COVID symptoms TRANSCRIPT: 3/25/20, All In w/ Chris Hayes
ARI MELBER, MSNBC HOST: You can also e-mail me if you want to call that the
old fashioned way at Ari@MSNBC.com. That does it for us. You can find me
again tomorrow at 6:00 p.m. Eastern on “THE BEAT” or guest-hosting here
again tomorrow at 7:00 p.m. Eastern. Now, “ALL IN” with Chris Hayes is up
CHRIS HAYES, MSNBC HOST: Good evening from New York. I`m Chris Hayes.
Here`s the facts. Right now, there is not a single outbreak of the
coronavirus in the United States, and there certainly is no single
coordinated federal response. These are the dual challenges the U.S. faces
as it continues to outpace any other nation in its rate of growth of new
cases. At this rate, we are due to pass Italy and China in total cases in
just the next few days.
Now, primarily, this is because we were single-handedly alone amongst other
nations of our sort, the worst in the world and testing. We are just
catching up now. But we have a situation today where the data is spotty and
incomplete access to tests wholly unequal (AUDIO GAP) and where different
places in the U.S. have different levels of intensity with different parts
of the curve.
New York City, the situation is brutal. As of today, there are over 17,000
confirmed cases in the city. We are hearing about shortages of ICU beds and
ventilators and protective equipment for doctors and nurses. The New York
Times in a stunning article reports that 13 people died from the
coronavirus at just one Queen`s Hospital in just a 24-hour window.
Yesterday, over the course of several hours, one doctor performed chest
compressions on a woman in her 80s, a man in his 60s, and a 38-year-old who
reminded the doctor of her fiance. All had tested positive for the
coronavirus and had gone to cardiac arrest. All eventually died.
Today, New York Governor Andrew Cuomo warned that the number of cases is
still three weeks away from reaching its peak. Washington State and
California also have a lot of cases although California, we should note, is
testing at a level much less than New York, so it is hard to know for sure.
We are already getting worrying signs from other places in the country,
Atlanta, from Detroit, and now Louisiana, which has seen its numbers
absolutely spike, approaching 1,800 total cases. Over 400 of those, 400
just identified today. In each of those different areas of the country,
these disparate regions of our nation are being left to fend in many
fundamental ways, to fend for themselves.
Now, when other countries have had regional outbreaks, Wuhan, Hubei
province in China, the north of Lombardy in Italy, they`ve responded with
national action because their governments recognized the virus was not
going to remain in one place.
We here in the U.S. have a certain amount of federalism which makes sense.
It allows governors to make decisions for their own states, but the
fundamental bedrock of the response, the need for a surgeon hospital
capacity, in testing capacity, and an interstate coordination of resources
have not been there.
In fact, time and time again, the Trump administration, the White House,
the federal government has told these states basically, you`re on your own.
The Washington Post reports about what that looks like for a practical
standpoint. Basically, it`s not a stretch to imagine the states right now,
like shoppers at grocery store, competing to get the last bags of rice and
In refusing to actively coordinate a national plan and coordinate
resources, the federal government is creating the conditions for
competition and for hoarding that will cost lives. And then on top of that,
there is, of course, the persistent fear grounded in reality that the
president who notoriously plays favorites, who has used California and New
York and the city of Baltimore as scapegoats to beat up on in the past,
who`s used the federal government to outright threatened states represented
by Democrats is playing favorite in a time of crisis.
The Daily Beast reports Democratic governors, including New York`s Andrew
Cuomo, are worried that if they criticize the president, they risk losing
support for the things their citizens need to keep them alive and fight the
virus. Speaking on Trump T.V. yesterday, the President himself said, he
would help Democratic governors but, and I quote him here, “It`s a two-way
street. They have to treat us well, also.”
And that comes days after ProPublica reported that as states requested
supplies from the federal government, only Florida, a state with a
Republican governor has himself repeatedly said the virus is not a
statewide problem, got everything I`d asked for. Meanwhile, the hardest-hit
states like New York and New Jersey got only a fraction of what they
Earlier this week, Illinois governor J.B. Pritzker tweeted a chart showing
the small fraction of the state`s requests that have been fulfilled to this
point. Past outbreaks in the U.S. have been followed by natural responses
and natural coordination. In fact, there is the infrastructure in place
right now throughout the federal government for that kind of coordination.
But this time, we just do not have that and things are getting worse.
Joining me now, one of the governor who`s been in the frontlines of this,
who said this of the President`s plan to reopen the country by Easter, “We
don`t think we are going to be in any way ready to be out of this in five
or six days or so or whenever this 15 days is up from the time they started
this imaginary clock,” Republican Maryland Governor, Larry Hogan.
Governor, thank you for joining me. I guess I want to start with what you
need as a governor in Maryland. What are the needs that you have right now?
What are the most pressing needs?
GOV. LARRY HOGAN (R-MD): Well, my needs are the same as just about every
other governor in America, Chris. I`m the chairman of the National
Governors Association. We had our seventh phone call today with all of the
nation`s governors as we`re talking about the same kinds of things that you
were just talking about in your lead in.
Everybody is short on testing, on all of the various things like
respirators and masks. And we`ve all got requests into the federal
government, and all of the states are taking action to try to find these
things on our own. And we`re also pushing the federal government to get
Now, the good news is we are starting to get some after not getting a lot.
So, you know, many of the states have not gotten a portion of their
requests. So you talked about governor Pritzker getting a small portion. We
got some of our requests here in Maryland, as did most other governors
across the country. But most of the volume is now going to those states
with the biggest problem like New York, and California, and Washington.
The bottom line is there really – there really is a shortage nationwide.
Governors are trying to do everything they can to step up and respond in
their states, and we`re also pressing the federal government to provide
more assistance to us and to get some of these things out here to all of us
in the States on the front lines.
HAYES: Yes. I guess on this coordination question. I mean, there`s two
issues here, right? There`s a supply limit. That`s the real problem. I
mean, we just do not physically have enough ventilators in the country at
the moment, and how you apportion there is a grim kind of triage, right,
between the states because the life of someone from Maryland is as
important as life of New York. But if you`re the governor of Maryland, you
want it for your citizen. Like, how is that being worked out?
HOGAN: Well, so, FEMA, now, as of – as of last Thursday or Friday, is in
charge of trying to get those limited supplies out to all of the states.
And while no state got their full request, or nobody was able to get the
kinds of supplies that they needed, there was an apportionment out to I
believe all of the states. None of it was adequate enough, and we`re all
trying to supplement that with our own individual activities on the open
market, both domestically and from other places around the world.
But, you know, it just does – it`s not that helpful to point at where the
thing broke down. The bottom line is right now in America, we do not have
enough of these supplies and we`re trying to get – the governors are
trying to get both the federal response ramped up, but also, you know, just
trying to figure out way for the federal state and local governments to all
kind of get on the same page.
We`re all just trying to save people`s lives. I mean, that`s really where
we are at this point. We`re – not what did we do wrong yesterday, but what
can we do today and tomorrow to try to do a better job.
HAYES: Let me – let me ask you this coordination question, and then I want
to ask you about the sort of decisions you`re making there. You talked
about the National Governors Association. Is there like – is there a daily
call? Is there – is there a call that the governors are all on every day
and who is – who is engineering that? Like, what is that? Because right
now you`ve got this situation where it`s almost like a time-traveling
Andrew Cuomo can talk to the folks back in Minnesota or Michigan and say,
look, we`re two weeks ahead of you. Here`s what we need. There`s
communication that can happen there.
HOGAN: No, it`s – that`s one of the – one of the few things that`s
working really well. So I`m the chairman of the National Governors.
Governor Cuomo is the vice-chairman. We`ve had ongoing discussions with all
of America`s governors. Really, in some cases, more than 50 governors. We
have 55, including the territories. We typically have nearly all of them on
We had another one this afternoon. We have another one tomorrow with the
president and vice president leaders, and the leaders in the
administration. They`re not on all of the calls. We have some with just the
governors. And in addition to those formal ongoing discussions where there
really is great collaboration and sharing of information and ideas between
the states and quite frankly, it`s been tremendous to see the bipartisan
cooperation among the governors, we`re also having lots of one on one
discussions and phone calls and text back and forth.
I`ve been talking with, you know, dozens of my colleagues across the
country on both sides of the aisle about here`s what`s happening in our
state, how are you dealing with this? What problems are you faced with? How
are we going to fix this? And so, you know, it`s a – it`s a problem, we`re
all in this together. And it`s amazing, but there`s not a whole lot of
Republican-Democrat stuff going on. It`s about hey, what can we do to help
HAYES: The President seems obviously anxious to sort of reopen the country.
He`s reiterated that. He talked about an Easter possibility. Today he
tweeted and basically said that that it was the media that was the dominant
force trying to get him to close the country and close off its economy so
that that it would hurt his reelection chances. And as a governor who has
to make these decisions about what to open and what to close, like, is that
how you`re making your decisions?
HOGAN: No, not at all. So we – you know, look, I think that none of that
messaging is helpful at all to any of the governors. Many of my colleagues
on both sides of the aisle are not happy with that kind of messaging. On
Monday, they were talking about, you know, we`re getting near the end of
the 15 days. So that would mean next week, we`re going to start opening and
then a day or two – you know, then the next day, yesterday, they changed
it to Easter, which was two weeks later. It`s not – all of it is
We`re making decisions based on the facts on the ground and by listening to
the scientists and doctors in our state. I`m talking to folks at Johns
Hopkins, and the University of Maryland, and NIH. And look, the bottom line
is, we`re all ramping up, not down. And nobody sees the end of this in two
weeks. We see it as you know – nobody knows the exact numbers and we`re –
as you pointed out earlier, the data is incomplete. But, you know, we`re
going to make decisions based on saving lives.
The economy`s critically important, and we are concerned about helping
people who are going to be out of work and helping those small businesses.
But the decisions have to be first about saving lives, and then how are we
going to help people get back on their feet economically. You can`t just
arbitrarily pick a date and say everything`s going to be great.
HAYES: All right, Governor Larry Hogan of Maryland, thank you for making
some time amidst all this.
HOGAN: Thank you, Chris.
HAYES: Last week, New York Governor Andrew Cuomo talked about the coming
surge and coronavirus cases as a wave. A wave he was afraid would overwhelm
the hospitals and the people working within them. I`m joined now by a
doctor who can give us an on the ground report of what that wave looks
like, Dr. Craig Spencer, Director of Global Health Emergency Medicine at
Columbia University Medical Center.
And Doctor, we had you on I think exactly a week ago. You`ve been tweeting
out these firsthand accounts of what it`s like in an E.R. in New York. And
just first, the difference between a week ago when we spoke, what you were
seeing, and what you`re seeing now. What what`s the difference?
CRAIG SPENCER, DIRECTOR OF GLOBAL HEALTH EMERGENCY MEDICINE, COLUMBIA
UNIVERSITY MEDICAL CENTER: Yes, great question. So a week ago, we were
looking for the one or two coronavirus patients that might be in the E.R.
Everyone was a little anxious. We were trying to think about who they might
be. Now, there might be one or two patients in our E.R. that are not
coronavirus, even a drastic shift within the past week where it`s become
the majority of what we`re seeing.
A lot of these people, all the young are really sick. They`re being
intubated, put on breathing machines, despairs no one and the increase has
been pretty drastic. It`s palpable to anyone that crosses a threshold and
walks into the emergency room today.
HAYES: Anyone I think who`s in emergency medicine is used to a lot of
activity and I think fair to say kind of adrenaline junkies as a kind, the
ones that I`ve met my life. What you`re describing, though, is on a plane
that is really – not really comparable to other things. Is that – is that
SPENCER: Yes. The analogy I`ve been given is that I worked in West Africa
during Ebola. That was scary, of course. I`ve worked in the middle of civil
wars providing trauma care. There`s something about this that feels kind of
palpably worse. One knowing that we`re kind of just at the beginning of
this. You know, case numbers are increasing on a daily basis, that drastic
You`re already hearing hospitals throughout New York City that are short on
personal protective equipment, on ventilators. People is setting up a kind
of these temporary morgues outside of hospitals. This idea that in two or
three weeks we`re going to be somehow past this when we just recorded our
first case here in New York City just over three weeks ago, to me is crazy,
HAYES: One of the things in your documenting this that struck out – stood
out and it lines up exactly with first-person accounts of healthcare
workers in northern Italy and in Wuhan, which is just the relentless
drumbeat of the same kinds of issues. I mean, patient after patient short
of breath. Patient after patient that needs ventilators. That too feels
unique from what I`ve read. Is it – have you encountered something like
SPENCER: Absolutely. You know, we find outpatients every time we change
shift. And generally, what we find out is chest pain, this one has
appendicitis, this one has – needs to see the obstetrician, sign out as
now patient is COVID positive, and then we`re kind of triage and who are
the most severe, who needs to be put on breathing tubes, who needs to be
admitted to the hospital?
You know, it`s going to be impossible to admit every person that`s COVID
positive as a coronavirus patient. We just don`t have the space even if we
increase by 50 or 100 percent, it`s just not possible. So we`re thinking
about different protocols. How do we risks ratify? How do we find who are
the sickest patients and how to focus on them?
HAYES: One thing that`s really unnerving about this virus, and again, we`re
still learning about it is it seems very random in in that, you know, we
know that there`s elevated risk for people immune-compromised and senior
citizens. The older you get, the more that fatality rate goes up. But on
30-year-old can get it and it feels like a cold and one 30-year-old,
healthy otherwise, is being intubated a few days later. Do you have a sense
of why that is or does it feel random to you as well?
SPENCER: I think it feels pretty random to all of us, which is a scariest
part of it, right? The majority of deaths are going to be in older patients
with comorbidities, with hypertension, with diabetes, but that does not
exempt anyone, whatever your age, whether you`re a teenager whether in your
30s from getting this disease and having severe complications from it.
HAYES: What is morale like? What is – what is the atmosphere like among
your fellow healthcare workers on the frontlines of this?
SPENCER: We are all unbelievably proud to be able to show up to work every
day and take care of people. We want to know that we`re prepared. We want
to know that we`re protected. But the other thing is, and this is what I`ve
been trying to share with my colleagues and my friends, this is something I
learned in West Africa in 2014. Everyone is afraid.
Eight percent of all total infections in Italy were amongst health care
workers. We know that some of our colleagues already are being infected,
are being intubated, being put on breathing machines. We know that we`re
all at risk. So we`re all anxious. I tell all of my colleagues to try to be
vulnerable. Share their stories. Share their concerns with someone else in
the emergency department, one of their friends so that they don`t feel like
they`re going through this alone.
HAYES: All right, Dr. Craig Spencer, you`re doing amazing work. Your
colleagues are doing amazing work and I really can`t thank you enough.
SPENCER: Thanks a lot, Chris.
HAYES: All right, next, the Senate announced a bipartisan rescue deal to
address economic fallout of the coronavirus early this morning. The details
of what`s in it, however, still up in the air. There`s no one better to
break down what`s at stake than Congresswoman Katie Porter and she joins me
HAYES: After five days of intense talks, early this morning at 1:00 a.m.,
Senate leaders announced that they reached a deal with the White House, a
bipartisan coronavirus rescue package. Now, the actual final language of
that deal of the bill is still being hammered out. One thing that seems
certain is that it will be the largest economic stimulus package or rescue
package in U.S. history.
Nearly $2 trillion bill, trillion dollars after we`ve spent 15 months in
the campaign about how you will pay for that, to address the economic
fallout of the coronavirus pandemic. The details have been shifting all day
as Republicans and Democrats been fighting over their respective
priorities. It remains a very fluid situation.
Just one example, the big impasse we seem to be at right now. A group of
Republican senators are now threatening to delay the bill because they
believe the unemployment benefits are, get this, too generous for low-wage
The White House predicted a Senate vote by tonight but that vote has yet to
happen. If and when the Senate passes the bill, the House will have to vote
it before it goes to the President. One of the members of Congress who has
been digging through the fine print of the bill all day, Democratic
Congressman Katie Porter of California, she joins us now.
I will note, the Congresswoman was currently self-quarantining after
experiencing possible symptoms of Coronavirus. She`s been tested and is
awaiting the results. So let me begin, Congresswoman, by asking you how you
REP. KATIE PORTER (D-CA): I feel tired. I`ve been sneezing. I spent a lot
of the day today in the last week in bed, on conference calls, doing the
best I can to stay awake, take notes, and follow what`s happening. But I`m
grateful that my symptoms have been mild to moderate. And I really have a
lot of concern about all the public health and everyone out there right now
who`s either feeling sick or worried about getting sick.
HAYES: So you`ve been going through the legislative language, I know that
there`s a lot circulating around. I wonder if you can give us like, maybe a
good and bad column in terms of your read on where this is right now, what
you like that`s in there, what you`re concerned about. Let`s start with
what you think good that that is in this bill.
PORTER: Yes. I actually went through the summary of what we believe is
going to be in this package. As you know, we haven`t seen language yet. And
I actually marked it up exactly this way. Green, good, red bad. So here`s
some of the green good. $100 billion for our hospitals and our health care
providers. That money is critically needed right now. $45 billion for FEMA
disaster grants, and lots of money for state and local government
stabilization. All of that is really, really good.
Also, some really good news for our small business owners. For the first
time, what`s on the table is actually grants that would not have to be
repaid. So small businesses would be able to get help and not have to worry
about repaying it because it`s going to be a long time for some of them
until their business recovers. That`s the good.
HAYES: All right, what`s marked in red on your copy? What`s the bad?
PORTER: So there`s bad news here for patients which is really concerning to
me. One of the things we`re told is, while this bill is going to provide
for free testing, well, I already held the CDC sector`s feet to the fire to
get free testing, free testing was in our last bill. What`s not in this
bill is free treatment. That is covering costs for uninsured people who
have free treatment or covering the out of pocket costs that people might
face for treatment.
And those things go hand in hand. A lot of people will hesitate to go get
tested, if they`re symptomatic if they`re worried about the cost of
treatment. So that`s one of my concerns. It`s an area that Democrats know
that we have to do better on.
My second big bucket of concern is I`m very worried about the
accountability measures here. I was very involved in watching the bank
bailout with TARP, the Troubled Asset Relief Program. That was $700
billion. Here we`re looking at a similarly sized fund. We`re told around
$500 billion for the largest corporations.
But as we saw with tarp, the accountability mechanisms are not strong
enough. It`s not good enough to have an inspector general or oversight
panel on the back end. The money will be out the door and in the pockets of
the largest corporations. And I`ll give you one example that just
specifically really highlights where I think there`s an opportunity to
still improve this bill.
In the bill, there is a 10,000 – up to $10,000 per worker tax credit for
businesses that retain employees on payroll. That`s terrific. That`s going
to be a big help in keeping businesses keeping people on payroll. But if
you`re a small business, you have to choose. Do you want that SBA loan, or
do you want that $10,000 worker retention payroll tax credit? If you`re a
large business, you don`t have to make a choice. You can get a bailout and
that tax credit. We should put small businesses and large businesses on a
level playing field here.
HAYES: In terms of the mechanics of this. It`s a tricky situation
procedurally. A lot of members are – some of your colleagues are actually
hospitalized. Ben McAdams from Utah, I believe, who has tested positive,
has had fairly severe symptoms. A lot of self-quarantining. a lot are away.
How – what is your understanding of how this actually is going to go down
as a vote in the next day or so?
PORTER: So, I spent over six and a half hours today on conference calls,
and I have no idea after six and a half hours how exactly the House is
going to be voting on this. We were told, no to remote voting. That`s been
consistent. We`ve – I think – I think that we`ve been told, no to proxy
voting. I think they`re expecting people to try to come back. There`s still
talk about whether or not we could do this with a voice vote, or unanimous
But clearly, members like me who are symptomatic cannot leave their homes.
It`s a public health risk. And there are a lot of members that are going to
have difficulty traveling all the way from the other side of the country to
make this vote fast enough.
So we`re waiting on the Senate to take action. A lot of my colleagues I
know are hopping in cars and starting to drive. But those are not people in
California, they`re not people in Alaska, they`re not people in Hawaii.
It`s going to be easier for some folks to get there than others.
And the problem is my constituents need my voice right now. They need me to
be voting in their interests. And it`s impossible for me to do that because
of this public health crisis.
HAYES: Final question. It does seem to me – I know that the idea here is
to pass this somehow, and then there`s going to be a recess and I
understand why recess has happened. But the rest of the entire world
including me talking to United has been adapting to how you can do your job
remotely if you can and how to make a work. It really does seem if this is
going to go on for several months, the Congress is going to figure – have
to figure out how to do this remotely, right?
PORTER: Well, you would hope so. I mean, I think it`s wrong for Congress to
act like we`re an exception. We`re asking businesses, schools, nonprofits,
healthcare providers, so many different entities to step up in this moment,
to meet the moment and to be flexible and to adapt. So I do think Congress
is going to have to do that.
I mean, we have lots and lots of conference calls, so information sharing
is happening. But the most common thing I heard on these conference calls
today was, excuse me, you might have yourself on mute, you`re going to need
to unmute yourself. So it`s not easy to do this with several hundred
And so I really trust Chairman McGovern, the chair of the Rules Committee.
And I know that he, along with Zoe Lofgren, the chair of House Admin, are
working to figure out how we can honor our duties to our constituents, but
also not risk public health.
HAYES: All right, Congresswoman Katie Porter, thank you for being with me
PORTER: Thank you so much.
HAYES: Joining me now is Dave Dayen, executive editor of the progressive
magazine, the American Prospect. Dave has been following the back and forth
over this bill quite closely. What`s your – what`s your sort of top-line
here about what the shape of the compromise it`s coming into focus is?
DAVE DAYEN, EXECUTIVE EDITOR, AMERICAN PROSPECT: Well, I mean, I think you
see temporary necessary help for individual workers, whether it`s the
direct payments or the unemployment insurance boost. And you see long term
transformation of American society through a largely unrestricted bailout
that is actually higher than meets the eye.
And what Representative Porter was saying was about what`s in the bill,
which says $500 for large – or $500 billion for large corporations. But a
portion of that, most of that, $425 billion goes, as I understand it, to
the Federal Reserve, as 10 percent of a credit facility that they build,
which would total $4.25 trillion that they could point as a money cannon at
any large corporation they want.
And that just dwarfs any other support for small business or any other
entity. And I really – we`ll be transformative in terms of what these
large corporations will be able to do with that money.
HAYES: Well, so I want to – let me give this what I`ve read is the sort
of best version of the argument for something like that is essentially, you
– we could find ourselves in a kind of domino situation in which this
turns into a really gnarly credit crisis and financial crisis. If you have
a lot of companies starting to go under, if you have a lot of bonds
starting to tank, the credit markets have already been a little wooly and
no one is really to blame here. It`s not like the banks with the, you know,
who took on all this leverage and screwed themselves and then got bailed
out. Everyone here just ended up with the virus running through the
economy. Like what`s so bad about shooting money cannons at American
business to keep it propped up?
DAYEN: Well, I mean, if it was a bailout because of the unfortunate
situation that we`re in, that would be certainly understandable. I think
the money for hospitals who are in a really strapped situation is
completely understandable, for example. This actually, to me, feels more
like a bailout for a decade of irresponsibility. These are corporations
that had record profits for 10 years, paid very little in taxes for 10
years, created the system that created this extreme vulnerability in the
United States, which does not have the manufacturing capacity, has this
system where inventory is seen as a luxury good, seen as like something
that`s a cost center. It`s created this system with leaking money out to
investors, not investing in people, creating inequality, which puts people
further on the edge in a sudden shock situation like this.
And all of that is getting papered over without any conditions to change
these terms in any way, these, you know, proclivities of the large business
sector. There`s no restrictions on the money. There is one very small
restriction but of course, Secretary Mnuchin can override that at his will.
You know, these companies can give dividends out with this money. They can
do mergers and accusations with this money. They can do virtually anything
they want with this money.
And if you see the parallels between this and the small business sector,
which is going to be serviced by the Small Business Administration, one of
the slowest agencies in the government compared to the concierge service
that the Federal Reserve is going to give these large banks and large
corporations, you know, what is the landscape of America look like after
this bill is over? That`s what I`m concerned about.
HAYES: You know, that final point about I am worried, Alexandria Ocasio-
Cortez raised this point last night, which I thought was an interesting
point, because it`s, you know, not a left-wing point, necessarily, or a
liberal point, it`s just about the mechanics of this, which is can the SBA
do what it`s tasked with doing here? I mean, can – the volume that we`re
talking about, the number of small businesses, the amount of aid they are
going to need, I`m just worried that the facility could be stood up and get
to the people that need it in time to rescue them before they go under.
DAYEN: I mean, I think the run rate that the SBA is going to be dealing
with is something like 13 to 14 times their annual budget and they have to
do it in weeks rather than over the course of a year and you talk to small
businesses right now and that`s just not the way this works. You could
extend this parallel out to the fact that individuals who don`t have direct
deposit on file with the IRS might wait as much as four months for the
direct payments. You can extend this to the fact that state unemployment
state insurance systems in some states are collapsing. They are not well
run systems. And they`re going to have to, you know, deal with the huge
boost in uninsurance and get it out to people.
This is – you know, you see the rickety parts of this system are what the
small businesses and individuals have to deal with and the strongest most
robust part of the system, the Federal Reserve, is who the large
corporations get as their concierge.
HAYES: That – yeah, that is very well put. Dave Dayen, thank you for
being with me.
DAYEN: OK. Thank you.
HAYES: Coming up, what is it about Coronavirus that makes it so dangerous?
What we`re learning about the virus itself as the crisis grows ahead.
HAYES: Today officials in Italy announced nearly 3,500 new cases and more
than 680 new deaths. Those are, of course, gruesome, awful numbers. Italy
continues to be one of the countries hardest hit by the virus, but chart
along with the rest of the data from the outbreak in that country, it
really is starting to look like the curve is flattening, is bending in
It is a hopeful sign in a weird way and an indication that there might be
some sort of light at the end of this tunnel.
The problem with what we are going through right now, all of us here in the
U.S. – the social distancing, the staying at home, the home schooling,
your kids on Zoom telling other kids to mute, the shutting down of
businesses, all the emotional and economic pain that comes with that, is
that the numbers of cases and deaths are just continuing to tick up.
And that is because there is a lag between what we`re doing collectively as
a society and when we actually get to see its effect. And that lag could be
anywhere between one to three weeks, we don`t really know, but we are
actually able to get a bit of interesting insight into what is happening
right now, the frontier of that thanks to this company you may have seen
called Kinsa that makes these smart thermometers, and they`ve started
publishing the data collected off the thermometers.
Now, obviously, this is not comprehensive by any means. But it is
interesting data looking when and where people are getting fevers, one of
the most common symptoms of Coronavirus we might be able to start to see
results from recent interventions without having to wait for that lag. So,
here`s an example from Dallas.
This graph is measuring atypical fevers recorded by people using that smart
thermometer in the area. And 48 hours after the mayor ordered bars and
restaurants to close, you can see the number of atypical fevers went down
sharply, right there, after March 17. Same graph for San Francisco where
they locked down early. Last Monday, March 16 – and again, we see a steep
decline in atypical fevers starting right after that.
So, based on this data, those early interventions, those calls for social
distancing, they do seem to be doing something, having an effect, working.
And that is some promising news in the fight against this brutally nasty
And we`re going to talk about some of the actual biological reasons why
this thing is so bad, so hard to fight, next.
HAYES: Epidemiologists who deploy to Wuhan, China from around the world,
and others who first started looking at the Coronavirus up close and what
it was doing to patients and hospitals, would talk about it almost like
they had seen a ghost. Coronavirus, this Novel Coronavirus that we`ve
encountered is both much more transmissible than the seasonal flu, and way
According to some published studies, the Coronavirus is, we think, about
twice as transmissible as the flu, and the rate of hospitalization is
nearly 15 times that of the flu.
Now, there is still a lot we do not know and are learning about this virus.
People understandably have a lot of questions about why exactly it`s so bad
and crucially how it`s transmitted and also, crucially, how you can protect
yourself for the people you love.
Here to talk about that, Nadia Abuelezam, an epidemiologist at Boston
College`s Connell School of Nursing.
Let`s start with this question of what – why is this virus seem to be more
transmissible, or more effective at moving from human to human than either
the flu or earlier Coronaviruses we saw, like SARS and stuff?
NADIA ABUELEZAM, INFECTIOUS DISEASE EPIDEMIOLOGIST: Sure, I mean, I think
the brief and the quick answer is that our human bodies have not been
exposed to it before, so we have no prior experience with it, and we have
no prior immunity to it. And so our bodies are sort of completely naive to
it and are reacting for the first time, which is probably what`s leading to
some of these more severe cases. And it`s also probably what`s contributing
to the fact that we`re able to spread it from person to person much more
easily than something like the flu.
And I think your stats that you presented were exactly right. We think
that, you know, one infected person can spread the disease to between two
and three other people. That number is between one and two people for the
So it is much more transmissible, a much more infectious, we believe, than
the flu and that`s what we`re seeing now from the data that`s coming in.
HAYES: There`s a real question I`ve seen a lot of competing ideas, you
know, again, we`re learning about this how it gets transmitted. So, the
sort of consensus view that everyone agrees on is some, you know, droplets,
the coughs or sneezes like that that get into people. And, you know, you
touch your face or something like that. But there is questions how long it
lives on certain surfaces. What do we know about that part of it, whether
it can be transported, airborne, how long it lives on surfaces, and the
ABUELEZAM: Yeah, so there was a recent study that was published in The New
England Journal of Medicine, which was done in a lab environment, which I
think is really important to say because that does not necessarily reflect
what happens in the real world, but that experiment suggested that there
was potential for droplet transmission. And there was potential for the
virus to live on surfaces for a few hours, depending on the type of surface
that it was. And in that particular experiment, they also showed that it
can be aerosolized, so it can stay in the air.
But we do believe that in sort of normal, real life experiences the most
likely ways that this virus can be transmitted is through droplet
transmission, so if someone coughs or sneezes near you and that droplet
finds its way into your mouth or your nose or on to your hand and then your
mouth or nose, or transmitted from surfaces to individuals. So those are
the primary ways we think that this virus can be transmitted, but of
course, more data needs to be collected to figure that out.
HAYES: What about asymptomatic transmission? This is something, as well,
that I`ve read some debate on. The degree to which asymptomatic
transmission either is possible and what percentage of transmissions that
makes up. What is the research that we know so far suggest about that?
ABUELEZAM: Yeah, so I think there is, as you said, some debate about this.
I think most of us are assuming that there is a bit of asymptomatic
transmission, meaning that you can transmit this virus while you`re not
showing symptoms. The duration of that asymptomatic transmission is still
unknown, but it is believed to be relatively short.
Of course, when you are showing symptoms, that`s also a time when you can
be transmitting and much, much more – transmitting much more when you`re
showing severe symptoms, as well.
HAYES: All right. Nadia Abuelezam, that was really, really illuminating.
So, thank you for that.
Coming up, a look at how the world was caught on the wrong foot by the
Coronavirus and why the U.S. seems to have been particularly unprepared,
HAYES: Last December, on New Years Eve, the World Health Organization
learned that dozens of people in China were being treated for a mysterious
pneumonia. Eight days later, a new type of Coronavirus was identified as
the cause. And now months later it has landed here and taken most of
American society along with many governments around the world by complete
Why were we caught on the wrong foot? One person who started writing very
early about this virus and the ways it preyed on institutional dysfunction,
particularly in China, wrote in The Atlantic that, quote, we had time to
prepare for this pandemic at the state, local and household level, even if
the government was terribly lagging, but we squandered it because of
widespread asymptomatic thinking. The inability to think about complex
systems and their dynamics.
Joining me now, the author of that piece, Zeynep Tufekci, an associate
professor at the University of North Carolina.
Professor, you have been writing about this a lot from the very beginning.
You wrote a great piece about China and you sort of made parallels to
Chernobyl. What was it that sort of captured your interest about the virus
from the beginning?
ZEYNEP TUFEKCI, ASSOCIATE PROFESSOR UNIVERSITY OF NORTH CAROLINA: Well, it
was SARS mostly. In 2003, we had a similar outbreak, which started in
China, and China covered it up for a while, and it got out of hand, and it
almost became a pandemic, right. We came this close to having a global
crisis. So, when we heard again that the first week of January there was
now this viral pneumonia linked to a seafood market, a wet market, which
means probably a zoonotic virus jumping species, it was a five alarm fire
right there. And it was identified very early. And later, on January 20th,
when China itself shut down Wuhan and Hubei, which are these 50 million
person provinces, that was also a very strong signal, if they`re doing
this, they`re facing something very significant, because they is switched
from cover-up to, you know, all hands on deck.
And then at the end of January, we started getting papers from top notch,
you know, scientific journals, like New England Journal of Medicine, The
Lancet, that told us that some of the patients were asymptomatic or had
atypical clinical presentation, they didn`t necessarily have fever, they
were shedding the virus before they were sick, which in SARS in 2003, the
fever and the infection came together, which is how we caught it, right, we
could put a temperature gun in airports and check the people.
So, at the end of January, if you look at it honestly and if you were
following the epidemiologists and the people who kind of follow this stuff,
they were telling us that this was going to be a pandemic. This was really
The thing that got me very worried were the early reports on how much
ventilators and ICU care this was requiring from the patients, because if
it was just a pandemic, let`s say of a flu-like illness, that would be
terrible enough, because flu is terrible enough, and if we have a flu plus
a flu-like illness, that is going to overwhelm our hospital system right
there, even if it is just like the flu.
But worse in this particular case, we weren`t getting reports of a flu,
which – what happens with flu, is that it makes you weak and you get sick
and there are infections, perhaps, like bacterial opportunities for
infections, and this one was putting patients in pneumonia directly.
So, the way I explain it in my article is that flu is like the person who
unlocks your door for the robber, and this COVID-19 is the thing that just
comes in and robs you, hits you over the head. So, that`s the big
difference, so that method, I see the ventilator capacity was going to be
overrun. Well, I say all over this, because by the end of January and early
February, all of this is was known.
So as you note that a lot of us that were either close to studying
pandemics or following the epidemiologists, were really frustrated because
in February, we should have been getting ready. We should have been ramping
up the masks and personal protection. We should have stopped travel. We
should have started screening. We should have gotten the tests ready. So it
is really tragic that this kind of failure of listening to the right
expert, and failure of imagination.
People kept saying, it doesn`t kill more or less than the flu. But that`s
not the question, because if you have a flu, and then you have one more
illness, and you have no room in your hospitals, right now, I`m hearing of
NICUs being emptied to make room, right, so you`ve got babies who not
catching the disease, but their health care is threatened. We he have
reports that people can`t give birth with anyone else in the room, because
there are no masks around to give to a single person.
So the kind of complexity that goes to something like this is a known
expertise, but unfortunately it doesn`t really fit into either the media
narratives, and also of course, the government failed, our government
failed, the European governments failed, the Chinese government failed in
another way, so that`s all – and here we are, I`m doing an interview from
my house, trying, hoping not to become (inaudible) with something
HAYES: What do you account for the countries that did sort of figure it
out quickly? Do you think it was just the experience with SARS. There`s
some reporting to indicate in the case of South Korea, that was definitely
TUFEKCI: So Hong Kong, which I actually did a lot of research on Hong
Kong, because I studied the protests, the moment the news of this viral
pneumonia came out of China, because they are part of the greater China, if
you want to call it that, right, Mainland China, two countries – two
systems, one country, they went into lockdown, the people went into
lockdown, which is important to example, because their government did not
want to contradict Beijing, did not want to close the border, they were
kind of downplaying it, but the people that lived through SARS, right, so
they were – started universal mask wearing, started social distancing
Taiwan, which had also gone through this, tried – heard from Mainland
China, that there was human-to-human transmission and they did the same
thing – ramped up production, locked down. Those are the countries that
have it under control.
We should have been one of them.
HAYES: Zeynep Tufekci, who is one of my favorite writers on a variety of
topics, thank you so much for your time tonight.
TUFEKCI: Thank you, Chris.
HAYES: That is ALL IN for this evening. “THE RACHEL MADDOW SHOW” starts
right now. Good evening, Rachel.
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distributed, transmitted, displayed, published or broadcast without the
prior written permission of ASC Services II Media, LLC. You may not alter
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