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All In with Chris Hayes, Transcript 3/27/2020

Guests: Andrew Cuomo, Debbie Dingell, Sheri Fink, Charlene Babcock, Abdul El-Sayed, Michael Linden

ARI MELBER, MSNBC HOST: We want to let you know something else as you plan your evening. There`s been a lot of news out of Washington and speaker Nancy Pelosi will be here on MSNBC with Rachel Maddow at 9:00 p.m. Eastern. That should be an interesting interview. You can find me, Ari Melber, back here 6:00 p.m. Eastern on Monday for THE BEAT, also be filling in again in this 7:00 pm hour as well for our special coverage. Don`t go anywhere. "ALL IN" with Chris Hayes starts now.

CHRIS HAYES, MSNBC HOST: Good evening from New York. I`m Chris Hayes. It is now day two of America having the worst outbreak of the coronavirus in the world. And if there is a single lifesaving thing we need right now above all else, it is more ventilators. We know from everything we have seen that a shockingly high percentage of people with the virus will need to be hospitalized.

And because of the way this virus works, it`s way through the lungs, many will find themselves unable to breathe on their own. They need a machine to breathe for them. That`s what a ventilator does. If these critically ill patients get a ventilator, their chances of surviving go way up. If they do not, they are much more likely to die.

American hospitals are not equipped to the scale events later need presented by this pandemic. And this has been clear, I want to make this clear, for a long time, including in the National Security Council handbook for pandemic given to the Trump administration by the Obama administration, and in a pandemic simulation practice by the Trump administration itself, codenamed Crimson Contagion that found and I quote here, "States experienced multiple challenges requesting resources from the federal government due to a lack of standardized well understood and properly executed resource request processes."

This administration`s own wargames told them that they need to be more prepared. And so now in New York City, doctors are already hacking ventilators themselves to split them between multiple patients. York`s Governor Andrew Cuomo said the state can eat up to 30,000 machines in just the next few weeks. This is a simple matter of life and death, OK. If we don`t get the ventilators, more people will die. It`s not complicated. The president -- the President seems to think that the whole ventilator thing is some kind of con job.

(BEGIN VIDEO CLIP)

DONALD TRUMP, PRESIDENT OF THE UNITED STATES: New York is a bigger deal, but it`s good to go also. But I have a feeling that a lot of the numbers that are being said in some areas are just bigger than they going to be. I don`t believe you need 40,000 or 30,000, ventilators. You know, these are two major hospitals sometimes is they`ll have two ventilators and now all of a sudden they`re saying, can we order 30,000 ventilators?

(END VIDEO CLIP)

HAYES: First of all, all of a sudden, all of a sudden, he said all of a sudden, what`s going on? You need a lot of ventilators. All of a sudden there`s this pandemic. That`s what the whole thing is about. That`s what all of a sudden is. Yes, yes, all of a sudden, all of a sudden, thousands of people need ventilators who did not need them a few months ago before, because of the pandemic that has shut down two-thirds of the country. That`s all of the sudden. That`s the pandemic our government did not prepare for.

And what is becoming clearer by the day is that there is such a complete disconnect between what the president says and the frontline medical workers who are right now fighting this disease. Listen to how this ICU nurse in Michigan describes her new reality earlier this week.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: So today was the first day that I`ve worked since our unit was designated the second COVID ICU in my hospital. And I don`t know what the (BLEEP) just happened for the past 13 hours. Honestly, guys, it felt like I was working in a warzone.

I`m completely isolated from my team members, limited resources, limited supplies, limited responses from physicians because they`re just as overwhelmed as we are dealing with a ton of other stuff. So basically, I just spent the last 13 hours, like treating too critically ill COVID patients on the bed basically by myself. This is my new normal for the next however long it takes for this virus to die down. So, look, I`m already breaking. So for (BLEEP) please take this seriously. This is so bad.

(END VIDEO CLIP)

HAYES: This is so bad. This is so bad. But it`s actually worse than that. Yesterday, the New York Times reported that the Trump administration backed away from a deal for General Motors to produce ventilators because the price tag was too high. Oh, and because, quote, listen to this. "Some government officials expressed concern about the possibility of ordering too many ventilators leaving them with an expensive surplus."

They were worried about having too many ventilators, God forbid we would have them the next time we have a global pandemic or maybe share them with the rest of the world when they need them. And not only to the president nixed that GM plan as of a few hours ago, he refused to use the defense production act -- production act to mandate the production of them. And then late this afternoon, he changed his mind announcing he was requiring GM to accept, perform, and prioritize federal contracts for ventilators using the Defense Production Act.

Of course, the production of those ventilators will be probably a month away. I want to be as clear as possible on this. If there are not sufficient ventilators, people will needlessly die. End of story. The situation is dire.

Joining me now by phone, a man currently managing this crisis in what has become the epicenter of the pandemic globally, the Governor of New York, Andrew Cuomo. Governor, thank you for making some time. I want to start on the ventilator issue. The President seems to think that the estimate of needing 30,000 ventilators, he feels it`s too high, that you`re overestimating how much you`re going to need. What`s your response to that?

GOV. ANDREW CUOMO (D-NY): Yes. Well, Chris, listening to your lead in -- and thank you for having me. You`re exactly right. This all comes down to ventilators. And by the way it did in China, it did in South Korea, it did in Italy, and it did as soon as the numbers started to break here. And it is unusual. The number of ventilators we have in our healthcare system, when you add up all the hospitals in the state of New York is about 4,000. We need about 40,000 here.

This is a disease that is a respiratory disease. People are on respirators, the ventilators, and ventilators are a matter of life and death. And they`re on ventilators longer with this disease than most other diseases. The average length of stay on a ventilator is about four to five days. Here, it`s about 20 days, which is one of the reasons why you need so many.

The President says 30,000 sounds high. You know, I don`t -- I don`t know what the basis is. I don`t -- I don`t have a medical degree. So what I do is I just study the numbers and the science and the data and I follow the data. We have McKinsey and Company, we have Cornell Weill Medical Center. I talked to the World Health Organization. You look the models of China, look at the model of South Korea, look at the models of Italy, and look at the models of the numbers in my state. You see, it takes you to 40,000 ICU beds with ventilators, and 140,000 hospital beds. That`s what the numbers say, at apex. So I plan by the numbers, and I don`t know how to do it any other way, Chris.

HAYES: Where are you right now? I think -- I know when this went into, you said the state had 4,000. I think there was maybe another 7,000. Some of which did come from the federal government. Like how far are you From what the state needs right now to handle that peak if it comes at what the model suggests?

CUOMO: We`re scrambling to buy them all across the globe. One of the things that has happened here because the states were left on their own to purchase, in a cruel irony, the states are bidding against other states, Chris, for the same materials, and they`re actually bidding up the price.

So I`ll get an order for ventilators, and I`ll have a company say, I`ll send you 5,000 ventilators in three weeks, and then they call me back and they say sorry, I sold them to Illinois or California or Florida. That`s the situation we`re in. I need about 30,000. We`re about halfway there counting orders that we have. We`ve gotten 4,000 from the federal government. I had 4,000 in our -- in our hospital system. We bought about 7,000. And then we have a scattering of orders which may or may not come in.

One other point on something you mentioned. I applaud the president for using the defense production act. I said last week, he should have used it. This is not a time to be bargaining with corporations or relying on the voluntourism of corporations. We need these ventilators and we need them now, not when the corporation decides it`s convenient for them to do the design and to put up a new line in operation.

You`re talking about my possible apex, it`s 14 days away. If I don`t have the ventilators in 14 days, Chris, people die.

HAYES: You know, that strikes me as part of the difference in which governors I think across the ideological spectrum, generally, and the President have approached this which is a kind of planning for the worst and hope you met -- hope you`re wrong, right? So if you get too many ventilators, what`s the worst thing in the world that happens as opposed to planning for the optimistic case scenario and erring on the other side? Like, what are the stakes if you`re wrong in the wrong direction for people in New York, sick people in New York?

CUOMO: No, you`re exactly right. The difference is somebody who`s been out there and somebody who has been through it, and somebody who has it, right. I used to be in the federal government. As you know, I was HUD Secretary, and I`ve done floods, hurricanes, all sorts of disasters. Yes, maybe you send out too much equipment. So what? The real crime and the heartburn is if you have too little.

So -- and I`m not even taking an aggressive model. I have a reasonable numerical model based on our numbers. And again, you have a whole world data going back to China. And we`re just asking for what we need for our reasonable model. I`m not -- because of many of these I`m paying with state money. And these ventilators, they`re about $25,000 each, Chris. So I`m not eager to buy more ventilators than I have to.

HAYES: Right. You had been a critic of the relief bill that has now been passed and signed because of precisely the issue you`re articulating here, whether there was sufficient money for the state. Obviously, all these states are scrambling. They`re going to be paying out of pocket for all these things as they should, these emergency funding. Less money is going to be coming in taxes. Every state`s going to be wall up to the deficit. Do you think what came out of Washington today is sufficient for the kind of hole that New York is going to be looking at?

CUOMO: No. It`s not even close. Look at the bill, they all applauded them. The bill did a lot of good. The unemployment insurance is good, the small business aid is good, the healthcare rate is good, but they left out a very important function, which are the state governments and the local governments.

You know, my economy is shut down like everybody else`s. I have no revenue, and all I have are expenses. And none of the aid went to a state government. Now, it`s not like it`s my money and I`m going to go out and buy something. If you starve the state government, where -- what I fund is education, and I fund healthcare.

So when I have no budget, Chris, it means I have to turn around and cut schools all across my state and cut health care all across my state. It makes no sense. Now, you know, states don`t have a voting constituency, right? You can`t come and hand me a big check. So it`s not as politically advantageous when you do a bill in Washington, but I think it was short- sighted and I think they are -- they say they`re going to come back, but you know, who knows?

HAYES: There`s been -- I think the state announced a release of some prisoners in New York State. I know that New York State has a very large elderly prisoner population in the state. There is real concern about incarcerated folks in the state, particularly those elderly folks and them -- the susceptibility to the coronavirus, the prisons as vectors for infection, particularly when you have COs and other people who are going to be coming in and out and going into rural areas that maybe have fewer hospitals. What steps are you taking to deal with that? Are you considering trying to decarcerate some of these places to get out ahead of that?

CUOMO: Yes, we have been very aggressive, Chris, number one in bail reform in general. We passed one of the most sweeping bail reform bills in the history of the state of New York. So we`re incarcerating fewer people than ever before. We`ve then taken special measures for this virus situation. For example, we`re releasing people who are in jails because they violated parole for non-serious reasons.

And wherever we can get people out of jails, out of prisons, now we are. We also put in additional protections in the prisons to try to protect both the workers and the prisoners.

HAYES: Just one follow up, and then I`m going to ask a question about the White House, and then I will let you get back to work. But I just -- you just touted bail reform. You`re not trying to undo that right now? There`s been reporting that you are.

CUOMO: No. There is -- there`s a discussion back and forth between the houses. You know, it`s a sweeping bill that we did on bail reform. And many times when you make a change, a basic change in a complex system, you have to go back and do some fine-tuning And that`s what we`re dealing with between the houses of the legislature.

But that`s usual. You know, you go near a system like education or health care or the criminal justice system and you change the major gear in the system, you then often have to come back and make some other adjustments to make it work.

HAYES: Final question for you and then I will let you get back to work. The relationship between the President and governors has been tempestuous in many cases. Today he talked about the governor of Michigan and called her that lady. He told Mike Pence that he advised Mike Pence not to call the governor of Michigan and not to call the governor of Washington because they were insufficiently appreciative.

What -- how does that hit your ears as you are in up to your neck in this crisis, and you hear the governor -- the President of the United States essentially saying everyone has to be sufficiently appreciative or they`re not going to get the help they need?

CUOMO: Well, Chris, by the question, I would be doing my state a disservice if I now attacked the president, right?

HAYES: Exactly.

CUOMO: Let me just say this. The President hasn`t -- I probably been the number one critic of President Trump since he got into office. And we`ve had some real battles and he`s tweets -- has tweeted a lot of nasty stuff about me and about my family. On this situation, I said to him, look, forget the politics, let`s put it aside. It`s very simple. I need help. You`re the federal government. And this relationship has to work or a lot of people die. You do the right thing by my state, and I will be appreciative and vice versa. And that`s how it has been working.

He has been responsive. He`s done a lot of good things. He has the Army Corps of Engineers in our state, FEMA, he waived the 25 percent state match which is a big deal. So he has been -- he`s been very helpful and cooperative overall. And when we have differences, I say we have differences. We have a difference on the Defense Production Act, etcetera.

So I`m not shy when we have a disagreement. But when things are working well, I say that also. And this can`t be personal and it can`t be political. Because literally, we are on the cusp of losing thousands of people who did not have to die, Chris. That`s what the ventilators are about. They did not have to die if we do what we have to do.

HAYES: All right, Governor Andrew Cuomo, I really do appreciate you taking all that time this night.

CUOMO: Thank you. My pleasure, Chris.

HAYES: Yesterday, Dr. Deborah Birx who`s the response coordinator for the White House Coronavirus Task Force chastise the media saying they`re making people panic unnecessarily that hospitals may have to decide which patients to save.

On the same day, she said that, a letter from Henry Ford Hospital in Detroit was leaked online describing exactly that situation, about how they are going to ration their ventilators by prioritizing patients with the best chance of surviving.

Patients who have the best time chance of getting better, the letter reads, are our first priority. Patients will be evaluated for the best plan of care and dying patients will be provided comfort care. The hospital basically confirmed the letter`s authenticity, saying, "With a pandemic, we must be prepared for worst case. With collective wisdom from an industry, we crafted a policy, provide guidance for making difficult patient care decisions. We hope we never to have to apply them."

All of a sudden, this virus is here, and all of a sudden we need to get our hospitals and machines they need to save lives. Joining me now is Democratic Congresswoman Debbie Dingell of Michigan. Congresswoman, I know things have been very tough in Michigan.

I want to start with something the President said earlier today, where he said that he advised Mike Pence not to call your state`s governor, Governor Whitmer and she told press reports that she`s actually had orders canceled for needed equipment because she thinks that there`s a kind of you know, blockade being offered by the President. What do you -- what do you make of that?

REP. DEBBIE DINGELL (D-MI): So, first of all, I agree with Governor Cuomo that this is a time that we`ve all got to work together. He again took shots at our governor tonight, and I just wish we would put this aside. Tuesday night, our delegation met in a bipartisan way. We were not the only state that has gotten conflicting signals.

You know that last week the governors were told, go out and get your supplies on your own. Governor Cuomo has been very articulate and talking about that. But she did receive as other states have phone calls from suppliers that they had lined up to deliver these supplies that said we can`t deliver them to you. We`ve had to stop. The feds are going to -- become in charge of the distribution center.

Look, we need President Trump. We need him to be the leader. Tonight, at the briefing, Dr. Birx said that Detroit and Dearborn, my hometown are now on their target list, their watch list. Michigan is going to be the next -- one of the next epicenters like Cook County, New Orleans. We need to work together. We can`t do this.

We need -- I have been an advocate of the federal government and the president invoking the Defense Procurement Act so that we have federal coordination of all of these so the resources are going where they need to go.

HAYES: Can you walk me through? I know that you had been very involved. Obviously, we`ve got a long history with the big three automakers in your home state. And I know you had been back and forth with some of them about the possibility of ventilator manufacturers and you expressed some frustration about it. How do you understand what`s played out? I`ve had a hard time tracking it.

DINGELL: So I`ve talked to all three autos. I`ve been talking to them every single day since this crisis began about a variety of issues. The fact of the matter is, they all know that this country is in a crisis and they want to step up and contribute, as does the UAW. The UAW has got a number -- not a number, they`ve got thousands of volunteers who want to help produce.

The PPE equipment is also equally important. You talked about the nurses or doctors on the front line. You showed a picture of a nurse from Michigan. I`ve heard those stories. Every day from doctors and nurses, the tears. An intensive care nurse called me and said to me, Chris, you need to make me this promise. I`m writing my will. I`m probably going to die. Will you make sure my child doesn`t go into foster care?

So the autos have all began evaluating what they could do last week. I kept asking General Motors, are you producing the ventilators They were working on it. They were working on it with Ventech corporations that they are announced today. The reality is that there are a lot of components that go into these ventilators. They were working with the suppliers. You need someone coordinating all of this. And we do need to speed it up. We need these ventilators now.

Ford Motor Company immediately last week started talking to other manufacturers. They knew they couldn`t do it at the speed at which it was needed, and they said that point-blank, you know. So all of them are stepping up. All of them are going to produce what they can but we need to be realistic about what can be done in the next two weeks, like Governor Cuomo said, and what`s going to take time.

HAYES: Yes, it`s going to take a few weeks, probably a month at the very minimum. Congresswoman Debbie Dingell, thank you so much.

DINGELL: Thank you.

HAYES: For more on the life and death fight against coronavirus inside American hospitals, joining me now Dr. Sheri Fink, Correspondent for The New York Times. She`s been embedded at Brooklyn Medical Center for the last week. And her latest piece is titled "We`re in a disaster mode, courage inside our Brooklyn hospital confronting coronavirus." You know, we -- obviously, for obvious reasons, Dr. Fink, we can`t bring cameras inside these places. We`re sort of relying on you and the other workers there to be our eyes and ears. What is it like in this hospital?

SHERI FINK, CORRESPONDENT, NEW YORK TIMES: So -- and I should -- I should clarify, I`m a New York Times correspondent and was able to embed there on Monday and then stayed in touch over the recent days about what`s been happening there. We spent a whole day there, 12 hours.

And what`s been happening, it is -- I`ve reported on disasters. I`m a physician myself, I`ve worked in disasters and conflict areas as an aid worker before I became a journalist, and it felt it`s not business as usual. It felt like it was a different thing.

And so you saw half of the emergency room, they had put up a wall, hastily put up a wall so that they could divide it between coronavirus, you know, suspect or confirmed coronavirus cases, and the cases that are, you know, your heart attacks, your strokes. People don`t stop having those.

And the intensive care unit was full. There were patients who were waiting to go upstairs. They were boarding in the emergency department and those staff members, those nurses were caring for them. One of them even on a ventilator already down in the emergency room.

In fact, Wednesday night, they opened up a new part, a whole new section, additional beds, intensive care unit beds, because they had exceeded their normal -- you know, their normal intensive care unit capacity. So that`s what`s happening. It is not business as usual and they`re really stretching.

I was very impressed with the spirit that the staff were just putting their -- you know, kind of putting their game face on and doing this work at some risk to themselves as well.

HAYES: Yes, the sort of stretching and the capacity, I mean, this is -- this is unfortunately probably relatively early in the crest of hospitalization in New York. How much room was there? I mean, how close to the sort of capacity edge did that hospital feel to the people working there, to you as a reporter and a doctor yourself?

FINK: Well, I mean, they`re beyond the typical capacity, right? And I think people forget that in a normal flu season, our ICU is are quite full. We don`t have a lot of extra capacity. We run a lean healthcare system in our country. We have a lot of capacity, but it`s not limitless, so they`re already going beyond.

In fact, as you know, the governor had asked hospitals to come up with a plan by Monday for how to take an additional 50 percent of patients and also plans to double the number of patients that they usually do. So they`re doing things like canceling. They have, of course, canceled elective surgeries. Those surgeries don`t feel so elective to people who were expecting to have them, but that is what they needed to do to at least free up space in this hospital.

Another issue is testing. It was taking -- it is taken seven days to get test back from the commercial lab that they use.

HAYES: Wow.

FINK: That means every single one, there were 65 patients as of Wednesday night, who were in the hospital waiting for test results. They each have to have an individual room. This is the hospital where a lot of them would be in double rooms. But until you know exactly what they have, they can`t be with other patients.

So it`s issue after issue and they`re doing everything they can to avoid that rationing scenario that what my -- part of my family uses that hospital system in Michigan. So that is what every hospital now is looking at those plans, unfortunately.

HAYES: All right, Dr. Sheri Fink is one of the best medical writers in the entire country. Your work is always fantastic. Thank you very much. Next, the federal response continues to fall well short of providing the equipment needed for healthcare workers on the front line, leaving hospitals to improvise. How one hospital preparing for worse after this.

(COMMERCIAL BREAK)

HAYES: You`ve seen everyone everywhere in civil society, particularly front line health workers improvise in the moment to deal with the failures of the federal response of the Coronavirus and just the difficulty of the challenge itself.

Look at this headline in The New York Times, "the other option is death: New York starts sharing ventilators." This week, some hospitals in New York City started experimenting with hooking up two patients to a single ventilator, which is something was only ever been done twice in practice as far as we can tell in the immediate aftermath of the 2017 Las Vegas shooting and for Coronavirus patients in Italy.

Just two week aces ago, an ER doctor in Detroit posted this YouTube video showing how to modify a ventilator to use on up to four people. She joins me now, Dr. Charlene Babcock, emergency medicine physician at Ascension St. John Hospital in Detroit.

Lots of folks shared that video, which is a remarkable thing. You had actually written it up for a medical journal. Before we get to the sort of method, can you just explain to a layperson like what a ventilator is and how it works?

DR. CHARLENE BABCOCK, ASCENSION ST. JOHN`S HOSPITAL: So a ventilator actually pushes air into a patient`s lungs, and it can do it by volume control, which basically means you set how much volume goes into the patient, or pressure control, which means you set a peak pressure and as much volume will go in as possible. And to do something like this we recommend pressure control so that it sets a pressure and the volume of air goes in to meet that pressure.

HAYES: So how much, on a normal -- if you`re dealing with a ventilator and you have a patient with one in an ER like what are the normal conditions that put someone in need of that before we`ve hit this pandemic?

BABCOCK: So, normally in air we have 20 percent oxygen but you can, you sometimes need more oxygen when you have lung disease like you do in COVID- 19. So we increase the amount of oxygen by a mask that we put on the patient, but sometimes that`s not enough oxygen and we have to push 100 percent oxygen through an endotracheal tube, which is the mouth going into the trachea.

HAYES: So normally -- so these are people that are struggling to breathe and you can actually use the machine to push a higher percentage of oxygen into their lungs than the air that they are bringing in and makes it easier for them to breathe?

BABCOCK: Yes. And also takes the work of breathing away because we push it in so that don`t have to like work to breathe. It pushes the air in so not only are you getting a higher concentration of oxygen, but you`re taking the work of breathing away.

HAYES: How much does the machine have to be monitored when someone -- oh, we may have just lost you for a moment. I think we did lose you. I think we still have you, Dr. Babcock. We`re all rolling with this -- Dr. Babcock had this incredible YouTube video...

BABCOCK: That`s OK.

HAYES: She had a YouTube video in which she describes how she was able to sort of hack together a ventilator to actually connect a bunch of different tubes and get those tubes working on perhaps as many as four patients at the same period of time. That has gone viral.

You`re starting to see people actually now try this. Now they had never actually used it on human subjects, it`s only been done twice before, but as a kind of emergency triage, almost battlefield kind of situation, if it does work, that innovation was that video of Dr. Babcock might be responsible for saving a lot of lives.

We`ll be right back with much more after this.

(COMMERCIAL BREAK)

HAYES: Right now, the U.S. has the worst outbreak of Coronavirus in the world, both in terms of total cases and the rate of growth at this point in the curve. And part of what makes us unique is that we have a bunch of different epicenters around the country. That was really not the case in China and not the case in Italy, as Trump`s former FDA commissioner Scott Godley pointed out using this chart as evidence, our epidemic is likely to be national in scope.

We`re seeing this play out right now in Louisiana. New Orleans has the highest per capita Coronavirus death rate in America per 100,000 residents, and this is the stark warning Louisiana`s governor laid out yesterday.

(BEGIN VIDEO CLIP)

GOV. JOHN BEL EDWARDS (D-LA): If we don`t flatten the curve and do it soon, as I mentioned yesterday, we could be out of ventilators in region one, the New Orleans area, by as early as April 2. It is not conjecture. This isn`t some flimsy theory, this isn`t a scare tactic, this is what is going to happen.

(END VIDEO CLIP)

HAYES: Joining me now from New Orleans is Dr. Corey Hebert, chief medical officer at Dillard University.

Doctor, what is it like there right now? The data we see looks grim. What is it like on the ground?

DR. COREY HEBERT, CHIEF MEDICAL OFFICER, DILLARD UNIVERSITY: Well, the hospitals are being overwhelmed as we would expect, but it`s something that, you know, if you don`t know your history, you`re doomed to repeat it. We know that in 1918 in Philadelphia, there was a Liberty Loan parade of about 200,000 people. They had the parade even though they knew the H1N1 Spanish flu was coming. And what actually happened? 12,000 people died in a six-week period because they had that big gathering. That is the actual curve that we use now when we start talking about flattening the curve and the what not to do. So, you see that giant spike, that was 200,000 people at a parade.

In New Orleans, we actually had millions of people for a parade about four weeks ago, so that is what we`re seeing and what we`ll continue to see in other urban areas around the country because when you look at the density of populations around the country, Detroit, New York, these are the places where you`re seeing a lot of cases, it`s like a parade every day. And these people were interacting socially.

And so on the ground in New Orleans, what you see is the outbreak in the pandemic of what actually occurred for to five weeks ago.

Yeah, I should note the president of the United States the day before Mardi Gras, he said the Coronavirus is very much under control in the U.S. and the mayor of New Orleans, LaToya Cantrell, had an interesting response when asked should you have canceled Mardi Gras. Take a listen to what she said.

(BEGIN VIDEO CLIP)

MAYOR LATOYA CANTRELL (D-LA): The federal government did not issue any red flags, and therefore we moved forward. We rely on the facts to make decisions for the people that we serve. Given no red flags, we moved forward.

In hindsight, if we were given clear direction, we would not have had Mardi Gras, and I would have been the leader to cancel.

(END VIDEO CLIP)

HAYES: Do you think that`s fair? Do you think that`s a copout. Who do you think is responsible for this decision, ultimately, which will cause a lot of pain?

HEBERT: Well, I will tell you the lack of leadership at the highest levels has actually started this whole domino effect, so I do agree with the major. And she did cancel several giant events, such as St. Patrick`s Day and many other events here in New Orleans, Jazzfest, and all these things.

So, it was very unfavorable when she did that, but I think that she would have actually canceled Mardi Gras had we had the appropriate information.

All these cities that are around the United States are having these issues. I mean, I know you`ve been to China, I`ve been to China. When you look at the Hubei province, they are so closely knit in Hubei Province, it is exactly the same as urban centers in the United States, and so when you have a Mardi Gras, you expect this.

But, you know, when you have to have leadership and when I tell you we go through several exercises with the federal government as talking about all types of emergencies before we have an event, including Mardi Gras, and at no point -- I`ve worked with the city for many years, at no point was there any leadership to say that we should not have Mardi Gras.

So, I think she actually did step up. But, you know, a lot of people had a lot of events and I think that`s why our numbers are spiking like in Philadelphia around 1918.

HAYES: Yeah, and unfortunately, that is baked into the cake for the next foreseeable weeks. Dr. Corey Hebert, thank you for making some time tonight.

Another national hot spot is the city of Detroit. Their confirmed cases rose to 851 yesterday, 11 times the number reported just a week ago.

Part of that is because people do not have access to running water, and without water, well, you cannot wash your hands. The Associated Press today, quote, the city has restored water to more than 840 homes with about 190 work orders still pending, but does not know the exact number of homes without service. And officials at the city plans to reach out to 5,400 houses out of an abundance of caution.

To talk more about what is happening in Detroit, I`m joined by Dr. Abdul El-Sayed, an epidemiologist, who was Detroit`s city`s former health director, author of the forthcoming book "Healing Politics: A Doctor`s Journey into the Heart of our Political Epidemic."

First, doctor, let me just ask you as a Michigander, as someone who ran in a primary against Gretchen Whitmer to be governor of Michigan, your reaction to the president saying that he was explicitly telling Mike Pence not to call the governor of your state back for needed supplies, because I guess he didn`t like her tone.

DR. ABDUL EL-SAYED, FRM. HEALTH COMMISSIONER FOR THE CITY OF DETROIT: This is absurd. The idea that the president would blame the governor of Michigan on her tone when you`ve got Detroit suffering one of the fastest growing epidemics of Coronavirus just to me makes no sense, it speaks to his failure of leadership.

I think Governor Whitmer has been doing a fantastic job considering the circumstances, and she`s been leading to the best of her ability considering the fact there has been no federal leadership here.

HAYES: Detroit, like New Orleans obviously, is a place with some distinct challenges. Obviously, there is a very high poverty rate in Detroit, also there has been massive depopulation in the city, which has put strains on all kinds of municipal services. What are your fears, what are your worries, what are your concerns about how this epidemic is going to play out in this city?

EL-SAYED: When we talk about epidemics, it`s easy to focus on the pathogen, in this case the Coronavirus. But you have also got to talk about the host and you`ve got to talk about the environment. In this case, you got this interplay between the host and the environment that`s left folks vulnerable, particularly in a city like Detroit where asthma rates are already three-fold the state average, where the probability of lead poisoning is exceedingly high, where the rate of diabetes is exceedingly high, and all of that is because you`ve got a city that`s been unfortunately the receptacle of huge levels of poverty that have led to environmental racism, that have led to structural racism, that have led to systematic poverty. And all of that imprints itself on the bodies of individuals.

And so it`s to me, it`s no coincidence that the risk in Detroit and the outcomes in Detroit are so poor, it`s what I wrote about in the book, this epidemic of insecurity that leaves people vulnerable to things like this pandemic.

HAYES: You know, you`re a doctor and then you`re a Rhodes Scholar, you then went into public health because you were sort of frustrated by the fact that, you know, doctors care for patient one at a time, wanted to do broader things. You taught public health.

One thing that struck me here is the difficulty for policy makers and for everyone to get into a public health mindset, people using sort of their economic mind or their political mind or their real estate investor mind. And there`s just a different way to think about things from a public health perspective that do you think that has sunk in among policy makers that are having to confront this?

EL-SAYED: I think we`re starting to get there, Chris. And I think you`re absolutely right. One adage in public health is it`s always better to prevent than it is to cure. Think about it kind of like a fire in a toaster. You can put it out when it`s small, or you`ll be battling it when it`s in the neighborhood. And right now we`re battling is in the neighborhood.

One point that Dr. Anthony Fauci made that I think is really right is that we`ve got to stop skating to where the puck is, we`ve got to go where it`s going to be, and so it`s not enough to just respond to the numbers that we`re seeing right now, which are vast underestimates, we`ve got to be asking what will we need in the future, and how do we make sure we prepare for that future. And if we can`t prevent early, then we`re going to be fighting late, but we better be fighting what`s coming, not necessarily what is.

HAYES: Do you think we`re doing enough? I mean, there is some talk now about the unique geographical problem that is presented by the U.S. right now. What you saw in both China and Italy was an outbreak in a specific place. They tried to sort of lockdown that place, then the national government steps in and says, oh no, it`s not going to stay there, we`re locking down basically the whole country. We saw in Wuhan, Hubei province, all of China. We saw it northern Italy where they had a red zone. The rest of the country is green zone, a week later, the whole country is locked down.

We don`t have that here, and I`ve talked to public health experts who are worried that in the absence of that, we`re just going to have a bunch of awful outbreaks.

EL-SAYED: You know, that really is a fear. I think if we were all to invest in social distancing appropriately, if we were all to take this seriously, then the kind of cross movement between communities would end.

The point here, though, is this showing us that we really are a collective, that we have to act collectively, and if we don`t, and any of us deviate from what all of us need to do, then all of us suffer. And so there is a real responsibility that all of us have to simply stay home, to stop communicating this disease.

The other point, though, is that we`ve always been a federalized system. We have strong state and local public health leadership. The challenge, though, is it hasn`t always been well funded, and it`s always relied on federal leadership at the top to help coordinate it.

And so the fact that right now we`re seeing a breakdown, it really leads to the fact we have not had that centralized leadership at the top to help the whole thing move in concert.

HAYES: All right. Dr. Abdul El-Sayed, thank you so much for making time tonight.

The massive $2 trillion Coronavirus rescue bill is now law. The president signed the bill this afternoon after the House passed it earlier in the day. This enormous inconsequential piece of legislation is designed to mitigate some of the economic devastation we`re now experiencing as a nation. It is a very complicated bill. There is a lot in there. And I will tell you this from my sort of cursory reading and the people I`ve talked to, there is some good stuff, some bad stuff, and some down right ugly stuff.

There is money to boost large corporations, small businesses, state and local governments, along with some very sketchy tax breaks that we`ll be covering in the future.

But and this is key, I think, there is also a fair amount of relief in there for just regular people, average Americans, and we thought it would be useful to just walk through what actually is in the bill for anyone who is watching this, who may be struggling to pay their rent or who has been laid off, or has seen their work dry up.

So to talk through what is in the bill and how people can take advantage of it, I`m joined now by Michael Lyndon. One of my favorite budget wonks. He`s a fellow of the Roosevelt Institute, and executive director of the groundwork collaborative, a progressive think tank.

Michael, I`m bringing you in because I think of you as a real details guy when it comes to these big pieces of federal legislation. And I thought maybe we could sort of walk through three kind of major parts of this. And the first are the cash payments. There are cash payments to Americans. What do you have to do, or how do you qualify for that cash payment? What`s the amount? Walk me through it.

MICHAEL LINDEN, ROOSEVELT INSTITUTE FELLOW: Yeah, so basically, most Americans will get the cash payments. If you make up to $75,000 if you`re an individual or $150,000 if you are a married couple, you will get $1,200 per person plus an additional $500 per child and then it starts to phase out after that. People making up to about $200,000 if they are married will get some portion of this.

As long as you filed taxes in either 2018 or 2019, you`re going to get this automatically with a couple of important exceptions. You have to have a Social Security number, so people who only have a taxpayer identification number, unfortunately. But you don`t have to have taxable income, that was really an important improvement that the congressional Democrats got in the bill, so you don`t have to -- you can have almost no income or no income at all, to still be eligible for this.

HAYES: Now one thing we should note here is that when you say -- and we are talking about that income threshold -- $75,000 in income, that`s based on your 2019 filings. So there is some universe of people that maybe had a good year last year, have had a rough year now and are really hard up who won`t get the checks, right?

LINDEN: That -- there are probably some people like that. You can file your taxes now to try and adjust for that.

The other thing...

HAYES: Ah, I see.

LINDEN: The other thing -- and we`re going to get to this, though, is if you`re having a rough year this year it may be because you just got laid off, or you`re about to be laid off, or you run a small business, and there are elements in this package that will be directly beneficial to those folks.

HAYES: Yeah, so let`s talk about the unemployment insurance part of it. Now, I think that the theory that we pursued, which is different than the European nations in which they basically paid companies to keep you on payroll, I think that is a superior method, frankly.

LINDEN: Yeah.

HAYES: We didn`t -- we chose not to do that, that`s not what we`re doing. We`re instead using the unemployment insurance vehicle. So people that are laid off can apply for unemployment insurance. All of that said, I personally think it`s not as good as the other alternative. But if you are going to use that, this actually is better than I thought it would be. Walk me through if you`ve just been laid off, what this means.

LINDEN: Right. So if you`ve just been -- in normal times if you`ve been laid off and you qualify for uninsurance benefits, you can get them, and they will basically cover up to about 40 percent on average of your wage, but this bill includes an additional $600 on top of that per week. So for most workers, that`s going to actually increase their benefit to their entire wage. And for some people actually a little bit, above, for some people a little below, but for a lot of people, that`s going to mean that they aren`t actually going to lose any wages, their income will stay the same.

It also expands the eligibility for unemployment insurance, which is an important thing because a lot of people who lose their job and we think of should be eligible for unemployment benefits, typically aren`t but this bill actually expands that.

HAYES: Yeah so those two provisions I think are -- when I saw that $600 I think in my head -- I thought it was monthly, but it`s a weekly benefit.

LINDEN: It`s weekly, yeah.

HAYES: So the unemployment insurance check is 340, you`re talking 940 a week, which again, like, you know, nobody is rolling in the dough and celebrating how great they are, but terms of income replacement, like is hopefully going to put a pretty good majority of people in the ballpark of their earnings.

LINDEN: Yeah, that`s right.

Now here is the big downside in my view, it`s that it`s only for the next four months. And, you know, I got to think that four months from now, unfortunately, we`re going to be right back here arguing with congressional Republicans why they need to extend that, because we`re not getting out of this hole any time soon unfortunately.

HAYES: Final thing, and a lot of people that would normally don`t qualify can qualify under this new category that was created. So, if you`re a gig worker, you`re a freelancer, you`re someone who put together an income, but didn`t have a normal W-2, didn`t get laid off in a traditional sense, but have lost your work because of this, you can basically self-certify is that how it works? You just tell the government that?

LINDEN: That`s right. You can just basically self-certify and say that you lost your job based on any number of factors relating to the current crisis. And it does, it exactly what you said, it extends now to people who are self-employed, people who weren`t, didn`t have a long enough employment history to typically qualify for uninsurance benefits.

So, it really an important expansion. And I just -- the credit really does go here to congressional Democrats who fought tooth and nail to get that in there.

HAYES: Yeah, all right. Michael Linden, always illuminating. Thanks for being with me tonight.

Next, I want to share a bright spot, a moment of humanity I found particularly moving in these very scary times. That video, it`s a good one, right after this.

(COMMERCIAL BREAK)

HAYES: Well, that was a week. Everything is surreal and it`s frightening and it`s strange right now, but people have been sharing these incredible moments of support and celebration and expressions of human solidarity. My heart was warmed by this moment in New York tonight when people all over the city clapped from their windows, balconies, and doorsteps to applaud the health care workers, grocery store workers, delivery drivers, sanitation workers and others for the incredible heroic work that they are doing.

(BEGIN VIDEO CLIP)

CROWD: (CHEERING)

(END VIDEO CLIP)

HAYES: I`m very lucky in many, many ways. One of those ways to be able to do this job while doing the physical distancing. Our whole staff we`re mostly working remotely now in this new normal thanks to some incredible work by our executive producer and others.

It`s hard in a lot of ways. I`m sure you found it hard to be doing all this. But I will say this, for me, the one nice thing is I`m around my family more. And today my 6-year-old David had a birthday, turned 6 today. He count really have a birthday party, but he and his big sister got to watch the show here in a remote studio.

So I want to introduce you, here they are. As we are physically distancing. This is the birthday boy, David, who is 6. And this is Ryan. And I will say this, hold your loved ones close if you have them close by. Have a good weekend.

That is All In for this evening, the Rachel Maddow Show starts right now. Good evening, Rachel.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED. END