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NYC virus cases TRANSCRIPT: 3/18/20, The Rachel Maddow Show

Guests: Donald McNeil, Jared Bernstein

 

CHRIS HAYES, MSNBC HOST: Yes.

 

DR. JONATHAN GIFTOS, RIKERS ISLAND, FORMER DIRECTOR CORRECTIONAL HEALTH 

SERVICES: -- but for people in city sentences or, you know, pre-trial on 

felonies, that`s done at the local level with D.A.`s office and judges. 

 

HAYES: All right. And I hope D.A.s and judges are listening. 

 

Dr. Jonathan Giftos, Hamed Aleaziz, thank you both.

 

That is ALL IN this evening.

 

"THE RACHEL MADDOW SHOW" starts right now. 

 

Good evening, Rachel.

 

RACHEL MADDOW, MSNBC HOST: Good evening, Chris. Thank you, my friend. Much 

appreciated.

 

Thanks to you at home for joining us this hour as well. Very happy to have 

you with us. 

 

Our set may look a little different tonight. I may look a little different. 

We`re trying out a remote studio option to see how it works. We`re going to 

have some of our guests tonight joining us by Skype. We`re just trying out 

a whole bunch of different things to see what works, while we try to make 

this broadcast as resilient and as permanent and as safe as possible for 

everybody involved in producing it, including our crew of all different 

types, our staff, our guests, everyone. 

 

So if anything looks or sounds a little hinky, as we try out some new 

stuff, A, forgive me and please be patient, we will work it out, we are in 

this for the long haul and so we have to try to innovate. You are in this 

for the long haul as well. We all are. 

 

So let`s jump right in. 

 

In Italy, they have crossed a new threshold today. The number of people who 

died in Italy from the coronavirus over the last 24 hours hit an all-time 

high, 475 deaths reported in the last 24 hours. That`s the highest one-day 

death toll in any country, including China, since the start of the pandemic 

-- 475 deaths in one day. 

 

Italy has reported more than 300 deaths per day in each of the last four 

days. That itself is a terrible new standard. China, when they were in the 

worst of it, they only once reported more than 200 deaths in a day. Again, 

Italy is at more than 300 deaths a day for four straight days and today, 

475. 

 

The situation in Italy remains the worse in the northern part of that 

country, particularly in the wealthy region of Lombardi, which has now 

become basically the warning to the world of what will happen in countries 

all over the globe if they don`t take serious steps to bring down the rate 

of infection as dramatically as possible and as quickly as possible.

 

But it`s worth knowing that the reason it`s going so violently terribly 

wrong in Italy, with more deaths per day than we have seen anywhere else, 

including China now, the reason it is going so badly wrong in Italy is not 

because of something that`s inherently wrong with Italy and their health 

care system. Quite the contrary. In 2017, the World Health Organization did 

a report on the health care system in Italy, and they were critical of some 

stuff, they wanted them to, you know, up their spending on some stuff, and 

realign their priorities in some ways.

 

But honestly, by and large, the WHO report card for the Italian health 

system was pretty good. Here`s part of that report. 

 

Performance of the Italian health system, quote, the relatively low 

mortality rates in Italy suggest that the Italian health care system is 

effective in dealing with life-threatening conditions. Amenable mortality 

rates trended downward over the past decade. Italy has a strong acute care 

sector. 

 

That`s Italy as a whole. Northern Italy itself is even better. Northern 

Italy is the richest part of Italy. It`s not some backwater, when it comes 

to advanced medicine, or advanced anything. I mean, that`s where they make 

the most expensive yachts in the world. That`s literally where they make 

Ferraris. 

 

And there are big modern hospitals there, full of lots of fully-qualified 

doctors and world-class equipment. And there, that place, is where they`re 

now losing more than 300 people a day, 475 deaths in the last 24 hours. 

 

Reporter Chico Harlen wrote this for the "Washington Post," with the last 

line, it will put your heart in your throat, quote, even as lockdown 

measures have gradually slowed the number of new cases, the country`s death 

toll has exploded, more than tripling in the span of a week. Italy`s death 

toll is increasing exponentially in the way that mirrors the growth of 

total cases earlier this month, as people lose battles with the disease 

after several weeks. 

 

Today, the governor of the hardest hit Lombardi region, Attilio Fontana, 

said that medical care facilities -- excuse me, said that medical 

facilities there will soon be unable to help the sick. Quote: We will soon 

be unable to give a response to those who fall ill. We will be unable to 

give a response. 

 

What he means there is that the hospitals in that region in Italy are about 

to be unable to treat people, as hundreds of people are dying every day. 

 

The hospitals are at the point of collapse. And that note there about the 

deaths in Italy, now, mirroring the rise in new cases there, earlier this 

month, that`s really the whole ball game. Like if there is a relationship 

between two numbers or two things or two trends that you have to 

understand, in order to know why all of the epidemiologists and public 

health people are so freaked out right now, as well as the political 

leaders who get it, it is the different between these two number, the new 

cases followed three weeks later by the intensive care demand. 

 

Marc Lipsitch explained today in a piece for "STAT" about what our options 

are as a country. Marc Lipsitch is an epidemiologist who runs the Center 

for Communicable Disease Dynamics at Harvard University, he said today, 

very simply, in a way that I think is actually memorable for all of us, he 

said, quote, intensive care demand lags new infections by about three weeks 

because it takes that long for a newly-infected person to get critically 

ill. 

 

And again, not everybody who gets infected will become critically ill, but 

the people who need critical care will start showing up in ICUs about three 

weeks after they became infected. 

 

So if this is the past month, in Italy, showing the rise, rise, rise, of 

infections in Italy, we will add in a three-week lag time and that`s where 

you see the rise, rise, rise, in hospitalizations. A slice of those same 

new infections from three weeks ago are the people who are now critically 

ill and needing to be treated in hospital. And that is why their hospitals 

are collapsing, the steep rise in infections foretells by about three 

weeks, the collapse in their hospitals happening today. That region`s 

governor again saying that we will no longer be able to treat people in 

hospitals. 

 

That is the terrible news from Italy. That`s why you keep hearing people 

talk about Italy like it is the boogieman in this story. That`s why New 

York officials in particular are sounding the alarm about the mirror 

between New York cases and Italy, about how the steep rise in cases in New 

York now foretells a crush in hospitals here coming very, very soon, just 

as we have seen it play out in real time in northern Italy. 

 

There`s some good news though from Italy, as well today. And it is smaller 

scale good news but I will take good news where I can get it, the town in 

northern Italy that reported the first death from coronavirus is a town 

immediately called Vo, that I can remember, V-O, was the name of the town, 

to the Veneto region, forgive me, I don`t speak Italian, my pronunciation 

is terrible, but there are about 3,300 people in that town of Vo, where 

they have the first deaths. 

 

And they did a study, the local university, and they decided that what they 

were going to do in that town is that they were going to tests every single 

resident of the town, 3,300 people. They tested everybody. They got 90 

positive tests, including at least half a dozen people who were completely 

asymptomatic and would never have been otherwise identified had they not 

done this experiment in which they tested everyone regardless of symptoms. 

 

But they tested everybody, everybody who tested positive, they isolated 

them, and then after the period of isolation, they tested the whole town 

again. Anybody newly positive again, isolated. Well, after having done 

that, after having done universal testing and universal isolation of all 

positive cases, they have now gone days with no new cases in that town. 

 

And you don`t want to extrapolate globally from one experiment in one town. 

But as a matter of principle, mass testing does find asymptomatic people 

who are positive and therefore still infectious. And once you identify 

positive people, isolation can work, to stop people who are positive from 

giving it to anyone else. 

 

And if those are the principles with which you can extrapolate from that 

experiment, well, that at least gives you a way to plan for moving ahead. 

If only we could get a test for the freaking virus in this country, maybe 

we could start to think about the implications of that for our big country, 

and the thousands of cases we`ve got here now, as our numbers really 

skyrocket. 

 

New York City had 814 cases as of yesterday. As of today, the number is 

1,871. That is way more than doubling in a day in New York City. New York 

state has enough cases, that if New York state were a country, there would 

be only ten other countries on earth with more known cases. 

 

In the United States, the worries about testing, and our hospital capacity, 

and how well we`re taking care of our health workers, who after all, will 

be the people who run the hospitals, and take care of the sick, those 

worries are really screaming now as the American case numbers take off. Tom 

Bossert is one of the people who is supposed to coordinate the national 

response to a pandemic for our federal government before he and his 

colleagues were all fired by the Trump administration and the Trump 

administration then just never hired anybody else to take that job, here is 

Tom Bossert`s take on what we need to be doing now as of today, and what in 

two weeks we will wish we had spent today working on. 

 

(BEGIN VIDEO CLIP)

 

TOM BOSSERT, FORMER HOMELAND SECURITY & COUNTERTERRORISM ADVISOR: If we`re 

like Italy, and every reason to believe our numbers will grow along that 

line, we could see 2,500 dead in two weeks time, and we could see over 

100,000 cases, and those are planning assumptions, not predictions, but if 

that`s the case, in two weeks, I`ll look back on today and said I wish I 

had done three things, and they would be personal protective equipment, 

personal protective equipment, and personal protective equipment, because 

these doctors that we just saw interviewed, if they`re absent, they can`t 

take care of us and they can`t use those ventilators. So, that`s -- that`s 

my fear today and that`s where I think we should be focused. 

 

(END VIDEO CLIP)

 

MADDOW: We`re going to look back on this day two weeks from now and what we 

wish we would have focused on is three things, personal protective 

equipment, personal protective equipment, personal protective equipment. 

 

Tom Bossert is one of the officials who would have been in charge of 

coordinating this response for the U.S. federal government had the Trump 

administration not fired all of the pandemic response teams from the 

federal government two years ago. This is from "The Wall Street Journal" 

today, quote, administrators at Renton, Washington headquarters -- at the 

Renton, Washington headquarters, the Providence Health System, are in 

conference room, assembling makeshift face shields from vinyl elastic and 

two-sided tape, because supplies are drying up. 

 

Providence, a system of 51 hospitals across seven states, has less than a 

week`s supply of face shields and medical masks at its Seattle area 

hospitals. 

 

Literally, that`s how we`re dealing with this, in this country. In one of 

the places that had the earliest experience with large numbers of cases. At 

the hospital, they are making face masks themselves. Like the HR people and 

the accountants and the managers at the hospital are all sitting in 

conference rooms with stuff they got at hobby stores and hardware stores, 

MacGyvering face masks for the doctors and nurses to use to protect 

themselves in their hospital. That`s our level of preparedness as a 

country, even though we got advanced notice that countries who had it worst 

than us than before us, so we can see how it is going to go, that`s how 

we`re coping. 

 

In Massachusetts hospitals, they`re rationing testing of coronavirus as of 

today, not only because of a shortage of tests which we still have all over 

the country but because in Massachusetts, they even have a shortage of just 

the swabs, just the big Q-tip like type things to collect the samples. They 

don`t have those either. 

 

A new study of a nursing home clusters of coronavirus in Kirkland, 

Washington, shows that part of the way the virus spread to nine different 

nursing homes there was this chain reaction that led to 129 new cases in 11 

days, they`ve done an epidemiological study of how it happened, and how it 

spread to those nine nursing homes, they found that part of what happened 

is staff spread it from facility to facility in part because they had a 

lack of access to personal protective equipment, because we haven`t 

prioritized that. Even for staff who are working in cases, in places where 

there are known clusters, and with patients who are known to have been 

exposed. 

 

So things are moving very fast now, obviously. The response, obviously, is 

nowhere near the size of the task. The first member of Congress to test 

positive for the virus is Mario Diaz-Balart, Florida Republican 

congressman. He announced tonight that he`s now the first member to be 

testing positive and if his name is familiar, he is the brother of our 

beloved colleague Jose Diaz-Balart, who you know from MSNBC and Telemundo. 

 

Just in the last hour, a second member of Congress, a Democratic 

Congressman named Ben McAdams from Utah, has announced he too has tested 

positive for the virus. The federal government announced today that they 

will deploy hospital ship, U.S. navy hospital ships to try to provide 

hospital overflow capacity, one in New York, and one in some undetermined 

location on the West Coast.

 

While that seems good, it should be noted that that will take a number of 

weeks to get up and running. 

 

And all major U.S. automakers announced the shutdown of their plants, in 

the U.S., and Canada, and Mexico today, there`s been some nonspecific 

murmurs from the administration that U.S. manufacturing facilities, 

including potentially auto facilities might be repurposed to start building 

ventilators instead for intensive care units, since we`re going to need 

tens of thousands for those than we have. 

 

Again, that seems more kind of aspirational or brain storming at the moment 

but you may have seen headlines about that today as the administration 

tries to advance that concept at least. Tonight, Ford Motor put out a 

statement confirming they have had preliminary discussions with the federal 

government about the possibility of producing ventilators and other 

equipment. 

 

Palm Springs, California, today, adopted a shelter in place order that`s 

like the one that is in effect now for seven million people in the San 

Francisco Bay Area but so far those shelter in place orders are just in 

California. The U.S.-Canada border is closed for nonessential travel in 

both directions now. 

 

The economy`s crash continues unabated with another 1,300-point loss in the 

Dow today even as the federal government unveiled new proposals for big 

stimulus spending to try to shore things up. We`re going to get expert 

advice on those proposals coming up later this hour. 

 

Delta Airlines announced today that they`re cutting 70 percent of their 

flights. The nation`s airports announced today that without their own 

bailout, they may start defaulting on the bonds that were sold to pay for 

their construction. 

 

The largest shopping mall operator in the country announced that it is 

shutting all of its properties nationwide, after a four state consortium of 

New York, New Jersey, Pennsylvania, Connecticut, ordered the closing of all 

indoor retail shopping mall spaces, along with amusement parks and bowling 

alleys. 

 

But even as there is more and more focus of what states are pioneering new 

ideas, about what they can do to shut down and slow the spread of the 

virus, it`s also worth noting, we spend all of this time saying California 

is trying, the Bay Area is trying this, this city is trying this, schools 

are shut down here -- we`ve been talking about the places where new stuff 

is being tried, where new strictures are being announced.

 

Look at it from the other side, though, too it is worth noting that there 

are a bunch of states in this country that aren`t doing much at all. We 

checked with the National Governors Association today, which is tracking 

state by state responses and I was shocked to find that there are seven 

states as of right now where there are no mandated bans on gatherings of 

any size, there are no state mandates ordering restaurants or bars or any 

businesses to close, and there`s no state mandate for school closures. None 

of those things

 

In Idaho, Mississippi, Missouri, Oklahoma, Tennessee, Texas, Wyoming -- no 

state-mandated school closures, no state-mandated limits on large 

gatherings, no state mandates on the operations of businesses like bars and 

restaurants. 

 

Now, in some of these cases, there are, you know, recommendations, 

nonbinding recommendations, urgings, strong feelings expressed by leaders, 

and within these states, some schools and some businesses have followed 

their own lead, or followed those urging the nonbinding recommendations, 

you know, local school districts, having to make those calls themselves. 

 

But in all seven of those states, no statewide rules. Because sure, why 

not, make it up yourself. See how it goes. Now, no reason to panic, right? 

No reason to hustle. Let`s see how this plays out. 

 

Joining us now is Donald McNeil. He`s a veteran science and health reporter 

at "The New York Times". He`s covered AIDS, Ebola, SARS, swine flu and bird 

flu for "The Times". He`s now reporting on the coronavirus outbreak. Mr. 

McNeil did some of the pioneering reporting on the pandemic at the very 

inception. He`s a bit of a voice in the wilderness from those early days 

warning how bad this would get and how quickly. 

 

Mr. McNeil, sir, thank you for coming back. I really appreciate your time. 

I`m going to ask you that I ask every time, which is have I said anything 

since the show started that is wrong or wrong-headed. I know you felt like 

those of us in the media have sometimes sort of put the emphasis in the 

wrong place here. 

 

DONALD MCNEIL, SCIENCE AND HEALTH REPORTER, THE NEW YORK TIMES: No, 

everything you said is correct. I`m shocked at those states that are doing 

nothing. There is just, I mean they`re asking for it. 

 

When Donald Trump uses the expression, you know, the virus is going to wash 

through the country, and he does it with this hand motion like washing 

through like a gentle breeze, that is a very common expression of 

epidemiologists, the virus will wash through the population, and they mean 

it will wash through the population like a tidal wave, with no immunity. 

 

And that`s what we`re facing in this country. It`s not some gentle breeze 

going through the country, it`s a tidal wave, and they`re doing nothing to 

hide behind a barrier to protect themselves. 

 

MADDOW: The surgeon general is now admitting something that you have been 

saying for a while, which is we`re now on a point, on our own 

epidemiological curve where you can basically see our future by looking at 

the timeline of where Italy was about ten days or two weeks ago. If that is 

where we`re heading, with the death rates spiking, now, in Italy, with the 

Lombardi government, the governor saying we are about to not be able to 

offer care in hospitals anymore, if that`s where we are, what priorities 

should we derive from that, what are the single, what are the most 

important things our medical system should be doing right now, to prepare 

for that happening to us within two weeks? 

 

MCNEIL: OK, I will predict that we, since we are going down the path of 

Italy and much bigger country than Italy, that we will surpass Italy in the 

number of dead in a few weeks because we are following the Italian model, 

not the Asian model. 

 

I don`t understand why we`re looking at a small town like Vo in Italy, when 

that same lesson that you have to test and isolate as many people as 

possible, was a lesson learned in cities all over Asia months ago. And we 

have been paying very little attention to what they`re doing. 

 

I talked before about doing fever checks at every building, and doing 

testing as much as possible. And how you do the safe testing, but on 

hospital preparation, there is, we`re doing things like ending elective 

surgery at hospitals, which is great, that is step number one, fine, but in 

China, and in other places, they segregated the hospitals, they said, OK, 

you three hospitals are going to be designated to do nothing but COVID-19 

patients, and the others are going to handle the heart attacks and the 

babies that need to be born and the car crashes and everything else, 

because we don`t want those coronavirus patients infecting the regular 

emergency patients. 

 

If they couldn`t do that, they would create separate wings in the hospital. 

It was basically known as the dirty wing and the clean wing. The wing of 

the hospital had nothing but coronavirus patients, and the other side had 

nothing but other emergency patients. And the two staffs never crossed the 

zone. It was assumed that like those nursing home employees, they would 

carry the virus from one side to the other. 

 

Inside those hospitals, inside those hospitals, they would build walls in 

the wings with windows in them so that a ward became an isolation ward and 

you went into it basically like you do into an Ebola treatment center. You 

had a gray area where you did -- put on your personal protective gear, 

under the eyes of the nurse who saw that you`re doing it perfectly, you 

would go through the ward in one direction only and come out at the other 

end when you finished with the patients and you would then take off your 

gear under the eyes of a nurse. That`s what they`ve been doing with Ebola 

wards with chlorine showers and you have to take it off carefully because 

it can contaminate you. 

 

The other thing they did all over Asia, is for the mild cases, the mild to 

moderate cases, in other words, people who did not need to be hospitalized, 

they didn`t go home. They went into isolation centers. 

 

They went into, you know, we have all sorts of empty buildings around now. 

Madison Square Garden is empty. The Barclays Center is empty. School 

gymnasiums all over the city are empty. Those become sort of miniature 

hospitals for the people who are infected, but don`t need to be put into a 

hospital because that way, they don`t infect their own families. 

 

It`s 80 percent, 75 to 80 percent of the clusters there, were spread within 

families and it`s important to stop that. And these were, you know, they 

were bed, oxygen tents, basic care, but that`s how you brought people 

through and in there for two or three weeks and most of them recovered and 

were able to go home and they were survivors and they were able to donate 

blood to help other people survive. 

 

They were able to walk the streets. They`re OK. They`ve recovered. And 

they`re thrilled. We`re not planning that here as far as I can tell. 

 

MADDOW: My guest is Donald McNeil, science and health reporter with "The 

New York Times," who has incredible international experience with these 

things. 

 

Mr. McNeil, I would like to ask you to stay with us a bit longer in part 

because I want to ask you about the piece which was posted at "The New York 

Times" which actually offers some of the first hopeful signs I`ve seen 

about a potential out of the box surveillance tool to get a handle how big 

this is and where clusters are arising. 

 

If you don`t mind sticking us with, we`ll be right back with Donald McNeil 

from "The New York Times." Stay with us. Thank you.

 

(COMMERCIAL BREAK)

 

MADDOW: We may not have a lot of coronavirus testing in this country, but 

we do have a lot of people all over the country who are realizing that they 

have fevers. Fever is one of the most consistent symptoms for the onset of 

coronavirus. 

 

This company called Kinsa Health, that makes thermometer, and what makes 

the company different, and what makes their product different, is that 

their temperatures not only take your temperature, they connect to an app 

on your smartphone. And when you take your temperature with that 

thermometer and you load it into the app and you connect to the app, that 

reading is saved for you so you can track your temperature over time on the 

app, but it`s also uploaded and sent to the hospital. You can set to do 

that when you use the thermometer. 

 

The company in turn tracks that data. And they map that data. And that has 

made the company uncannily good in the past at predicting upticks in the 

flu around the country. 

 

Quote: For the last few years, Kinsa`s interactive maps have accurately 

predicted the spread of flu around the United States about two weeks before 

the Centers for Disease Control`s own surveillance tool. 

 

So, the CDC maps flu outbreaks as they happen every year. This app that 

tells you where people in the country have fevers turns out to be even 

better at it than the CDC. The smart thermometer appears to be useful for 

spotting fevers and in this case, it may be very useful for spotting more 

than just the ordinary flu. 

 

There`s brand new reporting on this just out tonight from Donald McNeil at 

"The New York Times" and it`s fascinating. According to McNeil`s reporting, 

Kinsa health is already, quote, tracking the coronavirus in real time, 

something that had been impossible given the lack of testing for the 

disease. Literally, the interactive maps from this company, from these 

thermometers that they have sold all over the country, are providing data 

about where coronavirus case clusters may be emerging. 

 

This reporting tonight is a big deal. And this technology could make a 

difference in identifying new epicenters of the coronavirus as they start 

to pop up all around the country. The story broke tonight, we had Donald 

McNeil booked to talk on the show tonight, while I got that news, I was 

looking at my own, one of these thermometers, because I own one, I have 

been using it about, to be honest, five times a day, to take my 

temperature, as I have been trying out various work environments and 

dispersing our staff around the country, to try and get this show produced 

in as resilient a way as possible. 

 

We`re back now with the reporter who broke the story tonight, Mr. McNeil, 

science and health reporter at "The New York Times".

 

Donald, thank you very much for sticking with us. 

 

First, let me ask you if I hit the high points there and, accurately 

summarized what`s so enticing or potentially really useful about this 

technology. 

 

MCNEIL: God, yes, you have explained it incredibly well for somebody who 

has never seen it before, and I think the company owes you a finder`s fee. 

So, I`m kidding. 

 

But yes, it`s -- I mean, I`ve been watching this company for about two and 

a half years now, since the guy who started it, Inder Singh, came to visit 

me at "The Times" and he shed me the notion of hey, I have these -- I have 

these thermometers scattered all over the country, people buy them in 

stores, but they also hand them out to school children in health education 

programs and two million data points and they can produce maps where fevers 

are popping up all over the country that same morning as people get up to 

take their temperature and their kid`s temperatures.

 

And they know what the flu is, by the algorithm if it is a high temperature 

for three days in a row, we assume that`s flu, rather than a regular cold. 

So now, they`ve taken this data, and working with a professor at Oregon 

State, they`ve mapped the, basically the complete history, the typical 

range of flu in every zip code in the country, for years past. They know 

the high and the low of the range. 

 

And so they know once the season starts and they`re tracking it, where you 

might expect flu to be in Brooklyn at this point now, mid-March, as the flu 

season is winding up. And literally, in my neighborhood in Brooklyn, they 

showed me, look, there are many, many more fevers being reported from 

Brooklyn than we would have predicted with our flu-month-old. And we don`t 

know what those fevers are, but the obvious explanation is, those might be 

the coronavirus. 

 

And sure enough, just last week, they were seeing a big spike of extra 

fevers, if you want to call them, they basically subtract the flu data out 

and what is left looks like the coronavirus data. They saw that in Florida. 

South Florida was not reporting a lot of COVID cases. Now, it is. Now it`s 

an epicenter. They predicted it several days in advance. 

 

So what`s great about that, is you know where to bring your testing kits. 

You know where you bring your personnel. You know where to look for the 

virus if you can use these tools, instead of blindly testing people in 

every Walmart parking lot in the country because the worried are coming in, 

in a panic, causing traffic jams. 

 

MADDOW: Obviously, for all of these things, more data is always better, but 

with the kind of sample size that they`ve got and in your report, you say 

about a million of the thermometers in use around the country, does that 

give you an accurate sample size for national surveillance? I guess it 

gives you a place to start, if there isn`t any other form of widespread 

testing or monitoring going on that could direct public testing methods by 

any other means. 

 

MCNEIL: Well, a million data points is a lot more than the CDC has, and 

it`s, you know, getting weekly reports from doctor`s offices and emergency 

rooms and things like that. These things have started selling at the rate 

of 10,000 a day. So they`re running into production problems. But they`re 

getting a whole heck of a lot more data as a result of it. And you know, 

this means their algorithm is just going to get better at predicting this 

stuff. 

 

And, unfortunately, the CDC has basically ignored them for three years when 

they`d come to them and say, hey, we think we got something, because, you 

know, typically, CDC grabs your intellectual property. If you bring 

something and the CDC wants to cooperate with you, they want the rights to 

the data so that they can publish it in MMWR.

 

And this is a mistake. I talked to an expert today who says why is a 

private company running a foot race against the CDC? You know, and possibly 

beating it, when they ought to be cooperating and we could -- we could use 

this to predict, they were very excited, the person I talked to, said this 

is 21st century, you know, data gathering, and we`re stuck with a mid-20th 

century very labor-intensive system where, you know, a nurse at every 

doctor`s office in the country writes down a report and sends it to the CDC 

at the end of the week. 

 

This is real time. Like the minute you take your child`s temperature, they 

have the data. 

 

MADDOW: Fascinating. 

 

Donald McNeil, a reporter for "The New York Times," I really appreciate you 

taking the time to talk us to tonight. I know you`re in the middle of all 

of your own work. This is a real public service for you to talk to us about 

these emerging stories. Thank you. 

 

MADDOW: All right. We will have much more ahead. There`s some actual 

positive breaking news out of China, since we`ve been on the air, for the 

first time since the coronavirus virus began, China tomorrow, so the time 

zone difference, China will report no new local infections for the first 

day, for the first time, since this crisis started, they will have no new 

local infections for the first time, which is a point of hope for every 

country in the world, who is still on the upswing, most especially us. 

 

Stay with us. 

 

(COMMERCIAL BREAK)

 

MADDOW: We are all about to find out what it feels like when the American 

economy grinds to a halt. Plenty of Americans are already experiencing it. 

 

This week, today, this was the end of a "The Wall Street Journal" report 

this afternoon on the wave of job losses sweeping across the country right 

now. 

 

Quote: When Jenny Johnson received word about a week ago that her hours at 

a Seattle staffing firm were cut in half, she focused on the positive, more 

time to spend with her 17-month-old son and fiance. And then her husband to 

be, a prep cook and dishwasher, saw all of his shifts evaporate, her hours 

were further curbed late last week, leaving Ms. Johnson to worry about 

affording food and paying her electricity bill. The 25-year-old said, 

quote, I`m just feeling really terrified. 

 

On Tuesday, she is laid off entirely. 

 

Multiply that story by a thousand, by a million, by many millions. New data 

today already shows thousands of Americans being laid off because of the 

coronavirus pandemic. Those new numbers explicitly do not include all the 

job cuts at bars and restaurants forced to shut down across the country. 

 

There are nearly three million waiters and waitresses alone, in America, 

there are as many jobs in food service in America as there are in 

manufacturing. And manufacturing is shutting down, too. Ford, GM, and Fiat 

Chrysler shuttering U.S. factories at least through the end of this month. 

 

Unemployment claims have skyrocketed so fast this week, it`s straining the 

computer networks of state unemployment systems. The state of Kentucky, for 

example, they usually process 2,000 unemployment claims a week, and they 

got 9,000 unemployment claims yesterday alone. 

 

The stock market continued its collapse today. Now we`re in this pattern 

where it does swing wildly around every once in a while, but thousand plus 

point drops in the Dow are a day that ends in "Y" now.

 

There appeared to be consensus emerging today across the economic and 

political worlds, that the coronavirus pandemic has the potential to cause 

not just a recession but the great economic collapse since the Great 

Depression. Is that possible? Is it possible to avert it? Is it literally 

humanly possible for us to do anything as a society to stop that from 

happening? 

 

Today, the Senate got around to approving and tonight, President Trump 

signed legislation that the House passed last week to spend $100 billion on 

paid sick leave, unemployment insurance, and free coronavirus testing, 

although a compromise forced by House Republicans means the paid sick leave 

part of it applies to only about 20 percent of American workers. Thanks. 

 

Now to the White House and congressional Republicans are reportedly working 

on a trillion dollar measure that may send a couple of $1,000 checks 

directly to many Americans, that would also infuse cash into businesses 

large and small, to try to keep them alive, to try to keep them afloat, to 

try to keep workers paid. 

 

Are those the kind of measures that we need? Are they enough? How do we 

know? And what`s the smartest way to go about deciding whether or not we 

have confidence that`s true?

 

I have just the person to ask here with us next. 

 

Stay with us. 

 

(COMMERCIAL BREAK)

 

MADDOW: If you are feeling scared about the economy tonight, you might have 

a new single issue soul mate in Washington, D.C. 

 

(BEGIN VIDEO CLIP)

 

SEN. MITCH MCCONNELL (R-KY): I`ve been a few of these. I was here at 9/11. 

I was here during the financial crisis in `08. I was here during the fiscal 

cliff. We occasionally have these great crises, and when they occur, we`re 

able to rise above our normal partisanship, and many times, our normal 

positions, because these are not ordinary times. This is not an ordinary 

situation. And so it requires extraordinary measures. 

 

(END VIDEO CLIP)

 

MADDOW: Extraordinary times mean extraordinary measures. Details are still 

being hammered out but the ideas for a new stimulus include two rounds of 

checks sent directly to individual Americans, loans to small businesses, 

$50 billion just for the airline industry, more than a trillion total. 

 

Are there right and wrong ways to do this sort of thing? What more will 

need to be done if this is done? Will this stimulus of this amount be 

enough to stave off what is being described as an imminent economic 

collapse? 

 

Joining us now is Jared Bernstein. He`s the former top economic adviser to 

Vice President Biden. He`s now at the Center on Budget and Policy 

Priorities.

 

I asked Mr. Bernstein to be here tonight because he is good at explaining 

things to us who are not economists. 

 

Jared, it is great to see you. Thanks for making time for us tonight. 

 

JARED BERNSTEIN, CENTER ON BUDGET AND POLICY PRIORITIES SENIOR FELLOW: Of 

course. My pleasure. 

 

MADDOW: If they are willing to spend this kind of money, if this is the 

size that we`re talking about, and if you could design what the federal 

government was going to do, what would be the most effective, most 

necessary thing to do, with the amount of money that large? 

 

BERNSTEIN: Well, great place to start is to think precisely about the type 

of folks that are most vulnerable to the type of economic shock we`re 

seeing unfold in real time, and in the segment before our discussion here, 

you talked about exactly that type of person. Someone who is facing a cut 

in their hours, or a layoff, who doesn`t have paid leave, who almost 

certainly has almost no savings to fall back. 

 

If this person and their family misses a paycheck for a week or two, 

they`re facing fundamental problems, existential problems, meeting their 

basic needs for food and rent, and they could be facing both hunger and 

eviction. And so, we have to design measures that target those folks and 

get out the door very quickly. 

 

Now, I`m very glad to finally see some of the urgency that many of us have 

been talking about for awhile now, reflected in Congress. You heard that 

from Mitch McConnell, there is still yet a dollar to go out the door in 

terms of economic stimulus and so, therefore, they`re behind the curve that 

I`m describing. 

 

MADDOW: What do you think the government is capable of in terms of speed 

here? It`s not unprecedented to literally send people money away or another 

to immediately stimulate the economy and stem off a collapse? We did 

something like this in 2008 in the middle of the financial collapse there, 

too. But I remember it taking months. They`re talking about trying to get 

the first of these payments out in a couple of weeks. Does that seem 

feasible to you? 

 

BERNSTEIN: I think it might be on the edge of feasible. You`re right. It 

took three months last time in 2008. I think the check or tax rebate was 

passed in February and it got out in may. I`ve never seen anything like 

this get out in two weeks and I should say that the folks who are saying 

that don`t have the credibility track record need I tell you that leaves 

one with a lot of confidence. 

 

And in fact, while I think there are positive attributes to their plan, a 

number of us have been arguing that precisely these type of checks, 

targeted low and middle income people are the probably one of the best 

first ways out of the door to help folks who are soon going to be without 

paychecks or already in that situation. It could take longer than a few 

weeks but I`m quite certain we can do it in less than three months. 

 

Something that was missing, though, from the package discussed today, this 

$1 trillion package is significantly strengthen the unemployment insurance 

system. There is a bit of that in the bill that the Senate passed but it 

was really quite marginal. It`s essential that we stand up our state level 

unemployment insurance system so they can meet what is an onslaught of 

layoffs in the coming weeks. 

 

MADDOW: Jared, what do you say to people who wonder where a trillion 

dollars comes from for something like this? I mean, we have fights in 

Washington all the time ideologically driven fights and priorities fights 

about amounts of money that are many orders of magnitude smaller than this. 

What do you say to people who look at something like this and say where are 

they going to throw a trillion dollars to do something on this with zero 

notice and why couldn`t have had the money for other things? 

 

BERNSTEIN: Well, you know, in fact, the zero notice part is really an easy 

question to answer. One thing that is kind of working in our favor right 

now is because of the flight to safety meaning that is investors got out of 

the stocks, they get into bonds, and that lowers the interest rates that 

the government has to pay on the borrowing it does. And so, interest rates 

are extremely low right now on governing borrowing.

 

But here is the thing, Rachel, I have a feeling you and I discussed this 

maybe going on over a decade now, the right time to ask the question where 

are you going to get the trillions is when you`re contemplating a deeply 

wasteful tax cut that isn`t necessary to help the economy get out of a 

recession. So, what we`re talking about now is what economists called 

counter cyclical spending, or spending in order to meet the shock, this 

negative economic shock that is caused by the economic impact of the virus. 

 

That kind of deficit spending is not just legitimate but it`s essential. 

Now, what makes life difficult sometimes when you`re in this fiscal 

condition is if you`ve already spent your sort of fiscal outlet with 

wasteful tax cuts, but the point is that the treasury markets, the 

borrowing markets are saying to the government, you have all the fiscal 

space you need to do what it takes so we should not hesitate at all. 

Remember, what messes up your fiscal account in the long term is not 

temporary measures to offset a recession, it`s permanent tax cuts. 

 

MADDOW: Jared Bernstein, senior fellow at the Center for Budget and Policy 

Priorities, former economic advisor to Vice President Biden -- Jared, thank 

you for your time and for helping us understand this. Stay well. It`s good 

to see you.

 

BERNSTEIN: My pleasure.

 

MADDOW: All right. We got one more bit of news to get to tonight. We`ll be 

right back. Stay with us.

 

(COMMERCIAL BREAK)

 

MADDOW: Ohio was supposed to hold the Democratic presidential primary with 

three other states, Ohio did not. They postponed their election on orders 

of the state health officer just hours before the polls were due to open. 

 

In the three states that did vote last night, Vice President Joe Biden won 

by really big margins. In Florida, he won all 67 counties on route to an 

almost 40-point victory. 

 

In Illinois, which was the state where Senator Sanders actually kept it 

close to Hillary Clinton in 2016, Biden beat Sanders there by 23 points. In 

Arizona, Biden also won by a double digit margin. He won by 12. 

 

Going forward, Democratic primary contests have already been postponed in 

five states to come, presumably more will be added to that list. 

Interestingly, Alabama postponed their primary run off for Senate. They 

postponed that until July. That`s of national interest because that`s the 

race where Attorney General Jeff Sessions who`s trying to get his old 

Senate seat back.

 

But in the Democratic presidential primary with Vice President Biden 

doubling his delegate lead last night, there`s reasons to believe the 

Democratic primary may be coming to an end anyway functionally if not 

formally, it would come to an end formally if Senator Bernie Sanders 

decided to end his campaign. As of this morning, the Sanders campaign 

pulled all of it digital ads off Facebook. They haven`t reserved any TV ads 

beyond this week. 

 

An email to supporters today was frank. Quote: While our campaign has won 

the battle of ideas, we`re losing the battle over electability to Joe 

Biden. Instead of ending that email with a customary donate here button, 

the message instead linked to the senator`s coronavirus plan. 

 

Now, tonight, "The Washington Post" reports that staffers to both 

candidates have been in touch regularly to discuss the public health crisis 

that`s gripping the country, disclosing talks that could form the basis of 

a broader agreement on policies and might make Sanders more comfortable 

leaving the race. Again, that being reported just tonight in "The 

Washington Post", but watch this space. 

 

That`s going to do it for us tonight. We will see you again tomorrow. 

 

Now, it`s time for "THE LAST WORD WITH LAWRENCE O`DONNELL". 

 

Good evening, Lawrence.

 

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

BE UPDATED.

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