Frontline medical workers TRANSCRIPT: 4/17/20, The Rachel Maddow Show
CHRIS HAYES, MSNBC HOST, “ALL IN”: And that`s going to be a while. Tom
Colicchio, always great to talk to you. Thank you so 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. Thanks, my friend. Enjoy
your week. I appreciate it.
Thanks to you at home for joining us this hour.
You know, there were some positive signs over this past weekend, the
holiday weekend, when the U.S. daily death toll from coronavirus seemed to
be dropping. On Friday, a week ago today, you might remember the number of
Americans who died from coronavirus that day topped 2,000 for the first
time in this epidemic, which was a terrible milestone.
Again, that was a week ago today. We are over 2,000 deaths in one 24-hour
period for the first time. But then over last weekend`s holiday weekend,
over the Easter weekend, those numbers dropped, back, a little bit. And it
seemed like maybe the numbers had maybe hit their peak, and would start to
consistently drop, that`s obviously what everybody was hoping.
But since then, the numbers have been back up over 2,000 deaths each day.
Or Tuesday this week, Wednesday, Thursday, and now, for today as well.
It`s just astonishing to be having that many Americans killed every day
now, more than 2,000 Americans every day. But just look at how fast this
thing has exploded.
If you go back seven weeks ago, to the last Friday in February, that
Friday, February 28th, four Americans had been killed by coronavirus. A
week later, March 6th, it was 26 Americans who had been killed. The week
after that, March 13th, it was 55 Americans dead. The week after that,
March 20th, 247 Americans dead. One week after that, we went from 247 to
And the month of April has just been astonishing since then. In that one
week, between Friday, March 27th and Friday, April 3rd, we went from about
1,500 Americans dead, to more than 7,000. Last Friday, April 10, that
number had more than doubled, and now, since last Friday, we are having
more than 2,000 Americans die every day.
Now, we`ve got more than 32,000 Americans dead overall now, and that has
all happened, we`ve killed 32,000 Americans in less than eight weeks.
New York continues to have the worst toll. Even as we are seeing all these
good signs, statistical signs in New York, the number of new infections
each day, the slowing and its rise, the number of people hospitalized is
falling, the number of people in ICU beds is falling, but still, the death
toll is sky-high in New York, every day, and it is staying there.
Today, New York Governor Andrew Cuomo announced yet again, more than 600
deaths in New York, in the past 24 hours, 606 deaths yesterday, and 630
today. And those numbers, it has been above 600, 700, for all of the last
And of that 630 number today, the number of New Yorkers who have died in
the last 24 hours, again today, Governor Cuomo took care to specify how
many of those deaths in New York in the past 24 hours were in nursing
homes. It was 40 of those 630 deaths.
We`re going to check in later this hour, with one of the front line
intensive care doctors who has been serving in a bull`s eye New York City
hospital, Saint Barnabas. Dr. Ernest Patti, we spoke to last week, you
might remember about, the condition in his incredibly hard-hit ICU in Saint
Barnabas. We`re going to check back in with Dr. Patti tonight live tonight,
right at the end of his shift, to talk about what it is like in the ICUs
now, as New York is seeing, in the data, a possible light at the end of the
tunnel, but the tunnel is still so black and so long and so cold, with more
than 600 New Yorkers dying every day.
And it is interesting, we watched Italy, so closely, from here, as a
precursor, we were worried that Italy was going to be a precursor, as to
what we would go through in this country, those warnings were exactly right
in terms of us following Italy, and then them handing us the baton of
having the worst outbreak on earth. Because we saw Italy go before us, we
were also heartened when we saw Italy start to turn their curve, start to
bend their curve, we started to see their infection, new infections, their
new hospitalizations, their ICU utilization numbers, starting to go down.
But even as Italy turned the corner on those number, as New York is now,
Italy`s death toll still holds steady at an incredibly high rate, even now.
I mean they are a couple of weeks ahead of us. But Italy is still, even
today, up over 500 deaths per day. And it is not coming down.
I mean, just like New York looks like it`s turning the corner, on some very
important metrics, but New York deaths are staying high, high, high every
day. Over 600, over 700. And that, the plateau of very high death numbers
every day, that`s very worrying, in terms of thinking about the overall
number of Americans who are going to lose their lives here by the end of
this epidemic. I mean, we are seven weeks into it, we are over 30,000
And the worst-hit places are still turning in unimaginable daily numbers.
New York as I said, over 600 deaths minimum every day. New Jersey had 323
deaths in the past 24 hours. That`s their worst yet. New Jersey has had
more than 1,400 deaths in the past four days.
I mean those numbers, you start to combine those numbers, day after day,
and state next to state, and it is just, we are losing a lot of people, and
we are going to lose a lot of people. But this is the challenge that we
have as Americans now, who in our lifetimes are going through this, and who
will have to answer for what we did in this trying time. We will have to
answer for what we did as Americans, to minimize the number of lives lost.
Save as many people as possible.
And toward that ends, there`s two things, I think, that will be worth
keeping in mind tonight, this Friday night, and as we head into another
weekend. The first is something that we`ve been talking about in this show
a lot over the last, the past week or so, but I have some new news to share
about it tonight, that I think you will find interesting, and different
from the way we have been talking about it in recent days, and that`s the
issue of nursing homes and long-term care facilities, which, as you know,
has been, has robbed me of my ability to sleep the past week or so.
It`s because those are the places where the most American lives are at risk
from the pandemic, where the most vulnerable patients are at most risk of
infection, and at most risk of not getting the care they need to keep them
Now, I want to tell you tonight, that we are starting to see some important
movement on the issue of nursing homes and long-term care facilities. It`s
not from the federal government of course, which is where we really
immediate it to be. But we are at least seeing what I think is some
important movement from some states.
Now, I went out of my way to mention a moment ago that New York Governor
Andrew Cuomo has started briefing every day, not just on the death toll, in
New York state, but he specifically started breaking out the number of
those deaths in the past 24 hours, that came from nursing homes. And that
is good. That is really good that he is doing that because as much rightful
attention that there has been to the hospitals and the health workers at
hospitals fighting for the lives of Americans suffering with coronavirus,
the nursing homes and the long-term care facilities are the other place in
our country where huge numbers of coronavirus patients will be and are
being found, and ought to be tested and treated and either saved or not,
Making that visible, as one of the front lines alongside hospitals, is
good, because that`s the way we need to think about those facilities, in
terms of what places need resources, what places need our support, what
places need additional staff. So, today, New York state – as of this week,
New York`s governor is breaking out the deaths in nursing homes alongside
the deaths in hospitals. Very good.
Today, New York state also started releasing individual data about
individual nursing homes that have had more than five deaths on their
residents from coronavirus. I don`t know if you saw this today but I`m sort
of surprised it didn`t get more attention than it did. It is a long and
sobering list of New York nursing homes that have had more than five deaths
among their residents but you know what, there is no information this
information, no reason this information should be secret.
Just as hospitals and workplaces shouldn`t be keeping this information
secret, this stuff can`t be secret in an epidemic, letting people know that
you`ve got cases, that you`ve got an outbreak, that you`ve got deaths among
your workplace population or your resident population, that information has
to be known, it`s the only way that you can get help, that people know to
try to get your resources, to try to limit the additional body count.
I don`t mean to be that blunt about it but that`s why this information
needs to be made public even if under normal circumstances you wouldn`t
expect facilities like this to publicize when people died in their
facility, we now need to know. I mean, these places where dozens of
Americans are dying, we need to know where they are.
First of all, because it`s right, that we know, right? But also, because
the staff there, will need bolstering, will need help, will need PPE, the
remaining living residents in these places where lots of other residents
have died, they need us to see them, they need us to be able to see the
danger they`re in, because they need to be given help.
We can`t help trouble spots that we don`t know about, but now we know a lot
about them in New York state because New York state has started publishing
individual facility data, so we know, for example, today in Cobble Hill,
Brooklyn, this facility has had 55 residents die. In these two facilities
in the Bronx, the one on the left has had 45 of its residents die, the one
on the right had 35 of its residents die.
In this Manhattan nursing home on the left, 31 residents died, and the
Staten Island home on the right, they have lost 44 souls. Here`s four
facilities in Queens, new figures released by New York state saying that
148 Americans have died in these four facilities.
And I have to tell you, that may be an undercount, in just one of these
facilities, in Queens, the one on the far left of your screen there, the
Sapphire Center for Rehabilitation and Nursing, that is listed in New
York`s data today as having 26 of the residents die but an article that
appeared in “The New York Times” today says that the director of that
facility, the Sapphire Center, told his local state representative, that
the death toll there is actually higher than that, it is not 26, it`s 29.
“The Times” also spoke to two workers of that facility, who spoke with “The
Times” on the condition of anonymity, because they didn`t want to lose
their jobs, those workers told the jobs that they believe the real death
toll in that one facility in queens is more like 60 residents who have
died, which just knocks you back on your heels to think that.
But again, New York state reported 26 deaths from that facility today. Two
workers there telling “The New York Times” they believe it is more like 60.
And it is its own problem. Not just something to lament, literally
something to fix, it is something that needs to be fixed, that we don`t
know the real count at that facility, or in other facilities around the
We need to know, we need to know, because those places need help, and they
need targeted resources. If you`re associated with one of those facilities
and you don`t want people to know how bad your problem is, this is not the
time to be defensive or to be worried about your liability, this is the
time to stop the body count, by being public about your troubles, so you
can get help.
“The Times” today redid its own national count of nursing home deaths as
well. “The Times” concluded that more than 7,000 Americans have died from
coronavirus in nursing homes so far. But “The Times” acknowledges, as does
everybody, who has tries to do these counts, “USA Today” has a count,
“A.P.” has a count, NBC News has a count, “The Times” acknowledges that
that`s probably a huge undercut because some state, some county, some
facilities just aren`t reporting their deaths which is astonishing, but it
needs to be fixed, we need to have real data, real number, because
Americans just can`t be allowed to die in large numbers in secret, unknown
and therefore unlamented.
I mean, we`re a freaking first world country last I checked, we don`t allow
thousands of people elderly or not to die with no record of it, and without
giving all of us at least a chance to get help to them. And so, we need to
Multiple states, the federal government has been absolutely useless on this
score but multiple states this week are trying to change it. Ohio
Republican Governor Mark DeWine this week signed an executive order to
mandate reporting, public reporting by facilities in his state. Good.
Same thing from Democratic Michigan Governor Gretchen Whitmer who we spoke
with last night on this show, that executive order in Michigan, good.
New York, as we showed you is now breaking out the death toll in aggregate
from nursing homes and publishing information, as of today, on individual
facilities and the numbers that have died there, as painful as it is to see
that information, it is absolutely necessary.
And I want to tell you tonight that other states are stepping up, in other
ways. Yes, the federal government is still failing to do anything in this
part of this crisis at all. But the states in the absence of any federal
leadership are now innovating. And as new states, by necessity, innovate,
some of them will start to develop new best practices for how to deal with
this pandemic in the most vulnerable places in the country.
And as that happens, every state in the country should start to emulate
those best practices. And so we`ll try to track them as they develop. In
Massachusetts, for example, where half the state`s deaths have been in
nursing homes so far, the state has now told every nursing home and
assisted living facility in the commonwealth of Massachusetts that the
state will come in and do testing for free for all residents and all staff,
regardless of symptoms. That`s a good start.
I mean, those tests need to be repeated frequently. It can`t just be a one-
time thing. But the state, taking responsibility, for getting testing to
every facility in the state for all residents, for all staff, that is a
In some facilities, they`re using the National Guard to go in and do the
testing in Massachusetts nursing homes because the state says we`ll get
everybody tested in every facility. Good. It`s a good start. It`s just a
start. It`s a good start.
In the state of Oklahoma, today, word that will get somebody in heaven some
day if they are not empty words. The state health department announcing
within the past 24 hours in Oklahoma that getting testing and PPE, personal
protective equipment, into nursing homes, is now the top priority of the
Oklahoma state health department. I`ve been waiting for a state health
department to say that.
In Oklahoma, they have formed a state long-term health task force. OK? Call
it, whatever you want. They`ve got somebody working on the problem. They
broke the state into 11 regions, each region has reportedly been assigned
an epidemiologist, a dedicated nursing team, and long term care
Those teams will each be responsible in each of their 11 regions for
getting testing at each facility in their part of the state and the
Oklahoma newspaper today reports that those teams will work on how to
isolate residents who have it, they will beef up infection control
protocols in nursing homes and they will quote work with facilities, on
their personal protective equipment needs.
Now, working with them on those needs is not the same thing as committing
to get those facilities what they need. But at least they`re pointing in
the right direction, right? At least they`re point can at the part of the
problem where the most Americans will lose their lives if we don`t change
course and start helping.
Now, I will say the state of Oklahoma is also doing some really dumb things
at the same time. The state`s governor now says he wants to restart
elective surgeries next week for some reason. The Oklahoma Hospital
Association, the Oklahoma Medical Association, the Oklahoma Nurses
Association, are all screaming bloody murder about what a terrible idea
that is, particularly because Oklahoma has a dire shortage of PPE, and that
matters both for its hospital staff and also for its nursing home staff.
So, you don`t want to be burning PPE on surgeries you, by definition, don`t
have to do. “The Tulsa World” quotes the person in charge of the state`s
PPE supply saying that Oklahoma has roughly 10 percent of the masks they
believe they need right now, so choosing to go back to reopening elective
surgeries to use a ton of them is insane.
Oklahoma is making some terrible decisions, too, or at least the governor
is trying to make some terrible decisions but people can do good things and
bad things at the same time. And the state deciding to zero in on nursing
homes as the stated explicit top priority of the health department in that
state, yes, yes. Other states, honestly, should be doing that, too, if you
are trying to save the most lives and if you are looking at the numbers of
who is at the most risk, and who is dying at the quickest clip.
So that`s your update today in terms of nursing homes. Watch the states as
they try to figure this out. And then hopefully watch the states learn from
each other, as the federal government abdicates the lives of these tens of
thousands of Americans with that are at risk in these facilities. As the
states start to pick it up, other states should feel pressure to do what
the well-run states are doing, reporting that information, making it
public, making exceptions to your previous rules, to make that information
public, and then committed committing to get help to those places.
Use the National Guard if you need to. Use National Guard medics if you
need to. If you called up your medical reserve corps and asked recently
retired health care people to come back into the field, one of the places
you could be using them is uplift nursing homes and long-term care
facilities to staff them up, to shore them up, to help them develop better
infection control facilities around the other things that they`re going to
need to surge the medical care that they`re able to provide to their
Do it. All right. So watch that.
The other place to keep your eyes on right now, and watch this over the
weekend, as this is going to develop because I`m worried about this, a
cluster of states in the middle of the country that have no stay-at-home
orders in place, but where there are now big burgeoning epidemics, a number
of which seem to be springing from large meat processing facilities, where
lots and lots of people are working very, very close quarters, and where
circumstances have been such that it seems like we`ve got many burgeoning
outbreaks in many of these facilities. I mean big clusters, big outbreaks
are bad anywhere, they are particularly bad in states that are light on
hospital beds, while simultaneously being blessed with governors who don`t
want to do anything statewide to stop what are now fast-growing epidemics
in those place, and we`ve got a cluster of three states where that is
happening right now that shoe keep an eye on.
One of them, South Dakota. One of the fastest-growing case counts in the
country right now. They`ve got this huge cluster of cases at a Sioux Falls
meat processing plant. That cluster alone has now ballooned to 777 known
There aren`t even a million people in South Dakota. They`ve got 777 known
cases in that one cluster. There`s no stay-at-home order in South Dakota.
After total rejection of his requests for a stay-at-home order from the
governor, the mayor of Sioux Falls as of today has now dropped his own
effort to try to put it in place, a stay-at-home order, just for his city.
I mean, the South Dakota situation here, with the largest known cluster in
the country, it`s just like watching a slow motion train wreck. Nearly 800
known cases at that one plant, 250 at the start of the week. We are told
reliably that they still have not tested everyone who works at that plant.
There`s no stay-at-home order. The local paper, “The Argus Leader”, is
running a running tally every day now of all of the new workplaces in and
around Sioux Falls that have decided to shut themselves down or have
otherwise reported that they too now have coronavirus cases among their
workers. Well, that`s because everybody is still going to work, because
there`s no stay-at-home order in South Dakota, because the governor thinks
South Dakota has one of the most rapidly-increasing case loads in the
country. The entire state of South Dakota has a grand total of 2,300
hospital beds. The governor though is unperturbed.
(BEGIN VIDEO CLIP)
GOV. KRISTI NOEM (R), SOUTH DAKOTA: We do have a hot spot in Sioux Falls, I
think everybody`s well aware of that, and people are talking about that.
I also want to give you a little bit of perspective on the situation. I
know that the national news is talking about the fact that this is a hot
spot in the nation. You know, that`s fine, however they want to classify
it, we`ll take it,
We`ve given our businesses an opportunity to be innovative. They`ve had the
opportunity to still deliver services to their customers. We just have a
really business-friendly environment.
(END VIDEO CLIP)
MADDOW: It is very friendly.
South Dakota borders both Nebraska and Iowa, both of whom also have
Republican governors, who have not put in place stay-at-home orders. The
Iowa Governor Kim Reynolds has spent the last couple of days talking about
what appears to be a new burgeoning outbreak at a meat processing plant in
Waterloo, Iowa. Several meat processing plants in Iowa have already closed.
The one in Waterloo, though, is open. The local mayor in Waterloo has asked
for the plant to be closed given the burgeoning number of cases there.
Workers at the plant say they were only even told to cover their faces at
work as of Tuesday of this week.
The governor is repeatedly now acknowledging what looks like an outbreak at
the plant there but the plant for now is staying open. Worryingly the
governor keeps saying at press conferences this week that she believes the
USDA is probably doing something to keep workers safe at that plant. Nobody
knows what she is talking about with that, as the USDA appears to be doing
no such thing.
But she thinks that`s happening, and so they are blundering on in Iowa,
again, no stay-at-home order in Iowa. In Nebraska, this was the front page
of the “Omaha World Herald” today, lamenting that the outbreak in Grand
Island, Nebraska, which is the state`s third largest city, Grand Island,
Nebraska, has a per capita case rate on par with hard-hit states like
Louisiana and Michigan. Michigan which now has the third highest death rate
in the country.
They`ve only got one hospital in Grand Island. They`ve got hundreds of
cases in that community. Eleven patients at that one hospital were on
ventilators already, as of yesterday. But the state health director keeps
saying that everything will be fine there. They`re reporting that they`ve
got a beat on a few other ventilators they might be able to scare up from a
few other places maybe for that one hospital.
The local health director and the mayor of Grand Island, again this is the
local health director, not the state health director who says everything is
fine, the local health director and the mayor of Grand Island, Nebraska,
have asked the governor, please, for a stay-at-home order, shelter at home
order, please, maybe even for just a couple of weeks so they can try to get
their hands around this fast-growing outbreak there.
Governor Ricketts in Nebraska has told Grand Island, no, they can`t do
that, because everything`s fine. Governor Ricketts of Nebraska said today,
quote, our plan is working.
I don`t know what the plan is exactly, but it apparently involves opening
up the giant Nebraska Crossing Mall, as of next week, they`re planning on
reopening a big outlet mall next week, while they don`t deal with this huge
outbreak in the middle of the state that`s already pretty well full-up,
filled up the one hospital in that community.
The Nebraska Hospital Association is up in arms about them planning to
reopen this gigantic mall, saying doing that would quote pose a serious
threat to the health of all Nebraskans, but Governor Pete Ricketts is not
listening to the Nebraska Hospital Association. He`s got no plans to stop
the opening of that big shopping center. Open it all back up.
The real truth of what`s going on in America`s coronavirus outbreak is not
something that you are going to find by listening to whatever is said into
the podium at the White House daily briefings. The real truth of what`s
going on in America`s coronavirus epidemic isn`t just on the coasts, and in
the places that we know are the hardest hit already, like New York and New
Jersey. The real truth of what`s happening in our country, where we`ve got
30,000 Americans dead already, the real truth of it is right in the middle
of our heartland now, too.
Some of the biggest worries we`ve got right now are right in the center of
the country. And they`re also in those little-noticed, low-profile, nursing
homes and care facilities, and rest homes, that are in every city, in every
suburb, and every little town in the country, that are used to get nothing
attention. Well, it`s all of our business now, because that`s where the
most Americans need the most help.
Heads up. Eyes open. This is going to be a trying time.
(BEGIN VIDEO CLIP)
REPORTER: Four minutes ahead of schedule, Flight 9738 from China couldn`t
get to Illinois fast enough. Loaded with millions of masks and gloves for
Illinois first responders, we`re told security was heightened out of an
abundance of caution, some saying that there was concern the feds might
somehow intercept this precious cargo.
The state calling it a herculean task. The flight which began in Shanghai,
costing Illinois taxpayers $888,000, according to these state receipts, saw
its final leg take off from Anchorage, Alaska, a second flight with similar
cargo, scheduled for next week, dubbed by some as secret flights, to keep
Washington from muddying the pricey delivery.
(END VIDEO CLIP)
MADDOW: At 3:21 p.m. local time, a chartered FedEx flight landed at O`Hare
International Airport in Chicago yesterday, carrying two dozen pallets of
masks and gloves, PPE, bought by the state of Illinois, brought to
Illinois, basically in stealth mode, so the federal government couldn`t
swoop in and try to seize the supplies.
The reason they`re worried about is that is because the federal government
has been doing that with shipments to other states. Illinois managed to
land that plane full of supplies less than an hour after announcing the
state`s highest single day death toll so far.
Today, Illinois reported the highest single day rise in new confirmed
cases. And Governor J.B. Pritzker announced what Illinois parents and
families have honestly been expecting to hear about the rest of their lost
(BEGIN VIDEO CLIP)
GOV. J.B. PRITZKER (D), ILLINOIS: I`ve said time and time again, my
decisions are hard ones but they will follow the science. And the science
says our students can`t go back to their normal routine. Therefore, I am
suspending in-person learning in schools for the remainder of the 2019-2020
(END VIDEO CLIP)
MADDOW: That announcement today affects two million school kids across
And Illinois, they`ve got a big epidemic. They`ve got hospitals struggling
with surging patient loads. They got very worrying outbreaks in nursing
homes and other worrying outbreaks behind bars.
Now, like other Midwestern states, Illinois has multiple cases in an
important meat packaging plant.
Well (ph), Illinois state officials say the peak there is yet to come.
Joining us now for the interview is a man who has a lot to do at the
moment, J.B. Pritzker is governor of the great state of Illinois.
Sir, I know that you are incredibly busy right now. Thank you for making
time to talk with us.
PRITZKER: Thanks for having me on, Rachel.
MADDOW: Let me ask you how concerned you are about what you know is coming,
in terms of apex patient loads and what you`re expecting in terms of case
numbers, and the resources that your state has to handle them. You`ve
obviously had to go to pretty extreme lengths to try to make sure that
those pallets full of equipment landed safely and actually got to the right
place in Illinois.
What are you most worried about in terms of scaling up to meet the
PRITZKER: Well, I`d remind you that we put our stay-at-home order in place,
we`re actually second in the nation, to do so, and so we were in a very
good position from the start in terms of bending the curve, and we`ve seen
a bending of the curve. So, originally, you know, we had estimates of
thousands and thousands of deaths that would come to Illinois, if we didn`t
put the stay-at-home order in place.
And we believe that based upon hospitalization numbers, based upon even the
new cases, even with the high of new cases today, that we`re reaching an
apex. It`s going to be a couple of weeks. But we have been preparing for
some time now.
So, in addition to expanding hospital beds, at existing hospitals, I also
contracted to build out McCormick Place, our convention center in Chicago,
so that we would have plenty of space – 3,000 beds, in fact – for any
overflow that might occur at our hospitals.
MADDOW: You`ve been pretty outspoken about your frustrations with the
federal response and with what feels like the sort of random approach from
the federal government toward individual states, in terms of what the
federal government is willing to help with. Is that relationship getting
any more rational over time? Are you seeing improvement at all from the
federal government in terms of what they`re offering the states and what
they`re willing to help with?
PRITZKER: Well, we`ve gotten a lot of terrific help from the Army Corps of
Engineers and the Army. And FEMA and HHS on the ground, they`ve really been
very good to us.
But the irrationality has come out of the White House, it`s when they make
promises from the White House directly to me and then don`t deliver.
Originally, they promised tens of thousands of tests. We never got those.
Then, they promised hundreds of thousands of PPE. We never got what we
In fact, I got – I asked for 300,000 N95 masks directly to the president,
and his staff, and they said, we`ll deliver that – in fact, they said, in
Trump time. And then a few days later, 300,000 surgical masks arrived. As
you know, those are very different things.
So, we`ve been very disappointed over time about the promises and the
failure to deliver on those promises by the White House.
Having said that, you should see what the Army Corps of Engineers has done
at McCormick place, and three other hospitals across the state, that we`ve
been building out, to make sure that we have surge capacity. They really
are heroes. They work together with our union laborers across the state.
And I`m just so pleased and proud.
And I am hopeful, very hopeful that we`ll be able to manage the surge.
MADDOW: Governor, let me ask you about nursing homes in your state. We are
watching the federal government essentially abdicate any responsibility for
overseeing or helping nursing homes, but we are starting to see states
innovate. Just in the past week, we`ve seen the states of Michigan and Ohio
put in place executive orders from their governors, among other things,
requiring nursing homes to make public account of their cases, and/or their
death counts. In some cases, other states are going further in terms of
guaranteeing that all residents and staff at every nursing home can get
tested at state expense.
What are you doing in Illinois? What are you doing specifically on the
issue of Illinois nursing homes publishing information about the case load
that they`re dealing with?
PRITZKER: Well, let me start by saying that we`ve been on top of our
nursing homes from very early on. In fact, before our stay-at-home order
was in place, I was on the phone with Governor Inslee in Washington, I was
on the phone with Governor Cuomo in New York, both of which have had
terrible times with their nursing homes, to learn what went wrong and what
should we be doing to get it right.
And so, from early on, we created a strike team, each nursing home where
something has flared up, we`ve thrown that strike team on top of it, made
sure that they have the proper PPE, that they know how to use the PPE, that
they separate out the COVID-positive patients from those who are negative,
and make sure generally that we`ve clamped down on, with a quarantine.
Now, we also closed down to visitors, very early on, and we`ve been taking
temperatures, and generally checking the medical condition of all of the
staff at those nursing homes, again from the middle of March. So, those are
the things that we did back then.
Now, what we`re making sure we do, because I`m a big believer in
transparency, I don`t need an executive order to put this information up.
In fact, over the weekend, we`re going to put every single nursing home and
every single case, whether it`s staff or a nursing home resident, online,
everybody will be able to take a look at it. But we`ve already known that
data, and we`ve been looking at it internally to make sure that we take
care of those staff and those patients.
MADDOW: You`re going to put that, as of this weekend, you`re going to start
making that data public?
PRITZKER: That`s correct, every nursing home in the state of Illinois. And
again, we know who they are, we know who the private owners are, and we`ve
made sure that we have all of the right information, because we`ve been
actually collecting that for some time, and looking at it ourselves. But
now, we want to make sure that the public can see it, too.
MADDOW: I`m glad to hear it, sir.
Governor J.B. Pritzker of the great state of Illinois – sir, you`ve got a
lot on your plate with this. Stay in touch with us. Let us know when – if
there`s things going on in Illinois that the country needs to know, if you
want to talk about it here, we`ll have you back any time, sir. Thank you.
PRITZER: Thanks, Rachel.
MADDOW: All right. Much more ahead here. Stay with us.
(BEGIN VIDEO CLIP)
DR. SAMPSON DAVIS, EMERGENCY MEDICINE PHYSICIAN: Hey, Dr. Sampson Davis,
emergency medicine physician. Our volume I thought was going down but
realized we were on divert which means that we were filled to capacity at
the hospital and not accepting any patients at this time.
But I went off of divert today, and the volume was spiked again. We had
about 20 patients today, all very, very, very, very sick, multiple code
blues called. Lost one patient here in the emergency department today that
passed away, and most of the people that we`re seeing now again, we`re
seeing an older population of people, some nursing home patients now as
well. So if you have family members or friends in the nursing home, you
want to check on them as well to make sure they`re OK and the message to
young people is to make sure that you keep the physical social distancing
It`s very important, because you can be carriers of this virus. And do you
not want to spread it. It is so imperative at this time right now, that we
stay the course, and do not gather, in order to prevent, prevent re-
expansion of this virus.
Again, people are dying. This is real. This is happening. And we will get
there, we will guest past this moment, we just have to stay the course.
DR. STEVEN MCDONALD, ER DOCTOR, COLUMBIA UNIVERSITY IRVING MEDICAL CENTER,
NEW YORK CITY: I do have an update which is that today was meaningfully
different than shifts in the last couple of weeks. I did not pronounce a
single patient dead today, as opposed to the last few weeks, where it`s
been multiple people per shift. I still have many patients today come in
very ill and while not through death`s door, definitely knocking on it, so
we`re still having those conversations with patients, and with families,
about end of life wishes, round the clock.
So while no one died today, this is still very much a threat, and still
very much with us, and part of our society, but positive news. So –
(END VIDEO CLIP)
MADDOW: One emergency medicine physician in New Jersey, saying he thought
the volume was going down, but then he realized he was on divert status, so
their patients were going to other hospital, once they took themselves off
divert status, the volume came right back up.
And the New York physicians saying while things are still bad, there are
New York continues to lap all other states in terms of the toll of this
virus. But there have been signs of improvement. New infection, new
hospitalization, ICU bed usage, all down. That`s good.
But still, the death toll is coming out of New York state every day, huge,
more than 600 deaths in the last 24 hours alone, and that has been true
every day this week. Last week, we heard from an emergency room physician,
one of the hardest hit hospitals in New York, Dr. Ernest Patti, at St.
Barnabas Hospital in the Bronx.
Here he was a week ago tonight.
(BEGIN VIDEO CLIP)
DR. ERNEST PATTI, EMERGENCY ROOM PHYSICIAN, ST. BARNABAS HOSPITAL: Well,
the battle continues, the end of another shift. We still have a large
number of people intubated down here. I believe there are 13 intubated, and
about five or six on CPAP.
(END VIDEO CLIP)
MADDOW: As you heard him there, Dr. Patti sort of fighting to be heard over
the background noise in the ICU, in the E.R., not your garden variety
hospital background noise, that`s the sound of multiple patients being
mechanically kept alive. That`s the sound of more than a dozen ventilators
Well, today, we heard from Dr. Patti again, with an update on the situation
for him at St. Barnabas.
(BEGIN VIDEO CLIP)
PATTI: Today is Friday, April 17th, the first thing you notice is the noise
level is much less than last Friday, significantly decreased. I have to say
the hospital is still full and still running at max capacity, but the
emergency department is definitely a little less congested.
Let`s hope it stays this way. I`ll report at the end of the shift. Stay
safe. Stay healthy. Stay strong.
(END VIDEO CLIP)
MADDOW: Dr. Patti recorded that today, just before he started his shift, as
you heard there, he promised to update us when his shift was over. His
shift has just ended and he`s going to join us live next.
MADDOW: Joining us now because he said yes to coming back and I`ve been
happy about it all day is Dr. Ernest Patti. He`s a senior emergency
medicine physician at St. Barnabas Hospital in the Bronx.
Dr. Patti, I appreciate you coming back a week after we last spoke. Thank
you so much.
PATTI: My pleasure, Rachel. Thank you for having me back on. I appreciate
MADDOW: We`ve been watching some of the metrics kind of turn in the right
direction in New York, writ large. But you said today at the start of your
shirt that St. Barnabas is still full, still at capacity. Are things
different this week compared to last week?
PATTI: Well, I definitely felt that way during the week, Rachel. When I
came in for my shifts in the middle of the week, we happened to be on
divert status as well for a bit, and we seem to be decompressing the
You spoke to one of my colleagues yesterday, Dr. Chris Grantham (ph) or
your MSNBC did, forgive me, and he had mentioned that the ICU is still
running at max capacity. It is. But I`ve noticed today that the volume
coming in has slightly decreased. I didn`t pronounce anybody today, which
was wonderful, and I didn`t have to put – we didn`t have to put very many
people on ventilators today.
It was actually a day where we felt maybe we were plateauing out a bit, and
we`re very optimistic. We still have – are getting sick patients in
because I had a number of sick folks but not to the extent that I reported
to you last Friday.
MADDOW: I`m so glad to hear you say it, although, I recognize the situation
is still incredibly taxing.
Is anything improving in terms of patient prospects? I mean, by the time
they get to you in the E.R., I know people are in trouble. They don`t end
up there by accident.
But with this incredible volume of patients that you and your colleagues
have seen, do you feel like you`ve learned anything in terms of how to
maximize patient outcomes, how to optimize what`s going to happen in terms
of outcomes to these patients overtime?
PATTI: Well, we have learned a number of things. We learned, you know,
there was a lot of information being sent back and forth from institution
to institution, trying to, you know, give colleagues a hence or helpful way
to approach the patients. A lot of it revolved around PPE and creative ways
to use it and, you know, and reuse it.
Others, though, death with the way in which we actually treated these
folks, as far as how much oxygen to put them on, what goals to set our
oxygen levels at and those things have been helpful. We`ve learned about
giving intravenous fluids, how much to give, how little to give, and how to
approach the process as folks come in. It`s a steep learning curve for us.
We learned a tremendous amount.
What we do know is, though, that the folks who come in that have lots of
comorbidities, meaning other illnesses like COPD, asthma, diabetes,
cardiopulmonary issues, obesity, those folks tend to be more challenging
because they present other problems in addition to having the COVID-19
So, yes, we`re learning a lot. Every day I`m learning something. I`m a
lifelong student, Rachel.
MADDOW: Well, your position on the learning curve is going to be a position
of incredible power and is going to be an incredible asset to medicine. I
feel like you and your colleagues seeing the number of patients that you`ve
seen, seeing the volume that you`ve seen, when other places in the country,
I was just talking with the governor of Illinois a moment ago, when other
cities have patient apexes, I feel like you and your colleagues are going
to have so much to offer in terms of best practices.
Does the system of medicine and emergency medicine work in such a way that
you`ll be able to share this with your colleagues around the country?
PATTI: Definitely. We are – all of us, I know many of my colleagues that I
work with, remember, I told you it`s a team sport, emergency medicine, and
the team doesn`t just necessarily live within the four walls of your
hospital. The teams lie in the greater good for the United States.
I mean, we all are in communication with our different medical societies
and groups and circle of friends, and we definitely share the information.
It`s been a really, really amazing experience.
You know, I do have to tell you, though, we did get a bit of bad news and
when I was talking to some of my senior members of the hospital, as well,
we actually did lose so far four staff members at our hospital, in addition
to Dr. Verrier, who we mentioned last week.
So, it`s been – it`s been a battle for us where we`ve done a lot of, you
know, leaning on a lot on each other, leaning on each other because many of
us knew all of these staff members quite well. Like I said, we`re a big
family at St. Barnabas, or as I affectionately refer to it as the Barn, you
know? It`s been a challenge.
MADDOW: Dr. Ernest Patti, senior emergency medicine physician at St.
Barnabas and the Bronx, I am sorry for your loss and thankful for your
sacrifice. Thank you for your time tonight, sir.
PATTI: It`s my pleasure. Thanks for having me.
And everyone should please remember to practice social distancing, check in
on all your relatives and loved ones and really, really practice good
hygiene, it`s super important. And one day, I`ll tell you a funny story
growing up with my kids. I noticed hygiene was decreasing years ago and now
I guess we`re paying the price.
MADDOW: I will have you – I will have you back to tell that story. Thank
you, Dr. Patti. Appreciate it.
All right. We`ll be right back. Stay with us.
PATTI: Thank you.
MADDOW: That`s going to do it for us tonight.
Now, it`s time for “THE LAST WORD” with Ali Velshi filling in for Lawrence
Good evening, Ali.
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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