CHRIS HAYES, MSNBC HOST, "ALL IN": This is not a small logistical feat ahead of us.
ROBERT REICH, FORMER LABOR SECRETARY: It`s not a small feat. But, look, Chris, we are in a kind of, if you want to call it a New Deal or a war mobilization or a depression, I mean, this is a time for big thinking and big action.
Now, it`s true we don`t have necessarily the most competent people in the administration, but to say --
HAYES: Big action nonetheless.
REICH: But we have no choice. We`ve got to do it --
HAYES: Robert Reich, thank you very much. That is "ALL IN" for this evening.
THE RACHEL MADDOW SHOW starts right now.
Good evening, Rachel.
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. Again, I ask for your forbearance tonight if things look or sound a little different than you are used to. We are still trying out new options and new technology in new ways of working that are designed to keep this broadcast as resilient as it can be even as almost everybody who works on it is dispersed with the four winds.
Tonight, I can tell you we`re going to be talking with one of the world`s leading epidemiologists who runs the Center for Communicable Disease Dynamics at Harvard School of Public Health. We are going to be speaking with one of the world`s most accomplished scientists when it comes to understanding viral dynamics and developing life-saving antiviral treatment.
The first results are the results of the first major study of a potential drug treatment for coronavirus, was published today, the results of that study were not good. But I want to hear from someone who knows these things about treatment possibilities and also about possible technological innovation that might get us some way forward on testing in this country.
We`re also going to be speaking tonight with a PhD biologist who was the White House official in charge of global health security and emerging infectious disease threats under President Obama and under President Trump for a while. I should tell you that she no longer has that job, and no one has that job now because President Trump inexplicably eliminated that job within the federal government for reasons that remain still unclear. But she is going to be joining us here tonight.
All of those guests are going to be joining us over the course of this hour. And that`s kind of a high-powered group of guests. I`m not saying that to brag. I`m telling you that -- it tells you something about the seriousness of this moment that we`re in, that people like that, people who do work that important are all at the same time recognizing that they need to stop their own work for a hot second because it`s very important that they communicate with the public about what they know.
Experts who are working at the highest levels on this crisis taking time to tell the public what`s going on right now is a public service we should all appreciate it. It`s humbling for me as somebody who owns this little piece of public discourse to be able to bring them on.
But, you know, people, particularly people who have special expertise are really stepping up wherever they can and however they can. Here`s one small example. Mayor of New York City made a public call for recently retired doctors and nurses to please sign up for the city`s medical reserve corps. So those recently retired doctors and nurses could be called on to report for duty as we head into this emergency.
More than 1,000 doctors and nurses responded within 24 hours of that call and signed themselves up. New York City has gone from nearly 2,000 confirmed cases of coronavirus as of yesterday to nearly 4,000 confirmed cases today. The number of cases in New York City more than doubled in one day. The rise in cases in New York City is undoubtedly due to an increase in testing, and specifically an increase in the processing of tests in New York, but still, I mean, the numbers are what they are.
New York City has again almost 4,000 cases. They`ve got more than 500 people hospitalized right now for coronavirus. Remember the rule of thumb is that the demand for hospitalization including intensive care hospitalization, it lags behind new infections by about three weeks. Three weeks is about how long it takes, roughly, for people to go from getting infected to potentially needing intensive hospital care.
Keeping in mind that lag time is a really important single metric to keep in mind when you think about the public health threat and why the reaction to these rising cases in our country is as extreme as it is and probably needs to be significantly more extreme. I mean, our ability to test as a country is still so terrible. It`s still so bad compared to the rest of the industrialized world that we really don`t have a grasp of how quickly people are being newly infected in this country.
But, you know, again, we`ve got some raw numbers. More than 500 people hospitalized in New York City alone. Already 169 people in intensive care units in New York City, while the number of confirmed cases just in that one city is doubling per day. I mean, this is vertigo. This is standing on the edge of the abyss in terms of understanding our capacity to continue to treat sick people as the numbers rise.
And the epidemic doesn`t have the same shape over the country. Some places will be hit harder first. Some will be hit harder later. Some places might`ve gotten serious enough about social distancing measures fast enough to hold their part of the curve down further and longer than the rest of us will suffer.
But the nationwide picture is not good. The number of confirmed coronavirus cases in the United States as a whole, the number of confirmed cases doubled in the past two days in our country. And there remain places in the country that aren`t doing much at all to try to slow down the number of people getting infected, even know we know the infection is in all 50 states.
Last night on this show, we highlighted seven states that were doing almost nothing in terms of statewide measures to combat the spread of the disease. I singled out Idaho, Mississippi, Missouri, Oklahoma, Tennessee, Texas, and Wyoming. As I reported last night, these states stood out because even as other states started to scale up their efforts and do their part, these states had no statewide mandates to limit gatherings of any size, no statewide mandates on bars or restaurants or any other businesses. No statewide mandates on schools.
Now, I should note, while Oklahoma was on that list last night, I was wrong to say that last night Oklahoma hadn`t closed their schools. The state board of education actually did order schools closed in Oklahoma earlier this week.
But Oklahoma is the state where the governor this weekend tweeted out a picture of himself and his family at a crowded restaurant in Oklahoma City bragging about how packed it was. And then his spokesman put out a supportive statement saying the governor will continue to take his family out to the dinner and the grocery store without living in fear and encourages Oklahomans to do the same.
Yes, they`re climbing down from that now. Schools are now closed in Oklahoma. I should mention there is still no statewide order from the governor limiting the size of gatherings from that state. There is still no statewide order related to bars and other businesses. Some local governments are making those decisions as best they can. But the state is still basically AWOL.
As of tonight, I should also mention that two of the five members of Congress from Oklahoma are in quarantine after potential exposure to the virus. I should also mention that the state`s corrections department, the state prisons have announced in Oklahoma that new no longer accept any new prisoners being transferred from county jails. So it`s not like they don`t know they had a problem.
Since we singled out those seven states that were lagging last night, three of those states, Mississippi, Wyoming, and Texas this afternoon changed course and decided finally for the first time they will institute some statewide restrictions.
That leaves Idaho, Missouri, and Tennessee, though, still, I guess, just hoping for the best, assuming the best? Presuming it will be fine? Presuming other people will take care of them? Or something?
Meanwhile, in Pennsylvania tonight, the governor there ordered the closure of all nonlife-sustaining businesses. Governor Tom Wolf today ordering nonlife-sustaining businesses in Pennsylvania to close their physical locations as of 8:00 p.m. today. Enforcement actions against businesses that do not close physical locations will begin at 12:01 a.m. Saturday. So midnight on Friday.
The state says in terms of enforcement actions, any business that doesn`t comply with the order to shut down will not only forfeit their ability to receive any disaster relief. They may also be subject to having their license yanked, violators the state says, quote, are subject to fines or even imprisonment.
So, you know, your results may vary depending on where you live and how on the ball your state government is and how much they decided to follow the early conservative media and presidential device that this was all a hoax designed to flummox people, and it wasn`t a real pandemic. Your results may vary depending on where you are in the country.
But I also want to show you something positive, where actually the only footage I`ve got of it is from local news. And it`s strange because, honestly, this is right now only a local story but it ought to be getting national attention. I want to show you something important that is happening finally in one corner of the country. The numbers nationwide suggest that this ought to be happening in a ton of places around the country right now.
This is what you should want to see in your region in your city, in your state. But so far, we only know of it happening in one place, in King County, Washington. And the reason I can show you what`s happening there is because we`ve got this report from King 5, which is the local NBC station in that part of the country.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE TV ANCHOR: King County is also taking action, converting a soccer field near the shoreline pool on First Avenue Northeast into a temporary 200-bed hospital.
King 5`s Tony Black is live at that soccer field where significant progress has already been made.
Tony?
REPORTER: Yes. Good evening to you, Joyce.
When we got here earlier this afternoon, there wasn`t much up here beyond just this fence and "closed" signs. And they have already made that significant progress right now.
Now, the city says that they have pledged to do their part to help this global crisis. For some of the residents that we spoke with, they say they get that, but this is still pretty weird.
This soccer field is turning into a temporary hospital where King County will send those who are sick with the coronavirus or who have been exposed to it or could be. This is one of several locations King County has mentioned they are working on as sites for those with the virus. (INAUDIBLE) also have locations, but this is one of the first being built to serve as a hospital.
(END VIDEO CLIP)
MADDOW: They`re building a field hospital on a soccer field. This is King County, Washington. Part of the country that saw the first case, the first death, the first large cluster of coronavirus cases, the first large number of Americans being hospitalized. This is also the county that bought a local hotel to use to try to protect their hospital capacity by having somewhere else appropriately outfitted where they could house people who needed to be isolated but who didn`t need to be hospitalized, at least not yet.
That first hotel they bought has 85 beds. They have since leased a second motel that they are getting up and running for the same purposes as well. And that same county now in one day put up the basic framing for what will soon be a pop-up 200-bed hospital on a local sports field.
In that county alone, in King County, Washington alone, they believe they need 3,000 additional beds to support their hospital capacity. Rather than wring their hands about it though or wait for the federal government to get it together to start providing some sort of crash facilities, rather than even waiting for clear direction to local officials about what to do, King County is just getting on with it. They are building now themselves.
Two hundred beds will be on that soccer field soon. They`ve got more in those requisitioned hotels and motels. And they`re still looking to build or find more than 2,000 other beds.
And they`re going to do it. I mean, they`re trying to get those beds up right now right away. Buy them, repurpose them, build them right now. Protect your hospitals because if your hospitals get to the point where they cannot care for sick people anymore, the lived experience of the epidemic in your community will pretty quickly turn Stone Age.
King County, Washington, is doing it. Why aren`t more places in the country doing that? It`s not like we don`t know what the start of the influx looks like and feels like.
In Massachusetts last night, we talked about how shortages of key equipment were leading to breakdowns even in the conduct of the minimal testing that we`re doing in this country. "The Boston Globe" reporting last night that Massachusetts hospitals were rationing the availability of the coronavirus test even when they had tests to give because they had a shortage of the long swabs they need to take the samples that ultimately go to the testing facilities.
Well, they also need to take care of and protect health professionals when they are administering those tests. Tonight, the Massachusetts Medical Society, the professional association for doctors in the state, they put out a statement saying that they cannot safely administer the tests they have got even if they have got swabs and even if they have got tests, because doctors in Massachusetts right now don`t have enough protective gear to keep themselves safe, to keep themselves from getting infected while they are administering these tests.
Statement from the association, quote: The shortage of personal protective equipment is a dire situation. If we have access to testing kits, we cannot safely administer the test without appropriate PPE. To do so without precaution would jeopardize the health and safety of our patients and the health care workforce.
Again, that`s the Massachusetts Medical Society tonight saying the lack of protective gear for doctors is so dire, it means they right now cannot even safely administer the test to people in the state of Massachusetts.
Tonight, the president of Mass General in Boston, one of the great hospitals in the world, put out a plea, I kid you not, for people who have 3D printers to please start 3D printing masks for doctors and health workers to use at the hospitals.
In Evansville, Indiana, tonight, one hospital is asking the public to fire up their sewing machines and please start sewing CDC-compliant cloth face masks for use at the hospital. They made a video of a person with a sewing machine putting one together to show people how to sew one of these masks that they might be able to use at your local hospital. They say they`re going to sterilize the mask before they distribute them, but they have literally published a sewing pattern to help people learn how to sew these themselves and donate them, because that`s what the hospitals are down to.
The vice president today at the White House and the president, both gave a very cheery presentation about how millions of masks are available. Everything`s fine with the masks. Yes, millions of masks coming online. Yes, ask at the hospitals.
Here`s the headline in "The New York Times" tonight. Quote: It feels like a war zone. Doctors and nurses plead for masks on social media. Quote: As supplies have dwindled, doctors and nurses have improvised ways to make their stock last.
An intensive care nurse in Illinois was told to make a mask last for five days. An emergency room doctor in California said her colleagues had started storing dirty masks in plastic containers to use again later with different patients. A pediatrician in Washington state trying to make her small stock last has been spraying each mask with alcohol after use until the masks break down.
Here`s a second story on the same freaking problem. Doctors and nurses plead for masks and other equipment. Quote: The open cities community health center in St. Paul, Minnesota, is considering shutting its doors because of a dwindling supply of face masks. Doctors at Barnes Jewish Hospital in St. Louis have been forced to perform invasive procedures with loose-fitting surgical masks rather than the tight respirator masks recommended by health agencies.
At one Los Angeles emergency room, doctors examining a suspected coronavirus patient were given a box of expired masks when they tried to secure them to their faces the elastic bands snapped. With cases soaring, doctors, nurses and other front-line medical workers across the U.S. are confronting a dire shortage of masks, surgical gowns and eye gear to protect them from the White House.
At a White House briefing today, President Trump said millions of masks were in production and that the federal government had made efforts to address the shortages. But he said it was largely up to governors to deal with the problem. Quote: The federal government isn`t supposed to be out there buying vast amounts of items and shipping. We`re not a shipping clerk, he said. The president said there were no immediate plans to activate the Defense Production Act which authorizes presidents to take extraordinary action to force American industry to ramp up production of equipment needed for national security. The president said, quote, we hope we are not going to need it.
The president`s optimistic statements contrasted starkly with the situation on the ground.
Rebecca Bartles heads infection prevention efforts for Providence St. Joseph hospital in Washington state. She said it was only a matter of days before some of that system`s 51 hospitals and 800 clinics run out entirely of personal protective equipment. She said, quote: We are on mile one of a marathon. If we are out of protective equipment now, what does mile 25 look like?
I don`t know why at the White House today, they bragged about all these millions of masks being available. I don`t know where they are counting those millions. But the situation in the hospitals with the health care providers who are already actually coping with patients and infection right now, that`s the only place that the count matters.
Again, the key thing to keep in mind here, if you`re going to keep one metric in mind here for our country, keep this metric in mind, three weeks, the three-week lag time between when people become newly infected and when critical patients start turning up at the hospital highly infectious and in need of intensive care. This is the rate of increase in new confirmed cases in the United States right now. And that is still with us having an absolutely ridiculously low number of tests being performed.
But that`s the rate of increase that we`re seeing. And it`s all 50 states. As a rule of thumb, the crush at the hospital starts three weeks after initial infection. Look how fast those test results are rising.
It is go time right now for heroic marshaling of resources to keep doctors and nurses safe so they can stay on the job. It`s go time right now for building out hospital overflow capacity. Building it, requisitioning it, repurposing it, just doing it. Not just talking about it, doing it right now. Now is the time this stuff needs to happen.
Joining us now is somebody who knows what government can do in a situation like this. Beth Cameron served as the senior director for global health security and bio defense on the National Security Council. It`s essentially the White House pandemic prevention office. She was there through the early months of the Trump administration. But President Trump thereafter shuttered that office a couple years ago, he closed it in 2018 for reasons that remain to be explained.
Beth Cameron is now the vice president for global biological programs and policy at the Nuclear Threat Initiative.
Dr. Cameron, thank you so much for taking the time to be with us. I really appreciate it.
DR. BETH CAMERON, FORMER SENIOR DIRECTOR FOR GLOBAL HEALTH SECURITY FOR THE NATIONAL SECURITY COUNCIL: Thanks for having me.
MADDOW: First, let me just ask you if I said anything in those opening remarks or in those reports that strike you as wrong or wrong-headed or putting the wrong emphasis on anything.
CAMERON: No. I think you`re absolutely right. I -- particularly right now I am happy that the president invoked the Defense Production Act. But I am really nervous about the need to actually implement that act because, as you rightly said, we are seeing personal protective equipment shortages. We are worried about ventilator shortages and also shortages of test kit reagents like swabs that you mentioned as well. And this is really not just a United States problem. It`s a global problem.
And so, I also would like to see the United States leading, working with partners and allies to address these shortages all over the world.
MADDOW: One of the things that we`ve started to see requested or recommended or asked about by some frontline health care providers who are, you know, asking for help who are trying to raise the alarm about what`s going on is the question of whether there ought to be or whether there could be a federal role in essentially monitoring the personal protective equipment needs around the country, figuring out where the need is most acute, where the shortages are most dire and most consequential, and coordinating some sort of federal role to make sure that the equipment that we`ve got gets to the places where it is most needed.
Is that the kind of thing that a federal coordinator working on something like this could do?
CAMERON: Yes. I absolutely think so. And I think that it`s something that a White House pandemics office would be doing and should be doing. Not to be the ones to actually monitor the actual numbers but to make sure that the departments and agencies in the United States understood where the shortages actually are, and hopefully the federal government and the Department of Health and Human Services is doing that right now.
I think it would be really, really important to understand exactly where our supply chain is for personal protective equipment. I think there is a disconnect between the numbers that we`re hearing in the press conferences and the reports that we`re getting on the ground. I think it`s also important for us to understand what the supply chain for personal protective equipment is all over the world.
The World Health Organization, the World Bank, the World Economic Forum which is a group that brings together companies, are monitoring the supply chain for personal protective equipment which is a global supply chain. And so, it`s really important for us to understand where we can go to get more personal protective equipment, where we can buy it from, and also really to ramp up production and really to do it now.
MADDOW: Let me ask you about the steps I described being taken in King County, Washington, right now. King County obviously was hard hit early on. They were coping with this in a way that places in the United States weren`t.
And they`ve made some decisions at the local level, I mean, obviously, in coordination with the state, in coordination with the federal government to a certain extent. But they`ve made their own decisions. They`ve taken over motels and hotels. As of today, they started setting up a tent 200-bed hospital on a local soccer field. I mean, this is local authorities taking the initiative. They reportedly think they need 3,000 additional beds to supplement their hospital capacity locally right now, and they are building them out and finding them and repurposing them, dozens or hundreds of beds at a time.
Should there -- in other places around the country, people aren`t taking the same kind of initiative. Should there be federal directives to get them to do stuff like this? Should state and local official recognize that`s going to come from the federal government and they just start doing it on their own say so?
CAMERON: I think there needs to be a lot more communication about what exactly states should be doing and at what place in the crisis they should be doing it.
And so, one of the things that we`re working on with other organizations is how to get decision support to states so people who are making the decisions, mayors, governors, people in their offices because right now the states are doing a lot of the leading. I think it`s encouraging to see what`s happening in Seattle and King County and around the country.
But I do think that there`s a lot of confusion that we`re hearing about when to start pulling triggers on things like creating new field hospitals to improve bed capacity or when they should be looking at school closures. We were hearing that a few weeks ago before more states started closing schools as a larger measure. So I do think that there is a role for the federal government in providing not only really good public health guidance which the CDC does provide but clear guidance to decision-makers at the state and local level.
I don`t think that they should be on their own. But right now they are leading.
MADDOW: They are leading in some of the best leadership in the country is literally at a horizontal level from localities and states to look at each other and find out who has the best ideas.
Beth Cameron, former senior director for Global Health Security and bio defense at the National Security Council, a job that I wish still existed. She is now vice president for global and biological programs and policy at the nuclear threat initiative. Thank you for being with us tonight. I really appreciate you being here and sharing your expertise.
CAMERON: Thanks so much for having me.
MADDOW: All right. We`ve got much more to get to tonight. As I mentioned, we are going to be speaking with one of the world`s leading epidemiologists, plus one of the most accomplished antiviral therapeutic researchers ever. One of the things that is not getting a lot of discussion right now is a potential cure, a potential treatment for the disease caused by the coronavirus. We`re going to get to that.
Stay with us.
(COMMERCIAL BREAK)
MADDOW: Last night, we brought you some fascinating new reporting about a company that now sort of as a matter of happenstance has ended up tracking the coronavirus in real time in a way that I`m not sure anybody else is able to.
It`s a company called Kinsa Health that makes thermometers. Their thermometers will take you temperature. They tell you whether or not you`re running a fever. But you also hook them up to an app.
Through that app they transmit the data about what temperature they are taking of all Kinsa thermometer users around the country. They transmit that data to the company. And Kinsa Health then puts that data on a map.
And their thermometers are in over a million households nationwide. So that`s over a million data points nationwide every time somebody uses those thermometers. Through their maps they have been uncannily good at tracking who has fevers around the country and what that translates to.
In a normal year, that translates to them being really good at tracking which Americans have the regular flu and where. They have these interactive maps that have accurately predicted the spread of flu about two weeks before the CDC is able to do so.
Well, now, they are using the same technology to track the coronavirus in real time. They are looking at what kind of fever data they`d expect to see under normal cold and flu season conditions. And then they are comparing that with the fever readings they are seeing now, ones that are over and above what would be those normal conditions.
What they find when they compare those two data sets just turned out to be very helpful in identifying places where epidemiologists and public health folks maybe ought to be looking, maybe where test efforts ought to be directed, maybe preparations for people being hospitalized ought to be geared up.
Take a look at this map that is being regularly updated by Kinsa Health. This is what it shows as of right now. And as you can right at the top, it says it`s tracking atypical illness. That means it`s tracking fevers that are higher than you would normally expect to see this time of year.
And as you can see, Florida is kind of lit up on this map. It`s not the only place but more than any other place.
Florida has a particularly high amount of atypical fevers being reported right now. And that`s just one data point, but it is striking, and it`s worrying and it`s probably caused for public health attention.
It`s particularly worrying to see stuff like this because we are relying on data points like this one in the absence of real widespread testing in the United States. It`s something that`s being radically ramped up in other countries.
Yesterday, for example, we talked about a town in northern Italy called Vo, V-O. It`s the name of the town. There are only about 3,300 people in that town but it was the site of the first coronavirus death in Italy.
After that they decided they would do an experiment in the town and test every single resident there. What they found was that some of the people who came back as positive were completely asymptomatic. These are people who would otherwise never have been tested had they kept to these rules that say they should only test people who have symptoms.
Had they not tested everyone they wouldn`t have found those positive but asymptomatic people. Because they did test everyone, even the people who were asymptomatic, they were able to isolate positive cases, all the positive cases, with that information, the town has now gone days without any new cases being reported there at all.
Today, there is a sort of similar story out of the small nation of Iceland. Iceland is now carrying out large-scale testing of its general population. Already, they have tested a larger proportion of their citizens than any other country on earth. The country`s chief epidemiologist says the goal there is to try to find the actual prevalence of the virus in that country`s population as a whole.
Again, most countries are only testing symptomatic people or people thought to have been exposed. In Iceland, they are trying to test everyone including non-symptomatic people with no known exposure. Just like they did in that little town in Italy. What they found in Iceland thus far is in line with what they found in that little town in Italy. They are finding a bunch of people who are testing positive who are non-symptomatic. In Iceland, it`s about half the people who are testing positive are non- symptomatic. They would never be identified had they not been testing everyone.
More and more what we`re learning from the places that have tons of testing is that asymptomatic people have it and can transmit it. The question is, how do we in this country respond to that news, right? Could we live in this country for a while as if we are all positive, just assuming that we`re all positive?
I mean, we`re not testing widely. We`re not even testing narrowly. We`re not even testing nearly the number of people who have symptoms in this country. If we can`t do mass surveillance testing where everybody who`s positive is identified, should we, even those of us who are asymptomatic assume that we`re positive and behave accordingly?
Do we have the will as a country to do that? If we don`t, what`s the next best thing? I have just the guy to ask. That`s next.
(COMMERCIAL BREAK)
(BEGIN VIDEO CLIP)
GOV. GAVIN NEWSOM (D-CA): At the end of the day we`re one body. There`s a mutuality and there`s a recognition of our interdependence that requires of this moment that we direct a statewide order for people to stay at home. That directive goes into force and effect this evening.
And we are confident that the people in the state of California will abide by it. They`ll do the right thing. They`ll meet this moment, as they`ll step up as they have over the course of the last number of weeks to protect themselves, to protect their families and to protect the broader community in this great state in the world that we reside in. I have confidence in that.
(END VIDEO CLIP)
MADDOW: That`s the governor of California Gavin Newsom speaking just moments ago announcing a remarkable order. California is a state of 40 million people. And the governor tonight has just ordered a stay-at-home order statewide starting tonight.
There had been an earlier order related specifically to Los Angeles, the largest city in California. There had also been what they were calling a shelter-in-place order in effect in the San Francisco Bay Area and multiple counties around the San Francisco Bay Area. But now, California Governor Gavin Newsom ordering statewide a stay-at-home order as of this evening because of the coronavirus crisis. That`s just happened moments ago.
Joining us now live is Dr. Marc Lipsitch. He`s the director of the Center for Communicable Disease Dynamics at Harvard School of Public Health.
Professor Lipsitch, thank you very much for joining us tonight. I really appreciate you making the time.
DR. MARC LIPSITCH, CENTER FOR COMMUNICABLE DISEASE DYNAMICS DIRECTOR: Thank you for having me.
MADDOW: Part of the reason that I wanted to talk with you is because you issued some of the first public estimates that made -- sort of took my breath away in terms of the amount of the existing population that could ultimately become infected with this virus, also because recently you have been saying very bluntly. There are two options for COVID-19 at the moment, long-term social distancing or overwhelmed health care systems.
I`m worried at this point that we are going to have both.
LIPSITCH: Well, I think that is a real risk. And the statements you described earlier about efforts to mobilize the country are both encouraging where there is some progress and really discouraging that the progress is not uniform and that the federal leadership does not seem to be taking seriously the idea that we have to prepare not only for getting -- rapidly getting supplies of personal protective equipment and testing kits and all of that but also for dealing with the disruption that this will cause to people`s lives, the economy, their social well-being and other things. So -- and education.
So, there`s a lot to be done, and it feels as though individual places are very hopeful like King County that you described earlier and other -- but the general picture is really uneven.
MADDOW: Let me ask you about this new announcement from California`s governor. Obviously, California the most populous state in the country. It`s also a massive place. We had seen local efforts, six counties around San Francisco put in place a strict stay at home order. We then saw Palm Springs do a similar order.
Now we are seeing it announced by the governor tonight statewide. In New York there`s been discussion about whether or not that should happen in New York City, which has its numbers of cases absolutely skyrocketing and already 500 people in the hospital heading toward 200 people in intensive care already. The governor has said that he doesn`t want to do something like that for New York state or for New York City.
Do you think that those measures are warranted even though it may be hard to sustain them in the long term?
LIPSITCH: I think we need to pretty much pull out all the stops right now in order to slow things down, in order to give us time to build up supplies of all these things that we need to respond, and also in order to make an informed decision about how we are going to manage this over the long term.
This is a very long-term problem. If we do manage to slow the spread of the infection, that means that we are in this position where we are waiting for slowly to -- for cases slowly to occur so that we begin to build up immunity in the population. But the more effective we are at slowing the spread which we have to do to protect the health care system, the slower that buildup of immunity will be.
So we need to sort of slam on the brakes now in order to preclude an overwhelming of intensive care as you described earlier. And then we need to figure out ways to mitigate the problem, both the disease itself and the consequences of the social distancing.
MADDOW: One of the things that you`ve talked about is using the time that we can earn ourselves, the time before health systems are overwhelmed. Use that hopefully to try to innovate, to try to develop new ways that we don`t know now of how to cope with it and how to try to lessen the impact. I wonder if, in your thinking about this, you`re factoring into that the possibility of an effective treatment, if not a cure, something that lessens the severity of illness, something that might be able to keep people out of the intensive care units.
Is that something that you think we should reasonably hope for in terms of our arsenal?
LIPSITCH: Absolutely. I know there are a number of efforts to test existing chemical entities, drugs, that have been approved as safe and effective for other things. There are screening efforts of other chemical compounds underway, and we don`t know what`s going to work and what`s not.
I am cautiously hopeful that we will find something, that the research will find something. But we have to slow things down enough so that has time to occur. We also could do things like what Seattle is doing and expand our hospital capacity and make a large effort to get a greater supply of ventilators and other intensive care equipment.
That would not only cushion the blow in the health care system, but our models suggest it would also help to speed up the process of building up immunity because we can afford to have more cases if we have greater health care capacity.
So, there are -- those are two of the issues. We also need to redouble our efforts to get to a vaccine and think about new and innovative ways to test those vaccines that may be faster. All of these are uncertain and each one may not be -- may not pan out. But if we don`t try all these different efforts, then we will be sorry that we haven`t.
MADDOW: Marc Lipsitch, epidemiologist, the director of the Center of Communicable Disease Dynamics at the Harvard School of Public Health -- thank you very much for your time tonight, sir. Thank you for work and for taking time to talk to the public about it. I really appreciate it.
LIPSITCH: Thank you.
MADDOW: All right. Up next, one of the most -- one of the foremost doctors in infectious disease, and particularly in antiviral medication joins us live next.
Stay with us.
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MADDOW: There is no vaccine. There is no treatment.
And yet, the president inexplicably announced today in -- a malaria medicine had been approved by the FDA as a treatment for coronavirus. It`s not true, at all. That is not true. Not true. Not true, and it is insane that the president of the United States would say something that false and that irresponsible in the middle of a crisis this serious.
But let`s be clear, there is no approved treatment. There is no vaccine.
"The New England Journal of Medicine" published results today of one study of a potential treatment for seriously ill patients with coronavirus. This is one of the first major studies so far. Unfortunately, it was not a success. This was about the combination of two anti viral drugs used to treat HIV. It turned out it has no efficacy against coronavirus.
The pandemic has evolved so rapidly that doctors and scientists are trying a range of existing drugs, including antiviral drugs to see if they might work. But so far, it hasn`t made a difference in mortality.
The good news is this is only the beginning. This was just the first study. It`s also good news some of the best scientists in the world are racing to find effective treatments for coronaviruses. Scientists like Dr. David Ho.
Dr. Ho`s groundbreaking HIV research changed the course of the AIDS epidemic in the 1990s. Now he`s leading a team of researchers at Colombia University trying to find a cure for this coronavirus that has turned our world upside down.
Joining us is Dr. David Ho, scientific director and CEO of the Aaron Diamond AIDS Research Center.
Dr. Ho, welcome back to the program. It`s good to see you again. I`m sorry we have to do this by Skype.
DR. DAVID HO, AARON DIAMOND AIDS RESEARCH CENTER DIRECTOR AND CEO: Good to see you, Rachel.
MADDOW: Let me put a couple clear questions to you and you can tell me whether they are the right questions to be asking.
The first is, what the prospects are, into your mind, for developing therapeutics -- treatment for this virus? Obviously, this first test today published in the New England Journal of Medicine was a failure. But how do you feel about the prospects of developing something that could save lives?
HO: Well, in the long term I feel the prospects are good but, unfortunately, we`re in the midst of an explosive outbreak and we need to have solutions for patients now. So the idea of repurposing approved drugs to apply to the most severely ill patients is the appropriate thing. But this study you just cited is repurposing an HIV drug called lopinavir for treating COVID-19.
And as you read, it`s unsuccessful. It`s not all that surprising because we knew the activity was rather low.
And I think the president was referring to chloroquine which is a drug that we take for malaria, particularly if one is traveling to regions that endemic for that parasite. And it`s been reported to have low level activity and there`s some flat-out statements made by Chinese scientists and doctors that it was helpful, but it was helpful in maybe shortening the course of the infection or course of the disease by a little bit, but there is no evidence that it made a huge difference in terms of mortality or survival.
MADDOW: One of the reasons I wanted to come back to you on this looking at that study today, is that you had talked about the kind of time frame that we should have in mind if a new drug is found or if a drug is found that was effective against coronavirus. If it turns out that a drug is found that is repurposed for another purpose, something that has been tested and proven effective in human patients for other conditions and it also works against coronavirus, would that significantly shorten the amount of time it would take to get something like that distributed if, in fact, that was the path to a cure or an effective treatment?
HO: Yes, for a licensed drug, then we could immediately apply it. But some of the drugs that are not yet licensed but have gone through human testing, for example, there is another drug called remdesivir which is being tested. The rationale behind that usage is, in fact, higher and that remdesivir has been shown to have activity against the SARS coronavirus, which is highly related to COVID-19 and also against another coronavirus called MERS, and there is two large clinical trials on going in mainland China and we should have readout in the near future.
And if that should work, that drug could be scaled up reasonably quickly, but repurposing a drug to be an effective agent against COVID-19, we would have to be very, very lucky. I think the most effective drugs will be newly discovered and that`s s going to take time. As we previously discussed, that`s likely to take a year, 18 months or even two years.
MADDOW: Dr. David Ho, scientific director and CEO of the Aaron Diamond AIDS Research Center, a legend in the field of antiviral research -- sir, thank you very much for your time tonight. I hope to talk to you whenever we can. Thank you.
HO: Thank you, Rachel.
MADDOW: All right. We`ll be right back. Stay with us.
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MADDOW: Here is an advanced look at the front page of "The New York Times" tomorrow. I think we got that that we can show you. Just a stark look how - - in terms of what the news is and what we`re facing.
In just a mom, seconds away from now, Lester Holt from NBC will be hosting a special report on the coronavirus that will feature a number of important guests including Anthony Fauci. You`re going to want to watch this.
Stay with us.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. END