COVID-19 crisis TRANSCRIPT: 6/26/20, The Rachel Maddow Show

Guests:
Will Humble, Cedric Dark
Transcript:

 

CHRIS HAYES, MSNBC HOST: 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. Happy

Friday. I appreciate it.

 

Thanks to you at home for joining us this hour as well. Happy Friday to you

at home.

 

Once upon a time, the last time we had a Republican president before this

one, there was a huge lobbying scandal that ripped its way through

Republicans in Congress, through the George W. Bush White House, through

the Republican revolving door part of the D.C. lobbying industry at that

time. It even ripped through the supposed Christian conservative movement.

If you lived through it, it was unforgettable. It became quickly known as

the Jack Abramoff scandal.

 

This is Jack Abramoff. He had this racket going in lobbying where the money

started from him ripping off American Indian tribes to the tune of tens of

millions of dollars. And in communications with his fellow lobbyists who

were working on this scheme with him, lots of the people he was working

with on this were former Republican congressional staffers. It would emerge

in court documents over the course of this scandal that they would

frequently deride and insult the Native Americans they were ripping off in

their scheme by calling them morons and troglodytes, and they would sort of

laugh and screech among themselves about how much they loved ripping off

these tribes and taking all their money.

 

One of the signature moves in this Abramoff scheme was that he was secretly

paying so-called Christian conservative leaders, guy likes Ralph Reed from

the Christian coalition and Lou Sheldon from the Traditional Values

Coalition, Abramoff and these guys would pay these Christian groups to gin

up anti-gambling activism, all these supposedly Christian pious outrage

about gambling.

 

And then Abramoff, having paid for that, he would swoop in and

magnanimously offer his services to Indian tribes that had casino interests

because he said he could protect their interests, their casino interests

against these anti-gambling forces, these anti-gambling forces that

Abramoff himself had ginned up and paid for. Super classy. Super classy.

 

It was also something that infected a huge swath of Republican Washington,

D.C. in the second term of the George W. Bush administration because what

Abramoff and his guys did with all that money they ripped off from the

Indian tribes is they used it to bribe members of Congress and members of

the George W. Bush administration. Twenty different officials and political

figures ended up pleading guilty or being convicted in the Abramoff

scandal, including staffers to Tom DeLay, who was the top Republican in the

House of Representatives at that time. Tom DeLay himself appears to have

only narrowly avoided prison himself in this scandal, or at least I should

say indictment.

 

If you`re thinking about Tom DeLay`s mug shot right now, that`s actually

from a whole other corruption scandal from which he even more narrowly

avoided prison. The Abramoff scandal also put one Republican member of

Congress in jail, a congressman named Bob Ney.

 

The Abramoff scandal produced prison sentences for a senior official from

the office of management and budget in the George W. Bush White House. And

for the number two official in the Interior Department under George W.

Bush. It was just a mess.

 

But now, now in 2020, because you`ve been so good, because the news has

been so dark and so terrible for so long, so relentless, the news gods have

decided to give you a little Friday night amuse bouche tonight with the

unexpected return of one of the most wretched Republican political scandals

of the past generation. Because at the end of the George W. Bush

administration when George W. Bush`s approval ratings were so bad, they

were at like Trump levels, after all of those convictions in the Abramoff

scandal and all of the guilty pleas in the Abramoff scandal, including from

senior officials in George W. Bush`s administration, after Abramoff himself

started serving his four years in prison, after all this had unfolded in

all of its wretched glory, the Democrats in Congress passed and President

George W. Bush reluctantly signed a reform law, a new ethics law for

lobbying.

 

It was the Abramoff Scandal Reform Act. It required all sorts of new

disclosures and transparency around the profession of federal lobbying. So

that was passed in 2007.

 

But now, now, right now in the middle of everything else that`s going on in

our country, federal prosecutors for the first time have finally brought

charges against someone for allegedly violating that specific law that was

passed because of the jack Abramoff scandal. They have finally for the

first time charged someone with breaking the Abramoff law.

 

Do you know who they charged? They charged Jack Abramoff himself all these

years later. Same guy. He did his prison time for the original Jake

Abramoff scandal.

 

He`s been out of prison for a few years now, and apparently according to

federal prosecutors, what he`s been doing to keep himself busy since

getting out of prison for the original Jack Abramoff scandal, is that he`s

been doing a little surreptitious lobbying for a weird like cryptocurrency

thing but also for a marijuana company in California.

 

But Jake Abramoff according to prosecutors did this lobbying in secret. He

didn`t want to register as a lobbyist as the law now requires because of

him. He didn`t want to register as a lobbyist, so he arranged for somebody

else to do this lobbying on his behalf so as to keep his own role in it

secret.

 

Lucky for us, the person – at least lucky for us in knowing this story

now, the person Jack Abramoff picked to do the secret lobbying for him

turned out to be an undercover FBI agent. And so, now, he`s been charged.

 

That Jake Abramoff, that same guy has again been hit with federal felony

corruption charges except this time he`s been charged specifically with

violating the law they wrote about him during the last Republican

presidency before this one. Prosecutors told the court this week in

conjunction with his charges, quote: Abramoff was aware of the obligation

to register as a lobbyist in part because Congress amended the lobbying

disclosure act in 2007 as a reaction to Abramoff`s own past conduct as a

lobbyist.

 

This is – this is – this is because you`ve been so good, because you have

been such a good citizen and news consumer recently in these dark times.

The news gods have prepared this for you on this Friday night after this

long, grueling, terrible week of news, right? Whatever else is going on in

the world, whatever else makes no sense in our country right now, at least

there is some order in this little corner of American history that we`re

all banging around in right now together. Today at least we can say, the

anti-corruption law passed because of corrupt Republican super lobbyist

Jake Abramoff has just been used for the first time against Jack Abramoff

in a whole new scandal that he got himself into after getting out of prison

for his other scandal. Ta-da!

 

I mean, news doesn`t happen like – this is like they`re going to name the

IRS building after Al Capone. This is like if another Republican

presidential campaign after Watergate, after Nixon, got caught trafficking

in materials stolen from the DNC during a presidential campaign.

 

Oh, wait. Well, actually on that front, interesting news tonight from the

federal district court in Washington, D.C. where Trump campaign adviser

Roger Stone, who was convicted on seven federal felony counts related on

his efforts to serve as a conduit between the Trump campaign and the entity

that was publishing material stolen from the DNC during the last election -

- Roger Stone had been due to report to prison early next week. He`s due in

prison on Tuesday.

 

Now, as you know, Attorney General William Barr has inserted himself into

the Stone case already to insist that the sentencing recommendation for

Stone be lowered. The federal prosecutor quit the case in protest and then

became a whistle-blower about that this week when he testified to Congress

about Barr interfering in the case to protect the president`s friend. But

facing the prospect of reporting to prison on Tuesday of next week, Roger

Stone`s defense team this week asked for a delay. So instead of reporting

to prison next week, he could put it off and not report to prison until

September.

 

What is interesting in this case given what`s happened thus far, is that

the Justice Department said they were totally fine with that. They said

they would not contest that request for an extension from Roger Stone. They

said it was fine with us if he didn`t turn up to prison until September.

And that might have been the end of it, both the prosecution and the

defense both saying they`re okay with Stone not turning up to prison until

September.

 

But interestingly, the judge who oversaw Roger Stone`s case in which this

jury convicted him on all seven counts, right? The judge who has been

overseeing Stone`s case, the judge who sentenced him demanded that the

Justice Department explain why it was doing that, why they were saying they

were okay with Stone delaying his report to prison. And the Justice

Department had until midnight last night to submit their explanation of

that. They waited until midnight last night before they submitted their

filings.

 

But now the judge has responded. Tonight just before we got on the air,

Judge Amy Berman Jackson rejected the delay. He gets a little bit of a

delay but not what he asked for. Roger Stone, per the judge in his case,

will get 14 days extra, not three months like Bill Barr`s Justice

Department was prepared to give him. And that means we now know Roger Stone

will have to report to prison on July 14th.

 

Which means either Roger Stone is going to report to prison on July 14th,

or President Trump is going to cap off what has just been a stellar summer

for him so far by issuing a pardon to Roger Stone, a pardon to his campaign

adviser who was just convicted on all counts on seven felony charges by a

unanimous jury, right? Convicted on seven felony charges related to his

efforts to facilitate the hack and dump operation that the Russian

government carried out in 2016 to help get Donald Trump elected. Going to

pardon him? Tick tock.

 

Two weeks till Roger Stone has to be in prison. And this news from Judge

Berman Jackson in D.C. arrives tonight on the same night, actually within

an hour of “The New York Times” posting this bombshell on their front page.

Did you see this tonight? Russia secretly offered Afghan militants bounties

to kill U.S. troops. This is – this is sort of stunning.

 

Here`s the lead. American intelligence officials have concluded that a

Russian military intelligence unit secretly offered bounties to Taliban-

linked militants for killing coalition forces in Afghanistan, including

targeting American troops amid the peace talks to end the long-running war

there according to officials briefed on the matter.

 

The U.S. concluded months ago that the Russian unit had covertly offered

rewards for successful attacks last year. Islamist militants or armed

criminal elements closely associated with them are believed to have

collected some bounty money, the officials said. Twenty Americans were

killed in combat in Afghanistan in 2019 last year, but it was not clear

which killings were under suspicion.

 

Intelligence finding was briefed to President Trump and the White House`s

national security counsel discussed the problem at an interagency meeting

in late March. Officials developed a menu of potential options starting

with making a diplomatic complaint to Moscow and a demand that it stop

along with an escalating series of sanctions and other possible responses.

But despite having created that menu of potential options for the

president, quote, the White House has yet to authorize any step.

 

The officials did not explain the White House delay in deciding how to

respond to the intelligence about Russia. Yeah, raise your hand if you

think you might be able to explain that delay from the White House.

 

I mean, this is – this is jaw-dropping. This is like kind of sickening

news, right? Even for those of us whose jaws are already sprained from

having dropped so far and so frequently this summer. I mean, if this

“Times” report is correct, this means that U.S. intelligence has concluded

that Vladimir Putin is offering bounties for the scalps of American

soldiers in Afghanistan. Not only offering, offering money to people who

kill Americans, but some of the bounties that Putin has offered have been

collected, meaning the Russians at least believe that their offering cash

to kill Americans has actually worked to get some Americans killed.

 

The Russians at least believe if these bounties have been paid out that the

people to whom they have offered this money have successfully gone out and

killed American soldiers because of it and the Russians have therefore paid

for that service.

 

And President Trump was told about this in March, and he has done nothing,

nothing about it. He was given – what did they describe it as a menu. A

menu of possible responses. And so far, he has chosen off the menu that

he`ll have none of it, thank you. He`ll do nothing.

 

I mean, there are – there are 20 American families grieving today,

grieving right now because their American soldier, their dad or mom or son

or daughter or brother or sister was killed in combat in Afghanistan in the

past year. Imagine you`re a member of one of those families, and you have

just found out that Russia may have paid for the death of your loved one,

cash money paid as a reward for killing an American soldier. Imagine that

American soldier was a member of your family.

 

And now you know from this reporting in “The New York Times,” which has

since been confirmed by “The Wall Street Journal,” that not only does the

president know that Russia was paying for American soldiers` deaths, paying

rewards for Americans dead, the president knows it. He`s been told. And

what he`s done with that information since he was briefed on it in March is

– well, what has he done to Russia since then? Well, there was that

unexpected and apparently friendly conversation he had with Vladimir Putin

on June 1st. We learned about that from the Kremlin.

 

According to the Kremlin, what they discussed on that call was how much

Russia would please like to be allowed back into the G7. President Trump

then got off that call with Vladimir Putin and immediately started publicly

calling for Russia to be allowed back into the g7. Remember why they were

kicked out in the first place? They were kicked out for invading a

neighboring country and taking part of it for themselves.

 

The rest of the countries in the G8 decided a country like that, Russia,

could not be part of this elite club of countries that worked together on

big economic issues, not if Russia was going to behave like that. That`s

why they`re kicked out of the G8. That`s why it became the G7.

 

And, of course, Russia wants back into the G8. Of course they do. There`s a

reason why they were kicked out, though, right? Think about this timeline.

President Trump gets briefed in March that Russia is paying bounty money

for dead American soldiers right now, and his response to that is nothing

except a friendly call and please, hey, everybody, let`s now do this nice

thing for Putin and let him back into this elite club of major countries.

 

Oh, what else did he do right after that? He announced unilaterally that he

wants to pull thousands of U.S. troops out of Germany, which has freaked

out even congressional Republicans because of how much it is widely viewed

to be a unilateral strategic gift to Russia, one that would undermine NATO,

which is Russia`s main geostrategic imperative, and would directly benefit

Putin in exchange for nothing. That`s how President Trump is standing up

for Americans being killed for rubles paid by Putin`s government.

 

You know, there`s been this long string of resignations from the Trump

administration over the past few weeks, which haven`t received much notice,

right? The head of the criminal division of the Justice Department

resigned. The head of the civil division of the Justice Department

resigned. The solicitor general resigned.

 

The top financial person at the Pentagon resigned. The top Pentagon person

on international security issues resigned. The top two technology people at

the Pentagon also resigned.

 

This whole string of resignations has kind of gone unremarked upon. But we

also just learned that the person who runs the Russia desk at the National

Security Council, senior director for Russia at the National Security

Council also just resigned as well. I mean that`s been a pretty hot seat in

this particular administration. Trump has burned through four different

people in that job already in less than four years. But the fourth one just

left suddenly and with no explanation.

 

But now we know that that resignation was not long after the National

Security Council and Trump were told about Putin paying cash bounties for

dead U.S. soldiers, and Trump did nothing about it in response for months

and counting.

 

But, you know, he has been busy, continually and creatively botching the

response to a completely out of control viral pandemic that`s closing in on

125,000 American deaths in 16 weeks here at home. That is now, you know,

every day breaking records for the number of new infections reported each

day. That`s got to keep you busy.

 

Today, there were 43,122 reported new infections in the United States. We

used to freak about the fact that we had 20,000 new infections in a day.

Then it went 25,000, 30,000, 35,000, now we`re up over 40,000, up over

45,000.

 

Our new infections per day not only dwarves every other place on earth, it

shatters our own previous records for how quickly this thing can get worse.

Remember, that`s not cumulative cases. That`s new cases each day. That`s

how much bigger it`s getting each day.

 

When New York was at the apex of destruction, there were 10,000 new cases

in New York a day. That was the very peak. There were nearly 9,000 new

cases today in Florida. That was the new record for them today.

 

Nearly 6,000 new cases today in Texas. That was a record for them today

too. Arizona also hit a new record for infections reported today, as did

South Carolina, as did Tennessee, as did Idaho, as did Georgia, as did

Utah.

 

I mean, just for perspective on what`s going on right now in the country,

Maricopa County alone where Phoenix is in Arizona, they`re now seeing as

many as 2,000 new cases a day, which “The Washington Post” notes today,

quote, eclipses the boroughs of New York city even on their worst days from

what was previously the worst from the pandemic and remains the worst any

American can possibly imagine about how bad it can get. Maricopa County

more new cases per day than the worst of New York in the worst of it.

 

Arizona now has more per capita cases than those recorded by any country in

Europe, even more than the confirmed cases in Brazil. That`s Arizona.

 

Florida`s situation, think about this for a second – Florida is at 123,000

cases statewide, 123,000. More than 33,000 of those cases have come in the

last week. Nearly 9,000 came in the last 24 hours.

 

I mean this thing is taking off. This thing is hurtling through space now,

out of control.

 

And here`s Baghdad Bob Pence at the White House Coronavirus Task Force

briefing today, insisting that actually, if you look on the bright side,

everything seems fine to him.

 

(BEGIN VIDEO CLIP)

 

MIKE PENCE, VICE PRESIDENT OF THE UNITED STATES: We`ve all seen the

encouraging news as we open up America again. All 50 states and territories

across this country are opening up safely and responsibly.

 

(END VIDEO CLIP)

 

MADDOW: Ah. You know, here on earth one, Texas and Florida actually both

reinstated previous restrictions today. They`re not reopening safely or

otherwise. They are locking back down because they need to, because the

epidemic there is not only worse than ever, it`s worse than ever and

completely out of control.

 

Texas and Florida, very, very large American U.S. states. I mean, states

including Arizona, Arkansas, Utah, Michigan, Kansas, Idaho, North Carolina,

Delaware, New Mexico, I probably missed some, all of those states have now

stopped any reopening efforts in their tracks. But the White House says

everything`s fine. We are on track to reopen. Everybody`s just very jealous

of how great our reopening has gone.

 

That`s the White House while this thing is doing what it`s doing right now.

There`s one last thing I`m going to show you here before we move on

tonight. Just one little – maybe this is a glimmer that at least the

pressure may be starting to hit the right place, that maybe they will

finally start to pay some kind of political price for some of what`s been

done wrong. I think that little glimmer, at least for me, is this.

 

(BEGIN VIDEO CLIP, POLITICAL AD/ THE LINCOLN PROJECT)

 

AD NARRATOR: The most deceptive, lying president in history finally told

the truth. Somehow, it was more shocking than all his deceptions.

 

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: When you do testing to that

extent, you`re going to find more people. You`re going to find more cases.

So I said to my people, slow the testing down, please.

 

AD NARRATOR: Slow the testing down? Slow down our chance to save tens of

thousands of lives. Slow down our understanding of where COVID is and how

it`s spreading. Slow down the steps to reopen the economy. Every single

expert told him to test more and test faster. And now we know his response.

 

TRUMP: Slow the testing down, please.

 

AD NARRATOR: That`s why this November, more than ever the choice is clear.

It`s America or Trump.

 

(END VIDEO CLIP)

 

MADDOW: A little heavy-handed, I know. But that`s a new ad this week from

the Lincoln Project about the president`s response to this virus.

 

And, you know, it`s important to keep perspective on these things. You

know, I have spent the last 12 years on TV and lots of years on radio

before that talking about political scandals, including fatal political

scandals and big, bad corruption problems and really bad governance in our

country. We`ve never had anything like this, never, anything like this.

 

If our next big political decision as a country ends up being made on the

grounds of that ad, ends up being made about what`s been done wrong in this

epidemic, we could do worse than that. If it ends up being a referendum

with ads like that about what`s gone wrong in this epidemic and how this

has been botched and how many Americans have died because of it, we could

do worse than that as the basis for an election. That gives me hope we

might make better decisions this time around, maybe.

 

Lots more ahead tonight. Stay with us.

 

(COMMERCIAL BREAK)

 

MADDOW: I mentioned earlier this “Washington Post” report today, this

front-page story about how really, really bad things are in the great state

of Arizona. We`ve had eyes on Arizona for a couple weeks here on this show,

see this national coverage of how bad things are there. It`s more than

warranted.

 

“The Post” says, quote: Maricopa County which includes Phoenix is recording

as many as 2,000 cases a day, quote, eclipsing the New York City boroughs

even on their worst days. And that eclipsing part of the quote is actually

“The Post” quoting from the very well-regarded disease trackers at the

children`s hospital of Philadelphia. And their work on Arizona includes

this terrifying projection of the rise in cases in Maricopa County.

 

You see that dotted line shooting straight up. That`s the projection for

the next couple weeks in Maricopa County. That`s a two-week projection. The

disease trackers write, quote, it is fair to say that the state of Arizona

has lost control of the epidemic.

 

This is from “The Post” reporting. Quote: Physicians, public health

experts, advocates and local officials say the crisis was predictable in

Arizona where local ordinances requiring masks were forbidden until

Republican Governor Doug Ducey reversed course last week.

 

Quote: State leaders did not take the necessary precautions or model safe

behavior. These observers maintain even in the face of compelling evidence

and repeated pleas from authoritative voices.

 

Quote: When forbearance was most required as the state began to open,

despite continued community transmission, an abrupt and uniform approach

without transparent benchmarks or latitude for stricken areas to hold back

led large parts of the public to believe the pandemic was over. Well, yeah,

of course large parts of the public believed that in Arizona because that`s

the way the state was governed through all of this.

 

Remember how Arizona specifically opened up? Do you remember the specific

circumstances of it? Arizona had been relying on state-specific projections

about what was going on. The governor had been talking about potentially

doing some sort of reopening, potentially sort of weeks away.

 

But then he turned on a dime in early May. Arizona`s governor changed his

plans, told everybody everything was going so well, actually despite what

he had open up the state early. Why did he make that quick change and open

up everything early? Well, because that announcement – I`m not kidding,

was time to coincide with a visit to Arizona from President Trump, who on

that visit literally toured a mask manufacturing plant without wearing a

mask while the song “Live and Let Die” played over the loudspeakers.

 

That visit from the president seems to have been the occasion for Arizona

hurrying up its reopening. And now, lo and behold, less than two months

later, quote, Arizona is facing more per capita cases than recorded by any

country in Europe or even more than the confirmed cases in hard-hit Brazil.

Among states with at least 20 people hospitalized for COVID, no state has

seen its rate of hospitalizations increase more rapidly since Memorial Day.

 

This week, Arizona reported not just a record single-day increase in new

cases but also record use of inpatient beds and ventilators for suspected

and confirmed cases. Public health experts warn Arizona hospitals could be

stretched so thin, they may begin triaging patients by mid-July. Soon, the

only option might be crisis standards of care, said Will Humble, former

director of the Arizona Department of Health Services.

 

If you`re in a bed, normally, they`ll keep you for a few days. But they`re

going to send you home with oxygen.

 

Joining us now is Will Humble, former director of the Arizona Department of

Health Services, now executive director of the Arizona Public Health

Association.

 

Mr. Humble, you were here early on to talk to us about things seeming to go

off the rails in Arizona. What you said at the time early on was right, but

I have to ask you, if you knew that it was going to get this bad this fast

or if you are among those who is surprised at just how out of control

things got in Arizona?

 

WILL HUMBLE, ARIZONA PUBLIC HEALTH ASSOCIATION EXECUTIVE DIRECTOR: Let me

think about that. I knew things were going to get bad. You asked me how

soon. I thought it would probably be sometime in July, but I`m now

confident that we`ll be in crisis standards of care within the next few

days if not by the end of the weekend. I mean, it`s gotten so bad so fast,

and the reason is because the public policy that we developed and that was

used at the end of the stay-at-home order really set an honor system.

 

And an honor system isn`t adequate to direct the kind of human behavior

that we need to slow down the spread of this virus. So that`s really what

happened is this is directly related to policy decisions that have been

made. This is not bad luck. This isn`t like that. These are directly

related to policy decisions that happened in this state.

 

MADDOW: Can you explain in layman`s terms what you mean by crisis standards

of care? I know that`s a term of art in terms of public health and the way

that hospitals think about this. But for those of us who aren`t fluent in

that language, can you explain what that means?

 

HUMBLE: Well, a lot of it has to do with how you triage patients and how

you decide what patients get what kind of care. And so, there`s a protocol

we have in place in Arizona that provides guidance for doctors about how to

make those decisions when there`s inadequate resources to treat everybody

that`s in the hospital.

 

So there`s a – it`s actually a scoring system, and all states have this.

Part of it is how acute is the illness that the person has? How risky is it

that that person is going to end up in multi-organ failure? And the other

part of the equation is how old is this patient, and if they recover from

COVID, how many years or months would they likely have left anyway?

 

And so crisis standards of care, you combine those two parts of the

equation to come up with an algorithm to decide who gets care and who

doesn`t.

 

MADDOW: And in terms of not getting care, you mean people who are in the

hospital now getting discharged to make room for more people, or people

turning up sick and being told, sorry, there`s no room at the inn?

 

HUMBLE: Well, it`s all of those things. So like, for example, if you would

have gone into an emergency department under normal circumstances, they

might say, let`s send you upstairs to an inpatient bed and watch you for a

couple days so you can get better care. When you`re in crisis standards of

care, you might just be sent home from the E.D. when you normally would

have gotten a bed.

 

Likewise when you`re in a hospital bed under normal circumstances, if you

start to deteriorate, you might get an intensive care bed because you need

that kind of care. When you`re in crisis standards of care, you triage who

gets that ICU bed. So you might end up staying on a regular hospital floor

when normally you would have gotten that more intensive care.

 

So the standard of care changes when you get into surge status, and I think

it`s important for everybody to know in all the states, as your governors

and elected officials make decisions that when they start talking about

using hospital capacity as a control measure, as an end point for how

they`re going to manage this epidemic, start worrying because what you

really should be doing is putting together policies in place to change

people`s behavior, to slow the spread of the virus so that you don`t end up

like us in crisis standards of care.

 

MADDOW: Arizona has closing in on 70,000 cases now. 2,000 cases a day in

Maricopa County alone. We`ve heard so much what you`ve just described and

what we`ve heard from frontline providers about how strained the hospitals

are already in the state.

 

You used to run the department of health services for the state of Arizona.

If you were back in that job right now and you had a governor who said, I

need your guidance, you need you to tell me what this state needs to do, I

need you to set policy here, what policies would you put in place right now

for the state to try to turn this around?

 

HUMBLE: Well, there`s two – there`s two tracks. Number one is to do some

implementation of immediate policies to change what we`re expecting of

businesses, et cetera, a statewide mask-wearing requirement. That`s on the

prevention side, to try to slow things down in the future. Those things are

going to take at least two to three weeks to start working.

 

On the urgent side, it`s pulling together all your hospital stakeholders

and finding out what is it exactly that they need that the state can

provide to help them provide the best level of care that they possibly can,

given the circumstances that will be coming in the next weeks. We`re in a -

- this is a very dire situation, and at this point, there`s the prevention

side, which it`s late to do those things, but you still need to do them.

But the acute thing is that, you know, let`s try to keep as many people

alive as we can.

 

MADDOW: Will Humble, executive director of the Arizona`s Public Health

Association, the former director of Arizona`s Department of Health Services

– Will, thanks for helping us understand what`s going on in your state,

keeping us honest about this stuff, it`s been scary, but it`s just vital.

Thank you so much. Good luck over these next few days. Come back soon.

 

HUMBLE: All right. Take care.

 

MADDOW: All right. Much more to come here tonight. Stay with us.

 

(COMMERCIAL BREAK)

 

(BEGIN VIDEO CLIP)

 

JUDGE LINA HIDALGO, HARRIS COUNTY, TEXAS: Let me begin by stating a simple

but harsh truth. Today, we find ourselves careening toward a catastrophic

and unsustainable situation. Our current hospitalization rate is on pace to

overwhelm the hospital in the near future.

 

There are some who will say there`s no real cause for concern, that we can

adjust to this, that there is space in our hospital surge capacity. When

did we lose our respect for human life and the economy to the degree that

we`re saying let`s fill our ICU beds and surge capacity before we take any

meaningful action? Since when did we decide as a society that instead of

saving a life and preventing the spread of the virus, we would treat human

lives, the lives of our neighbors, as collateral damage to be dealt with?

 

I`ve directed that as of noon today, we elevate our public threat level

from significant orange level two to severe, red level one. This is the

highest possible COVID threat level in Harris County. It means there is

severe and uncontrolled level of COVID-19. The outbreaks are worsening. Our

public health capacity is strained or exceeded. Health care surge is not

only likely but is already in progress. This is a serious situation.

 

(END VIDEO CLIP)

 

MADDOW: That is the top elected official in Harris County, Texas, today.

Her name is Judge Lina Hidalgo. Harris County includes Houston, one of

America`s largest cities. Harris County is the third most populous county

in the nation, and it has one of the fastest growing outbreaks of

coronavirus not just in our country but in the whole world right now. So

that`s again the top executive from Harris County, Judge Hidalgo, moving

her county to the highest threat level that they have today, red, level

one.

 

All residents of Harris County are encouraged to stay home, to limit

nonessential travel, to cancel large gatherings and visits to nursing homes

because of what health officials say is a severe and uncontrolled spread

now of coronavirus in that community. What you see on the screen here is a

push alert that Harris County residents all got on their cell phones today.

Public safety alert: Stay home.

 

The uncontrolled spread of the virus in and around Houston is now

translating into an uncontrolled surge of sick people in Houston area

hospitals. Houston hospitals have now overtopped their normal ICU capacity.

Plans for an overwhelmed health care system have already been activated.

They`re in what they call surge capacity already, which means they`re

beyond their normal means.

 

We`re going to take a trip to those front lines next.

 

Stay with us.

 

(BEGIN VIDEO CLIP)

 

HIDALGO: Our hospitals, the largest medical center in the world, are using

100 percent of their base operational capacity right now. Every day since

June 13th, our hospital and ICU populations have been higher than our

previous highs in April. Our situation is far worse today than when we

issued the first stay-at-home order in Harris County and when the state

issued their first stay-at-home order. This is unacceptable.

 

(END VIDEO CLIP)

 

(COMMERCIAL BREAK)

 

MADDOW: Back in April, as Texas was bracing for a spike in COVID patients,

officials in Harris County, the county that`s home to Houston, unveiled a

new field hospital. They turned a football stadium into a field hospital

that could handle up to 2,000 patients.

 

They opened it up but within weeks, they shut it back down without ever

seeing any patients there, which is great news, right? Quote, area

hospitals were not overwhelmed as feared.

 

That was April.

 

Now that field hospital in Houston may be making a comeback. In fact,

cities across Texas are starting to scramble to find and build out

additional capacity now as the hospitals and ICU units have filled up now

thanks to what has turned out to be an out of control rush of COVID

infections in Texas here in late June. Houston says when it does activate

that field hospital again, they think it can be up and running within 72

hours. Staff for that site are on standby, which again is good news.

 

Ever since Texas went into phase two of reopening, hospitalizations in

Houston have gone straight up. These are the numbers.

 

This is specifically a snapshot of the ICU beds in Houston. It shows you a

breakdown between COVID and non-COVID patients in Houston`s 1,300 ICU beds.

But see that little number 5 there next to the zero percent? That`s the

literal number of how many open ICU beds Houston had as of two nights ago.

Five beds for a city with a population of 2.3 million.

 

Statistically speaking, you can go ahead and round that to 0 percent of ICU

beds still being available while new infections continue to climb through

the roof, right? And this two to three-week delay between new infection and

when some proportion of those newly infected people are going to start

turning up at the hospital door, many of them needing critical care

attention.

 

What`s it feel like to be in the middle of that?

 

Joining us now is Dr. Cedric Dark. He`s an emergency medicine physician in

Houston.

 

Dr. Dark, I know how valuable your time is right now. I really appreciate

you taking a few minutes to be here with us tonight. Thank you.

 

DR. CEDRIC DARK, EMERGENCY ROOM PHYSICIAN, HOUSTON, TX: Thank you very much

for having me on.

 

MADDOW: So I`ve just said a lot of words about Houston and about Texas and

how things are. Let me just ask if that comports with your understanding or

if you feel like from your perspective, we`re talking about any of this in

the wrong way or missing any of the important points.

 

DARK: I think you`re right on about it. I mean I was working a few days

ago, and it was pretty obvious to me that there were no hospital beds for

any patients that had COVID throughout the entire Houston area, and that`s,

you know, ranging as far south as Galveston and upwards into the Woodlands.

Nobody had any capacity to take care of a patient with coronavirus, and

it`s pretty ashamed to say that`s the state of our city. It`s very

worrisome, and one of the things I wish Judge Hidalgo would do is to

activate NRG so that we can have an escape valve for our overcrowded

emergency departments.

 

MADDOW: How does that manifest for you as a doctor, you and your colleagues

when you`ve got a patient with COVID who needs care that you don`t have

room for, and you start looking for someplace to transfer them to? Can you

tell us what that`s like and sort of what plan B is when you realize you

can`t fully find a place to send them?

 

DARK: Plan B is they stay in the emergency department ultimately. What we

tend to do if there`s a patient that needs any kind of care, whether it`s

COVID care or some other kind of higher level of care and they don`t have

space for that at their particular hospital, they have to seek a transfer,

and it requires another hospital have the capacity to be able to accept

that patient. Otherwise, you can`t transfer them.

 

So in our case, if we`re stuck in that situation, what we would have to do

is continue to manage those patients in the emergency department on our

own, and that`s not something that we as emergency physicians, you know,

necessarily want to do because we`re used to finding and diagnosing the

problem and then getting the person to where they need to be. But

unfortunately we`re put in a situation right now where we`re having to

function as either hospitalist or as an internist or an intensivist if

there`s no space upstairs in the hospitals for us to care for our patients.

This is what we saw in Europe.

 

MADDOW: Does that have an impact – does that have an impact on patients

who have other emergency room presentations? I mean, people who don`t have

COVID or might be infected but that`s not what they`re coming in for, is

that having an effect? Should people expect that would have an effect in

terms of the normal function of the E.R., and how people get care for all

kinds of things?

 

DARK: It certainly can because what happens is it can slow down the flow

through the emergency department and back up waiting rooms and therefore if

you are walking in or your loved one`s walking in with chest pain and they

need to see a doctor to make sure they`re not having a heart attack, you

know, every step along the way, if you slow down the output from the

emergency department, then it`s going to be slow on the input side, and

that might lead to delays in care, which can ultimately cause devastating

harm to patients that need it whether or not they have coronavirus or if

they have something like a heart attack or a stroke or trauma.

 

MADDOW: You mentioned New York just a moment ago. I found myself thinking

actually just over the course of this hour, talking to the former director

of the state health department in Arizona, talking to you right now,

looking at these numbers, and I found myself thinking about Governor Andrew

Cuomo in New York when New York was in the worst of it. And he`s just in

the last few days stopped doing his daily press briefings.

 

But I remember him saying in the worst of it that New York would

reciprocate, that he wanted other states to send health workers to New York

because New York was in such a crunch. And he said, and when this happens

to you, when this goes so badly in your state in the future and it will, we

will send people to you.

 

Are we at a place where states, places like Houston, places like Arizona

that are that hard hit, should start to think about tapping a sort of

medical reserve corps from workers around the country trying to tap

national resources to protect your hospitals? It`s very concerning to hear

you say that already, for the last few days, you got nowhere to send COVID

patients.

 

DARK: I mean the wonderful thing about Houston is there is like a doctor

almost everywhere around and a nurse everywhere around the city because we

are the home of the Texas Medical Center, which is the largest medical

center in the world.

 

So, for right now, I don`t think that the human resource is a problem. I

think right now it`s mostly the physical resources that we`re struggling

with and that we need a little help with.

 

MADDOW: Dr. Cedric Dark, emergency medicine physician in Houston, Texas –

again, your time right now is incredibly valuable. Thank you. Keep us

apprised going forward.

 

I`m hoping that there`s going to be change in terms of resources available

to you and your colleagues over the next few days. But we`d love to have

you back anytime soon to let us know how things are going.

 

DARK: Anytime. Just ask.

 

MADDOW: All right. Thanks.

 

We`ll be right back.

 

(COMMERCIAL BREAK)

 

MADDOW: It has been a tough week in the news this week, it`s probably going

to be a tough week in the news next week. If you get any time off this

weekend, take care of yourself, take care of yourself. Your country needs

you.

 

All right. We`ll see you again on Monday.

 

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

 

Good evening, Lawrence.

 

                                                                                               

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