CLIP)
SEN. RICHARD BURR (R-NC): There`s one thing that I can tell you about this.
It is much more aggressive than in its transition than anything we have
seen in recent history. It`s probably more akin to the 1918 pandemic.
(END VIDEO CLIP)
HAYES: Now, that`s somewhat of a different note that he was striking in
public where he was talking about how prepared we were. But get this, open
secrets reports that just prior to that, prior to giving that talk to those
well-connected constituents, Burr and his wife unloaded between $581,000
and $1.5 million worth of stock, including shares in several hotel
companies that have been rocked by the coronavirus pandemic.
While Senator Burr was warning about the risks and selling a bunch of
stock, he wrote an op-ed for Fox News claiming America was better prepared
than ever to face threats like coronavirus. The sucking vacuum of
leadership at the top is more and more apparent and deadly each and every
Yesterday, the President made a big announcement and a big thing about the
Defense Production Act, which he said he was going to put – invoke, which
will be a way of mobilizing resources in say factories to produce necessary
equipment to fight the virus. Now, this comes as lots of factories are
shutting down. Automakers are all shutting down production. And everyone
ran the story yesterday about what the President announced not what he did.
And then he tweets, “I only signed the defense production act to combat the
Chinese virus should we need to invoke it in a worst-case scenario the
future.” Oh, only in a worst-case scenario in the future, not this pandemic
with a soon to be catastrophic shortage of needed medical equipment.
And this is a pattern. So far, nearly everything the President has promised
has been nothing more than an attempt to get a good headline that then
turns out to be far, far less than it appeared, sometimes just flat out
Today, the same President Trump blamed the nation`s governors for not doing
enough to get supplies, saying the federal government can`t be shipping
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: You enabled, I guess is probably the best way to put,
the Defense Production Act yesterday but you didn`t pull the trigger on it.
DONALD TRUMP, PRESIDENT OF THE UNITED STATES: No, because we hope we`re not
going to need it.
UNIDENTIFIED MALE: You`re getting a lot of calls on Capitol Hill for the
Democratic leadership to pull the trigger on it. Why – what`s the
rationale for not doing it?
TRUMP: First of all, the governors are supposed to be doing a lot of this
work, and they are doing a lot of this work. The federal governments that
are supposed to be out there buying vast amounts of items and then
shipping. You know, we`re not a shipping clerk.
(END VIDEO CLIP)
HAYES: Joining me now, one of those governors President Trump is addressing
today, Governor Kate Brown of Oregon. First, I guess your response to the
idea of the federal government should not be a shipping clerk and that
these sort of production and supply issues essentially fall on you and your
– other governors, colleagues` shoulders?`
GOV. KATE BROWN (D-OR): I wish it weren`t true, but it absolutely is.
Governors across the United States are on the front lines of this horrible
disease. We are working hard to make sure that our communities are educated
about social distancing. We`re working hard to get the equipment we need,
whether it`s personal protective equipment, or ventilators. And frankly,
we`re working closely with our hospitals and medical providers to expand
HAYES: How much is personal protective equipment an issue in your state?
How much is it being rationed? And how much help Are you getting from the
BROWN: We`ve received about 25 percent of what we`ve requested. We made an
additional request today for over one million N-95 masks. We need this
equipment. We need it to protect our healthcare workers. We`re doing
everything we can to collect every piece of medical equipment we can.
I issued an order directing hospitals, dentists, and veterinarians to stop
all non-essential surgery and save this critical equipment.
HAYES: And that is – I saw Governor Jay Inslee, your neighbor issued
something similar. The idea there is to conserve. It`s not like space,
right? If you`re talking about a veterinary procedure, that`s not a space
that would go to a coronavirus software, right. You`re just trying to save
as much of those masks and personal protective equipment as you can.
BROWN: Absolutely. But we are honestly taking it from veterinarians and
we`re taking it from dentists as well. We have the ability to learn from
our neighbors to the north, in the state of Washington, where they`re about
two weeks ahead of us in terms of the crisis. So we`re taking lessons
learned and implementing them as quickly as possible.
We`re working hard to take aggressive social distancing measures, in our
communities around the state. We`re working to collect, conserve, and I
would say, create personal protective equipment. If we can`t buy it on the
market, we`re going to have to figure out a way to produce it. And of
course, we`re working to expand our hospital capacities because we are
going to need it.
HAYES: The governor of California today wrote that letter to the president
partly seeking an American ship to come – a hospital ship to come dock off
California to help with their capacity. He said their state`s modeling has
the 25.5 million people being infected in the next eight weeks. Do you have
internal modeling that you`re looking at since testing is lagging so far
behind to get a sense of where you are?
BROWN: Yes. And that`s been a huge issue. We know that in countries across
the world, that countries like South Korea that have implemented expedient
testing capacity. We know they`ve been able to slow the transmission, and
we call it flatten the curve of the numbers of cases of coronavirus. So
we`re also working to expand testing capacity here.
The federal government has committed to providing more capacity. We`re
working on the ground with private providers to make that happen as quickly
HAYES: But in terms –
BROWN: The key about testing?
HAYES: Yes, go ahead.
BROWN: What`s key about the testing is that if Americans – if Oregonians
know and can get the tests, they`re much more likely to comply with social
distancing measures. But we need everyone to know, you have to take these
social distancing measures to protect yourselves.
HAYES: How widespread are those measures and what are they in your state
right now since you are, as you said, two weeks behind Washington which has
been very hard hit?
BROWN: So we`ve taken a number of measures including - we`ve closed down
schools for six weeks. We`ve asked our – we`ve ordered our bars and
restaurants to only do take out. The reason why I limited to take out is
that we know in rural Oregon, our vulnerable citizens, our elderly, our
seniors, and those with medical conditions often rely on restaurants for
their basic sustenance.
We`ve also encouraged you know non-essential businesses to do the takeout
version of restaurants. What can they do to provide customers with
services? Any Bloom`s books, for instance, is having a drive-up option for
folks who need books for their kids or themselves.
HAYES: How concerned are you right now about how prepared you are from a
medical standpoint in terms of equipment, frontline healthcare workers, and
capacity in your ICUs?
BROWN: Look, all the governors across the United States are in the same
situation. There is essentially no playbook. We are making decisions as
fast as we can with the best information that we have at the time. But as
you know, things are changing extremely quickly. I`ve called up my joint
task force to have all of our hospitals in the region working together to
figure out what we can do to expand hospital capacity.
Our National Guard is as we speak putting up a tent hospital in Salem. So,
we are using the models. We`re looking at the numbers, but the most
important thing is for Oregonians is for Americans to use these social
distancing measures, because it slows the transmission, and it will flatten
HAYES: All right, Governor Kate Brown, thank you so much for your time. For
more on where we are in this crisis, how to deal with it, I want to bring
in Democratic Senator Doug Jones of Alabama. And Senator, let me start with
your home state.
Obviously, we have seen large outbreaks in the – concentrated in different
large metro areas. There are I think, as of now 68 confirmed cases in
Alabama. Are you confident that your state has the capacity preparation and
sort of awareness among citizens to be able to combat this should there be
a severe outbreak?
SEN. DOUG JONES (D-AL): Yes, and no. I think the state is doing a wonderful
job of trying to use the resources they got just like Governor Brown was
talking. We need more resources too. We need more tests. We need more
swabs. We need more PPE. We need all of the same things that other states
Our governor took a bold step today, I think it was the right step, to try
to shut down the state of Alabama essentially, closed the bars, close the
restaurants, that social distancing is what is so important. As we look
forward, you know, we`ve got 68 or so cases now and we know that`s going to
go up, but if we can blunt that curve in Alabama by taking those bold steps
now, it`ll be a big help.
HAYES: Let me ask you this. We`ve seen wide disparate reactions among
different Americans to the how seriously to take this. Everyone saw the
footage of spring break and Mardi Gras on the beach. And you know, everyone
has in their lives, people particularly were 70 and older, they`ve tried to
convince this as serious. Do you think the folks in your state recognize
what this is?
JONES: Yes and no. There is a lot of people that do. Obviously, as you go
back, and I`m obviously in D.C., I`ve been home since Monday. But from what
I can tell, people are doing that. They started doing that. But at the same
time, our beaches were crowded with Spring Breakers. I talked to folks
today where we`ve got officials around the state that is still believe this
is somewhat of a hoax and not a big deal.
I think that what the governor did today was so important because it`s
telegraphing this is very, very serious. And she`s going to – we`re going
to have to make some changes, because there`s some things that have to stay
open and do some things to help us get through this. But the fact is, it`s
a bold, bold step for her and it was the appropriate step that I believe is
going to get that message out.
HAYES: This Republican governor Kay Ivey of your state, the Republican
leadership in the Senate Mitch McConnell outlined some of their plans for
this next rescue bill that`s coming forward. And there are two things that
are notable I wanted to ask you about. One is, there is cash assistance,
but he would miss about 70 million Americans at the bottom or give them
diminished amounts, depending on how they made in 2018 or if they have no
tax liability. What do you think about that? Should it be universal? Should
there be assistance going to those people, some of the proposals floated by
your Democratic colleagues?
JONES: Yes – no, I want to look at this. Obviously, one of the problems
that we got in the Senate right now is that we`ve been here since Monday,
and these packages had been worked on, but we`re all just now seeing it on
Thursday evening, and that`s not the right way to do this. So we`re still
studying that, and I`ve looked at some of those.
And you know, I want to get, I want to get the assistance to the people
that need it the most. And I`m not sure this bill does that, but it`s at
least a step that we can talk about. There`s a lot of things that we need
to be looking at to get our small businesses into the hands of the workers
themselves. That`s expanding unemployment compensation.
I`ve got an idea out there that I`ve talked to some of my colleagues about
that folks tend to like a little bit that we may try to push some. And that
is using our payroll system that we`ve got. We`ve got companies that do
payrolls around the country for the small businesses. Use them – set up a
fund that they can draw on because their infrastructure is already there.
You could get the funds directly to these people either with their salary
or a proportion of their salary very, very quickly if we do. So there`s –
HAYES: So, wait, I want to – it`s an interesting idea. You want to use the
pay – like ADP in these payroll companies as an architect –
JONES: Yes, absolutely.
HAYES: – as an architecture to essentially give people their wages
backstop, maybe by the federal government paying it or providing it in some
JONES: Providing it. I mean, that is part of the providing, instead of this
$1,000 check, you provide the fund that will be administered by the Fed.
Let ADP and these others go into it for their customers. It could be their
full salary, but it could be a portion of the salary. You do it in the form
of a loan or you do it in the form to make sure that it`s a loan right now,
but if they bring these people back to work, that loan is forgiven. There`s
a lot of ways you can do it. But that infrastructure is there that we could
do something very quickly if we work on it.
HAYES: All right, Senator Doug Jones, a busy man in a Senate that usually
isn`t busy, but is now, thank you very much.
JONES: Thank you. Good to be with you.
HAYES: Coming up, what we know about the claims being made with the
president and others that a coronavirus treatment is just right around the
corner to esteemed doctors. You know where they speak. We`ll help try to
answer that question next.
HAYES: So a big part of the reason that you are watching this right now,
probably inside your home which you haven`t left very much, that we`ve got
millions of Americans locked down engaging in mass social distancing to
avoid further transmitting the virus is that one of our problems is we
don`t currently have a good way of treating the virus.
So not only is there no vaccine for COVID-19 like there is the seasonal
flu, we really don`t have proven and reliable treatments for the people
that do get sick, which means people are toughing it out are really
suffering or worse, right? A lot of people require hospitalization.
But that doesn`t mean people aren`t thinking about possible treatments.
Researchers are starting to go down several tracks at once. Now, the
president, of course, came out today to tell everybody we`ve got a possible
cure and the FDA approved it. Predictably, that had to be immediately
walked back because while there has been some limited evidence suggesting
that a malarial drug chloroquine might be promising, that drug has not yet
been approved by the Food and Drug Administration for the coronavirus.
So where do we stand on treatment? What does treatment look like for the
probably millions of people who are going to end up getting it? Dr.
Margaret Hamburg is a former FDA Commissioner under President Barack Obama,
and Dr. Amer Aldeen is the chief medical officer at U.S. Acute Care
Solutions in Tampa.
Dr. Hamburg, let me start with you first. This seems to be a fascinating
and difficult conundrum for the FDA. Normally, clinical trials and
approvals are very regimented process, but obviously, these are exceptional
circumstances. How should the FDA and the federal government be thinking
about trial treatments for this virus?
MARGARET HAMBURG, FORMER COMMISSIONER, FDA: Well, over many years now, the
FDA has had a mechanism to respond in emergency situations and crises, none
quite as overwhelming as this one. But you know, Ebola, Zika, the threat of
pandemic flu with H1N1 to try to make important medical products available
as quickly as possible, ensuring, of course, that they work, that they
won`t cause harm, and they will actually provide benefits, whether it`s
diagnostics or drugs, medical devices, and importantly vaccines as well.
So there`s a lot underway. And it`s very encouraging how the scientific
community has come together in this country across sectors, government,
academia, and industry, and also internationally to really bring the best
knowledge together and cutting edge science and technology to try to
develop new products and also to look at what products already exists that
might be repurposed for this terrible virus.
But they need to be studied. We need to know whether they actually work or
else they`re not doing anybody any good.
HAYES: Dr. Aldeen, as someone who used to run – was Executive Medical
Director for Center for Emergency Medical Education, so you`ve run
education in this field. Like what is the best state of the art knowledge
about treatment right now? If you have someone that is in your E.R., and
they have severe respiratory illness, and they`ve tested positive, like
what is the treatment regimen look like right now?
AMER ALDEEN, CHIEF MEDICAL OFFICER, U.S. ACUTE CARE SOLUTIONS: Well, right
now the treatment regimen is supportive care. That`s the best way to manage
these patients, which means good infection control for keeping other
patients away from the infected patient, but also taking care of these
patients using appropriate ventilator devices and airway control.
The medications that were mentioned, hydroxychloroquine and chloroquine are
showing some promise and very small trials. And we`re hoping that these
trials get bigger and they continue to show promise in both efficacy and
safety. But they`re not cures, not by any means, not yet. There`s also a
drug called Remdesivir which also might show some promise.
But I can`t echo enough what the governor of Oregon had said earlier, which
is personal protective equipment is really the key where you need – we
need to make sure that we pray prevent further illnesses among healthcare
workers as well.
HAYES: Dr. Hamburg, just to – just to take us through like the – to nail
this down a little bit. So let`s say you`re at the FDA right now, and I
know there was a peer-reviewed study I think today, actually, it was
actually published peer-reviewed clinical – small clinical trials, just 16
patients, right? So it was – it was the experience with them, chloroquine,
which seemed to show some promise. Just 16 patients.
What does that mean? So what does the FDA do with that? Is it like, hey,
let`s try it out in 100, hey – like, what happens next?
HAMBURG: Well, chloroquine is a special case in the sense that it`s already
been approved. It`s been used for decades now against other disease
conditions, importantly, malaria. So we know a lot about its safety. What
we don`t know is whether it works against this novel coronavirus.
So we can move very quickly into clinical studies. And we can learn whether
it works or not, whether it works for certain patients and not other
patients in terms of where they are in the stage of their disease. Maybe it
could even be used as a what we call a prophylactic measure to help prevent
people from getting infected. That`s one of the ways it`s used, in fact,
But we just don`t know and we need to study it. And, you know, I think it`s
really, you know, there are people on both sides, we obviously all hope
that it will work. But it`s not up to us to wish and hope –
HAYES: Right, of course.
HAMBURG: – it`s up (AUDIO GAP) to get the scientific answers so that we
can help patients.
HAYES: Yes, go ahead. Dr. Aldeen.
ALDEEN: I`m sorry.
HAYES: I thought you want to say something. Here`s my question for you. If
you`re dealing with people that don`t require hospitalization in terms of a
treatment regimen, so people who are watching this who maybe have a loved
one who`s self-isolating or are self-isolating right now, like, what is the
best knowledge we have about treatment in that sphere, right? Just you`re
not a hospitalization case. You don`t feel that profound distress, but
you`re sick, and maybe you test positive or maybe you just think you have
it. What do you know?
ALDEEN: Yes, it`s a good question. We don`t know that much right now. We
don`t know the effect of these drugs like hydroxychloroquine and
chloroquine on the patients who are not that sick. It stands to reason the
way that their mechanism works, that the viral loads for all patients are
decreased, such that potentially they might be less infectious or pass on
the infection less readily, or perhaps even they themselves will feel
We don`t know that yet, though. That`s a subject of ongoing research right
now. But at least the scientific community, the medical community, they`re
mobilizing. They`re acting and that`s a good sign.
HAYES: Dr. Hamburg, final question for you. Do you think the President`s
characterization of the treatment frontier today was an honest one or an
accurate one in terms of giving people a sense of how long this might be?
HAMBURG: Well, I think it was overstated in terms of how far along we are.
We`re still in the early days of studying a whole range of different drugs
and therapies that might prove beneficial. And of course, the vaccine
studies are underway and there are a number of promising vaccine
candidates. But it is going to take time, I think we`ll see drugs probably
go into use before we`ll have a vaccine.
But in the meantime, we have to focus on quality care, supportive care,
with health care workers who are equipped with the personal protective gear
that they need, and the medical care tools that they need. And we need to
really make sure that our hospitals can cope with the surge of patients to
HAYES: All right, Dr. Margaret Hamburg and Dr. Amer Aldeen, thank you so
much. I really appreciate it.
ALDEEN: Thank you.
HAYES: Ahead, remarkable new reporting on how the United States and South
Korea which both reported first coronavirus patients on the very same day
have diverged wildly in their containment of the disease. The grim reality
of America`s testing failure next.
HAYES: The first case of Coronavirus in the United States was confirmed on
January 20th, which happens to be the very same day that South Korea
confirmed its first case. And from there the two countries approaches
diverged wildly. As described in this incredible piece by Reuters, South
Korean officials immediately recognized they had a huge problem and had to
scale up testing immediately. They got everyone together, including
representatives of private labs, and told them to get to work. They
massively scaled up testing and they have managed to bend the curve of the
epidemic. That`s them on the left there.
The United States there on the right has done essentially the opposite.
Here is Trump on January 22.
(BEGIN VIDEO CLIP)
TRUMP: We have it totally under control. It`s one person coming in from
China and we have it under control, it is going to be just fine.
(END VIDEO CLIP)
HAYES: Well, South Korea is the most tested nation, we remain the
international laggard. And our epidemic is shooting straight up an
Joining me now, one of the Reuters reporters that wrote that piece on South
Korea`s response, Dan Levine.
Dan, it`s a great bit of reporting. Take me through the opening anecdote in
which a medical official in South Korea shortly after first case sort of
throws an emergency meeting. What happens there?
DAN LEVINE, REUTERS: So, as you pointed out, the first case in both
countries happened on January 20. And when we started reporting and talking
to people there, we learned about this extraordinary meeting which happened
a week later on January 27. And that also happens to be the last day of the
Lunar new year of the holiday. It`s a three-day holiday, so most South
Koreans were still home with their families.
And Korean government officials called in representatives from more than 20
private testing companies, and they all converged on this conference room
in the main train station in Seoul. And they were basically told that they
needed to ramp up testing and that the companies that were able to develop
the successful test would get almost immediate regulatory approval.
And so when we learned about that meeting, we really felt that it
encapsulated a lot of the differences between both countries and the way
that they approached this, both in terms of urgency – I mean, they had it
in the train station, because everyone was around the country and they
needed to – it was the easiest place to get everyone into one place and
actually talk to everybody.
But also, because they brought in private companies right away, which was
very, very different than what happened here where the FDA initially
approved only one test from the U.S. CDC, which now kind of famously didn`t
work and had many, many problems and set us back for weeks.
HAYES: And there`s – you know, there`s a trade off we were talking about
in the last block, right, if you`re the FDA. You don`t want to play too
fast and loose with this stuff, right, it doesn`t help anyone if you don`t
have an accurate test, but you also have to understand exigent
circumstances when you might err on the side of aggressiveness. It sounds
like that`s what they did there.
Were there concerns about going too fast and having an error-filled test?
Like, how are they making sure they were scaling at speed and also getting
LEVINE: So there – well that`s exactly right, and that`s exactly what the
FDA told us that they were very concerned about faulty test results.
What happened in Korea was that they had continuous spot checks, not just
in the beginning when they initially vetted the first submissions from
different companies, but throughout the roll-out. So essentially, they were
reacting briskly and ramping up briskly, but at the same time concurrently
spot checking there.
And so they were able to detect any kinds of problems that may come up
whereas here, everything was kind of halted on the front end.
LEVINE: And that`s where we saw a real problem.
HAYES: So they –deployed this quite widely. They had had – I mean, one
thing that I think binds together countries like Singapore and Taiwan and
South Korea is that they had had sort of outbreaks like this before, right?
There were SARS and then there was MERS, which was a sort of a Middle
Eastern originated respiratory illness that South Korea had had to deal
with, so there was a little bit of being further ahead on the learning
curve, is that fair to say?
And, not only did they have the experience, it was fresh. I mean, this was
only a few years ago in South Korea and the Korean CDC officials we we
spoke to really talked vividly about how engraved it was on them and how
much remorse they felt for getting MERS so wrong.
South Korea had the biggest outbreak outside of the Middle East. And at the
time, administration of Park Geun-hye, got a lot of criticism for the way
that – for their country`s response to MERS.
So, this was all pretty raw and was a very big driver in why they felt that
they had to ramp up so quickly here.
HAYES: That is fascinating. It`s a great piece of reporting, Dan, thank you
very much for sharing that.
LEVINE: Thank you. Thanks for having me.
HAYES: Coming up, every public health official in America will tell you
right now there are not enough ventilators to deal with the exponential
growth of Coronavirus. The question is why? And what is being done about
it, and we`re going to try to answer those pressing questions next. Don`t
(BEGIN VIDEO CLIP)
TRUMP: Where you have a problem with ventilators, we`re working very hard
trying to find – nobody in their wildest dreams would have ever thought
that we need tens of thousands of ventilators. T his is something that is
unique to this – to what happened.
(END VIDEO CLIP)
HAYES: Nobody would have ever thought in their wildest dreams we need tens
of thousands of ventilators. That was the president today yet again lying.
The idea that no one anticipated a shortage of ventilators is ridiculous.
Many people saw precisely this eventuality. And not just two months ago at
the beginning of this outbreak, no, scarcity of life-saving medical
supplies during a pandemic is something people have been writing about for
In fact, get this, Donald Trump`s own Department of Health and Human
Services ran a simulation scenario involving a pandemic that began in China
code named Crimson Contagion during a series of exercises that ran from
last January to August. And the folks in HHS in that study foresaw the
needs that we`re experiencing right now.
Domestic supplies of on hand stock of anti-viral medications, needles,
syringes and 95 respirators, ventilators, and other ancillary medical
supplies are limited and difficult to restock because they are often
manufacturing difficult to restock, because they are often manufactured
That`s in a report of that exercise from HHS last year in his own
U.S. hospitals have roughly 160,000 ventilators. And just like the Trump
administration study predicted that figure is far short of the 740,000 it
would need in a severe pandemic.
So the question is in a worst-case scenario, where are the ventilators are
going to come from? For answers, let`s turn to Sarah Kliff, an
investigative and health policy for The New York Times who co-authored a
piece out now titled “there aren`t enough ventilators to cope with the
Sarah, what is the mismatch right now in terms of what we have and what we
SARAH KLIFF, THE NEW YORK TIMES: So the mismatch is not necessarily for
what we have right now, but what doctors expect is coming. They expect that
they are going to to see a lot of patients in respiratory failure. And they
are going to need to put them on ventilators. And we might be two or three
or four times short of the number we actually need.
As you mentioned, Chris, there is about 160,000 in American hospitals,
another 12,700 in a national emergency stockpile, but we might need more
like 600,000, 700,000 to treat all the patients who are coming in, and
right now we note in that story I talked to a lot of hospitals, a lot of
ventilator makers, the story that we`re hearing is hospitals are trying to
buy these machines. They can`t find anyone to sell them, and ventilator
makers are trying to ramp up demand, but they can`t increase it fast enough
to meet the needs that hospitals think they are going to have in the coming
weeks and months.
HAYES: So, is that a – on the supply constraint side, right, so there are
some domestic manufacturers, though much of it manufactured in China, what
do they say about like how much they can scale? Is it they just don`t have
the ability to do it?
KLIFF: Yes, some of it is about supply chain. A ventilator is made up of
hundreds of parts, and those parts come from all across the world. And
right now ventilator makers are scrambling to get the same part.
There is a work force issue. One thing that`s challenging right now is
these ventilator companies want to bring more people into their factories
at a moment when we are trying to prevent large groups of people being in
the same place, so it`s expensive. You have to buy protective equipment,
which we know is also in a shortage. You have to increase your janitorial
staff. And you have to convince your workers that are new to your company
you should come do this work at a time when you`re being told, you know,
maybe it`s best to stay home.
So, there`s all these different issues that make it difficult. Ventilator
makers are trying to increase their capacity right now, but there`s a lot
of things that are working against them when we`re kind of in a moment of
HAYES: There is a headline earlier this week out of Britain that said that
it had asked manufacturers including Ford, Honda and Rolls Royce to help
make health equipment, including ventilators. The invocation of that
Defense Production Act, how feasible would like retro-fitting other
factories into ventilator manufacturing be or is that a fantasy?
KLIFF: I think we might find out in the coming weeks whether that`s
actually reality or fantasy. You see something here in the United States
where President Trump has talked about using a Korean war era law to do
something similar. Mary Barra from Ford was saying earlier today that she
would give over her manufacturing lines potentially.
So, we might see it.
But the ventilator makers that we spoke with for that article, they said it
was going to be pretty complex. You know, again, these ventilators are very
specialized machines, it`s going to be really challenging to change a car-
making manufacturing line to a ventilator making manufacturing line, and
train the people to do it right.
So, it might work but we just don`t know. We`ll probably find out in the
next few weeks if this is a feasible approach or not.
HAYES: I`ve been hearing a lot from ER docs and ICU docs that are worried
about this into the breach. There is this incredible video circulating from
Dr. Charlene Babcock (ph) who is an ER doctor in Detroit who actually
published a piece about how to hack your ventilator for one patient into
being able to use it for four patience by basically kind of like putting
more tubes into it and I saw another tweet today from a rural hospital that
it actually done a similar operation.
How much do you anticipate we`re going to be seeing doctors essentially try
to pull this off?
KLIFF: I think we`re going to be a lot – seeing a lot of makeshift things
like that, things I heard about in my reporting were possibly, for example,
using veterinary respirators for humans. You know, these are not things
that happen in normal circumstances, but if you are in a case where you
have no other supplies, they might be the only way to help people.
One other thing you might see is there are anesthesia machines that are
usually used during surgery. If surgeries get canceled, as we`re seeing
elective procedures get ended, those might be used, those could be kind of
retro-fitted as a ventilator in an emergency situation. So I think you`re
going to see a lot of sharing among emergency room doctors about what works
and what doesn`t.
But again, none of this is kind of the status quo. All of this is going to
be a little bit ad hoc. And I think this makes a lot of providers nervous
is that they have never really done this before. They are using machines in
ways that are completely new to them.
HAYES: That is worrisome. Sarah Kliff, thank you for making time tonight.
KLIFF: Thanks for having me.
HAYES: Next, what we know about how the government is planning to rescue
Americans from economic catastrophe and what it should look like with
former labor secretary Robert Reich.
HAYES: We have some breaking news tonight, which may further develop where
the priorities in the Trump administration truly lie. In the midst of the
economic collapse happening during the Coronavirus crisis, the Trump
administration, according to a notice just posted on the blog of The New
York Times, that are live updates, is asking state labor officials to hold
off on releasing figures on unemployment claims.
And this may be why, a Labor Department released today showed new
unemployment claims jump to 281,000 last week, 33 percent over the week
before. And according to the department,quote, clearly attributable to the
impacts from the Coronavirus.
The Trump administration would apparently rather you not hear those
numbers. Remember when the president, the CDC, when he was talking about
maybe he would take those people off ship and give them medical care? Said,
he liked the numbers where they were. He didn`t want the numbers to double.
It`s the numbers.
By now it is clear there must be, and will be, some sort of enormous
federal rescue package to stem some of the economic destruction we are
currently undergoing. There is no shortage of ideas floating around from
across the political spectrum. President Trump, for one, seems particularly
focused on bailing out big industries, including hotels, a type of property
he himself owns.
Just a short time ago Senate Republicans unveiled a plan for trillion
dollars in stimulus money including direct payments to some taxpayers,
though quite notably, with less money for the bottom 70 million tax filers.
Here to talk about what we need out of a rescue package both in scale and
details, former Labor Secretary Robert Reich, author of “The System, Who
Rigged it and How We Fix It.”
I don`t have any details here because The Times just posted this and pushed
this out. The Trump administration asking state labor officials to hold
back their numbers right now. That strikes me as not a great idea. We need
to know what`s going on.
ROBERT REICH, FORMER LABOR SECRETARY: Well, Chris, every time the
administration has tried to withhold numbers or withhold information, in a
sacrifice in public trust is extraordinarily large and very dangerous,
because particularly at a time like this, when people need to get
information and need to trust the government, we`ve discovered that we
can`t do either one. We can`t get the information we need and we can`t
trust the government.
The Trump administration has got to stop trying to cook the books and cook
HAYES: So, today Mitch McConnell outlined the plan from the Senate. And I
thought it was interesting, there was a lot of talk about this idea of sort
of a universal cash assistance. And there were some Democrats who were
saying, well, we should means-test at the higher end, which is that we
don`t need to send people making a million dollars a year a check. And some
other people said, well, just make it universal. You can tax them on the
But the Senate Republicans seemed to do something else, which is that they
would give less money to the people that make less money and zero money to
people that don`t have any tax liability it seems. What do you think of
REICH: Well, it`s exactly what the Republicans have tried to do before. You
know, their formula, whenever you have any kind of a crisis, whether it`s
an economic crisis or any other, is to provide tax relief to big
corporations and also to provide tax relief to the people who don`t need
it, that is people who are very wealthy who have, and necessarily by virtue
of being very wealth the highest taxes.
So what you want to do is exactly the opposite. This crisis is not
immediately an economic crisis, it`s a health crisis. This crisis demands
that people stay home. You want to make it so that employers and employees
have every – every possibility of staying home and getting the kind of
income support they need as fast as possible.
No bailouts to companies, particularly the big companies. Big companies can
get the loans they need at almost zero interest rates. Big companies got
huge tax breaks just two years ago that they used to basically buy back
their shares of stock and give big investors and executives a field day.
No, you don`t want that. Save the taxpayer money. Make sure it`s used for
people who need it to stay home and maintain their incomes while they are
HAYES: So, just one note that the McConnell plan does actually cap at
75,000, right? So they also have means testing on the top. I just want to
be clear on the details on that.
But let me follow up on this bailout question. I generally, ideologically,
am disposed to agree with you. But it also seems to me in this case like I
don`t know if the airlines can go out into the private credit markets and
borrow right now. The private credit markets aren`t looking so hot, right.
It does seem to me there`s got to be some backstopping.
REICH: Well, look at. First of all, the airlines – remember over the last
20 years, every major airline has not only merged, but has also undergone
bankruptcy, a kind of reorganization under bankruptcy to get out from under
labor contracts. That has been the standard airline technique in the 1990s,
in the first part of this century.
So, if they can`t get a low-interest loan, and they probably, they`ve got
collateral, it`s called planes. But if they can`t get a low-interest loan,
they can do what they`ve done before to get out from under the labor
contracts, and that is reorganize under bankruptcy.
You only have four major airlines. They`re not going to go under. They`re
not going to liquidate because of this.
HAYES: So, there`s the big companies, right? Then there`s the small
businesses, which I think everyone is acutely aware of right now. I mean,
if you live in a place where there are small businesses that you love, you
can just tell that they`re not going to be able to survive more than a week
or two weeks of this, and everyone`s talking two months.
What scale and what creative ideas should we be thinking about for them?
Because that seems actually the hardest nut to crack. Like, you can send
out cash assistance, and you can figure out how to backstop the airlines if
you have to, but that seems like the hardest policy problem. How should we
think about it?
REICH: Well, I think the easiest way of dealing with that is to provide
zero interest loans to small businesses. And those small businesses, if
they maintain their employment, not keeping people employed – I`m talking
about maintaining their employment, sending checks to their employees,
those small businesses can be eligible for a full remittance on those loans
from the federal government. I think that`s the way that keeps everybody in
place. It`s the simplest way of doing it.
HAYES: Right, I want to talk through this, right. So you say, you know, the
bar and my neighborhood bar that I love, which my heart is aching for them
right now, OK.
Look, there will be some federal government facility that lends you money
at zero percent to just keep paying everyone like you were open, and then
when it`s all over we will forgive it, basically is what you`re saying.
REICH: If you meet the criteria and those simple criteria are you maintain
your payrolls and let`s do this retroactively so you maintain your payrolls
from mid-January onward, and you paid your rent and you paid your
creditors, you did everything you`ve been doing. The only difference being
is that you had no business. And so that, yes, you get all of that loan
fully remitted to you because you were essentially – you were a small
business, you were part of the neighborhood, part of the community, you
were very important to the economy, and that`s the cheapest way of keeping
HAYES: Yeah, it seems to me there`s going to be have – the logistical
issues of that standing up – I mean, we`re – this seems like new deal
territory to me, like standing up some entity that can do this. I mean,
talk about millions and millions and millions of businesses, right? Like is
not a small logistical feat ahead of us.
REICH: It`s not a small feat.
But, look, Chris, we are in a kind of a – if you want to call it a new
deal or a war mobilization or a depression, I mean, this is a time for big
thinking and big action.
Now, it`s true we don`t have necessarily the most competent people in the
HAYES: But big action nonetheless.
REICH: We have no choice, we have got to do it and that`s it.
HAYES: Robert Reich, thank you very much.
That is All In for this evening. The Rachel Maddow Show starts right now.
Good evening, Rachel.
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protected by United States copyright law and may not be reproduced,
distributed, transmitted, displayed, published or broadcast without the
prior written permission of ASC Services II Media, LLC. You may not alter
or remove any trademark, copyright or other notice from copies of the