Coronavirus cases TRANSCRIPT: 4/2/20, All in w/ Chris Hayes
ARI MELBER, MSNBC HOST: We are wishing many, many more reunions like that
to people touched by this around the world. That does it for our special
coverage. I`m Ari Melber signing off. But don`t go anywhere, “ALL IN” with
Chris Hayes starts now.
CHRIS HAYES, MSNBC HOST: Good evening from New York. I`m Chris Hayes.
There`s a strange sort of time-lapse playing out throughout the country
right now. Places that have been hit first and hardest by the coronavirus
are further along the curve of growth. And those places are fairly dense
urban areas, big metropolises, and they are in really bad shape.
The grim reality of this virus is that everyone, every single state is
headed there. Here are the latest numbers. We now have more than 240,000
cases in this country, more than 5,800 deaths from the virus. More than
half the cases aren`t just three states. New York, which has more than
92,000 cases along with New Jersey and California.
We are also seeing disturbing surges in a number of other states. We`ve
been keeping an eye on and tracking for the last week at least, including
Florida, Michigan, Louisiana. Here`s the thing. The way this virus works is
that not everyone will have exactly the same epidemic at the same time. But
the actual way the virus spreads in the community is the same everywhere.
It`s the same virus, the same human bodies and that is why it is critical
there is a cohesive federal national response.
Last week, the governor of Alabama, Kay Ivey, who has taken some strong
steps down there, explained why she had not issued a shelter in place order
for residents first state opting instead for less restrictive measures.
This is what she said “You all, we are not Louisiana, we are not New York
State, and we are not California.” That`s right. You are not yet. It is
just a matter of time.
New York City ER doctor this morning offered a message to anyone who
believes they might escape the worst of it.
(BEGIN VIDEO CLIP)
NATE LINK, CHIEF MEDICAL OFFICER, BELLEVUE HOSPITAL: New York two weeks
ago, had only 300 cases. New York today has 30,000. The cities around
America with 300 cases should realize the only difference between them and
New York is two weeks.
(END VIDEO CLIP)
HAYES: So far, the places that have been hit the hardest, like I said,
fairly dense areas and blue states. But the country as a whole is headed in
that direction. This is the way the math of this works. It`s the way it`s
worked in every country. It`s a way it`s been working here. Every one of
the states that are behind on that curve are going to be in a similar
They`re going to need ventilators and hospital beds and personal protective
equipment, and they will be facing fatality numbers that seemed unthinkable
just a few weeks ago. And right now, a lot of states are refusing to see
what is plainly in front of their face. These 11 states have not issued
statewide stay at home orders. Some have localized orders in place.
One thing in common with all these states, they all have Republican
governors. Other states like Florida, and Texas, and Georgia only issued
stay at home orders recently. In Florida for example, just hours after
republican Governor Ron DeSantis finally issued the statewide state order,
he signed a religious exemption basically blocking local governments from
closing down church and synagogue ceremonies during the outbreak.
In Georgia, the state where the CDC is located, Republican Governor Brian
Kemp finally issued a stay at home order today claiming he just learned
that people without symptoms can spread the disease. As New York Times
reports, in areas where public officials have resisted or delayed stay at
home orders, people change their habits far less.
This Times graphic shows where people were still traveling last week. Gray
means no travel and red means closer to normal travel, and you can see that
a much of the Northeast there was essentially virtually no travel. Look at
the south look at the plain states. As you can see people in southern
states were far less inclined to change of behavior because they were not
getting the same messages from their leaders.
And there is reason to believe that parts of those states could get hit
even worse than what we`re seeing in the worst-hit states today, places
like New York. As the Atlantic points out, the coronavirus poses a unique
risk to the American South. Residents, on the whole, have high rates of
conditions like lung and heart disease and obesity, which makes the virus
far more deadly.
Take for example, the state of Mississippi. That state right now seems to
have the nation`s highest rate of people hospitalized for the coronavirus
at 31 percent. And the virus there is not expected to peak for nearly two
months. A week ago, the state`s Republican Governor Tate Reeves actually
overruled – get this – he overruled local safety measures to fight the
virus reopening restaurants and department store. The governor announced
Shelter in Place Order yesterday, which does not go into effect until
tomorrow at 5:00 p.m.
As a nation, we could have mitigated some of the worst of what has to come
with a strong, decisive, unified federal response. We just didn`t have one.
We know that. President Donald Trump refuses and refused and is refusing to
take a leadership role. Just today, he was whining about state requests for
life-saving medical supplies, and tweeting, “Remember, we are a backup for
That is Donald Trump`s idea of leadership. The federal government is a
backup, kind of Articles of Confederation kind of situation. And that is
why this crisis is already, already far worse than it ever should have
Joining me now is Dr. Ashish Jha, Global Health professor and the Director
of the Harvard Global Health Institute. He`s one of the – one of the most
informed people I know on this pandemic. Let me – let me start playing
devil`s advocate against myself in that monologue and see your response,
which is, look, the places we`ve seen these really bad outbreaks, in New
York, particularly, these are very dense places, they have high levels of
public transportation, people are living close to each other. That was true
in the city of Wuhan where we saw really bad outbreaks. Maybe it just
really won`t be that bad in vast swathes of rural America where folks
aren`t that close to each other. What do you say to that?
ASHISH JHA, DIRECTOR, HARVARD GLOBAL HEALTH INSTITUTE: It`s really
remarkable, Chris. And by the way, thank you for having me on. You know,
when the outbreak began in China, we said, well, this is a China problem.
Then it moves to the rest of East Asia, and we said, well, it`s an Asian
problem. Then for a little while, it was always Europe and all their crazy
health systems, it`s a European problem.
Then last week, we were this is a New York, California, Washington state
problem. Like at some point, we`re going to have to just accept the fact
that it`s a human problem, and it hits different places and different
densities at different times. But the idea that the number of people who
are infected won`t be the same in all these places defies logic.
The virus will spread, it might go a little more slowly in a rural area
than it does in a dense city, but it`s coming to a town near you. And like
the lesson we keep having this sort of denial of is going to be somebody
else`s problem. And I think finally this week, I got a sense that more or
less every American, certainly more or less every political leader started
realizing that the – that the problem is there as well and not just in New
York or California problem.
HAYES: So we have now hit a point where we`ve kind of ramped up testing
although plateaued, our death rate is growing at a just an unspeakable rate
that I just find really upsetting profoundly. Where are we right now on
this trajectory as of today?
JHA: Yes. So I think there is a national picture and then we really have to
realize that what we have done because of a lack of federal leadership is
we have turned this into 50 outbreaks, and different states have different
patterns. So nationally, we are still early days, exponential rise in
number of cases, long march towards more and more deaths, unfortunately
until we plateau. But it`s going to shift, right?
So, I think in New York, we`re going to see a peak – there`s some evidence
of the number of cases are starting to plateau. We have seen fabulous
progress in Northern California and Washington from all the shelter in
place orders. I am deeply worried about Florida, deeply worried about
Georgia, deeply worried about Louisiana.
And South Carolina, we just saw some data this afternoon. Their
hospitalization rates are really starting to pick up. You show the data for
other states. So, this is going to become now a 50-state game – it`s not a
game – 50 state epidemic and that`s a much harder thing to manage than a
single national epidemic.
HAYES: This is what it seems to me what I`m sort of losing sleep over as I
think about this problem here distinct from other places is other places
had regional outbreaks. Daegu in South Korea and Wuhan and Hubei province
in China, and Lombardi in the north in Italy, and then the national
government sort of maybe try to regional lockdown, realize that wasn`t
going to work, and sort of implemented a national strategy.
No place has had the kind of multi-geographic spread to deal with, I think
it`s fair to say, than we have. We have – we have something distinct now
that no other country has really had to wrestle with. Is that a fair
JHA: It is a fair characterization. And look, there are – kind of look at
some positives here – there are a few upsides of that regional approach.
Like we had some states that move pretty early well before the federal
government was ready to move, right? And again, we`re talking about
California, Washington State, Ohio with this Republican governor. Other
places have moved early, and I think the citizens of those states are going
to do better. But yes, this is no way to run up pandemic response.
HAYES: Well, and I guess the final point here is that one can imagine that
the one other benefit of this to the extent there is one, although it`s
hard to see one, is that you could move resources around. I mean, if you`re
– if you have different places peaking at different times, and New York
right now needs, you know, ventilators and PPE, and it needs actual
frontline medical workers, and then six weeks from now, that`s the case in
Alabama, you can imagine a universe in which the federal government was
coordinating moving those resources, right?
JHA: Yes. So, I`ve actually made that case that we need to do that. Again,
it`s the one of the silver linings and this is New York is going to be
next. So let`s put all of our resources towards getting New York through.
And then when New York is through its peak, let`s move those resources. I
think New York doctors and nurses will be happy to go elsewhere to take
care of people.
We can turn that sort of fragmentation to our advantage. It requires a
coordinator. It requires somebody looking at the entire national picture
and helping make this happen. Right now it`s ad hoc one on one basis. It`s
going to be very inefficient.
HAYES: All right Dr. Ashish Jha who is always illuminating on this, thank
you so much for your time. I really, really appreciate it.
JHA: Thanks for having me.
HAYES: I want to turn now to someone who has been fighting to keep the
people of his state healthy in the midst of this crisis, Governor Jared
Polis of Colorado. Governor, first let me – let me ask you where your
state is right now, how you assess where you are in that sort of time-lapse
we`re seeing between say New York out front and maybe some other states
that are much further behind.
GOV. JARED POLIS (D-CO): Yes. Colorado is closer to New York in that
continuum. Over 3,700 cases, that`s just the confirmed positives. Like many
other states, we haven`t even been able to keep up and we expect the number
of positives is probably between eight and 15,000 or more Coloradans. We
know that 25 to 50 percent are mildly, if they`re at all symptomatic.
We just are approaching about 100 deaths. I think we have 99. We`ll
probably have 100 today. A deputy sheriff in El Paso County passed away
today, younger man in his 40s, even younger than me. So we`re really seeing
this. We`re working on surging the hospital capacity. We have in a stay at
home order. And bringing everybody along on that as what`s critical, Chris.
It`s not so much about the order, it`s about the psychology, the social
license for that order, and really convincing people and maximizing the
likelihood in their individual decisions that they are staying at home.
HAYES: Has that been – has that been a challenge for you?
POLIS: It`s been the real challenge behind this. I think everybody knows
that there`s not any enforcement mechanism in terms of law enforcement. One
of the things I said at one of our announcements was, you know, the
ultimate enforcers, the Grim Reaper, you`re putting yourself and your own
life on the line, the lives of your neighbors, your aunts, your uncles,
your parents, if you`re not staying home and engaging in social isolation.
Of course, we`re doing what we can with local authorities to close
playgrounds and other sites that people might congregate.
But really, we have to bring the country, our state`s our residents,
Republican, Democrat, Independent, rural, urban, along with us in this
journey to see the urgency of staying at home.
HAYES: There are three states near you that don`t have stay at home orders,
Utah, Wyoming, Nebraska, does it – is there – is there any regional
concern about the spillover effects if there are states that that continue
to have folks sort of out and about?
POLIS: Absolutely. In fact, we`re even worried about that within our state,
we`ve had to several times warm our Denver Metro area residents, don`t go
to your second home in the mountains. Not only do that some of those
mountain and world-class Mountain Resort communities have a higher
infection rate because they have a lot of international travel leading up
to this, but that will further spread the virus.
Of course, we`re worried about people from some of our neighboring states
or even other states that don`t have that kind of stay at home order that
might come to Colorado, just as we`re also aware of – worried about, you
know, travels from across the world. But we have an endemic here, so our
first priority is reducing the spread in Colorado, and the best way we can
do that is, of course, step up, testing, isolation. In the meantime, stay
HAYES: Final question is about the state`s budget and economics. We saw
those 6.6 million claims for unemployment today. States are going to have
to put budgets together and they`re going to have 40, 50 percent hits the
revenue. I have no idea they`re going to be paying out unemployment
New York Governor Andrew Cuomo has worked out a budget deal. It`s going to
cut Medicaid in the midst of this. And I know that states – I think every
state has to balance its budget. What is your thinking about the finances
here? It seems to me that unless there is significant rescue money for
states, we are going to take this and compounded over the years and create
an enduring recession.
POLIS: Well, I`m even more worried about families who can`t make their
rent, who can`t put food on the table, who aren`t able to return to work.
That`s why staying at home is so important so people can get back to work
sooner and get back to earning a living sooner.
It`s also important to point out economic productivity and work is not the
enemy here, it`s physical proximity. So we need to maximize the opportunity
to earn a living, maximize our economic output without increasing physical
proximity. We`re, of course also worried about the hole in our state
budget, the hole in city budgets, but it really starts with families and
works its way up.
And we`re glad that there`s some help in the in the aid package that the
federal government passed, $1,200 for families, money for state
governments, money for hospitals, but we`re also – we also know that
Congress will need to do more and then days and weeks ahead.
HAYES: Yes, they will need to do more. Governor Jared Polis of Colorado,
thank you so much for taking a bit of time with us this evening. Next,
Senate Minority Leader Chuck Schumer on the administration`s willful
ignorance that escalated the National Emergency and the many warnings
ignored along the way, he`ll tell us what to do now.
HAYES: Republican governor – Georgia Governor Brian Kemp is being
ridiculed widely because just yesterday after weeks of wall to wall media
coverage of the coronavirus, he claimed he just learned that people without
symptoms can still spread the virus. This led to the social media hashtag
CDC is in Atlanta, trending today, the very agency that has been explaining
the risks to the virus the American people.
The Centers for Disease Control is in Georgia. It`s about a 20-minute drive
from the governor`s mansion. Here`s the thing. We have known about
asymptomatic transmission of the coronavirus for months. At a briefing on
January 31st, 62 days ago, Dr. Anthony Fauci said, and I quote, “You know
that in the beginning, we were not sure if there were asymptomatic
infection, which would make it a much broader outbreak from what we are
seeing. Now, we know for sure that there are.”
On March 6th, Governor Kemp even toured CDC headquarters in Atlanta with
President Trump and the director of the CDC. This is just one example of
the just insane aversion to repeated scientific warnings by experts about
precisely what we are encountering now. It has been missed signal after
missed signal after missed signal. And here are just a few.
The Nation reports that three years ago the Pentagon specifically warned
the White House about the significant threat posed by a novel respiratory
disease, which is exactly what coronavirus is. Yahoo! News reports in 2018,
the CDC warned the country was not ready to respond to a pandemic.
And just two months ago, the U.S. Army projected between 80,000 and 150,000
Americans could die if the coronavirus got out of control. That`s just two
months ago. The U.S. Army, they knew what was going to happen. And now the
White House is modeling that up to 240,000 people could die if we do
everything right. So the U.S. Army`s worst-case scenario from just two
months ago has become our best-case scenario.
Joining me now someone who did call for early action, Senate Democratic
Leader Chuck Schumer of New York, who back on January 26th, called for the
Department of Health and Human Services to declare a public health
emergency over the coronavirus. Senator, first, I want to start with your
exchange with the President. The President had a lot of harsh words for you
today. He wrote you a letter that was strange in the way that everything he
writes is strange. Why was he so angry at you? What was this about?
SEN. CHUCK SCHUMER (D-NY): Well, let me give you a little background. I
have heard for the last few weeks throughout New York and throughout
America, the desperate shortage of the kinds of things our frontline
workers need, whether it be masks or ventilators or PPE or anything else.
And so about two weeks ago, I called the president and said, why don`t you
invoke the Defense Production Act? That`s an act on the books from the
Truman administration. And it says that the military can commandeer both
manufacturing and distribution when there`s a national emergency or a war.
The President said he do it and then three hours later, he said no.
And now he hasn`t done it, and we sort of have this patchwork where
governors and mayors, my governor, my mayor, they`re doing good jobs, but
they`re going around looking for ventilators, looking for masks. It`s
uncoordinated, and it`s a patchwork.
So this morning I sent the president a letter and said, why don`t you
invoke the Defense Production Act and put in place a military person,
somebody who knows command and control, someone who knows logistics,
someone who knows a quarter mastering, to not only commandeer factories and
supply chains to make the stuff that we need, desperately need, but also to
distribute it in the places that are most needed, so not the 50 governors
will be hunting and pecking.
And then I spoke to the president late this afternoon and explained it and
the result is this letter. And so I`m just appalled. You know, I`d say to
the President, just stop the pettiness. People are dying. And so President
Trump, we need leadership, we need to get the job done. Stop the pettiness.
Let`s get it done. Let`s roll up our sleeves.
I sent the letter with the best of intensions trying to improve a very bad
situation that Dr. Jha was talking about a few minutes ago.
HAYES: You know, it`s come up a lot in our reporting and people I`ve been
talking to you both on the show and elsewhere about how haywire insane this
market has gotten. There`s all these sketchy middlemen, there`s deliveries
that state governors think they`re going to get that then don`t show up,
they get rerouted at the last second because someone outbids them.
So what you`re saying is, not only is the Defense Production Act, there
should be some kind of essentially unified acquisition process for the
whole of the country that is getting this material and distributing it in
such – in such a way so that you don`t have this weird bidding war that`s
SCHUMER: Exactly. And it`s a mystery to me why the President doesn`t invoke
this. It`s desperately needed, most experts agree that it`s needed, and
lives are at stake. We have in New York, we have these nurses and doctors
and health care workers risking their lives without the proper equipment.
And this is going to happen in other parts of the country too.
So you need this kind of command and control for not only manufacturing but
for distribution so it goes to the places that it`s most needed.
HAYES: So there`s a lot right now that Americans are sort of depending on
the federal government for. It`s a strange situation. It`s unlike anything
I think anyone has seen in their lifetime, frankly, in terms of that. The
rescue bill that was just passed, there`s a few different ways in which
that we`ll get – that help will get to Americans, but there`s some
reporting today about the $1,200 cash assistance different than the
unemployment insurance, when that`s going to get to people?
The IRS now estimating April 13th, I think, at the earliest for those who
already have direct deposit information with the IRS, but that it could
take as long as five months, five months to actually write the checks for
people that don`t have direct deposit. Is there any way that can be sped
up. That seems insufficient.
SCHUMER: It`s hard – Chris, I just heard that this afternoon. It`s hard to
believe that it would take five months. And on another front, you know, the
most major infusion that people who are losing their jobs will get is from
our unemployment insurance on steroids. Today we called on the
administration to get those checks to the unemployment offices and in
people`s hands who have lost their jobs, have to pay the rent, buy the
groceries in two weeks. I think that`s doable if they do it right, and if
they put all the muscle behind it that they should.
HAYES: Well, there just seems to me at a broader level, right. There`s a
real question here of competence and state capacity, right? So there`s some
conceptual soundness to a lot of things that are in that rescue bill, but
it really does seem like devils in the details here, particularly when
you`re looking at the Small Business Administration overseeing $350 billion
in loans. I mean, how confident are you that the help is going to get to
who it needs to get to as quickly as it needs to get to them?
SCHUMER: Well, we`re going to have to watch them like hawks. Obviously,
this is a huge enterprise $2 trillion in this whole proposal. It`s about as
much as the whole federal budget. It`s done in a week and it has to get out
quickly. Jobs are at stake, businesses are at stake, and whatever effort it
I suggested to the Small Business Administration that they just hire
whoever they need to get the money out quickly. I`ve suggested to Secretary
Scalia at the Department of Labor, which is in charge of the unemployment
insurance, that they do the same. We put over $1 billion into the
unemployment situation so they could hire people, get the computers going,
and get those checks out ASAP.
Now, we`ll have to watch them like hawks to see if they can do it. But as
you said, there is some question. Look at what we talked about with the DPA
of the competence of them getting it done. So we`re going to have to just
watch and push and pro and prod.
HAYES: Well, in terms of that oversight, the Speaker announcing the idea of
a select committee today. I don`t know if – I think she needs unanimous
consent for that, so she can`t call it into being unilaterally. But A, do
you – do you support that and B, what do you make of Secretary of Treasury
Steve Mnuchin basically saying we don`t need oversight, and the President
signing a signing statement that essentially scraps a lot of the oversight
that`s in the bill?
SCHUMER: Well, that`s what they proposed originally. The bill that
McConnell put on the floor that we Democrats resisted had three problems.
There was no real money. There wasn`t enough money for our hospitals and
healthcare systems. We call for a marshall plan for hospitals and clinics
and community health centers, and we got $150 billion.
The second thing we said is instead of putting corporations put first, put
workers first, and that`s where we got the small business. And most
important, this huge expansion of unemployment where people will get their
full salaries through July 31st, most of them. And it affects people who
have not been affected in the past, freelancers, part-timers, you know,
people – individual employees, people who need the work.
But the third thing we did is we put some real limits on these corporate –
on these corporate loans. We put – I worked closely with Elizabeth Warren.
We put three levels of both oversight, and we guaranteed transparency. So
anyone of these contracts that is either approved or rejected, the whole
contract has to be published within 14 days of the contract being either
approved or disapproved in additional to the smaller thing, but we put in a
provision that said President Trump couldn`t get any of this money because
left to his own devices, Lord knows.
But there is some real oversight there. Two of the three levels of
oversight don`t depend on the president, and we`re going to go at it. But I
think what Speaker Pelosi has done is exactly right. When you have this
much money with this administration, which seems to favor the wealthy, the
powerful, who`s your friend, there`s no – there`s no level of oversight is
too much. So to have this extra level is a very good thing.
HAYES: All right, Senator Chuck Schumer from what appears to be his
Brooklyn home in…
SCHUMER: It is.
HAYES: A great neighborhood in a great city…
SCHUMER: I`ve been in this house, Chris, with – I`ve only seen four people
since I got back from Washington – my wife, my daughter, my son-in-law and
my 1.5-year-old grandson. And let me tell you, I`m working almost 24/7, but
the most exhausting time is the one hour I`m in charge of chasing him
around the house.
HAYES: I`m sure that`s true.
Well, come back. Keep giving us updates. I appreciate it. Thank you so
SCHUMER: Thank you, Chris.
HAYES: Ahead, the testing failures continue from kit shortages around the
country to troubling new reporting about how accurate or inaccurate the
results might be. That story coming up.
(BEGIN VIDEO CLIP)
FRED ROGERS, CREATOR, MR. ROGERS NEIGHBORHOOD: And I just wonder how you-
all feel about your dad and his giving you this music as you were growing
BRANFORD MARSALIS, SAXOPHONIST: Well, I think that the most important thing
about dad is really not that he drilled us in music, music, music, music
but more so he made us see life in a certain way. We have a certain outlook
on how we`re supposed to carry ourself in the world and see other people
and treat other people that I think really has a profound effect on what we
play musically. And I think that`s really more important than anything that
he`s ever given us.
(END VIDEO CLIP)
HAYES: Ellis Marsalis was a jazz legend, as you can see there, a patriarch
of a musical family famous throughout American life, often described as
jazz`s royal family. Last night came word that Ellis, aged 85, had died
from complications of COVID-19 in his beloved hometown of New Orleans, one
of more than 5,000 Americans who how now lost their life to this virus,
each one a full world, a full universe.
The scope and the magnitude of these losses and this grief are slowly
dawning on all of us, slowly coming into focus for us as a society.
This week we also lost Dr. Frank Gabrin, a two-time cancer survivor, who
worked in New Jersey as an emergency room doctor treating patients with the
disease basically until his dying days.
And Hilda Churchill who was nearly 109 years old. She lived a remarkable
life. She survived the 1918 flu pandemic, which actually killed her baby
sister as well as two world wars.
We also lost Romi Cohen who during World War II, saved 56 families from the
Nazis in what was then Czechoslovakia, joined the underground resistance
there when he was just 15-years-old.
And Dez Ann Romain, just 36-years-old, 36, a woman who emigrated to New
York as a teenager, became the principle of Brooklyn Democracy academy
where she was beloved by teachers and by students.
And then there`s the legendary playwright and author Terrence McNally, an
out gay man who wrote about gay life in America, particularly surviving the
AIDS epidemic. McNally was a cancer survivor who last year won a Tony Award
for lifetime achievement in the theater. He died last week of complications
from Coronavirus at age 81.
(BEGIN VIDEO CLIP)
TERRENCE MCNALLY, PLAYWRIGHT: I think the most imperative message of art is
live, be involved with life, live it, fully, connect with other people,
engage with the world around you and do something, matter.
(END VIDEO CLIP)
HAYES: As Eugene Robinson of The Washington Post put it, the testing
failure is the original sin of America`s Coronavirus response. Now, in the
last month of so, testing capacity has ramped up enormously, but we have
now hit a snag. Daily testing appears to have plateaued, though it went up
again today. Huge parts of the country, though, just doesn`t have access to
the tests they need and so they are being rationed.
And then today we got reporting that maybe a third of infected patients are
getting negative test results. The most dogged investigate journalism on
testing has has come from two writers at The Atlantic, Alexis Madrigal and
Robinson Meyer, who both actually, along with another Atlantic colleague,
co-founded the COVID Tracking Project which tracks and publishes testing
data from across the country, it`s how we know how many tests we`re doing.
And Alexis Madrigal joins me now.
Alexis, we saw this really impressive effort. We started way behind. We
were behind the eight ball. Testing has ramped up quite a bit. It seems
sort of stuck now. Where are we right now? And what are the obstacles to
getting it further up?
ALEXIS MADRIGAL, THE ATLANTIC: Yeah, we`re doing about 100,000 tests a day,
a little more today, a few over the past few days. It is a big ramp up, but
it`s also not as much as we need it, and there are key supply chain
constraint and and swabs and then the chemicals that are used to do the
tests. And there is also incredible variability across the country. And
also most likely there are inequities in who is able to access these tests.
HAYES: Well, what are those inequities?
MADRIGAL: Well, you know, I think one of the things you`re seeing is that
people who have better access to health care and more money can get tests
more easily. And that means that low income communities, black and brown
people across this country may or may not be getting the kinds of treatment
that they need. And one of the ways we`re seeing that is my Atlanta
colleagues have been tracking stories across the south and wondering
whether places like Louisiana, which are showing unusually high death rates
among younger people, that some of that may be because of problems in the
health care system that are related to these health disparities.
HAYES: There`s also this huge issue right now in California which is a real
laggard in testing. If you look at the places that are sort of testing the
least, California stands out because it started very early and it has been
fairly proactive along other lines. And you wrote a piece about how
basically there is just this a huge backlog, right. Lab turn around time is
PPE is what Gref Barrett (ph) said, the acting laboratory medicine chair at
the University of Washington, more than a day is a tragedy, three to five
is OK for outpatients who can – if they can sit at home, but it doesn`t
address the problem in a hospital, meaning you have got people being tested
in California, there`s like 50,000 or 60,000 pending tests. Why is that?
MADRIGAL: You know, here is what we think happened. After the CDC`s failure
in testing in February, in March the Trump administration really tried to
throw this over to the private testing companies. It`s a pretty
concentrated industry. You`ve basically got Quest and LabCorp control most
of that market.
When the demand for testing surged, Quest and LabCorp started accepting
lots and lots and lots of specimens. They started to build up a big
backlog, and Quest, at least, didn`t stop accepting specimens. There were
two kinds of tests that they could do, one called a laboratory developed
test, and then later on the sort of more manufactured test from companies
like Roche. Roche has high throughput, the laboratory develop tests are not
, but they accepted a ton of specimens that only can use the materials for
the laboratory developed tests.
So they have got this glut, you know, like a python that ate a deer that
they need to work through the system. And we think that`s a pig problem in
But it`s not the only problem, something else is going on here, and we`re
still digging on it, for why California`s throughput, specifically, is so
bad, the lowest per capita testing rate for the states that report
completely that we know of through the COVID tracking project.
HAYES: There is all this talk about new tests. I mean, the president is
sort of doing his kind of monorail salesman act and showing some device in
this some talk about a test that is going to be – tell you in two minutes
or 10 minutes, like how close are we to sort of the point of care testing
like you have, say, for the normal flu?
MADRIGAL: Well, you know, those machines now exist. (inaudible) and Abbott
(ph) has been producing them. There are other companies that are going to
do the same.
The problem is we don`t know what is going to happen with those machines.
You know, there is reporting from The Washington Post yesterday indicating
that perhaps many of those machines would be sent to rural areas and places
in the south, which depending on where they get placed, would make sense.
On the other hand, it also sounds like the Trump administration sending
these machines to Trump country and some of the hardest hit places in the
country are decidedly not Trump country.
HAYES: Final question, quickly, the Wall Street Journal article today on
false negatives. Do we have a way of auditing the accuracy of these tests
MADRIGAL: The problem is it`s going to be variable across labs and it`s
going to be variable across actually individual people. The main problem
that we think exists is actually in the swabbing. I talked with Michael
Mina earlier, a Harvard epidemiologist and this was kind of the problem
that he highlighted that literally shoving the thing in your nose is a very
difficult thing to do and not all of the human beings actually doing that
work are going to do it in the same way.
HAYES: That`s a great point. Alexis Madrigal, thank you for all of your
fantastic reporting. It`s been really, really important.
Coming up, what to do if you`re among the growing millions of Americans who
have lost their job and their health insurance during the Coronavirus
crash, and why the Trump administration is denying pleas to open up the
Obamacare exchange, next.
HAYES: Well, we got the worst weekly jobless claim number anyone has ever
seen in history today. More than 6.6 million new initial jobless claims,
double what it was the week before. A lot of those people have probably
just lost their employer-sponsored health insurance in the middle of a
global pandemic just as worldwide COVID cases pass the one million mark.
Joining me now to talk about the implications of that, Margot Sanger-Katz
who writes about health care policy for The New York Times`s The Upshot.
And Margot, let`s start with folks who had employer-sponsored health
insurance and were just laid off, and now they don`t have it, what are the
options there for them? What can they do to make sure that they`re covered?
MARGOT SANGER-KATZ, THE NEW YORK TIMES: So those people actually have quite
a few options. There`s been a lot of publicity, because the Trump
administration declined to reopen the Obamacare markets for people who want
to buy insurance now, and I think people have gotten sort of the wrong
message from that. So if you`ve lost your job-based coverage, first of all,
you have access to Cobra, that means you could buy from your employer,
continue to buy the insurance that you already had. That is a pretty
expensive option and it may not be the best for everyone, but it could be
good if you`re undergoing ongoing treatment for a disease and you really
want to stick with all of the same doctors, and all of your same
prescriptions. You should talk to the company you used to work about that.
Another other option is you can go to the Obamacare marketplace. So there
is a provision in the law that says if you lose your job-based coverage,
then you`re automatically qualified for something called a special
enrollment period where you can go to healthcare.gov and shop for a plan
and you will get a plan with potentially some subsidies based on how much
you earned. And if your income had become low enough as a result of losing
your job, or maybe just getting cut back in your income, if you have less
work than you had before, it is possible that you may qualify for Medicaid
coverage, that is going to vary a little bit by state because not every
state has expanded Medicaid to adults, but if you have a relatively low
income, it would make sense to check in with your state Medicaid agency and
see if you qualify.
So not everyone is going to have a lot of options, but I think because of
Obamacare, there are more options for people who have lost their job-based
coverage than there had been in previous economic downturns.
HAYES: So on this question of opening up the enrollment period nationally,
right, that – the reason that matters, is the category of people that are
losing their employer-provided insurance because they got laid off, they –
the law says they can sign up. It would be the millions of people who don`t
have health insurance who are now looking – staring down the barrel of a
pandemic who can`t get health insurance now, can`t go and buy it because
the enrollment period is closed, right?
SANGER-KATZ: Yes, that`s exactly right. If you`re someone who didn`t buy
health insurance before and now you`re looking at this pandemic and
thinking wow, I would really like to have some coverage to protect me in
case I got sick or someone in my family gets sick, you have fewer options
than someone who had coverage through work and now has lost it.
But again, you know, several states have opened these special enrollment
periods, 11 states plus the District of Columbia, so in those places you
can go in for any reason, and buy insurance through the Obamacare
exchanges. And in the other states, you really are a little bit more out of
The Trump administration could have chosen to open up the exchanges, they
were facing a lot of pressure to do it, even health insurers wanted them to
do it, health care providers wanted them to do it, a lot of consumer
groups, governors, but they decided not to do it. And so it does mean that
some people who are uninsured now really don`t have a lot of options.
HAYES: Margot Sanger-Katz, who does great reporting for The New York Times
on health care, that was extremely illuminating because there has been a
lot of confusion, so thank you so much for taking the time to walk us
SANGER-KATZ: So glad I`m helpful.
HAYES: I want to now bring in Don Berwick. He`s the former administrator of
the Centers for Medicare and Medicaid Services and a health policy expert.
Don, you heard what Margot said there that some people are probably going
to get onto Medicaid in these states. It`s going to depend on what the sort
of qualifying income is, but I look at this and I think to myself the
Medicaid system is going to be overwhelmed right now. I mean, there`s real
worry, right, about whether Medicaid can handle the influx of patients and
the states can afford what`s about to happen.
DON BERWICK, FORMER ADMINISTRATOR CENTERS FOR MEDICARE AND MEDICAID
First, for what Margot was talking about, in terms of people that have
employer-based insurance and lose their jobs, there is still a bit of a
procedure to go through if the enrollment period is open, it gets a lot
easier and those people will find it easier to get insurance, but you`re
absolutely right, Medicaid is for people that aren`t in that position and
of course this administration has steadily weakened Medicaid. In their 2020
budget, they proposed to take away $200 billion of federal support for
state Medicaid programs. They put in work requirements. There are new
enrollment barriers. And there`s the public charge rule, which affects
So, unfortunately, the Medicaid system has been significantly weakened. And
it`s the main safety net. And it`s supposed to be counter-cyclical, so at
times when things are worse the federal government offers more help, not
less. This administration is holding back on offering the kind of help that
needs to be offered to people right now.
HAYES: There`s also, of course, the cost question.
So, there`s one story of a guy who went in and got tested. He traveled to a
place where the virus is early in the days of the sort of U.S. epidemic and
his patient responsibility, according to his insurer, was close to $2,000
just – that was the test fee. And then there`s the treatment right now. I
mean, if you had major complications, if you`re intubated, your in ICU,
that could run as much as $74,000, $42,000 with no complications.
There`s real worry about – if we`re looking at millions of cases what this
does to the entire insurance system and to people`s financial lives.
First, we still have 28 million people in this country with no insurance at
all, no other western Democracy can say that. These people can be seriously
Of course, hospitals suffer, because they don`t get paid. Also, the
extension of support for COVID diagnosis, which is now federal support for
free testing, in the federally-supported systems, does not apply to free
treatment. And so if you don`t have coverage, you are really up a tree.
We`re asking for big trouble for millions of people.
HAYES: And millions of people, and also my – the hospital economics here
are so strange. I`m reading stories about hospitals laying people off right
now, because the profit center for hospitals, the sort of revenue center
are elective surgeries, which are now all being canceled. So you have got
this perverse situation, where hospital economics are crunching hospitals
right at the time we need them to have the most people online.
BERWICK: I spoke to a multi-hospital system executive just this afternoon.
They`re looking at $300 million a month of loss. So unless the federal
government pitches in to help hospitals the way they are helping airlines,
we are going to have a very weakened health care system.
I don`t know what people expect, this takes resources to save lives.
HAYES: In a broad sense, I mean I have to say, as I was talking through
this sort of flow chart for people today, between Cobra, Medicaid and the
ACA and whether there is open enrollment, it is bringing into relief some
of the huge holes in the system we have, and the kind of Rube Goldberg
nature of the American health care system as this virus doesn`t care about
any of those – any of those obstacles.
BERWICK: Yeah, the virus didn`t happen to time itself with the normal
enrollment period, so we have to be a little more generous. We have a very
weak system when you look at coverage. 28 million people uninsured and that
has steadily risen since the low point in 2016. You had the most insurance
in this country, now it has been eroded steadily by millions. The insurance
coverage is weaker and weaker, more out-of-pocket payments. And now, the
administration is allowing basically junk insurance plans. They look cheap,
but they`re not going to be cheap for someone who has problems with the
So this is a time when we really need to take stock as a country and say
are we really providing the kind of security that our people need, not just
in a pandemic, but in normal life. These catastrophes hang over us all the
HAYES: That`s right. Don Berwick, it is always a pleasure to talk to you,
sir. Thank you very much.
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
Copyright 2020 ASC Services II Media, LLC. All materials herein are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of ASC Services II Media, LLC. You may not alter or remove any trademark, copyright or other notice from copies of the content.>
Copyright 2020 ASC Services II Media, LLC. All materials herein are
protected by United States copyright law and may not be reproduced,
distributed, transmitted, displayed, published or broadcast without the
prior written permission of ASC Services II Media, LLC. You may not alter
or remove any trademark, copyright or other notice from copies of the