All In with Chris Hayes, Transcript 3/27/2020

Guests:
Andrew Cuomo, Debbie Dingell, Sheri Fink, Charlene Babcock, Abdul El-Sayed, Michael Linden
Transcript:

ARI MELBER, MSNBC HOST: We want to let you know something else as you plan
your evening. There`s been a lot of news out of Washington and speaker
Nancy Pelosi will be here on MSNBC with Rachel Maddow at 9:00 p.m. Eastern.
That should be an interesting interview. You can find me, Ari Melber, back
here 6:00 p.m. Eastern on Monday for THE BEAT, also be filling in again in
this 7:00 pm hour as well for our special coverage. Don`t go anywhere. “ALL
IN” with Chris Hayes starts now.

CHRIS HAYES, MSNBC HOST: Good evening from New York. I`m Chris Hayes. It is
now day two of America having the worst outbreak of the coronavirus in the
world. And if there is a single lifesaving thing we need right now above
all else, it is more ventilators. We know from everything we have seen that
a shockingly high percentage of people with the virus will need to be
hospitalized.

And because of the way this virus works, it`s way through the lungs, many
will find themselves unable to breathe on their own. They need a machine to
breathe for them. That`s what a ventilator does. If these critically ill
patients get a ventilator, their chances of surviving go way up. If they do
not, they are much more likely to die.

American hospitals are not equipped to the scale events later need
presented by this pandemic. And this has been clear, I want to make this
clear, for a long time, including in the National Security Council handbook
for pandemic given to the Trump administration by the Obama administration,
and in a pandemic simulation practice by the Trump administration itself,
codenamed Crimson Contagion that found and I quote here, “States
experienced multiple challenges requesting resources from the federal
government due to a lack of standardized well understood and properly
executed resource request processes.”

This administration`s own wargames told them that they need to be more
prepared. And so now in New York City, doctors are already hacking
ventilators themselves to split them between multiple patients. York`s
Governor Andrew Cuomo said the state can eat up to 30,000 machines in just
the next few weeks. This is a simple matter of life and death, OK. If we
don`t get the ventilators, more people will die. It`s not complicated. The
president – the President seems to think that the whole ventilator thing
is some kind of con job.

(BEGIN VIDEO CLIP)

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: New York is a bigger deal,
but it`s good to go also. But I have a feeling that a lot of the numbers
that are being said in some areas are just bigger than they going to be. I
don`t believe you need 40,000 or 30,000, ventilators. You know, these are
two major hospitals sometimes is they`ll have two ventilators and now all
of a sudden they`re saying, can we order 30,000 ventilators?

(END VIDEO CLIP)

HAYES: First of all, all of a sudden, all of a sudden, he said all of a
sudden, what`s going on? You need a lot of ventilators. All of a sudden
there`s this pandemic. That`s what the whole thing is about. That`s what
all of a sudden is. Yes, yes, all of a sudden, all of a sudden, thousands
of people need ventilators who did not need them a few months ago before,
because of the pandemic that has shut down two-thirds of the country.
That`s all of the sudden. That`s the pandemic our government did not
prepare for.

And what is becoming clearer by the day is that there is such a complete
disconnect between what the president says and the frontline medical
workers who are right now fighting this disease. Listen to how this ICU
nurse in Michigan describes her new reality earlier this week.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: So today was the first day that I`ve worked since our
unit was designated the second COVID ICU in my hospital. And I don`t know
what the (BLEEP) just happened for the past 13 hours. Honestly, guys, it
felt like I was working in a warzone.

I`m completely isolated from my team members, limited resources, limited
supplies, limited responses from physicians because they`re just as
overwhelmed as we are dealing with a ton of other stuff. So basically, I
just spent the last 13 hours, like treating too critically ill COVID
patients on the bed basically by myself. This is my new normal for the next
however long it takes for this virus to die down. So, look, I`m already
breaking. So for (BLEEP) please take this seriously. This is so bad.

(END VIDEO CLIP)

HAYES: This is so bad. This is so bad. But it`s actually worse than that.
Yesterday, the New York Times reported that the Trump administration backed
away from a deal for General Motors to produce ventilators because the
price tag was too high. Oh, and because, quote, listen to this. “Some
government officials expressed concern about the possibility of ordering
too many ventilators leaving them with an expensive surplus.”

They were worried about having too many ventilators, God forbid we would
have them the next time we have a global pandemic or maybe share them with
the rest of the world when they need them. And not only to the president
nixed that GM plan as of a few hours ago, he refused to use the defense
production act – production act to mandate the production of them. And
then late this afternoon, he changed his mind announcing he was requiring
GM to accept, perform, and prioritize federal contracts for ventilators
using the Defense Production Act.

Of course, the production of those ventilators will be probably a month
away. I want to be as clear as possible on this. If there are not
sufficient ventilators, people will needlessly die. End of story. The
situation is dire.

Joining me now by phone, a man currently managing this crisis in what has
become the epicenter of the pandemic globally, the Governor of New York,
Andrew Cuomo. Governor, thank you for making some time. I want to start on
the ventilator issue. The President seems to think that the estimate of
needing 30,000 ventilators, he feels it`s too high, that you`re
overestimating how much you`re going to need. What`s your response to that?

GOV. ANDREW CUOMO (D-NY): Yes. Well, Chris, listening to your lead in –
and thank you for having me. You`re exactly right. This all comes down to
ventilators. And by the way it did in China, it did in South Korea, it did
in Italy, and it did as soon as the numbers started to break here. And it
is unusual. The number of ventilators we have in our healthcare system,
when you add up all the hospitals in the state of New York is about 4,000.
We need about 40,000 here.

This is a disease that is a respiratory disease. People are on respirators,
the ventilators, and ventilators are a matter of life and death. And
they`re on ventilators longer with this disease than most other diseases.
The average length of stay on a ventilator is about four to five days.
Here, it`s about 20 days, which is one of the reasons why you need so many.

The President says 30,000 sounds high. You know, I don`t – I don`t know
what the basis is. I don`t – I don`t have a medical degree. So what I do
is I just study the numbers and the science and the data and I follow the
data. We have McKinsey and Company, we have Cornell Weill Medical Center. I
talked to the World Health Organization. You look the models of China, look
at the model of South Korea, look at the models of Italy, and look at the
models of the numbers in my state. You see, it takes you to 40,000 ICU beds
with ventilators, and 140,000 hospital beds. That`s what the numbers say,
at apex. So I plan by the numbers, and I don`t know how to do it any other
way, Chris.

HAYES: Where are you right now? I think – I know when this went into, you
said the state had 4,000. I think there was maybe another 7,000. Some of
which did come from the federal government. Like how far are you From what
the state needs right now to handle that peak if it comes at what the model
suggests?

CUOMO: We`re scrambling to buy them all across the globe. One of the things
that has happened here because the states were left on their own to
purchase, in a cruel irony, the states are bidding against other states,
Chris, for the same materials, and they`re actually bidding up the price.

So I`ll get an order for ventilators, and I`ll have a company say, I`ll
send you 5,000 ventilators in three weeks, and then they call me back and
they say sorry, I sold them to Illinois or California or Florida. That`s
the situation we`re in. I need about 30,000. We`re about halfway there
counting orders that we have. We`ve gotten 4,000 from the federal
government. I had 4,000 in our – in our hospital system. We bought about
7,000. And then we have a scattering of orders which may or may not come
in.

One other point on something you mentioned. I applaud the president for
using the defense production act. I said last week, he should have used it.
This is not a time to be bargaining with corporations or relying on the
voluntourism of corporations. We need these ventilators and we need them
now, not when the corporation decides it`s convenient for them to do the
design and to put up a new line in operation.

You`re talking about my possible apex, it`s 14 days away. If I don`t have
the ventilators in 14 days, Chris, people die.

HAYES: You know, that strikes me as part of the difference in which
governors I think across the ideological spectrum, generally, and the
President have approached this which is a kind of planning for the worst
and hope you met – hope you`re wrong, right? So if you get too many
ventilators, what`s the worst thing in the world that happens as opposed to
planning for the optimistic case scenario and erring on the other side?
Like, what are the stakes if you`re wrong in the wrong direction for people
in New York, sick people in New York?

CUOMO: No, you`re exactly right. The difference is somebody who`s been out
there and somebody who has been through it, and somebody who has it, right.
I used to be in the federal government. As you know, I was HUD Secretary,
and I`ve done floods, hurricanes, all sorts of disasters. Yes, maybe you
send out too much equipment. So what? The real crime and the heartburn is
if you have too little.

So – and I`m not even taking an aggressive model. I have a reasonable
numerical model based on our numbers. And again, you have a whole world
data going back to China. And we`re just asking for what we need for our
reasonable model. I`m not – because of many of these I`m paying with state
money. And these ventilators, they`re about $25,000 each, Chris. So I`m not
eager to buy more ventilators than I have to.

HAYES: Right. You had been a critic of the relief bill that has now been
passed and signed because of precisely the issue you`re articulating here,
whether there was sufficient money for the state. Obviously, all these
states are scrambling. They`re going to be paying out of pocket for all
these things as they should, these emergency funding. Less money is going
to be coming in taxes. Every state`s going to be wall up to the deficit. Do
you think what came out of Washington today is sufficient for the kind of
hole that New York is going to be looking at?

CUOMO: No. It`s not even close. Look at the bill, they all applauded them.
The bill did a lot of good. The unemployment insurance is good, the small
business aid is good, the healthcare rate is good, but they left out a very
important function, which are the state governments and the local
governments.

You know, my economy is shut down like everybody else`s. I have no revenue,
and all I have are expenses. And none of the aid went to a state
government. Now, it`s not like it`s my money and I`m going to go out and
buy something. If you starve the state government, where – what I fund is
education, and I fund healthcare.

So when I have no budget, Chris, it means I have to turn around and cut
schools all across my state and cut health care all across my state. It
makes no sense. Now, you know, states don`t have a voting constituency,
right? You can`t come and hand me a big check. So it`s not as politically
advantageous when you do a bill in Washington, but I think it was short-
sighted and I think they are – they say they`re going to come back, but
you know, who knows?

HAYES: There`s been – I think the state announced a release of some
prisoners in New York State. I know that New York State has a very large
elderly prisoner population in the state. There is real concern about
incarcerated folks in the state, particularly those elderly folks and them
– the susceptibility to the coronavirus, the prisons as vectors for
infection, particularly when you have COs and other people who are going to
be coming in and out and going into rural areas that maybe have fewer
hospitals. What steps are you taking to deal with that? Are you considering
trying to decarcerate some of these places to get out ahead of that?

CUOMO: Yes, we have been very aggressive, Chris, number one in bail reform
in general. We passed one of the most sweeping bail reform bills in the
history of the state of New York. So we`re incarcerating fewer people than
ever before. We`ve then taken special measures for this virus situation.
For example, we`re releasing people who are in jails because they violated
parole for non-serious reasons.

And wherever we can get people out of jails, out of prisons, now we are. We
also put in additional protections in the prisons to try to protect both
the workers and the prisoners.

HAYES: Just one follow up, and then I`m going to ask a question about the
White House, and then I will let you get back to work. But I just – you
just touted bail reform. You`re not trying to undo that right now? There`s
been reporting that you are.

CUOMO: No. There is – there`s a discussion back and forth between the
houses. You know, it`s a sweeping bill that we did on bail reform. And many
times when you make a change, a basic change in a complex system, you have
to go back and do some fine-tuning And that`s what we`re dealing with
between the houses of the legislature.

But that`s usual. You know, you go near a system like education or health
care or the criminal justice system and you change the major gear in the
system, you then often have to come back and make some other adjustments to
make it work.

HAYES: Final question for you and then I will let you get back to work. The
relationship between the President and governors has been tempestuous in
many cases. Today he talked about the governor of Michigan and called her
that lady. He told Mike Pence that he advised Mike Pence not to call the
governor of Michigan and not to call the governor of Washington because
they were insufficiently appreciative.

What – how does that hit your ears as you are in up to your neck in this
crisis, and you hear the governor – the President of the United States
essentially saying everyone has to be sufficiently appreciative or they`re
not going to get the help they need?

CUOMO: Well, Chris, by the question, I would be doing my state a disservice
if I now attacked the president, right?

HAYES: Exactly.

CUOMO: Let me just say this. The President hasn`t – I probably been the
number one critic of President Trump since he got into office. And we`ve
had some real battles and he`s tweets – has tweeted a lot of nasty stuff
about me and about my family. On this situation, I said to him, look,
forget the politics, let`s put it aside. It`s very simple. I need help.
You`re the federal government. And this relationship has to work or a lot
of people die. You do the right thing by my state, and I will be
appreciative and vice versa. And that`s how it has been working.

He has been responsive. He`s done a lot of good things. He has the Army
Corps of Engineers in our state, FEMA, he waived the 25 percent state match
which is a big deal. So he has been – he`s been very helpful and
cooperative overall. And when we have differences, I say we have
differences. We have a difference on the Defense Production Act, etcetera.

So I`m not shy when we have a disagreement. But when things are working
well, I say that also. And this can`t be personal and it can`t be
political. Because literally, we are on the cusp of losing thousands of
people who did not have to die, Chris. That`s what the ventilators are
about. They did not have to die if we do what we have to do.

HAYES: All right, Governor Andrew Cuomo, I really do appreciate you taking
all that time this night.

CUOMO: Thank you. My pleasure, Chris.

HAYES: Yesterday, Dr. Deborah Birx who`s the response coordinator for the
White House Coronavirus Task Force chastise the media saying they`re making
people panic unnecessarily that hospitals may have to decide which patients
to save.

On the same day, she said that, a letter from Henry Ford Hospital in
Detroit was leaked online describing exactly that situation, about how they
are going to ration their ventilators by prioritizing patients with the
best chance of surviving.

Patients who have the best time chance of getting better, the letter reads,
are our first priority. Patients will be evaluated for the best plan of
care and dying patients will be provided comfort care. The hospital
basically confirmed the letter`s authenticity, saying, “With a pandemic, we
must be prepared for worst case. With collective wisdom from an industry,
we crafted a policy, provide guidance for making difficult patient care
decisions. We hope we never to have to apply them.”

All of a sudden, this virus is here, and all of a sudden we need to get our
hospitals and machines they need to save lives. Joining me now is
Democratic Congresswoman Debbie Dingell of Michigan. Congresswoman, I know
things have been very tough in Michigan.

I want to start with something the President said earlier today, where he
said that he advised Mike Pence not to call your state`s governor, Governor
Whitmer and she told press reports that she`s actually had orders canceled
for needed equipment because she thinks that there`s a kind of you know,
blockade being offered by the President. What do you – what do you make of
that?

REP. DEBBIE DINGELL (D-MI): So, first of all, I agree with Governor Cuomo
that this is a time that we`ve all got to work together. He again took
shots at our governor tonight, and I just wish we would put this aside.
Tuesday night, our delegation met in a bipartisan way. We were not the only
state that has gotten conflicting signals.

You know that last week the governors were told, go out and get your
supplies on your own. Governor Cuomo has been very articulate and talking
about that. But she did receive as other states have phone calls from
suppliers that they had lined up to deliver these supplies that said we
can`t deliver them to you. We`ve had to stop. The feds are going to –
become in charge of the distribution center.

Look, we need President Trump. We need him to be the leader. Tonight, at
the briefing, Dr. Birx said that Detroit and Dearborn, my hometown are now
on their target list, their watch list. Michigan is going to be the next –
one of the next epicenters like Cook County, New Orleans. We need to work
together. We can`t do this.

We need – I have been an advocate of the federal government and the
president invoking the Defense Procurement Act so that we have federal
coordination of all of these so the resources are going where they need to
go.

HAYES: Can you walk me through? I know that you had been very involved.
Obviously, we`ve got a long history with the big three automakers in your
home state. And I know you had been back and forth with some of them about
the possibility of ventilator manufacturers and you expressed some
frustration about it. How do you understand what`s played out? I`ve had a
hard time tracking it.

DINGELL: So I`ve talked to all three autos. I`ve been talking to them every
single day since this crisis began about a variety of issues. The fact of
the matter is, they all know that this country is in a crisis and they want
to step up and contribute, as does the UAW. The UAW has got a number – not
a number, they`ve got thousands of volunteers who want to help produce.

The PPE equipment is also equally important. You talked about the nurses or
doctors on the front line. You showed a picture of a nurse from Michigan.
I`ve heard those stories. Every day from doctors and nurses, the tears. An
intensive care nurse called me and said to me, Chris, you need to make me
this promise. I`m writing my will. I`m probably going to die. Will you make
sure my child doesn`t go into foster care?

So the autos have all began evaluating what they could do last week. I kept
asking General Motors, are you producing the ventilators They were working
on it. They were working on it with Ventech corporations that they are
announced today. The reality is that there are a lot of components that go
into these ventilators. They were working with the suppliers. You need
someone coordinating all of this. And we do need to speed it up. We need
these ventilators now.

Ford Motor Company immediately last week started talking to other
manufacturers. They knew they couldn`t do it at the speed at which it was
needed, and they said that point-blank, you know. So all of them are
stepping up. All of them are going to produce what they can but we need to
be realistic about what can be done in the next two weeks, like Governor
Cuomo said, and what`s going to take time.

HAYES: Yes, it`s going to take a few weeks, probably a month at the very
minimum. Congresswoman Debbie Dingell, thank you so much.

DINGELL: Thank you.

HAYES: For more on the life and death fight against coronavirus inside
American hospitals, joining me now Dr. Sheri Fink, Correspondent for The
New York Times. She`s been embedded at Brooklyn Medical Center for the last
week. And her latest piece is titled “We`re in a disaster mode, courage
inside our Brooklyn hospital confronting coronavirus.”
You know, we – obviously, for obvious reasons, Dr. Fink, we can`t bring
cameras inside these places. We`re sort of relying on you and the other
workers there to be our eyes and ears. What is it like in this hospital?

SHERI FINK, CORRESPONDENT, NEW YORK TIMES: So – and I should – I should
clarify, I`m a New York Times correspondent and was able to embed there on
Monday and then stayed in touch over the recent days about what`s been
happening there. We spent a whole day there, 12 hours.

And what`s been happening, it is – I`ve reported on disasters. I`m a
physician myself, I`ve worked in disasters and conflict areas as an aid
worker before I became a journalist, and it felt it`s not business as
usual. It felt like it was a different thing.

And so you saw half of the emergency room, they had put up a wall, hastily
put up a wall so that they could divide it between coronavirus, you know,
suspect or confirmed coronavirus cases, and the cases that are, you know,
your heart attacks, your strokes. People don`t stop having those.

And the intensive care unit was full. There were patients who were waiting
to go upstairs. They were boarding in the emergency department and those
staff members, those nurses were caring for them. One of them even on a
ventilator already down in the emergency room.

In fact, Wednesday night, they opened up a new part, a whole new section,
additional beds, intensive care unit beds, because they had exceeded their
normal – you know, their normal intensive care unit capacity. So that`s
what`s happening. It is not business as usual and they`re really
stretching.

I was very impressed with the spirit that the staff were just putting their
– you know, kind of putting their game face on and doing this work at some
risk to themselves as well.

HAYES: Yes, the sort of stretching and the capacity, I mean, this is –
this is unfortunately probably relatively early in the crest of
hospitalization in New York. How much room was there? I mean, how close to
the sort of capacity edge did that hospital feel to the people working
there, to you as a reporter and a doctor yourself?

FINK: Well, I mean, they`re beyond the typical capacity, right? And I think
people forget that in a normal flu season, our ICU is are quite full. We
don`t have a lot of extra capacity. We run a lean healthcare system in our
country. We have a lot of capacity, but it`s not limitless, so they`re
already going beyond.

In fact, as you know, the governor had asked hospitals to come up with a
plan by Monday for how to take an additional 50 percent of patients and
also plans to double the number of patients that they usually do. So
they`re doing things like canceling. They have, of course, canceled
elective surgeries. Those surgeries don`t feel so elective to people who
were expecting to have them, but that is what they needed to do to at least
free up space in this hospital.

Another issue is testing. It was taking – it is taken seven days to get
test back from the commercial lab that they use.

HAYES: Wow.

FINK: That means every single one, there were 65 patients as of Wednesday
night, who were in the hospital waiting for test results. They each have to
have an individual room. This is the hospital where a lot of them would be
in double rooms. But until you know exactly what they have, they can`t be
with other patients.

So it`s issue after issue and they`re doing everything they can to avoid
that rationing scenario that what my – part of my family uses that
hospital system in Michigan. So that is what every hospital now is looking
at those plans, unfortunately.

HAYES: All right, Dr. Sheri Fink is one of the best medical writers in the
entire country. Your work is always fantastic. Thank you very much. Next,
the federal response continues to fall well short of providing the
equipment needed for healthcare workers on the front line, leaving
hospitals to improvise. How one hospital preparing for worse after this.

(COMMERCIAL BREAK)

HAYES: You`ve seen everyone everywhere in civil society, particularly front
line health workers improvise in the moment to deal with the failures of
the federal response of the Coronavirus and just the difficulty of the
challenge itself.

Look at this headline in The New York Times, “the other option is death:
New York starts sharing ventilators.” This week, some hospitals in New York
City started experimenting with hooking up two patients to a single
ventilator, which is something was only ever been done twice in practice as
far as we can tell in the immediate aftermath of the 2017 Las Vegas
shooting and for Coronavirus patients in Italy.

Just two week aces ago, an ER doctor in Detroit posted this YouTube video
showing how to modify a ventilator to use on up to four people. She joins
me now, Dr. Charlene Babcock, emergency medicine physician at Ascension St.
John Hospital in Detroit.

Lots of folks shared that video, which is a remarkable thing. You had
actually written it up for a medical journal. Before we get to the sort of
method, can you just explain to a layperson like what a ventilator is and
how it works?

DR. CHARLENE BABCOCK, ASCENSION ST. JOHN`S HOSPITAL: So a ventilator
actually pushes air into a patient`s lungs, and it can do it by volume
control, which basically means you set how much volume goes into the
patient, or pressure control, which means you set a peak pressure and as
much volume will go in as possible. And to do something like this we
recommend pressure control so that it sets a pressure and the volume of air
goes in to meet that pressure.

HAYES: So how much, on a normal – if you`re dealing with a ventilator and
you have a patient with one in an ER like what are the normal conditions
that put someone in need of that before we`ve hit this pandemic?

BABCOCK: So, normally in air we have 20 percent oxygen but you can, you
sometimes need more oxygen when you have lung disease like you do in COVID-
19. So we increase the amount of oxygen by a mask that we put on the
patient, but sometimes that`s not enough oxygen and we have to push 100
percent oxygen through an endotracheal tube, which is the mouth going into
the trachea.

HAYES: So normally – so these are people that are struggling to breathe
and you can actually use the machine to push a higher percentage of oxygen
into their lungs than the air that they are bringing in and makes it easier
for them to breathe?

BABCOCK: Yes. And also takes the work of breathing away because we push it
in so that don`t have to like work to breathe. It pushes the air in so not
only are you getting a higher concentration of oxygen, but you`re taking
the work of breathing away.

HAYES: How much does the machine have to be monitored when someone – oh,
we may have just lost you for a moment. I think we did lose you. I think we
still have you, Dr. Babcock. We`re all rolling with this – Dr. Babcock had
this incredible YouTube video…

BABCOCK: That`s OK.

HAYES: She had a YouTube video in which she describes how she was able to
sort of hack together a ventilator to actually connect a bunch of different
tubes and get those tubes working on perhaps as many as four patients at
the same period of time. That has gone viral.

You`re starting to see people actually now try this. Now they had never
actually used it on human subjects, it`s only been done twice before, but
as a kind of emergency triage, almost battlefield kind of situation, if it
does work, that innovation was that video of Dr. Babcock might be
responsible for saving a lot of lives.

We`ll be right back with much more after this.

(COMMERCIAL BREAK)

HAYES: Right now, the U.S. has the worst outbreak of Coronavirus in the
world, both in terms of total cases and the rate of growth at this point in
the curve. And part of what makes us unique is that we have a bunch of
different epicenters around the country. That was really not the case in
China and not the case in Italy, as Trump`s former FDA commissioner Scott
Godley pointed out using this chart as evidence, our epidemic is likely to
be national in scope.

We`re seeing this play out right now in Louisiana. New Orleans has the
highest per capita Coronavirus death rate in America per 100,000 residents,
and this is the stark warning Louisiana`s governor laid out yesterday.

(BEGIN VIDEO CLIP)

GOV. JOHN BEL EDWARDS (D-LA): If we don`t flatten the curve and do it soon,
as I mentioned yesterday, we could be out of ventilators in region one, the
New Orleans area, by as early as April 2. It is not conjecture. This isn`t
some flimsy theory, this isn`t a scare tactic, this is what is going to
happen.

(END VIDEO CLIP)

HAYES: Joining me now from New Orleans is Dr. Corey Hebert, chief medical
officer at Dillard University.

Doctor, what is it like there right now? The data we see looks grim. What
is it like on the ground?

DR. COREY HEBERT, CHIEF MEDICAL OFFICER, DILLARD UNIVERSITY: Well, the
hospitals are being overwhelmed as we would expect, but it`s something
that, you know, if you don`t know your history, you`re doomed to repeat it.
We know that in 1918 in Philadelphia, there was a Liberty Loan parade of
about 200,000 people. They had the parade even though they knew the H1N1
Spanish flu was coming. And what actually happened? 12,000 people died in a
six-week period because they had that big gathering. That is the actual
curve that we use now when we start talking about flattening the curve and
the what not to do. So, you see that giant spike, that was 200,000 people
at a parade.

In New Orleans, we actually had millions of people for a parade about four
weeks ago, so that is what we`re seeing and what we`ll continue to see in
other urban areas around the country because when you look at the density
of populations around the country, Detroit, New York, these are the places
where you`re seeing a lot of cases, it`s like a parade every day. And these
people were interacting socially.

And so on the ground in New Orleans, what you see is the outbreak in the
pandemic of what actually occurred for to five weeks ago.

Yeah, I should note the president of the United States the day before Mardi
Gras, he said the Coronavirus is very much under control in the U.S. and
the mayor of New Orleans, LaToya Cantrell, had an interesting response when
asked should you have canceled Mardi Gras. Take a listen to what she said.

(BEGIN VIDEO CLIP)

MAYOR LATOYA CANTRELL (D-LA): The federal government did not issue any red
flags, and therefore we moved forward. We rely on the facts to make
decisions for the people that we serve. Given no red flags, we moved
forward.

In hindsight, if we were given clear direction, we would not have had Mardi
Gras, and I would have been the leader to cancel.

(END VIDEO CLIP)

HAYES: Do you think that`s fair? Do you think that`s a copout. Who do you
think is responsible for this decision, ultimately, which will cause a lot
of pain?

HEBERT: Well, I will tell you the lack of leadership at the highest levels
has actually started this whole domino effect, so I do agree with the
major. And she did cancel several giant events, such as St. Patrick`s Day
and many other events here in New Orleans, Jazzfest, and all these things.

So, it was very unfavorable when she did that, but I think that she would
have actually canceled Mardi Gras had we had the appropriate information.

All these cities that are around the United States are having these issues.
I mean, I know you`ve been to China, I`ve been to China. When you look at
the Hubei province, they are so closely knit in Hubei Province, it is
exactly the same as urban centers in the United States, and so when you
have a Mardi Gras, you expect this.

But, you know, when you have to have leadership and when I tell you we go
through several exercises with the federal government as talking about all
types of emergencies before we have an event, including Mardi Gras, and at
no point – I`ve worked with the city for many years, at no point was there
any leadership to say that we should not have Mardi Gras.

So, I think she actually did step up. But, you know, a lot of people had a
lot of events and I think that`s why our numbers are spiking like in
Philadelphia around 1918.

HAYES: Yeah, and unfortunately, that is baked into the cake for the next
foreseeable weeks. Dr. Corey Hebert, thank you for making some time
tonight.

Another national hot spot is the city of Detroit. Their confirmed cases
rose to 851 yesterday, 11 times the number reported just a week ago.

Part of that is because people do not have access to running water, and
without water, well, you cannot wash your hands. The Associated Press
today, quote, the city has restored water to more than 840 homes with about
190 work orders still pending, but does not know the exact number of homes
without service. And officials at the city plans to reach out to 5,400
houses out of an abundance of caution.

To talk more about what is happening in Detroit, I`m joined by Dr. Abdul
El-Sayed, an epidemiologist, who was Detroit`s city`s former health
director, author of the forthcoming book “Healing Politics: A Doctor`s
Journey into the Heart of our Political Epidemic.”

First, doctor, let me just ask you as a Michigander, as someone who ran in
a primary against Gretchen Whitmer to be governor of Michigan, your
reaction to the president saying that he was explicitly telling Mike Pence
not to call the governor of your state back for needed supplies, because I
guess he didn`t like her tone.

DR. ABDUL EL-SAYED, FRM. HEALTH COMMISSIONER FOR THE CITY OF DETROIT: This
is absurd. The idea that the president would blame the governor of Michigan
on her tone when you`ve got Detroit suffering one of the fastest growing
epidemics of Coronavirus just to me makes no sense, it speaks to his
failure of leadership.

I think Governor Whitmer has been doing a fantastic job considering the
circumstances, and she`s been leading to the best of her ability
considering the fact there has been no federal leadership here.

HAYES: Detroit, like New Orleans obviously, is a place with some distinct
challenges. Obviously, there is a very high poverty rate in Detroit, also
there has been massive depopulation in the city, which has put strains on
all kinds of municipal services. What are your fears, what are your
worries, what are your concerns about how this epidemic is going to play
out in this city?

EL-SAYED: When we talk about epidemics, it`s easy to focus on the pathogen,
in this case the Coronavirus. But you have also got to talk about the host
and you`ve got to talk about the environment. In this case, you got this
interplay between the host and the environment that`s left folks
vulnerable, particularly in a city like Detroit where asthma rates are
already three-fold the state average, where the probability of lead
poisoning is exceedingly high, where the rate of diabetes is exceedingly
high, and all of that is because you`ve got a city that`s been
unfortunately the receptacle of huge levels of poverty that have led to
environmental racism, that have led to structural racism, that have led to
systematic poverty. And all of that imprints itself on the bodies of
individuals.

And so it`s to me, it`s no coincidence that the risk in Detroit and the
outcomes in Detroit are so poor, it`s what I wrote about in the book, this
epidemic of insecurity that leaves people vulnerable to things like this
pandemic.

HAYES: You know, you`re a doctor and then you`re a Rhodes Scholar, you then
went into public health because you were sort of frustrated by the fact
that, you know, doctors care for patient one at a time, wanted to do
broader things. You taught public health.

One thing that struck me here is the difficulty for policy makers and for
everyone to get into a public health mindset, people using sort of their
economic mind or their political mind or their real estate investor mind.
And there`s just a different way to think about things from a public health
perspective that do you think that has sunk in among policy makers that are
having to confront this?

EL-SAYED: I think we`re starting to get there, Chris. And I think you`re
absolutely right. One adage in public health is it`s always better to
prevent than it is to cure. Think about it kind of like a fire in a
toaster. You can put it out when it`s small, or you`ll be battling it when
it`s in the neighborhood. And right now we`re battling is in the
neighborhood.

One point that Dr. Anthony Fauci made that I think is really right is that
we`ve got to stop skating to where the puck is, we`ve got to go where it`s
going to be, and so it`s not enough to just respond to the numbers that
we`re seeing right now, which are vast underestimates, we`ve got to be
asking what will we need in the future, and how do we make sure we prepare
for that future. And if we can`t prevent early, then we`re going to be
fighting late, but we better be fighting what`s coming, not necessarily
what is.

HAYES: Do you think we`re doing enough? I mean, there is some talk now
about the unique geographical problem that is presented by the U.S. right
now. What you saw in both China and Italy was an outbreak in a specific
place. They tried to sort of lockdown that place, then the national
government steps in and says, oh no, it`s not going to stay there, we`re
locking down basically the whole country. We saw in Wuhan, Hubei province,
all of China. We saw it northern Italy where they had a red zone. The rest
of the country is green zone, a week later, the whole country is locked
down.

We don`t have that here, and I`ve talked to public health experts who are
worried that in the absence of that, we`re just going to have a bunch of
awful outbreaks.

EL-SAYED: You know, that really is a fear. I think if we were all to invest
in social distancing appropriately, if we were all to take this seriously,
then the kind of cross movement between communities would end.

The point here, though, is this showing us that we really are a collective,
that we have to act collectively, and if we don`t, and any of us deviate
from what all of us need to do, then all of us suffer. And so there is a
real responsibility that all of us have to simply stay home, to stop
communicating this disease.

The other point, though, is that we`ve always been a federalized system. We
have strong state and local public health leadership. The challenge,
though, is it hasn`t always been well funded, and it`s always relied on
federal leadership at the top to help coordinate it.

And so the fact that right now we`re seeing a breakdown, it really leads to
the fact we have not had that centralized leadership at the top to help the
whole thing move in concert.

HAYES: All right. Dr. Abdul El-Sayed, thank you so much for making time
tonight.

The massive $2 trillion Coronavirus rescue bill is now law. The president
signed the bill this afternoon after the House passed it earlier in the
day. This enormous inconsequential piece of legislation is designed to
mitigate some of the economic devastation we`re now experiencing as a
nation. It is a very complicated bill. There is a lot in there. And I will
tell you this from my sort of cursory reading and the people I`ve talked
to, there is some good stuff, some bad stuff, and some down right ugly
stuff.

There is money to boost large corporations, small businesses, state and
local governments, along with some very sketchy tax breaks that we`ll be
covering in the future.

But and this is key, I think, there is also a fair amount of relief in
there for just regular people, average Americans, and we thought it would
be useful to just walk through what actually is in the bill for anyone who
is watching this, who may be struggling to pay their rent or who has been
laid off, or has seen their work dry up.

So to talk through what is in the bill and how people can take advantage of
it, I`m joined now by Michael Lyndon. One of my favorite budget wonks. He`s
a fellow of the Roosevelt Institute, and executive director of the
groundwork collaborative, a progressive think tank.

Michael, I`m bringing you in because I think of you as a real details guy
when it comes to these big pieces of federal legislation. And I thought
maybe we could sort of walk through three kind of major parts of this. And
the first are the cash payments. There are cash payments to Americans. What
do you have to do, or how do you qualify for that cash payment? What`s the
amount? Walk me through it.

MICHAEL LINDEN, ROOSEVELT INSTITUTE FELLOW: Yeah, so basically, most
Americans will get the cash payments. If you make up to $75,000 if you`re
an individual or $150,000 if you are a married couple, you will get $1,200
per person plus an additional $500 per child and then it starts to phase
out after that. People making up to about $200,000 if they are married will
get some portion of this.

As long as you filed taxes in either 2018 or 2019, you`re going to get this
automatically with a couple of important exceptions. You have to have a
Social Security number, so people who only have a taxpayer identification
number, unfortunately. But you don`t have to have taxable income, that was
really an important improvement that the congressional Democrats got in the
bill, so you don`t have to – you can have almost no income or no income at
all, to still be eligible for this.

HAYES: Now one thing we should note here is that when you say – and we are
talking about that income threshold – $75,000 in income, that`s based on
your 2019 filings. So there is some universe of people that maybe had a
good year last year, have had a rough year now and are really hard up who
won`t get the checks, right?

LINDEN: That – there are probably some people like that. You can file your
taxes now to try and adjust for that.

The other thing…

HAYES: Ah, I see.

LINDEN: The other thing – and we`re going to get to this, though, is if
you`re having a rough year this year it may be because you just got laid
off, or you`re about to be laid off, or you run a small business, and there
are elements in this package that will be directly beneficial to those
folks.

HAYES: Yeah, so let`s talk about the unemployment insurance part of it.
Now, I think that the theory that we pursued, which is different than the
European nations in which they basically paid companies to keep you on
payroll, I think that is a superior method, frankly.

LINDEN: Yeah.

HAYES: We didn`t – we chose not to do that, that`s not what we`re doing.
We`re instead using the unemployment insurance vehicle. So people that are
laid off can apply for unemployment insurance. All of that said, I
personally think it`s not as good as the other alternative. But if you are
going to use that, this actually is better than I thought it would be. Walk
me through if you`ve just been laid off, what this means.

LINDEN: Right. So if you`ve just been – in normal times if you`ve been
laid off and you qualify for uninsurance benefits, you can get them, and
they will basically cover up to about 40 percent on average of your wage,
but this bill includes an additional $600 on top of that per week. So for
most workers, that`s going to actually increase their benefit to their
entire wage. And for some people actually a little bit, above, for some
people a little below, but for a lot of people, that`s going to mean that
they aren`t actually going to lose any wages, their income will stay the
same.

It also expands the eligibility for unemployment insurance, which is an
important thing because a lot of people who lose their job and we think of
should be eligible for unemployment benefits, typically aren`t but this
bill actually expands that.

HAYES: Yeah so those two provisions I think are – when I saw that $600 I
think in my head – I thought it was monthly, but it`s a weekly benefit.

LINDEN: It`s weekly, yeah.

HAYES: So the unemployment insurance check is 340, you`re talking 940 a
week, which again, like, you know, nobody is rolling in the dough and
celebrating how great they are, but terms of income replacement, like is
hopefully going to put a pretty good majority of people in the ballpark of
their earnings.

LINDEN: Yeah, that`s right.

Now here is the big downside in my view, it`s that it`s only for the next
four months. And, you know, I got to think that four months from now,
unfortunately, we`re going to be right back here arguing with congressional
Republicans why they need to extend that, because we`re not getting out of
this hole any time soon unfortunately.

HAYES: Final thing, and a lot of people that would normally don`t qualify
can qualify under this new category that was created. So, if you`re a gig
worker, you`re a freelancer, you`re someone who put together an income, but
didn`t have a normal W-2, didn`t get laid off in a traditional sense, but
have lost your work because of this, you can basically self-certify is that
how it works? You just tell the government that?

LINDEN: That`s right. You can just basically self-certify and say that you
lost your job based on any number of factors relating to the current
crisis. And it does, it exactly what you said, it extends now to people who
are self-employed, people who weren`t, didn`t have a long enough employment
history to typically qualify for uninsurance benefits.

So, it really an important expansion. And I just – the credit really does
go here to congressional Democrats who fought tooth and nail to get that in
there.

HAYES: Yeah, all right. Michael Linden, always illuminating. Thanks for
being with me tonight.

Next, I want to share a bright spot, a moment of humanity I found
particularly moving in these very scary times. That video, it`s a good one,
right after this.

(COMMERCIAL BREAK)

HAYES: Well, that was a week. Everything is surreal and it`s frightening
and it`s strange right now, but people have been sharing these incredible
moments of support and celebration and expressions of human solidarity. My
heart was warmed by this moment in New York tonight when people all over
the city clapped from their windows, balconies, and doorsteps to applaud
the health care workers, grocery store workers, delivery drivers,
sanitation workers and others for the incredible heroic work that they are
doing.

(BEGIN VIDEO CLIP)

CROWD: (CHEERING)

(END VIDEO CLIP)

HAYES: I`m very lucky in many, many ways. One of those ways to be able to
do this job while doing the physical distancing. Our whole staff we`re
mostly working remotely now in this new normal thanks to some incredible
work by our executive producer and others.

It`s hard in a lot of ways. I`m sure you found it hard to be doing all
this. But I will say this, for me, the one nice thing is I`m around my
family more. And today my 6-year-old David had a birthday, turned 6 today.
He count really have a birthday party, but he and his big sister got to
watch the show here in a remote studio.

So I want to introduce you, here they are. As we are physically distancing.
This is the birthday boy, David, who is 6. And this is Ryan. And I will say
this, hold your loved ones close if you have them close by. Have a good
weekend.

That is All In for this evening, the Rachel Maddow Show starts right now.
Good evening, Rachel.


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