KATY TUR, MSNBC HOST: Thanks for being with us tonight. "ALL IN" with Chris Hayes starts now.
CHRIS HAYES, MSNBC HOST: Good evening from New York. I`m Chris Hayes. The country faces three crises right now, all interrelated. The first of course, is the public health crisis caused by the Coronavirus pandemic. The second is the economic crisis caused by efforts to battle the first crisis with social distancing and mass lockdowns. And the third is a leadership crisis caused by a person running the federal government who is completely incapable of dispatching his duties.
The White House and president`s responses from the beginning have been a disaster. We are the international laggard in testing. We do not have the preparations for this moment, despite President Trump`s own government running simulations that warned exactly, precisely of the shortages we now face.
And despite the warnings from other countries already ahead of us on the curve, already in over their heads, we are behind, the waters are rising. That`s just the reality right now. In the beginning, President Trump has viewed this pandemic as a political issue about his own approval.
He told us early on, he didn`t want to take infected Americans off a cruise ship because he didn`t want the numbers to go up, which may partially explained why exactly we are so behind that testing. He`s come out day after day in the last week to offer big bold promises, but then prove to not actually be true.
The Google site that was going to help you figure out if you need to be tested and where, what happened there? The drive-up tests we were going to get in Target and Walmart parking lots, where are those? He tweeted, he`s saving the Defense Production Act in case of an emergency. Today, he said, we`re making masks, we`re making ventilators. We don`t know if that`s true.
While the President`s tone is probably the least important issue we face, his response today to the most anodyne natural question from NBC News White House Correspondent Peter Alexander tells you everything you need to know about how the president is viewing this crisis.
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PETER ALEXANDER, NBC NEWS WHITE HOUSE CORRESPONDENT: What do you say the Americans who were scared though? I guess, nearly 200 dead, 14,000 who were sick, millions, as you witnessed, who were scared right now. What do you say to Americans who are watching you right now who are scared?
DONALD TRUMP, PRESIDENT OF THE UNITED STATES: I say that you`re a terrible reporter. That`s what I say. I thinks it`s a very nasty question, and I think it`s a very bad signal that you`re putting out to the American people. The American people are looking for answers, and they`re looking for hope. And you`re doing sensationalism and the same with NBC and Comcast. I don`t call it -- I don`t like Comcast. I like Comcast. Let me just -- for whom you work.
Let me just say something that`s really bad reporting. And you ought to get back to reporting instead of sensationalism. Let`s see if it works. It might and it might not. I happen to feel good about it. But who knows? I`ve been right a lot. Let`s see what happens.
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HAYES: He`s been wrong. He`s been wrong the entire time. He has not been right a lot and that`s largely while we`re here. And while he was dressing down that reporter, that was on the same day that we here at NBC learned the loss of one of our own Larry Edgeworth who`s come to the illness.
So while he is yelling at reporters and failing at his job, here`s what we`re facing right now with a health crisis. California is on lockdown, Illinois is on lockdown, New York State is on lockdown, New York City is indisputably now the epicenter of this pandemic here in the U.S.
Just this week, this week, the number of confirmed cases has grown from 464 on Monday when we started this week to over 5,000 by this afternoon. Now, that`s partly explained by a massive increase in testing in the New York City metro area. Today, Mayor Bill de Blasio said one-third of all confirmed coronavirus cases in the country are in New York City.
More than 1,200 people in the state have been hospitalized all but a few in the New York City metro area, which means and this is important to hear this, we are starting to get very close to seeing the edges or the beginnings of the edges of our hospital capacity.
Just the last few hours, the Wall Street Journal and New York Times published pieces about the strain the virus is already putting on the city`s hospitals. And unless extremely dramatic action, overwhelming federal force, and coordination are brought to bear this problem, this is what New York might be facing.
Sky News got access to a hospital in the hardest had part of Italy. The scene inside is just devastating.
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UNIDENTIFIED MALE: This is the main hospital in Bergamo in Lombardy province. It`s one of the most advanced hospitals in Europe. But it`s the most hard-hit of all the hospitals in Italy. The town is the center of the epidemic here.
This isn`t a ward. This is a waiting room. Wherever you go, people are on gurneys, in corridors, and meeting rooms, they`re everyone. All the medical staff urge other nations to see what`s happening and lock their nations down right now or face this.
(END VIDEO CLIP)
HAYES: Italy had its worst death total today almost two weeks after the country went into lockdown. Joining me now to help explain where we currently stand, Andy Slavitt, former Acting Administrator of the Center for Medicaid and Medicare Services. He`s now board chair for United States Care, which issued a comprehensive congressional proposal for a COVID-19 response.
And, Andy, I`ve been talking to you and following you on Twitter. You`re talking to health experts across the country, doctors, public health officials, hospitals. What is the latest that you`re hearing as of today?
ANDY SLAVITT, FORMER ACTING ADMINISTRATOR, CENTER FOR MEDICAID AND MEDICARE SERVICES: Well, the first thing is we all know this is very difficult to accept and understand exactly what`s happening. Chris, you were on this a few weeks ago raising the alarm bell, but for many people, this felt like something very, very far away. And what people have to understand is that the numbers you showed today, in a couple weeks-time, will sadly look like the good old days.
The number of people -- all of these numbers are expected to double every three days. And it doesn`t take a long time for thousands to turn into tens of thousands, and tens of thousands to turn 100 thousands, and sadly, hundreds of thousands to turn into millions. And in densely populated cities, in places where people are not respecting the fact that they need to be staying in, it`s going to create an onslaught that will be impossible to handle.
And we`re about a dozen days behind Italy, so any scene you see of a town in northern Italy, you can pretty much expect something very close to that here in the U.S. We have -- this is a virus that none of us have immunity for. I don`t care how good a shape you`re in, I don`t care how young you are, and it`s a virus that spreads invisibly in the air.
So you can walk into a room that your grandmother walks into 20 minutes later and you could have possibly infected her. So you have to take seriously what we -- what we call the #Stayhomeidea, which is that you have a lot of people`s lives in your hands. You don`t know it, but you do. And that`s where we are.
HAYES: So I think this as two phases. This current phase is like we are in the midst of the battle, and we haven`t quite gotten there. And to use another metaphor, there`s a weird feeling, and I think this was invoked by an Italian physician that I read, the sort of moment between the lightning and the thunder. Like, there was a moment in Italy where they knew it was coming and they were preparing. And then there was like a day or two where they were in the hospital, no one was there, and then it hit.
Like, that`s where we are right now. And the only way we can get through this is lockdown and social distancing, right? I mean, that`s basically what we have. That is the tool we currently have is mass mitigation, dramatically reducing human interaction, is that right?
SLAVITT: Once we blew it on containment were you didn`t able to contract trace people and it got into the community, and we didn`t plan well enough, sadly -- and look, we have to navigate from where we are not where we want wish we were but from where we are today, absolutely, this is more in our hands by staying home. Everybody`s got to do their part.
The federal government needs to step up and operate much more like a machine that`s supporting us. The governors are doing a great job, the mayors are all working at this, but no one really can do it alone. And I think this is a huge role to play. You know, I`m 53 years old. I never lived through the greatest generation, the sacrifices people made during World War Two. And if my sacrifice is to stay home and spend time with my family, probably more of a sacrifice for them then for me.
This is -- you know, and I don`t mean to make light of the fact that people are feeling economic hardship and anxiety and anguish, but we`re all feeling it together. It`s a sacrifice we can make together. And we can save a lot of lives. This will be over. The question is how many people can we save.
HAYES: Well, the will be over I think is the hard part for all of us. And I want to -- I spent all waking hours thinking about and talking to people and talking to experts about it, and I oscillate between real doomsday scenarios and sometimes these pinpricks of optimism. And you know, South Korea is a sort of optimistic case. They`ve taken a very different approach with mass testing and Singapore and Taiwan, things like that.
I want you to respond to the following, which is that epidemiologists tend towards a worldview that is prepare for the worst and hope for the best naturally and correctly in their line of work, but that maybe it won`t be as bad as they`re projecting, right? Like this idea of half the -- half of California infected or a peak in August, I mean, that -- those are at the extreme ends of the scenario. If we take the steps now, can we see some kind of light at the end of the tunnel in the next month or two? What is Italy? Tell us about that?
SLAVITT: Yes, look, I think -- you know, I was quoted as saying we should be closer to panic than calm. And what I -- what I mean by that is, if you haven`t gone through that initial sleepless night that you just talked about, then you`re not really getting what`s going on. But after you do that, you start to come back. There`s no reason to live in this panic space.
And even though we`ve done a number of things wrong, if you documented them at the top of the episode, there are strengths that we have as a country that I think are going to make this look better than what an epidemiologist will see in front of them on a piece of paper.
For example, every philanthropist, innovator, genius technologist that I know right now, this is a focusing moment for them. People are talking about different ways to invent different things, different therapies, and I have no doubt that we -- while, we have weaknesses as a country, we have strengths and they`re unique strengths. And so I wouldn`t be surprised if things start appearing these glimmers that you`re talking about months out from now.
Now, if I were the President, I wouldn`t lead a news conference based on some hope that someone told me about. And I think what we should expect from him -- he wants to be a wartime general, a wartime president I should say, is decisive focus, sober, worst-case scenario planning. And then you know what if we turn out to have been too pessimistic, that`ll be the most wonderful thing in the world.
HAYES: Yes, that`s right. That is what I -- plan for the worst, hope for the best, and let`s all hope that I look ridiculously panicked and over selling things in two months from now. I will -- I will -- as you will -- you will welcome any video montage to that effect. Andy Slavitt, thank you very much.
SLAVITT: Thanks, Chris.
HAYES: Joining me now are two people who understand what`s going on politically as the country, deals with these multiple crises, Michelle Goldberg, an op-ed columnist from the New York Times, and Michael Steele, former RNC chairman.
Michelle, you write a great column in the New York Times where you basically said, look, I get some impulse to say, let`s not talk about politics now, we have a crisis, but politics matter right now, and holding the federal government and the Trump administration and Donald Trump accountable for the failures matters. Why`d you write that column?
MICHELLE GOLDBERG, MSNBC CONTRIBUTOR: Well, because I think you`re starting to hear it not Just from right-wing hacks, from some reasonable people saying now is not the time to look backward, now is not the time to point fingers, now is the time to come together. And I do understand that impulse. I think the problem is that the political failure is not just happening in the past. It`s ongoing.
It`s going on in the fact that the President gives the press conference every day where he kind of lies and spreads misinformation and spreads false hope, says that the FDA has approved drugs that the FDA has not approved. You know, it basically tells people that they shouldn`t be as alarmed as in fact, they should. And you see that reverberating throughout the country. And just Republicans are telling pollsters that they`re not that worried and also not changing their habits in the same way that Democrats are.
HAYES: Right.
GOLDBERG: And then the other thing is just he has so far, inexplicably, he has invoked the Defense Production Act, which a number of congressmen have called on him to invoke this act from the Korean War that allows the president to direct domestic manufacturers to manufacture things for public defense or public safety. You know, we have this critical shortage of ventilators, masks, ICU beds, etcetera.
He invoked this and then said he`s -- but he`s not going to use it. But he`s not -- he just wants it to be there in case of a worst-case scenario as if the worst-case scenario is not unfolding in front of us. And one reason I think it`s very important for people to be vocal in their criticism is because that is the only thing that this President responds to.
He doesn`t respond to calls for public sacrifice or to calls for the public good. He responds to kind of feeling aggrieved because he`s getting bad press.
HAYES: And Michael, what`s been -- to Michelle`s point about the sort of like actual appreciable danger to this causes both -- and people are taking this seriously -- but also just the whipsaw effect of sort of these kinds of big -- it`s like a sales job where like they -- like now I got your attention and what can I do to get you in the car, and the car is a lemon.
Like this was a line I thought was a great from a Bloomberg piece and said a hospital ship that can`t yet sale, a drug that`s not approved for Coronavirus, a windfall of masks that`s not due until next year. Donald Trump has repeatedly overstated his government`s accomplishments as he tries to calm Americans and fight the spread of Coronavirus. What do you make of it?
MICHAEL STEELE, MSNBC POLITICAL ANALYST: I think it`s a little bit less about calming Americans and more about how the President sees himself in this -- in this narrative. That was, I think, testified to today about the President`s reaction to the press in the room with him, how personally he took it, and just how angry he got. Because he was asked, how will you console the American people? What would you say to them, to make them less nervous and less concerned?
And he -- and his response was, well, that`s an attack you`re a bad reporter. So this idea, I think, to Michelle`s point, that this President sees this virus, this contagion this, this epidemic in any other terms other than himself, is the root problem here. And then you have this sort of juxtaposition with some Republicans who are trying to sort of deal with the reality but also try to stay on the President`s good side.
The fact that he has these few people standing behind him watching Dr. Fauci today with his head to hands -- you know, hand to his head was like, OK, I get it. I know what you`re feeling.
HAYES: Well, and it`s -- there`s -- and this -- those two things are related. And this is why I think it`s so important to focus on this, Michelle. The President said, I don`t want my numbers to go up, the number are going to go down. He sent a message, the federal bureaucracy early in this, I don`t want there to be a lot of cases, and one way to not get a lot of cases is not to test.
Now, in terms of the cause and effect. I don`t know how appreciably those two things connect, but it does matter what the leader of organization or country says to people underneath them. That message was sent. And every single step of this has revolved around the President`s ego and narcissism as opposed to what is going on in the country.
GOLDBERG: Well, you know, one of the people I talked to when I was writing my column is a Johns Hopkins professor named Steven (INAUDIBLE) who teaches a class called policy failures, and this is obviously going to go on the syllabus. And one of the things he said is that in these historic policy failures, you know, only a certain number of decisions make it onto the President`s desk, any president.
And so you always have to have a bureaucracy that is both competent -- and that`s another way in which this President has already failed the country and just kind of rooting out professionals and replacing them either not replacing them at all or replacing them with hacks and lackeys. And you also have that people make their decisions based on the signals that they get from the top.
And so, if the person at the top is saying this is not urgent, this is not a priority, and I don`t want to hear any bad news. You know, if somebody like -- there was a CDC official who basically came out a few weeks ago and told us prepare for significant disruption in your life, and the President was reportedly furious. So you -- there is a proposal cost in telling the truth, in preparing the country.
And, you know, of course, people respond -- you know, extraordinary people act anyway, but ordinary people respond to those incentives.
HAYES: Michael, it struck me today as I watched the President, as you`ve been -- you know, he`s seized on the possibility of this malarial drug being used for treatment. And, and it`s not completely crazy. There`s some very, very initial and small and early results that maybe give us some promise. And God, I hope that hospitals, clinical trials, and this -- and it works outright.
But it`s -- you know, a power of positive thinking, selling other people -- believing and selling other people on your own B.S. is an adaptive trait in a real estate developer, but literally the worst trait in public health. Like, it is -- you couldn`t find a bigger personality and worldview mismatch than that.
STEELE: Absolutely. In fact, I Tweeted to that effect yesterday when the President had made another one of his statements of trying to, you know, make the American people feel good. And I was like, well, you`re not trying to close the deal on my part.
HAYES: Right.
STEELE: This is -- this is about, you know, how do we solve this problem, why don`t we have the necessary equipment in place and the testing in place? And these are fundamental issues that won`t go away. And I think the President doesn`t really appreciate that they don`t go away because the country is waiting for you to take the action necessary to do something about it.
The governors right now, Chris, as you know, with Governor Cuomo in New York, Governor Hogan here in Maryland, governors around the country are the tip of the spear on this. They are leading. And for the President to then look at them and go, well, you know, we`re not a supply shop, you guys are supposed to be doing this anyway.
HAYES: Yes.
STEELE: Dude, that`s not how this works. You know, they have to lead in their state, but they`re also looking to the federal response to aid and assist and to make better efforts worth to the betterment of the people. And that piece of this, again, that`s a big part that is missing.
HAYES: Michelle Goldberg and Michael Steele, thank you both so much.
GOLDBERG: Thank you.
HAYES: Coming up, calls to the resignation of two Republican senators who now face accusations they used information from private briefings about the pandemic for their own financial gain before things hit the fan. That story next.
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HAYES: Tonight, calls across the political spectrum for the resignation of Republican senators Richard Burr of North Carolina and Kelly Loeffler of Georgia. They`re facing strong accusations based on financial disclosures they themselves filed that one of the first things they did after they found out just how bad the coronavirus would be during closed-door Senate briefings was sell a huge amount of stock right before the market tanked.
Both senators deny doing anything unethical. I`m joined now by Derek Willis, the ProPublica reporter who co-authored the story revealing that Senator Burr had dumped up to $1.7 million in stock. Also with me, Tim Mak, NPR`s Washington Investigative Correspondent who uncovered audio of Senator Burr privately raising the alarm about the coronavirus back in February while the President was reassuring the public, there was nothing to worry about.
Derek, let me start with you. And take me through, basically, these two senators and what they did and why they look suspicious.
DEREK WILLIS, REPORTER, PROPUBLICA: Sure. Well, I think the first thing to keep in mind essentially, is that there`s a timeline here, right? The senators when they make stock trades or when stock made, trades are made on their behalf, they have to file reports with the Senate on a fairly regular basis saying what those were.
And in this case after that, January 24th briefing for all senators about the coronavirus, in the weeks after -- days and weeks after that, we`ve had a couple of different senators file reports of stock sales. In the case of Senator Burr, the reason that we wrote about his activity was just because it was so out of the ordinary for him in terms of his trading activity dating back over the last year or so that we looked.
And so with Senator Loeffler, her -- we don`t have a lot of history in that she`s a new senator, and so, all we have to go on is the reports that were filed and hers were filed, you know, again, in the -- in the days and weeks after that initial briefing. Senator Burr is the chairman of the Intelligence Committee, also obviously has access to classified briefings about all sorts of security threats to the nation.
HAYES: The two -- the two details that stick out to me are that Burr basically essentially sells a huge amount of stock, which he hasn`t done previously, right? Like, sort of gets out of the market and doesn`t buy a lot of stuff. Loeffler sells a lot of stuff that would later tank and also purchases a big chunk of stock in Citrix, which runs like tale meeting software, which just seems like amazing luck to just buy it at that time.
Tim, you -- you`re the one who reported on the fact that Burr behind closed doors was really concerned about the severity of this. And I want to -- want to play the audio that you unearthed of him telling sort of well- connected constituents at a meeting just how bad it could be. Take a listen.
(BEGIN VIDEO CLIP)
SEN. RICHARD BURR (R-NC): There`s one thing I can tell you about this. It is much more aggressive in its transition than anything that we`ve seen in recent history. It`s probably more akin to the 1918 pandemic.
(END VIDEO CLIP)
HAYES: That was not the note necessarily he was striking in public.
TIM MAK, WASHINGTON INVESTIGATIVE CORRESPONDENT, NPR: That`s right. In public, he was saying the United States was better prepared than any other time in his history based in part because of legislation that he had helped author. Now he -- Senator Burr is an expert in public health and pandemic preparedness, because he`s been working on this issue for decades, almost 20 years.
And the question is, with his expertise and his assessment, the very dark assessment of what was succumb, why did he not share his assessment with the public?
HAYES: Now you -- the senator attacked you for your journalism. I didn`t think he frankly landed any blows. But then there was after your piece, there was a reporting on his stock sales. Have been given an explanation -- has Senator Burr giving you or anyone or explanation for the sales, Tim?
MAK: No, not for the sales themselves. They said that they have not done anything wrong. They say that the sales were made based on public information that is news reports, CNBC news reports, and not private information that was obtained as a part of his role as a lawmaker or as a - - as the Senate Intelligence Committee Chairman. But not a general explanation of how that squares with his declination to tell the public about what his assessment was and how bad coronavirus would become.
HAYES: Yes. Well, this gets to the law here, Derek, right? I mean, so you can imagine a world in which Senator Burr is just a person who`s very tuned in to news about pandemics, right? That he hasn`t gotten some -- I mean, he`s getting -- he`s getting secret briefings, right? But even if he were, he was just like a pandemic dude, and he`s like, this is going to be bad.
The idea first of all, that your first thought is to sell your stock and not to also go to the public and warm them like, the question is, can he do this legally or is there legal liability under this new legislation called the Stock Act which restricted how Congress can sell individual stock that Burr voted against. Does he have legal liability?
WILLIS: So the question really is it depends, right? It depends on the context. And obviously, in this situation with what Tim`s reporting is uncovered, like that supply some additional context here. It`s unclear in terms of exactly what his liability could be, but this is the sort of situation that the Stock Act was literally written to address, right?
It forces disclosure, periodic disclosure that`s more timely so that the public can see when people are -- in Congress are trading on information that they know whether they get that from public sources or from private sources. The Senate Ethics Committee, the senator has asked for a review by the Ethics Committee. They certainly -- you know, they can look into this. I think that it`ll really be up to, you know, sort of the senator to provide the information that he was aware of, and then the Ethics Committee Committee will, you know, make a determination on what actually the responsibility is on his part.
HAYES: I should note, there`s a few other senators who sold stock in this period. Dianne Feinstein who`s a Democrat, Ron Johnson of Wisconsin, Sonny Perdue, it looks like in Georgia, all of them I should just note, I think are in a different category and have been somewhat persuaded or not quite as suspicious as this, which is why we`ve kind of kept them out of this reporting until we sort of get a further fuller picture.
But the politics here are terrible, Tim, for Senator Burr. Thom Tillis from North Carolina, Senator Burr owes North Carolinians and explanation, which is really quite a thing to say about your fellow senator.
MAK: Well, Senator Burr is not running for re0election, Senator Tillis is running for re-election and obviously has to react. There`s a lot of bipartisan outrage over this issue of stock selling. If there was inside information on coronavirus being traded upon, there are folks in the left and right united to say, hey, Senator Burr should resign or should at least explain how it is he came to make these sales.
HAYES: All right, Derek Willis and Tim Mak, thank you both for being with me.
Still ahead, as the pandemic rose, many front line health workers can`t find the necessary protective gear and are getting exposed. We`ll talk to an emergency room doctor about just how dire a situation we are in coming up.
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HAYES: We`re living in a strange and sometimes terrifying world right now, and if you`re like me, and I`m not proud to confess this, but just compulsively watching the numbers, right? The numbers go up and up and up. And those numbers of course, you can lose sight of for a moment that each number represents a real human life, inevitably lives of people close to you.
Earlier this week, my first friend was diagnosed with Coronavirus, then another person I know and another and another, and today the brutal news for all of us at NBC about the death of one of our colleagues due to complications from Coronavirus.
Larry Edgeworth, age 61, a husband, a father of two sons, who had some underlying health complications. For most of his 25 years at NBC News, Larry was an incredibly skilled audio technician, traveled the world covering stories for the network.
I got to work with Larry a bunch. First, I think, when we were covering the protests in Ferguson, and he exemplified grace and professionalism and camaraderie. He was tough, funny, kind, downright courageous and cool under pressure.
And I have to say that`s true of the NBC crew as a whole, men and women I`ve had the great honor of working with. These are people who work in war zones and natural disasters under incredible pressure with tremendous, tremendous competence.
I`ve been in some dicey situations where I depend on them, on Larry, totally. And those folks are still doing their work amidst this crisis. This loss, Larry Edgeworth, is incredibly hard for all of us here. We will miss you Larry.
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HAYES: So, one of the most pressing problems right now, perhaps the most pressing at this very moment, is just protecting front line health care workers from getting infected, that`s both a matter of their own safety and their families` safety, and also the safety of public health.
In Wuhan, China and in parts of northern Italy, large numbers of health care workers contracted Coronavirus, even with protective equipment and then got sick and were not able to provide care. In short, if health care workers get sick, enough of them get sick, the whole system can crash. This is precisely why health care workers across the country are more or less jumping up and down screaming, raising the alarm they either do not have access or are running out of protective equipment, like masks, gowns and visors, the very things they need to provide care.
This is no longer some abstract fear. We are already getting stories about those workers getting infected, including our next guest Dr. Dara Kass, an emergency room physician at Columbia University Hospital, who recently tested positive for Coronavirus, and Deborah Berger, a registered nurse and president of National Nurses United.
Dara, let me start with you and ask just how are you feeling? And how do you find out that you had gotten the virus?
DR. DARA KASS, ER PHYSICIAN COLUMBIA UNIVERSITY HOSPITAL: So I got tested -- I had some (inaudible) and I knew I was at risk, because I had taken care of patients who had tested positive, so I went and got tested just to make sure that I was not going to take care of any more patients after I was positive, and I was confirmed last night, so I`ve been home in quarantine -- actually still doing telemedicine, because I feel pretty good, actually. I think I`m lucky so far.
HAYES: I want to ask Deborah about what your concerns are for the folks in your union. I saw a protest outside a San Francisco hospital. I have seen reporting like this one, for instance, on the shortage of respirator masks. Federal health officials say respirator masks should be discarded after treating an infected patient. Many doctors around the country said they are being given just one to use indefinitely, spray it down with Lysol or wipe it off, not knowing whether that will help preserve it.
Are you encountering situations like that?
DEBORAH BERGER, PRESIDENT NATIONAL NURSES UNITED: We are encountering those situations all over the country, and in Sonoma County where I live. People in construction are donating their masks to nurses, dropping them off at nurses` homes. And it`s really alarming because we have been yelling about this for months, and still masks are under lock and key. We`ll have to go get a manager to get them. They`re told to reuse them.
Now the CDC is saying if there aren`t masks, go ahead and make your own. Go to a craft store, get some felt or whatever you think might filter out this virus, and feel safe and good about working in the storm like that , and it`s really become crazy.
You wouldn`t send a firefighter into a burning building with a squirt gun to put out the fire and that`s what we`re being asked to do here.
HAYES: We should say here, Governor Andrew Cuomo has just been essentially pleading for creative solutions. He said New York has a critical need for personal protective equipment, including gloves, gowns, and masks, as well as ventilators. If you can -- if you have or can make any of these supplies New York is buying. I have heard of labs, construction workers trying to using theirs and donate them.
Dara, as someone who is at the point of care in an emergency room, just describe to me the -- first, why is it so important and what the process is in terms of using the equipment when you have got a place where a lot of people, particularly in New York City right now, are coming who are infected, obviously as you know.
BERGER: Yes, so the process is evolving as we learn more about the disease and we see the patients coming in different volumes, so we know that in the high risk area, like the ICUs, and we`re doing procedures that are really at risk, we have layers of levels of equipment that we use, both body protection, masks, gloves, double gloving, maybe goggles. If we`re in a lower humidity area, an area that maybe isn`t necessarily high risk, we`ll use maybe just goggles and masks and gloves.
The issue is every time you use the equipment, you`re supposed to change the equipment in theory. And it`s harder and harder to do that when you know we`re going into this weeks and months on end. And that`s why it is encouraging to see leadership like Governor Cuomo asking for resources early before we run out in New York. We will (inaudible) running out sooner rather than later, and we need everybody to chip in to help us get them.
HAYES: Deborah, do you have clear coal communication from hospitals or from state and public health officials or governors about what is being done on this problem? It seems to me this is a problem everyone is going to face and you can`t set localities and governors and hospitals to fight each other in a battle for a fixed supply, that`s the worst possible outcome, so then you lead to hoarding. It is going to look like the toilet paper aisle in the grocery store, right.
You need federal coordination. Is there any federal coordination?
BERGER: That`s what we`re extremely concerned about. President Trump signed the Defense Production Act yet he`s failed to implement it by demanding that corporations come come up with better production lines for masks, for ventilators, for all the equipment.
If you look at the other countries that are -- some of them less well off than we are, their protections for their health care workers are far superior than ours and it looks like they`re managing to be able to protect their health care workers.
And right now that is not happening, we`ve had to even start a petition to the federal government to put protections in place and give us the equipment we need or we won`t be there.
HAYES: Dara, two questions for you, one is how are things in the emergency room you work in? You`re not physically there, but in touch with colleagues in terms of what you`re seeing right now as this pandemic has an epicenter in New York City, that`s very clear.
KASS: I`m first and foremost so proud of the people that I work with, of where I work, because everyone is really putting all the patients first. They are trying so hard to take care of patients in an uncertain time when they are putting their families on hold when they are going to work really just with the care of the patients first.
You know, we are now officially the epicenter of the country in New York, and we are feeling it. We`re seeing it on patients on the ground, we`re seeing it with our admissions. These are numbers that the governor is putting out every single day. And we`re trying to rise to the challenge. And I commend all the hospitals in New York City for doing that.
But it is going to be a big list for us, and it`s going to be a long haul.
HAYES: What about testing? I know this has been an issue for some folks, and I want to ask you both this, not just personal protective equipment but you really do need testing for health care workers. I mean, it seems so urgent that you can`t have health care workers who are positive caring for people, obviously, but you also can`t just prophylactically take them off- line when you need all hands on deck.
And I`ve been hearing stories for two weeks about health care workers having a hard time getting tested. I would like to want to hear from you, Dara, and you Deborah, about what you`re hearing. You first, Dara.
KASS: The truth is is that we are doing the best with what we have. And I think this shows a lack of forethought on the availability of testing from the outset. Knowing that we are going to have an escalating number of patients and exposed health care workers, we were going to need a higher magnitude of tests.
We are testing exponentially every single day in New York City and not keeping up with the need, which includes health care workers. So we are waiting days sometimes from the onset of symptoms to be tested, because there just aren`t enough tests for anybody.
HAYES: Deborah, what are your members finding?
BERGER: Well, that`s the problem is that nurses are being asked to work if they are asymptomatic even though they know they`ve been exposed to the virus. They are asked to monitor themselves and still show up for work. So we`re really concerned because we know that there are cases of the COVID virus that have been passed along even though they are asymptomatic. So, it`s a huge concern for us.
We need universal health care worker testing fast now, yesterday, a week ago, two weeks ago.
Dara Kass, Deborah Berger, thank you so much for making time tonight.
KASS: Thank you.
HAYES: Coming up, former senior official of national security pandemic response unit created by President Obama, disbanded, demoted by President Trump, joins me next.
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HAYES: The Obama administration faced several epidemics during his time in office, from Swine flu to Ebola, and one of the lessons they learned from that is how important it was to prioritize response throughout the government.
So in 2015, he created a pandemic team called the directorate for global health security and bio-defense. That team would work very closely with the president on that very essentially important body called the National Security Council.
About two years ago, a senior health official from that team attended a conference marking the 100th anniversary of the 1918 pandemic flu, one of the deadliest pandemics in world history, that took the lives of at least 50 million people. Here is what she said in that conference back in May of 2018.
(BEGIN VIDEO CLIP)
DR. LUCIANA BORIO, DIRECTOR, NSC MEDICAL AND BIODEFENSE PREPAREDNESS: Are we ready to response to a pandemic? I fear the answer is no.
The threat of pandemic flu is our number one health security concern. We know that it cannot be stopped at the border, and we also know that we do not close borders to control flu pandemic. It just doesn`t work.
(END VIDEO CLIP)
HAYES: Within days of that conference, the Trump administration dismantled the NSC`s pandemic team.
Joining me now is that senior official who sounded that alarm, Dr. Luciana Borio, former director of medical and bio-defense preparedness at the National Security Council, former acting chief scientist at the FDA.
Doctor Borio, first, I want to talk about the lessons that were learned in battling epidemics in the Obama administration that led to the creation of the sort of unit you were working in. Like what was the idea behind that?
BORIO: Sure, good evening.
So the idea of the unit was to help coordinate all of the assets available in the U.S. government so that there could be a comprehensive preparedness policy stance as well as to facilitate a response in a public health emergency. That was the idea of the directorate. And it would be focused only on public health emergencies and bio-security, so very dedicated focus of work.
HAYES: In a bureaucratic sense, I mean, this may seem too granular or small ball, but I know from reporting on the White House, where things sit in the organization chart are a reflection of prioritization, and they matter, right? I mean, having that directorate created some sort of institutional focus in terms of how an administration would respond.
HAYES: Chris, you know, that may be true, but it`s true also that the NSC -- the leadership at the time thought it was important to streamline sometimes streamline and create efficiencies, and they had their own reasons for streamlining, and what I can say that there was a re- organization and the portfolio that I managed at the time was fully supported by the NSC leadership at the time, so the work continued throughout my tenure there.
HAYES: What are the lessons here? I mean, mean what should the government be doing to prepare? When you said, I fear we`re not prepared back in 2018, why were you saying that?
BORIO: That`s right.
So it doesn`t really depend on any single directorate, but it`s about sound policy, it`s about resource programs, it`s about learning from lessons from prior experiences, and continuing to optimize the solution set, some solutions that may have worked 10 years ago, that were necessary back then, may need to be revisited.
So we really need to be a very dynamic process. And what I think is the most important thing today is to first of all, look forward, we have a long path ahead of us. This is a very serious crisis, it`s going to be protracted, it`s very stressful for most people. But you know, Americans need to realize today that each one of us is public health, the actions that we take as individuals within our families and our communities to limit the spread of this disease, is going to be the most important action that public health can take, to break the chain. It`s not going to be sufficient. These are temporary measures. But today, this week, next week, we are public health.
The second thing I think...
HAYES: But there -- go ahead. No, please.
BORIO: I would just going to say, you know, it is really critical to realize that there are hundreds of career government employees that are working around the clock, I have worked with so many of them throughout my career. They`re very dedicated, they`re very experienced, they`re incredibly smart, and most of the response is going to happen at that level.
And most people don`t realize, for example, that there is already a very incredible effort to evaluate treatments for Coronavirus. There are about 40 -- 30 or 40 now, academic medical centers that are already conducting a randomized controlled study that was launched by the NIH. There again, about 30 or 40 patients are already enrolled.
So these types of efforts are not necessarily happening on the headlines, but they`re already underway. And it`s really my hope that sooner rather than later, we`ll identify potential cures, and later have a vaccine that can help counter this terrible pandemic.
HAYES: I want to ask you for a little more detail on the Defense Production Act, which is not legislation that`s in the news every day. A lot of people probably learned about it in the last week. What, is it something that you studied in your preparedness when you thought about this? And what can it actually do?
BORIO: Yes, that`s an interesting question. You know, there`s a theory that allows the U.S. government a lot of latitude to manage the production of vital resources. It`s not my area of expertise, but my impression right now is that the private sector has responded, and is responding, and taking this very seriously.
As far as I`m aware, there is unprecedented number, for example, of companies developing vaccines and therapies, engaging in diagnostic development, manufacturers of personal protective equipment, ramping up their production capacity, so I would like to see whether the DPA would augment those efforts.
But it`s my impression that the private sector is reacting appropriately.
HAYES: What do you think the biggest lesson that will -- the biggest change for us in the way we think about this threat will be?
BORIO: Well, it`s we need to completely look at how we are managing diagnostic testing and development for the future. The situation that we`re in today, we`re still relying on highly complex laboratories that sometimes we have to send our tests, it`s unnecessary given the technology that is at our disposal in the 21st Century.
I think we need to leverage more technology that can support public health efforts, including contact tracing, isolation. We need to also leverage the power of the American people where it`s up to us to be able to counter this are our most valuable source.
HAYES: Dr. Luciana Borio, thank you so much. Appreciate it.
That is All In for this evening, the Rachel Maddow Show starts right now. Good evening, Rachel.
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