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Italy tops China TRANSCRIPT: 3/19/20, All In w/ Chris Hayes

Guests: Kate Brown, Doug Jones, Margaret Hamburg, Amer Aldeen

STEVE KORNACKI, MSNBC HOST: That is going to be tonight 10:00 Eastern on  NBC and MSNBC. Thanks for being with us here tonight. Don`t go anywhere.  "ALL IN" with Chris Hayes is up next.

CHRIS HAYES, MSNBC HOST: Good evening from New York, I`m Chris Hayes. A  grim milestone today in the spread of the global coronavirus pandemic.  Italy recording over 41,000 total cases and another 427 deaths just since  yesterday. This was a scene in Bergamo, Italy where hospitals are so  overwhelmed with deaths that a convoy of military trucks would use to  transport bodies out of the city. 

The death toll in Italy is now more than 3,400 passing China for the most  recorded deaths. Obviously, that`s enormously more deaths per capita than  China. Italy`s case-fatality rate now is just over eight percent, which is  very, very high. And this is all happening in one of the richest regions in  the E.U. a region with incredibly good health care, high-quality doctors,  and higher hospital per capita than the United States. 

What we are desperately trying to avoid here is their fate. The grim  dispatch there is very possibly a look into our own future. We`ve already  seen health care workers in this country infected, hospitals starting to  run low on space and running out of supplies. We are many epidemiologist  estimate, probably 10 days to two weeks behind where Italy is. 

And there are health care workers in Washington state right now that are  making their own protective masks. The American Red Cross warns that the  Red Cross is facing a severe blood shortage due to an unprecedented number  of blood drive cancellations, even though they say it is still safe to  donate blood, but it is an example of a problem that probably requires some  federal mobilization and coordination. 

Also, as you no doubt know, our cases continue to climb as testing ramps up  though we still lag in testing capacity. Photojournalists with the Houston  Chronicle posted this video today, where she reports is a person who drove  up to be tested a drive-by site that had symptoms so severe that the person  was pulled aside and placed on a stretcher with medical workers and  personal protective equipment and rushed into an isolation area inside the  adjacent Medical Center. 

As New York State ramps up testing capacity becomes clearer and clearer how  much New York City is and has been an epicenter. The total this afternoon  was over 3,600 cases up from just over 2,000 just last night in just New  York City. Today, in a letter to the President, requesting federal  assistance, California Governor Gavin Newsom explained the severity of that  state situation. We project that roughly 56 percent of our population, 25.5  million people will be infected with the virus over an eight-week period.  25.5 million people. 

This virus did not appear in America out of nowhere. We saw the havoc it  wreaked on China and then more recently, we see the havoc it is wreaking in  Italy. And our leaders, the federal level particularly should have been  preparing, and some really did understand what was coming. NPR obtained a  secret recording of Republican Senate Intelligence chair Richard Burr, who  they say "warned a small group of well-connected constituents three weeks  ago to prepare for dire economic and societal effects of the coronavirus.


SEN. RICHARD BURR (R-NC): There`s one thing that I can tell you about this.  It is much more aggressive than in its transition than anything we have  seen in recent history. It`s probably more akin to the 1918 pandemic.


HAYES: Now, that`s somewhat of a different note that he was striking in  public where he was talking about how prepared we were. But get this, open  secrets reports that just prior to that, prior to giving that talk to those  well-connected constituents, Burr and his wife unloaded between $581,000  and $1.5 million worth of stock, including shares in several hotel  companies that have been rocked by the coronavirus pandemic. 

While Senator Burr was warning about the risks and selling a bunch of  stock, he wrote an op-ed for Fox News claiming America was better prepared  than ever to face threats like coronavirus. The sucking vacuum of  leadership at the top is more and more apparent and deadly each and every  day.

Yesterday, the President made a big announcement and a big thing about the  Defense Production Act, which he said he was going to put -- invoke, which  will be a way of mobilizing resources in say factories to produce necessary  equipment to fight the virus. Now, this comes as lots of factories are  shutting down. Automakers are all shutting down production. And everyone  ran the story yesterday about what the President announced not what he did. 

And then he tweets, "I only signed the defense production act to combat the  Chinese virus should we need to invoke it in a worst-case scenario the  future." Oh, only in a worst-case scenario in the future, not this pandemic  with a soon to be catastrophic shortage of needed medical equipment. 

And this is a pattern. So far, nearly everything the President has promised  has been nothing more than an attempt to get a good headline that then  turns out to be far, far less than it appeared, sometimes just flat out  wrong.

Today, the same President Trump blamed the nation`s governors for not doing  enough to get supplies, saying the federal government can`t be shipping  clerks.


UNIDENTIFIED MALE: You enabled, I guess is probably the best way to put,  the Defense Production Act yesterday but you didn`t pull the trigger on it.

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: No, because we hope we`re not  going to need it.

UNIDENTIFIED MALE: You`re getting a lot of calls on Capitol Hill for the  Democratic leadership to pull the trigger on it. Why -- what`s the  rationale for not doing it?

TRUMP: First of all, the governors are supposed to be doing a lot of this  work, and they are doing a lot of this work. The federal governments that  are supposed to be out there buying vast amounts of items and then  shipping. You know, we`re not a shipping clerk.


HAYES: Joining me now, one of those governors President Trump is addressing  today, Governor Kate Brown of Oregon. First, I guess your response to the  idea of the federal government should not be a shipping clerk and that  these sort of production and supply issues essentially fall on you and your  -- other governors, colleagues` shoulders?`

GOV. KATE BROWN (D-OR): I wish it weren`t true, but it absolutely is.  Governors across the United States are on the front lines of this horrible  disease. We are working hard to make sure that our communities are educated  about social distancing. We`re working hard to get the equipment we need,  whether it`s personal protective equipment, or ventilators. And frankly,  we`re working closely with our hospitals and medical providers to expand  capacity.

HAYES: How much is personal protective equipment an issue in your state?  How much is it being rationed? And how much help Are you getting from the  federal government?

BROWN: We`ve received about 25 percent of what we`ve requested. We made an  additional request today for over one million N-95 masks. We need this  equipment. We need it to protect our healthcare workers. We`re doing  everything we can to collect every piece of medical equipment we can. 

I issued an order directing hospitals, dentists, and veterinarians to stop  all non-essential surgery and save this critical equipment. 

HAYES: And that is -- I saw Governor Jay Inslee, your neighbor issued  something similar. The idea there is to conserve. It`s not like space,  right? If you`re talking about a veterinary procedure, that`s not a space  that would go to a coronavirus software, right. You`re just trying to save  as much of those masks and personal protective equipment as you can.

BROWN: Absolutely. But we are honestly taking it from veterinarians and  we`re taking it from dentists as well. We have the ability to learn from  our neighbors to the north, in the state of Washington, where they`re about  two weeks ahead of us in terms of the crisis. So we`re taking lessons  learned and implementing them as quickly as possible. 

We`re working hard to take aggressive social distancing measures, in our  communities around the state. We`re working to collect, conserve, and I  would say, create personal protective equipment. If we can`t buy it on the  market, we`re going to have to figure out a way to produce it. And of  course, we`re working to expand our hospital capacities because we are  going to need it.

HAYES: The governor of California today wrote that letter to the president  partly seeking an American ship to come -- a hospital ship to come dock off  California to help with their capacity. He said their state`s modeling has  the 25.5 million people being infected in the next eight weeks. Do you have  internal modeling that you`re looking at since testing is lagging so far  behind to get a sense of where you are?

BROWN: Yes. And that`s been a huge issue. We know that in countries across  the world, that countries like South Korea that have implemented expedient  testing capacity. We know they`ve been able to slow the transmission, and  we call it flatten the curve of the numbers of cases of coronavirus. So  we`re also working to expand testing capacity here. 

The federal government has committed to providing more capacity. We`re  working on the ground with private providers to make that happen as quickly  as possible.

HAYES: But in terms -- 

BROWN: The key about testing? 

HAYES: Yes, go ahead.

BROWN: What`s key about the testing is that if Americans -- if Oregonians  know and can get the tests, they`re much more likely to comply with social  distancing measures. But we need everyone to know, you have to take these  social distancing measures to protect yourselves. 

HAYES: How widespread are those measures and what are they in your state  right now since you are, as you said, two weeks behind Washington which has  been very hard hit?

BROWN: So we`ve taken a number of measures including - we`ve closed down  schools for six weeks. We`ve asked our -- we`ve ordered our bars and  restaurants to only do take out. The reason why I limited to take out is  that we know in rural Oregon, our vulnerable citizens, our elderly, our  seniors, and those with medical conditions often rely on restaurants for  their basic sustenance. 

We`ve also encouraged you know non-essential businesses to do the takeout  version of restaurants. What can they do to provide customers with  services? Any Bloom`s books, for instance, is having a drive-up option for  folks who need books for their kids or themselves.

HAYES: How concerned are you right now about how prepared you are from a  medical standpoint in terms of equipment, frontline healthcare workers, and  capacity in your ICUs?

BROWN: Look, all the governors across the United States are in the same  situation. There is essentially no playbook. We are making decisions as  fast as we can with the best information that we have at the time. But as  you know, things are changing extremely quickly. I`ve called up my joint  task force to have all of our hospitals in the region working together to  figure out what we can do to expand hospital capacity. 

Our National Guard is as we speak putting up a tent hospital in Salem. So,  we are using the models. We`re looking at the numbers, but the most  important thing is for Oregonians is for Americans to use these social  distancing measures, because it slows the transmission, and it will flatten  the curve.

HAYES: All right, Governor Kate Brown, thank you so much for your time. For  more on where we are in this crisis, how to deal with it, I want to bring  in Democratic Senator Doug Jones of Alabama. And Senator, let me start with  your home state. 

Obviously, we have seen large outbreaks in the -- concentrated in different  large metro areas. There are I think, as of now 68 confirmed cases in  Alabama. Are you confident that your state has the capacity preparation and  sort of awareness among citizens to be able to combat this should there be  a severe outbreak?

SEN. DOUG JONES (D-AL): Yes, and no. I think the state is doing a wonderful  job of trying to use the resources they got just like Governor Brown was  talking. We need more resources too. We need more tests. We need more  swabs. We need more PPE. We need all of the same things that other states  do. 

Our governor took a bold step today, I think it was the right step, to try  to shut down the state of Alabama essentially, closed the bars, close the  restaurants, that social distancing is what is so important. As we look  forward, you know, we`ve got 68 or so cases now and we know that`s going to  go up, but if we can blunt that curve in Alabama by taking those bold steps  now, it`ll be a big help.

HAYES: Let me ask you this. We`ve seen wide disparate reactions among  different Americans to the how seriously to take this. Everyone saw the  footage of spring break and Mardi Gras on the beach. And you know, everyone  has in their lives, people particularly were 70 and older, they`ve tried to  convince this as serious. Do you think the folks in your state recognize  what this is?

JONES: Yes and no. There is a lot of people that do. Obviously, as you go  back, and I`m obviously in D.C., I`ve been home since Monday. But from what  I can tell, people are doing that. They started doing that. But at the same  time, our beaches were crowded with Spring Breakers. I talked to folks  today where we`ve got officials around the state that is still believe this  is somewhat of a hoax and not a big deal. 

I think that what the governor did today was so important because it`s  telegraphing this is very, very serious. And she`s going to -- we`re going  to have to make some changes, because there`s some things that have to stay  open and do some things to help us get through this. But the fact is, it`s  a bold, bold step for her and it was the appropriate step that I believe is  going to get that message out.

HAYES: This Republican governor Kay Ivey of your state, the Republican  leadership in the Senate Mitch McConnell outlined some of their plans for  this next rescue bill that`s coming forward. And there are two things that  are notable I wanted to ask you about. One is, there is cash assistance,  but he would miss about 70 million Americans at the bottom or give them  diminished amounts, depending on how they made in 2018 or if they have no  tax liability. What do you think about that? Should it be universal? Should  there be assistance going to those people, some of the proposals floated by  your Democratic colleagues?

JONES: Yes -- no, I want to look at this. Obviously, one of the problems  that we got in the Senate right now is that we`ve been here since Monday,  and these packages had been worked on, but we`re all just now seeing it on  Thursday evening, and that`s not the right way to do this. So we`re still  studying that, and I`ve looked at some of those. 

And you know, I want to get, I want to get the assistance to the people  that need it the most. And I`m not sure this bill does that, but it`s at  least a step that we can talk about. There`s a lot of things that we need  to be looking at to get our small businesses into the hands of the workers  themselves. That`s expanding unemployment compensation. 

I`ve got an idea out there that I`ve talked to some of my colleagues about  that folks tend to like a little bit that we may try to push some. And that  is using our payroll system that we`ve got. We`ve got companies that do  payrolls around the country for the small businesses. Use them -- set up a  fund that they can draw on because their infrastructure is already there.  You could get the funds directly to these people either with their salary  or a proportion of their salary very, very quickly if we do. So there`s -- 

HAYES: So, wait, I want to -- it`s an interesting idea. You want to use the  pay -- like ADP in these payroll companies as an architect -- 

JONES: Yes, absolutely. 

HAYES: -- as an architecture to essentially give people their wages  backstop, maybe by the federal government paying it or providing it in some  way?

JONES: Providing it. I mean, that is part of the providing, instead of this  $1,000 check, you provide the fund that will be administered by the Fed.  Let ADP and these others go into it for their customers. It could be their  full salary, but it could be a portion of the salary. You do it in the form  of a loan or you do it in the form to make sure that it`s a loan right now,  but if they bring these people back to work, that loan is forgiven. There`s  a lot of ways you can do it. But that infrastructure is there that we could  do something very quickly if we work on it.

HAYES: All right, Senator Doug Jones, a busy man in a Senate that usually  isn`t busy, but is now, thank you very much.

JONES: Thank you. Good to be with you.

HAYES: Coming up, what we know about the claims being made with the  president and others that a coronavirus treatment is just right around the  corner to esteemed doctors. You know where they speak. We`ll help try to  answer that question next.


HAYES: So a big part of the reason that you are watching this right now,  probably inside your home which you haven`t left very much, that we`ve got  millions of Americans locked down engaging in mass social distancing to  avoid further transmitting the virus is that one of our problems is we  don`t currently have a good way of treating the virus. 

So not only is there no vaccine for COVID-19 like there is the seasonal  flu, we really don`t have proven and reliable treatments for the people  that do get sick, which means people are toughing it out are really  suffering or worse, right? A lot of people require hospitalization.

But that doesn`t mean people aren`t thinking about possible treatments.  Researchers are starting to go down several tracks at once. Now, the  president, of course, came out today to tell everybody we`ve got a possible  cure and the FDA approved it. Predictably, that had to be immediately  walked back because while there has been some limited evidence suggesting  that a malarial drug chloroquine might be promising, that drug has not yet  been approved by the Food and Drug Administration for the coronavirus.

So where do we stand on treatment? What does treatment look like for the  probably millions of people who are going to end up getting it? Dr.  Margaret Hamburg is a former FDA Commissioner under President Barack Obama,  and Dr. Amer Aldeen is the chief medical officer at U.S. Acute Care  Solutions in Tampa.

Dr. Hamburg, let me start with you first. This seems to be a fascinating  and difficult conundrum for the FDA. Normally, clinical trials and  approvals are very regimented process, but obviously, these are exceptional  circumstances. How should the FDA and the federal government be thinking  about trial treatments for this virus?

MARGARET HAMBURG, FORMER COMMISSIONER, FDA: Well, over many years now, the  FDA has had a mechanism to respond in emergency situations and crises, none  quite as overwhelming as this one. But you know, Ebola, Zika, the threat of  pandemic flu with H1N1 to try to make important medical products available  as quickly as possible, ensuring, of course, that they work, that they  won`t cause harm, and they will actually provide benefits, whether it`s  diagnostics or drugs, medical devices, and importantly vaccines as well. 

So there`s a lot underway. And it`s very encouraging how the scientific  community has come together in this country across sectors, government,  academia, and industry, and also internationally to really bring the best  knowledge together and cutting edge science and technology to try to  develop new products and also to look at what products already exists that  might be repurposed for this terrible virus.

But they need to be studied. We need to know whether they actually work or  else they`re not doing anybody any good.

HAYES: Dr. Aldeen, as someone who used to run -- was Executive Medical  Director for Center for Emergency Medical Education, so you`ve run  education in this field. Like what is the best state of the art knowledge  about treatment right now? If you have someone that is in your E.R., and  they have severe respiratory illness, and they`ve tested positive, like  what is the treatment regimen look like right now?

AMER ALDEEN, CHIEF MEDICAL OFFICER, U.S. ACUTE CARE SOLUTIONS: Well, right  now the treatment regimen is supportive care. That`s the best way to manage  these patients, which means good infection control for keeping other  patients away from the infected patient, but also taking care of these  patients using appropriate ventilator devices and airway control. 

The medications that were mentioned, hydroxychloroquine and chloroquine are  showing some promise and very small trials. And we`re hoping that these  trials get bigger and they continue to show promise in both efficacy and  safety. But they`re not cures, not by any means, not yet. There`s also a  drug called Remdesivir which also might show some promise. 

But I can`t echo enough what the governor of Oregon had said earlier, which  is personal protective equipment is really the key where you need -- we  need to make sure that we pray prevent further illnesses among healthcare  workers as well.

HAYES: Dr. Hamburg, just to -- just to take us through like the -- to nail  this down a little bit. So let`s say you`re at the FDA right now, and I  know there was a peer-reviewed study I think today, actually, it was  actually published peer-reviewed clinical -- small clinical trials, just 16  patients, right? So it was -- it was the experience with them, chloroquine,  which seemed to show some promise. Just 16 patients. 

What does that mean? So what does the FDA do with that? Is it like, hey,  let`s try it out in 100, hey -- like, what happens next?

HAMBURG: Well, chloroquine is a special case in the sense that it`s already  been approved. It`s been used for decades now against other disease  conditions, importantly, malaria. So we know a lot about its safety. What  we don`t know is whether it works against this novel coronavirus. 

So we can move very quickly into clinical studies. And we can learn whether  it works or not, whether it works for certain patients and not other  patients in terms of where they are in the stage of their disease. Maybe it  could even be used as a what we call a prophylactic measure to help prevent  people from getting infected. That`s one of the ways it`s used, in fact,  with malaria. 

But we just don`t know and we need to study it. And, you know, I think it`s  really, you know, there are people on both sides, we obviously all hope  that it will work. But it`s not up to us to wish and hope -- 

HAYES: Right, of course.

HAMBURG: -- it`s up (AUDIO GAP) to get the scientific answers so that we  can help patients.

HAYES: Yes, go ahead. Dr. Aldeen.

ALDEEN: I`m sorry. 

HAYES: I thought you want to say something. Here`s my question for you. If  you`re dealing with people that don`t require hospitalization in terms of a  treatment regimen, so people who are watching this who maybe have a loved  one who`s self-isolating or are self-isolating right now, like, what is the  best knowledge we have about treatment in that sphere, right? Just you`re  not a hospitalization case. You don`t feel that profound distress, but  you`re sick, and maybe you test positive or maybe you just think you have  it. What do you know? 

ALDEEN: Yes, it`s a good question. We don`t know that much right now. We  don`t know the effect of these drugs like hydroxychloroquine and  chloroquine on the patients who are not that sick. It stands to reason the  way that their mechanism works, that the viral loads for all patients are  decreased, such that potentially they might be less infectious or pass on  the infection less readily, or perhaps even they themselves will feel  better faster. 

We don`t know that yet, though. That`s a subject of ongoing research right  now. But at least the scientific community, the medical community, they`re  mobilizing. They`re acting and that`s a good sign. 

HAYES: Dr. Hamburg, final question for you. Do you think the President`s  characterization of the treatment frontier today was an honest one or an  accurate one in terms of giving people a sense of how long this might be?

HAMBURG: Well, I think it was overstated in terms of how far along we are.  We`re still in the early days of studying a whole range of different drugs  and therapies that might prove beneficial. And of course, the vaccine  studies are underway and there are a number of promising vaccine  candidates. But it is going to take time, I think we`ll see drugs probably  go into use before we`ll have a vaccine. 

But in the meantime, we have to focus on quality care, supportive care,  with health care workers who are equipped with the personal protective gear  that they need, and the medical care tools that they need. And we need to  really make sure that our hospitals can cope with the surge of patients to  come. 

HAYES: All right, Dr. Margaret Hamburg and Dr. Amer Aldeen, thank you so  much. I really appreciate it. 

ALDEEN: Thank you.

HAYES: Ahead, remarkable new reporting on how the United States and South  Korea which both reported first coronavirus patients on the very same day  have diverged wildly in their containment of the disease. The grim reality  of America`s testing failure next.


HAYES: The first case of Coronavirus in the United States was confirmed on  January 20th, which happens to be the very same day that South Korea  confirmed its first case. And from there the two countries approaches  diverged wildly. As described in this incredible piece by Reuters, South  Korean officials immediately recognized they had a huge problem and had to  scale up testing immediately. They got everyone together, including  representatives of private labs, and told them to get to work. They  massively scaled up testing and they have managed to bend the curve of the  epidemic. That`s them on the left there.

The United States there on the right has done essentially the opposite.  Here is Trump on January 22. 


TRUMP: We have it totally under control. It`s one person coming in from  China and we have it under control, it is going to be just fine. 


HAYES: Well, South Korea is the most tested nation, we remain the  international laggard. And our epidemic is shooting straight up an  exponential curve.

Joining me now, one of the Reuters reporters that wrote that piece on South  Korea`s response, Dan Levine.

Dan, it`s a great bit of reporting. Take me through the opening anecdote in  which a medical official in South Korea shortly after first case sort of  throws an emergency meeting. What happens there?

DAN LEVINE, REUTERS: So, as you pointed out, the first case in both  countries happened on January 20. And when we started reporting and talking  to people there, we learned about this extraordinary meeting which happened  a week later on January 27. And that also happens to be the last day of the  Lunar new year of the holiday. It`s a three-day holiday, so most South  Koreans were still home with their families.

And Korean government officials called in representatives from more than 20  private testing companies, and they all converged on this conference room  in the main train station in Seoul. And they were basically told that they  needed to ramp up testing and that the companies that were able to develop  the successful test would get almost immediate regulatory approval.

And so when we learned about that meeting, we really felt that it  encapsulated a lot of the differences between both countries and the way  that they approached this, both in terms of urgency -- I mean, they had it  in the train station, because everyone was around the country and they  needed to -- it was the easiest place to get everyone into one place and  actually talk to everybody.

But also, because they brought in private companies right away, which was  very, very different than what happened here where the FDA initially  approved only one test from the U.S. CDC, which now kind of famously didn`t  work and had many, many problems and set us back for weeks. 

HAYES: And there`s -- you know, there`s a trade off we were talking about  in the last block, right, if you`re the FDA. You don`t want to play too  fast and loose with this stuff, right, it doesn`t help anyone if you don`t  have an accurate test, but you also have to understand exigent  circumstances when you might err on the side of aggressiveness. It sounds  like that`s what they did there. 

Were there concerns about going too fast and having an error-filled test?  Like, how are they making sure they were scaling at speed and also getting  it right?

LEVINE: So there -- well that`s exactly right, and that`s exactly what the  FDA told us that they were very concerned about faulty test results.

What happened in Korea was that they had continuous spot checks, not just  in the beginning when they initially vetted the first submissions from  different companies, but throughout the roll-out. So essentially, they were  reacting briskly and ramping up briskly, but at the same time concurrently  spot checking there.

And so they were able to detect any kinds of problems that may come up  whereas here, everything was kind of halted on the front end. 

HAYES: Right. 

LEVINE: And that`s where we saw a real problem. 

HAYES: So they --deployed this quite widely. They had had -- I mean, one  thing that I think binds together countries like Singapore and Taiwan and  South Korea is that they had had sort of outbreaks like this before, right?  There were SARS and then there was MERS, which was a sort of a Middle  Eastern originated respiratory illness that South Korea had had to deal  with, so there was a little bit of being further ahead on the learning  curve, is that fair to say? 

LEVINE: Absolutely. 

And, not only did they have the experience, it was fresh. I mean, this was  only a few years ago in South Korea and the Korean CDC officials we we  spoke to really talked vividly about how engraved it was on them and how  much remorse they felt for getting MERS so wrong. 

South Korea had the biggest outbreak outside of the Middle East. And at the  time, administration of Park Geun-hye, got a lot of criticism for the way  that -- for their country`s response to MERS.

So, this was all pretty raw and was a very big driver in why they felt that  they had to ramp up so quickly here. 

HAYES: That is fascinating. It`s a great piece of reporting, Dan, thank you  very much for sharing that. 

LEVINE: Thank you. Thanks for having me. 

HAYES: Coming up, every public health official in America will tell you  right now there are not enough ventilators to deal with the exponential  growth of Coronavirus. The question is why? And what is being done about  it, and we`re going to try to answer those pressing questions next. Don`t  go anywhere.



TRUMP: Where you have a problem with ventilators, we`re working very hard  trying to find -- nobody in their wildest dreams would have ever thought  that we need tens of thousands of ventilators. T his is something that is  unique to this -- to what happened.


HAYES: Nobody would have ever thought in their wildest dreams we need tens  of thousands of ventilators. That was the president today yet again lying.

The idea that no one anticipated a shortage of ventilators is ridiculous.  Many people saw precisely this eventuality. And not just two months ago at  the beginning of this outbreak, no, scarcity of life-saving medical  supplies during a pandemic is something people have been writing about for  years. 

In fact, get this, Donald Trump`s own Department of Health and Human  Services ran a simulation scenario involving a pandemic that began in China  code named Crimson Contagion during a series of exercises that ran from  last January to August. And the folks in HHS in that study foresaw the  needs that we`re experiencing right now. 

Domestic supplies of on hand stock of anti-viral medications, needles,  syringes and 95 respirators, ventilators, and other ancillary medical  supplies are limited and difficult to restock because they are often  manufacturing difficult to restock, because they are often manufactured  overseas. 

That`s in a report of that exercise from HHS last year in his own  government. 

U.S. hospitals have roughly 160,000 ventilators. And just like the Trump  administration study predicted that figure is far short of the 740,000 it  would need in a severe pandemic.

So the question is in a worst-case scenario, where are the ventilators are  going to come from? For answers, let`s turn to Sarah Kliff, an  investigative and health policy for The New York Times who co-authored a  piece out now titled "there aren`t enough ventilators to cope with the  Coronavirus."

Sarah, what is the mismatch right now in terms of what we have and what we  need?

SARAH KLIFF, THE NEW YORK TIMES: So the mismatch is not necessarily for  what we have right now, but what doctors expect is coming. They expect that  they are going to to see a lot of patients in respiratory failure. And they  are going to need to put them on ventilators. And we might be two or three  or four times short of the number we actually need.

As you mentioned, Chris, there is about 160,000 in American hospitals,  another 12,700 in a national emergency stockpile, but we might need more  like 600,000, 700,000 to treat all the patients who are coming in, and  right now we note in that story I talked to a lot of hospitals, a lot of  ventilator makers, the story that we`re hearing is hospitals are trying to  buy these machines. They can`t find anyone to sell them, and ventilator  makers are trying to ramp up demand, but they can`t increase it fast enough  to meet the needs that hospitals think they are going to have in the coming  weeks and months. 

HAYES: So, is that a -- on the supply constraint side, right, so there are  some domestic manufacturers, though much of it manufactured in China, what  do they say about like how much they can scale? Is it they just don`t have  the ability to do it?

KLIFF: Yes, some of it is about supply chain. A ventilator is made up of  hundreds of parts, and those parts come from all across the world. And  right now ventilator makers are scrambling to get the same part.

There is a work force issue. One thing that`s challenging right now is  these ventilator companies want to bring more people into their factories  at a moment when we are trying to prevent large groups of people being in  the same place, so it`s expensive. You have to buy protective equipment,  which we know is also in a shortage. You have to increase your janitorial  staff. And you have to convince your workers that are new to your company  you should come do this work at a time when you`re being told, you know,  maybe it`s best to stay home.

So, there`s all these different issues that make it difficult. Ventilator  makers are trying to increase their capacity right now, but there`s a lot  of things that are working against them when we`re kind of in a moment of  crisis.

HAYES: There is a headline earlier this week out of Britain that said that  it had asked manufacturers including Ford, Honda and Rolls Royce to help  make health equipment, including ventilators. The invocation of that  Defense Production Act, how feasible would like retro-fitting other  factories into ventilator manufacturing be or is that a fantasy?

KLIFF: I think we might find out in the coming weeks whether that`s  actually reality or fantasy. You see something here in the United States  where President Trump has talked about using a Korean war era law to do  something similar. Mary Barra from Ford was saying earlier today that she  would give over her manufacturing lines potentially.

So, we might see it.

But the ventilator makers that we spoke with for that article, they said it  was going to be pretty complex. You know, again, these ventilators are very  specialized machines, it`s going to be really challenging to change a car- making manufacturing line to a ventilator making manufacturing line, and  train the people to do it right.

So, it might work but we just don`t know. We`ll probably find out in the  next few weeks if this is a feasible approach or not. 

HAYES: I`ve been hearing a lot from ER docs and ICU docs that are worried  about this into the breach. There is this incredible video circulating from  Dr. Charlene Babcock (ph) who is an ER doctor in Detroit who actually  published a piece about how to hack your ventilator for one patient into  being able to use it for four patience by basically kind of like putting  more tubes into it and I saw another tweet today from a rural hospital that  it actually done a similar operation.

How much do you anticipate we`re going to be seeing doctors essentially try  to pull this off?

KLIFF: I think we`re going to be a lot -- seeing a lot of makeshift things  like that, things I heard about in my reporting were possibly, for example,  using veterinary respirators for humans. You know, these are not things  that happen in normal circumstances, but if you are in a case where you  have no other supplies, they might be the only way to help people.

One other thing you might see is there are anesthesia machines that are  usually used during surgery. If surgeries get canceled, as we`re seeing  elective procedures get ended, those might be used, those could be kind of  retro-fitted as a ventilator in an emergency situation. So I think you`re  going to see a lot of sharing among emergency room doctors about what works  and what doesn`t. 

But again, none of this is kind of the status quo. All of this is going to  be a little bit ad hoc. And I think this makes a lot of providers nervous  is that they have never really done this before. They are using machines in  ways that are completely new to them. 

HAYES: That is worrisome. Sarah Kliff, thank you for making time tonight. 

KLIFF: Thanks for having me. 

HAYES: Next, what we know about how the government is planning to rescue  Americans from economic catastrophe and what it should look like with  former labor secretary Robert Reich.


HAYES: We have some breaking news tonight, which may further develop where  the priorities in the Trump administration truly lie. In the midst of the  economic collapse happening during the Coronavirus crisis, the Trump  administration, according to a notice just posted on the blog of The New  York Times, that are live updates, is asking state labor officials to hold  off on releasing figures on unemployment claims. 

And this may be why, a Labor Department released today showed new  unemployment claims jump to 281,000 last week, 33 percent over the week  before. And according to the department,quote, clearly attributable to the  impacts from the Coronavirus.

The Trump administration would apparently rather you not hear those  numbers. Remember when the president, the CDC, when he was talking about  maybe he would take those people off ship and give them medical care? Said,  he liked the numbers where they were. He didn`t want the numbers to double.  It`s the numbers.

By now it is clear there must be, and will be, some sort of enormous  federal rescue package to stem some of the economic destruction we are  currently undergoing. There is no shortage of ideas floating around from  across the political spectrum. President Trump, for one, seems particularly  focused on bailing out big industries, including hotels, a type of property  he himself owns. 

Just a short time ago Senate Republicans unveiled a plan for trillion  dollars in stimulus money including direct payments to some taxpayers,  though quite notably, with less money for the bottom 70 million tax filers.

Here to talk about what we need out of a rescue package both in scale and  details, former Labor Secretary Robert Reich, author of "The System, Who  Rigged it and How We Fix It."

I don`t have any details here because The Times just posted this and pushed  this out. The Trump administration asking state labor officials to hold  back their numbers right now. That strikes me as not a great idea. We need  to know what`s going on.

ROBERT REICH, FORMER LABOR SECRETARY: Well, Chris, every time the  administration has tried to withhold numbers or withhold information, in a  sacrifice in public trust is extraordinarily large and very dangerous,  because particularly at a time like this, when people need to get  information and need to trust the government, we`ve discovered that we  can`t do either one. We can`t get the information we need and we can`t  trust the government.

The Trump administration has got to stop trying to cook the books and cook  the numbers.

HAYES: So, today Mitch McConnell outlined the plan from the Senate. And I  thought it was interesting, there was a lot of talk about this idea of sort  of a universal cash assistance. And there were some Democrats who were  saying, well, we should means-test at the higher end, which is that we  don`t need to send people making a million dollars a year a check. And some  other people said, well, just make it universal. You can tax them on the  back end.

But the Senate Republicans seemed to do something else, which is that they  would give less money to the people that make less money and zero money to  people that don`t have any tax liability it seems. What do you think of  that?

REICH: Well, it`s exactly what the Republicans have tried to do before. You  know, their formula, whenever you have any kind of a crisis, whether it`s  an economic crisis or any other, is to provide tax relief to big  corporations and also to provide tax relief to the people who don`t need  it, that is people who are very wealthy who have, and necessarily by virtue  of being very wealth the highest taxes.

So what you want to do is exactly the opposite. This crisis is not  immediately an economic crisis, it`s a health crisis. This crisis demands  that people stay home. You want to make it so that employers and employees  have every -- every possibility of staying home and getting the kind of  income support they need as fast as possible. 

No bailouts to companies, particularly the big companies. Big companies can  get the loans they need at almost zero interest rates. Big companies got  huge tax breaks just two years ago that they used to basically buy back  their shares of stock and give big investors and executives a field day.

No, you don`t want that. Save the taxpayer money. Make sure it`s used for  people who need it to stay home and maintain their incomes while they are  home.

HAYES: So, just one note that the McConnell plan does actually cap at  75,000, right? So they also have means testing on the top. I just want to  be clear on the details on that. 

But let me follow up on this bailout question. I generally, ideologically,  am disposed to agree with you. But it also seems to me in this case like I  don`t know if the airlines can go out into the private credit markets and  borrow right now. The private credit markets aren`t looking so hot, right. 

It does seem to me there`s got to be some backstopping.

REICH: Well, look at. First of all, the airlines -- remember over the last  20 years, every major airline has not only merged, but has also undergone  bankruptcy, a kind of reorganization under bankruptcy to get out from under  labor contracts. That has been the standard airline technique in the 1990s,  in the first part of this century.

So, if they can`t get a low-interest loan, and they probably, they`ve got  collateral, it`s called planes. But if they can`t get a low-interest loan,  they can do what they`ve done before to get out from under the labor  contracts, and that is reorganize under bankruptcy.

You only have four major airlines. They`re not going to go under. They`re  not going to liquidate because of this.

HAYES: So, there`s the big companies, right? Then there`s the small  businesses, which I think everyone is acutely aware of right now. I mean,  if you live in a place where there are small businesses that you love, you  can just tell that they`re not going to be able to survive more than a week  or two weeks of this, and everyone`s talking two months.

What scale and what creative ideas should we be thinking about for them?  Because that seems actually the hardest nut to crack. Like, you can send  out cash assistance, and you can figure out how to backstop the airlines if  you have to, but that seems like the hardest policy problem. How should we  think about it?

REICH: Well, I think the easiest way of dealing with that is to provide  zero interest loans to small businesses. And those small businesses, if  they maintain their employment, not keeping people employed -- I`m talking  about maintaining their employment, sending checks to their employees,  those small businesses can be eligible for a full remittance on those loans  from the federal government. I think that`s the way that keeps everybody in  place. It`s the simplest way of doing it.

HAYES: Right, I want to talk through this, right. So you say, you know, the  bar and my neighborhood bar that I love, which my heart is aching for them  right now, OK. 

Look, there will be some federal government facility that lends you money  at zero percent to just keep paying everyone like you were open, and then  when it`s all over we will forgive it, basically is what you`re saying.

REICH: If you meet the criteria and those simple criteria are you maintain  your payrolls and let`s do this retroactively so you maintain your payrolls  from mid-January onward, and you paid your rent and you paid your  creditors, you did everything you`ve been doing. The only difference being  is that you had no business. And so that, yes, you get all of that loan  fully remitted to you because you were essentially -- you were a small  business, you were part of the neighborhood, part of the community, you  were very important to the economy, and that`s the cheapest way of keeping  you going.

HAYES: Yeah, it seems to me there`s going to be have -- the logistical  issues of that standing up -- I mean, we`re -- this seems like new deal  territory to me, like standing up some entity that can do this. I mean,  talk about millions and millions and millions of businesses, right? Like is  not a small logistical feat ahead of us.

REICH: It`s not a small feat. 

But, look, Chris, we are in a kind of a -- 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...

HAYES: But big action nonetheless. 

REICH: We have no choice, we have got to do it and that`s 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.