Nancy Pelosi TRANSCRIPT: 4/17/20, MSNBC Live: Decision 2020

Guests: Nancy Pelosi, Jill Colvin

DR. ANTHONY FAUCI, DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES: -- that was corrected, and it was an issue of embracing the way we have now and should have. The private sector, who clearly has the capability of making and providing tests at the level that we will need them for any of the things that I`ve just spoken about.

So, having said that, right now, I totally understand, and I know I`m not alone, my colleagues understand, that although we say there are X number of tests out there, and you`re going to hear from Admiral Giroir about that, the fact is there have been and still are situations that are correctible and will be corrected and some of which have been corrected.

I know. I get on the phone a lot with my colleagues because, believe it or not, some long time ago, I was where they are in the hospitals, in the emergency rooms looking at very sick individuals that you need to take care of. And I know what it means when someone tells you, hey, you have what you need and you look around and you say, well, maybe you think I have what I need, but I don`t really have what I need. So we have to figure out how do we close that gap.

And there are a lot of things that I think we`ve learned and that we are correcting and going to correct. Namely, you have a situation where tests are needed and appropriated and either people are found there`s no tests or there`s no reagents or there`s no swabs or a person needed a test and were told that there was a restriction, they couldn`t get a test. These are all the things that I`m telling, you already know because you`ve heard them.

So right now -- or there`s a delay of five to seven days. And what does that mean if you want to do -- if you want to get somebody out of circulation? We understand that that existed. But upon careful examination, what you are going to hear that many of those have been already corrected and other of those will be corrected.

Because what I think people don`t appreciate, through no fault of their own, is that, this is -- there are two issues. There`s supply and demand. And if you have a supply that can meet the demand, but the supply has not connected the demand, then the supply and demand falls apart. What do I mean by that? I mean there is existing capacity that we have that for one reason or other maybe has not been fully communicated as to the availability of that existing capacity, and you`re going to hear about that now.

There`s production capacity that gets better and better and better. And that`s what we`re talking about. Because for what we need now, we believe that with better communications, we`ll be able to make that happen.

So I know there`s going to be a lot of questions about that. I don`t want to go on too long. But let me just finish by saying, given what I`ve just said and what I believe what you`re going to hear that for what we need in the first phase, if these things are done correctly, what I believe they can, we will have and there will be enough tests to allow us to take this country safely through phase one. Thank you.

MIKE PENCE, VICE PRESIDENT OF THE PRESIDENT:  Dr. Redfield?

ROBERT REDFIELD, CENTERS FOR DISEASE CONTROL DIRECTOR:  Thank you, Mr. Vice President.

I want to make a few comments here. First, I want to talk a little bit about -- CDC has developed multiple systems to monitor disease outbreaks. I think many of you are familiar, for example, how we monitor for food borne illness, or how we monitor antibiotic resistance in hospitals. But we`ve also developed a system to monitor for upper respiratory tract disease.

If I can get the first slide there, this is an example. Because when we talk about what we know about this current pandemic, reality, is we know a lot because we`ve developed this monitoring systems. Up on the slide is a system that we`ve developed initially for flu. And what it does, as you can see, there`s a multiple different flu seasons and they track them over the course of a year.

I want you to look the red line, and that happens to be this year`s respiratory season. And you see there`s a peak there up over the 50-52 week. And that peak what is when we actually had a peak of influenza B. This year was a little different because after that, Barrow (ph) Syndrome came down and you can see it, that actually, we had another peak and that`s when influenza A was active through our country. And you can see influenza A started to drop, but then you saw a third peak. That peak was -- you were looking at the coronavirus 19.

So we have systems all the way down to the county level that we can see where there`s respiratory tract illness. And so it`s not just taking a test, it`s monitoring these systems that have been developed over the last -- over decades. And we have multiple ones. We have another one. It is monitored in emergency rooms looking at syndrome diagnosis. And they showed the same thing.

So we`re well-equipped to monitor to see when respiratory tract viral disease will come and it becomes a very good surrogate for when you begin to understand that we need to start looking more ideologically about what`s going on. You can see now in week 15, we`re really coming down to the baseline background in terms of our flu surveillance system from the overall coronavirus situation right now.

The second thing I wanted to say is that CDC continues to enhance the state`s public health capacity to accelerate their ability, as Tony talked about, it`s critical as we open America again, to diagnose individuals that present with influenza-like illness or coronavirus-like illness, to diagnose them, be able to isolate them and to be able to contact trace around them and then diagnose the contacts and those that are coronavirus positive, to go back and do their contacts.

This is the traditional public health approach, which when it started in this outbreak in January and February, and was quite successful, and as I mentioned before through February 27th, this country only had 14 cases, we did that isolation and that contact tracing and it was very successful. But then when the virus more exploded, got beyond the public health capacity. But right now, CDC is enhancing that public health capacity.

And if I can get the second slide, I want to show you that this is just showing as we sit here today that CDC has embedded in these health departments and all of these states across this country, more than 500 individuals. We also have an additional, almost 100 individuals, that are working on more than 20 coronavirus outbreaks that are going through all these states.

And, finally, at the direction of the president, we`ve been asked to further enhance this deployment in each of the states, as the vice president said, so that there`s additional health personnel to help accelerate the state`s ability to basically move forward aggressively and we assist them so they can operationalize the president`s guidelines to open up America again. So I just wanted to make those points for you today.

PENCE:  Thank you. Dr. Birx?

DR. DEBORAH BIRX, WHITE HOUSE CORONAVIRUS RESPONSE COORDINATOR:  Thank you, Mr. Vice President. And thank you Dr. Fauci and Dr. Redfield for all of that clarity. If we can have the next slide, I`m going to go back to what Dr. Fauci was talking about just to emphasize those points about the two types of tests and I`m going to talk about a third one.

So, first, we all know about sampling in the front of your nose. To all of the labs out there and to the providers, you don`t have to use the nasopharyngeal swab anymore. You can do front-on (ph) nose sampling. And, again, as Dr. Fauci, talk about is that is sampling for the virus itself. That replicates in your nose and as we know throughout some of the respiratory tissues.

The second test is, of course, then your immune response to that infection that`s in your nose, and so that`s the antibody test. And so those are the two tests we want to talk about. But I want to come back to something that both Dr. Fauci and Dr. Redfield said, and we covered it yesterday.

Testing is a part of the exquisite monitoring that needs to occur in partnership with CDC and state and local governments utilizing the surveillance systems that are available, what we just talked about, the flu surveillance system, because we no longer have flu, and the syndromic respiratory system, that is across the United States. And you can see it`s going back to baseline so that we`ll be able to see at the community level any deviation from that baseline.

In addition, what we talked about yesterday was adding that asymptomatic component because I think you`ll see as more and more articles come out for surveillance at other -- and monitoring that other states have done, higher and higher antibody in multiple individuals who don`t remember having a sickness.

And that will give us an idea -- that`s our asymptomatic monitoring in these sentinel monitoring sites. And what we`ve talk about yesterday, we`ve talked about nursing homes, we`ve talk about indigenous people and we`ve talk about vulnerable people in the inner city, really ensuring that something that is so small that can`t even be seen on the surveillance monitoring will be able to be seen in the asymptomatic.

And so those are the two tests that we have. One available now, two that have been approved or three by the FDA. I want to just leave you with my last concept on the antibody tests.

Antibody tests have different specificity and sensitivities. The FDA, we`ve made -- the FDA has been very cautious about the antibody test because I know you see reports every day of countries that ordered the antibody test and found that they were 50, 60, 70 percent faulty. So we`re taking that very seriously because you never want to tell someone that they have an antibody and potential immunity when they don`t. And so those tests perform better when there`s a high prevalence or a high incidence of disease.

So we want to work with mayors around the United States as those antibody tests become available to really see what it is in first responders and healthcare workers in the highest prevalence states so that we can know about the quality and the real life, real field experience of those assays. Because things can look very good in the lab, and then when you take them into the field, sometimes they`re not as good. I`ve learned this lesson repeatedly in working around the globe.

The next slide. So this is what we have asked commercial and diagnostic companies to be working on. Because when you talk about multimillions worth of tests, the way we do this in the United States today for strep, for influenza and for malaria, is we test for the antigen.

Now, we don`t know right now as you shed antigen in the front of your nose. And so that is a question that scientists and companies are working on right now, because that becomes a simpler test.

Now, the flu test, I think many of you will look it up tonight, you will see that outside of the flu season, because of the specificity of the test, it doesn`t work so well. So these are tests we`re working on today that would be like a screening test. Because if you`re positive on it, it`s a good test. But it may miss that you actually have the flu. So then you would move into the -- what we call the nucleic acid test.

So we`re trying to build an algorithm of tests that bring the full talent of the science of the United States into the reality of the clinic, and so bench the clinic. And so this is what we`re working on for the future.

Next slide.

So as I promised both the senators and the governors, this is the United States` current platform capacity designated as high and low throughput. And what do I mean by that? We`ve talked about the high throughput platform of Roche and Abbott and others and then we`ve talk about the gene expert and other machines that may be moderate to lower throughput. I want to see how it`s distributed through the United States.

So these are the current testing platforms available today throughout the United States for COVID-19. And as you heard from Dr. Fauci, everything has to be working from the swab, to the transport media, to the laboratory to really get those tests run and the results back to the client.

The next slide. So then we`ve looked at all of the testing capacity from those platforms and this gives you an idea of what that capacity is. The darkest red, you can see like in Texas and New York, Those are states that have lots of different platforms, as you saw on the prior slide, and the ability, if you just add up the platforms and the potential for tests of over a million tests per month. And so this is what we`re working with each of those states on unlocking that full potential.

And how are we doing that? Well, we`re calling on the American Society of Microbiologists. they have -- they work closely with 300 lab directors around the country. We talked with them this morning. And the Walter Reed team who developed the entire HIV testing program for the military 35 years ago, I called them back into service and they are calling lab by lab to find out what are the technical difficulties to bring up all the platforms that exist in your lab. Is it swabs, is it transport media, is it extraction? And I just really want to thank them.

They`ve already worked through over 70-plus of those laboratories to really understand and the American Society of Microbiologist and the academic societies of the laboratories are working together to ensure that all of this potential can be unlocked.

Next slide, please.

We talked a little bit yesterday about New Orleans. And the president talked about how many tests New Orleans has done. During its outbreak, which you can see now is waning, they`ve done throughout the last month, 27 tests for a thousand New Orleans and Louisianans, so 27 in per thousand. So that is a good mark and that`s what Italy has done about 20 per thousand. So in evaluating an outbreak and really to get control of this outbreak, they did about 27 tests per thousand.

So using that as a measure, next slide, we then looked across all the states of the United States of America and looked for states that had 30 or more, ability to do 30 or more tests per thousand of their inhabitants in each state. And you can see that across the country, except for Oregon and Maine and Montana -- I worked overseas way too long. Thank you all. So those are the three states that we`re working on building capacity in, yes.

So this is just to give you a perspective of how seriously we`re taking the testing issue. As we`ve described, we`ve measured every single platform and every single state. We know exactly where they are by geography, by address, by zip code, what their capacity is, what their accumulative capacity is, what their roadblocks are, not ability to run all their full capacity and we`re addressing those. Because each one of those is different and you have to address each of them one by one with the governors, with the state and local labs and with all of the hospitals.

I have not come across one laboratory or one laboratory director or one society that doesn`t want to contribute to solving this issue of testing and ensuring that this testing is available for everyone. There is a strong, just as all the Americans have social distanced in behind everyone, we don`t often talk about the laboratories.

We`ll talk about the nurses and doctors on the frontline. Behind all of them are the laboratory technicians and laboratory directors are coming in every day and putting things together to ensure that every single person that needs to be diagnosed is diagnosed. And hopefully, you can see from these labs, I mean, these slides that really there is capacity out there. It is our job working with the states and having the state and the leadership role and the laboratory directors in the leadership role to provide support to ensure that all the potential for testing in the United States is brought to bear.

I just want to end with -- these are nucleic acid tests. There will never be the ability on a nucleic acid test to do 300 million tests a day or to test everybody before they go to work or to school. But there might be with the antigen test. And so that`s why there`s a role for nucleic acid test, there`s a role for antibody tests and there`s a role for the future development of these other key tests to bring the full ability to the United States.

And so when we finish this, we`ll be talking to all Americans because there`s other tests that other Americans should have. And I think this is really brought to light the importance of diagnosis and we`ll talk to you further about hepatitis C and T.B. and other things that we can do to assure that every Americans is healthy because I think this really raises the awareness among all Americans about how you do test for different kinds and different parts of your disease state and what is long-lasting immunity and what made the long-lasting immunity and what is a nucleic acid test and what an antigen test is.

And with that, Admiral Giroir.

PENCE:  Great, and let me amplify one point as the Admiral steps forward to concluded remarks about our approach and the efforts we`ve put underway. Governors across the country have been working very closely with us to roll out the level of testing that we have today. And all the information we presented to you is going to be reviewed in the days ahead with all of our governors.

Our objective is to connect every one of America`s governors and state health officials and to all of the labs that are currently able to do coronavirus. And, but as Dr. Birx, Dr. Fauci both described, we believe today that we have the capacity in the United States to do a sufficient amount of testing for states to move into Phase 1 at the time and manner that they deem to be appropriate.

And with that, I`ll allow Admiral Giroir to complete our briefing on testing and we expect the President to return.

ADM. BRETT GIROIR, HHS ASSISTANT SECRETARY FOR HEALTH: Thank you, Mr. Vice President. And thank you to all my really great colleagues. Can I have my next slide.

So, I wanted to start by where we are today and just to visit where we`ve come in such a short period of time. As everyone on the stage has said before, our testing right now is well over 3.78 million tests that have been completed. And if you are impressed by bar graphs, that`s over 1.2 million tests reported just in the last week.

Ambassador Birx talked to me a little earlier and she said, you know, we only do about 2 million molecular tests a year for HIV, something that`s been done for - developed for 35 years. We`re now doing twice that number of tests in a month for a disease that has never been known before, that there`s never been a test developed before. And that`s sort of where we are and where we`ve ramped up.

Also, I want to give you a little idea. The lighter blue or lighter gray is our ID now tests. So, we talk about them a lot, because they`re a point of care tests that can be between five and 15 minutes. And they have a very specific role, but they`re not for everybody. If you`ve got a screen, a few thousand people for test an hour, it doesn`t get you there on a machine. You have to use some of the larger, higher throughput items. But they have a very important role. And again, coming into the market at 50,000 per day is really an important adjunct to us.

She talked about the GeneXpert from Cepheid. Very important. We don`t talk about that very much, but it is one of the backbone mobile point of care, not as easy to do per se as the Abbott, but it is a point of care test that really carries tuberculosis screening all through Africa.

There are these machines you saw that on her slide. Every one of the 50 states have this and over 600 sites and they`ve done over 700,000 tests just on that relatively low throughput, but very important platform. Next slide, please.

I wanted to give you an idea sort of how the tests are distributed and how they`re changing overtime. On the left are the state public health laboratories. And although their numbers are relatively small, about 350,000, the state public health laboratories are absolutely critical. They`re an absolutely critical core component of our testing. Not only were they there early in first, but they also do things like support outbreak investigations in nursing homes or investigations in certain plants that have a close proximity with everyone because of their work environments.

They also do the testing on many people who do not have the opportunity to be tested elsewhere and they are performing outstandingly well.

ACLA, I know we hate acronyms, but the American Clinical Laboratory Association, this is America`s commercial industrial backbone that we`re standing behind the President, the Vice President, and when I was there a few weeks ago in the Rose Garden, this is the lab core, the quest, the bio reference laboratory, Mayo, Sonic and ARUP.

And you`ll see, they`ve done almost 2.3 million tests. This is the very large high throughput machines that Dr. Birx talks about. And I want to be clear about this group is that it doesn`t matter where you are. I just took one of the largest labs and I said, map out for me where you are within 10 miles of where you are, every site in the country. And when you do that, within 10 miles of a site of one of these, 93 percent of the U.S. population is covered.

These are truly national reference labs that cover almost everybody within the United States. So, if you cannot get a test at your hospital, the chances are overwhelming that you could send this to these labs that are fully caught up now. They have no backlog of tests. They`ve ramped up their production. So, their turnaround time is about 48 hours because you may need to transport it from the middle of America out to a lab and result that. But that`s really very, very, very good.

The American Hospital Association also academic labs. As the Vice President and the President have said, as more and more labs come online, they`re increasing the amount of testing that are done just at the hospitals or academic medical centers now almost at 600,000 tests.

And again, matching the other slide I had of the Abbott point of care tests, just to give you a distribution. And that point of care test is being used very importantly in very select populations, where a point of care test is really needed. That could be in some hospitals where someone needs to know exactly if a person is positive or not to go on a clinical trial or in a nursing home investigation or sometimes to get people screened to go back into the work environment.

Most people don`t need a point of care test. In fact, a point of care test does not - cannot replace the millions of tests that are here on the other side. Next slide.

I don`t know how interested you are in swabs. I did not know a whole lot of swabs before a few weeks ago. But there`s two points I want to make with these slides is, yes, there have been constraining elements and they`re constrained for a couple reasons.

Number one, because this is an unprecedented scale up of this type of very sophisticated molecular test that has never put a demand on the system like we have. When we started out a few weeks ago, there`s very specific one type of swab, only get at one place in the U.S., one place in Italy. And we were stuck with that for a while because it`s not just the quantity, it`s the quality. What I don`t want to do is put a lot of things in the system to make people believe that this is a good test when it hasn`t been validated by the FDA to say that a positive is a positive and a negative is a negative.

But over the past weeks, both the scientific community, the Gates Foundation, academic medical centers, the FDA have really opened up our ability to not stick that all the way back in your nasal fairings, but do the interior nose and to greatly broaden the amount of swab types that are available. So, we are really at a point right now that over the neck by the end of April, we`ll put another 5 million swabs in addition to everything that`s out there now. And by the end of May, over 12 million new swabs in the system, more than enough to obtain the capacity that we need. Next slide.

For these molecular tests, you take a swab and you stick it in a test tube, and that test tube has to have a specific kind of liquid in it. And when we started, it was viral transport media, a very special kind of media. The CDC has a make-your-own-recipe if you`re interested in cooking, you could probably do that, but it has a lot of ingredients that go in there, but still very limiting.

We`ve worked with many, many different laboratories. We`ve worked with the FDA. So now, PBS, phosphate buffered saline, a kind of just laboratory great salt water can be used for this. This greatly opens the ability to expand the tests to support all the capability that Dr. Birx talks about.

And again, by the end of April, we will have put a well over 5 million new tubes of either viral transport media or saline into the system. I`m going to get to a conclusion here, but this was going to be more of a technical briefing. Next slide.

So, let`s talk about the fact that the science tells us that we have and will continue to have enough test to safely go into Phase 1. So, let me be very granular about this. We`ve already heard that it is beyond the possibility to test everyone in this country every day. It`s not possible, but it`s also a bad strategy because testing a person now just means they`re negative now.

Dr. Fauci could be positive tomorrow, because it`s brewing in his system right now and we don`t know it. Or that he contacts that. That`s not the way we go about things. The way we go about things, as Dr. Redfield said, just think of the weather radar. OK. If the weather radar is clear, you`re not going to have a thunderstorm or tornado.

When something pops up, that`s when you`ve got to go to where the action is or know that your warning system is up. So, sort of think of that in the background and I`ll go specifically about that. So, that`s monitoring.

Let me talk about how much testing we need just for overall testing. I`m just going to give you a number. I`m not saying that this is the number that`s there, but let`s just take a number that we are going to enter Phase 1 when there are 200,000 new cases per month in the United States.

Don`t get hung up on that. It`s going to be much less than that. But let`s just say 200,000 cases. So, how many tests do we need? Well, we need to test those 200,000 people to make the diagnosis. Right. Everybody, nod your head about that. We have to do that.

Now what`s the safe number over that? You know, if every I test has the disease I`m not testing enough. Right? But if I test 100 people to have one person with the disease, that`s probably over testing.

So, we kind of assume that a safe number that really gives us a good idea is if about 1 out of 10 people are positive. Then we know we are oversampling the population enough that we are getting all the positives.

So, if there`s 200,000 cases, I need about two million tests. OK? Now to go to Dr. Redfield`s point, each one of those that are positive have contacts that need to be traced. On average, the CDC tells me that for every positive, there are about five contacts that really need to be traced.

So, let`s assume that those 200,000 people have five contacts. So now we have an extra million tests. So two million tests out there to detect the 200,000 cases. An extra million out there to trace those contacts, so we are up to about three million cases. If you want to put a fudge factor, states four million. OK?

Those are generally done at the main hospital labs, the commercial labs, state and regional labs. All this can be done as well as some of the labs talked about by Dr. Birx.

Next slide. This second group of testing fits exactly perfectly with the influenza-like surveillance system that Dr. Redfield talked about. This is the monitoring. This is sort of the radar, the weather radar that would be out there. That we are not testing on people who are symptomatic, we want to do testing on people who are asymptomatic. Because you can have a symptomatic carriage. You know, you could have this virus and shed it and not have symptoms or only mild symptoms.

So, what is the strategy here? The strategy here, this is an unprecedented strategy, OK. This is really unprecedented. But we are going to do between 300,000 and 500,000 tests per week in the most vulnerable populations that we know that the virus could circulate. And what are they?

Number one, nursing homes and long-term care facilities. We know that from the history of this virus that that can circulate and be devastating. And it could circulate even in a way that you don`t have symptoms. So, we are going to survey in a very controlled way driven by the CDC, supervised by the CDC. Surveys over, we may not get to everyone but surveying in the areas to cover in a selective way the 15,000 or so nursing homes.

Secondly, we want to work in vulnerable members in cities. And this is the way we think about that is community health centers. I`m a huge fan of community health centers that are led by HR SA. There are -- there are about 30,000 community health center sites. They take care of 30 million people. Children, adults, elderly.

They care for about one-third of Americans below the poverty level. They are arrayed to take care of our most vulnerable populations. So, we want to survey asymptomatic people in those community health centers. We also want to do and some of our indigenous population and you know very early I was out here bringing machines to the Indian Health Service.

And in fact, 1,800 members of the public health service provide care to the Indian Health Service and their director and chief medical officer are both the admirals in the Indian Health Service.

Also, workplace monitoring, particularly for workplace environments that may have very close contact or may have high risk. And some of those could be agricultural facilities.

So, let`s just total that up. We have 200,000 people who needed diagnosis. To make that diagnosis, we want to test two million. OK? So that`s two million. We`re going to contact trace with a million. And let`s just throw you a fudge factor of about 25 percent on that, so that`s four million. And we have this background testing of about 400 -- of about 400,000.

So, to safely do the testing, we need to be in the range of 4.5 million. You followed my number so I want you to understand per month that --

(CROSSTALK)

PENCE:  For phase one.

GIROIR:  Pardon me?

PENCE:  For phase one.

GIROIR:  For phase one. Right. For phase one. And I want to tell you that`s really how it adds up and that`s where we are. Right now, we are doing about one million to 1.2 million per week. We are going to continue to push that further and further as we open up the laboratories and we are able to open all the supplies that we need for that. I think that`s where I would like to end. Thank you.

PENCE:  Thank you. I will ask the team to step back up for questions. We do anticipate as his schedule permitted, that the president will be returning momentarily. Please?

UNIDENTIFIED MALE:  Talking about phase one, will there be enough testing for phase two? Do you have to ramp up to (Inaudible)? Or how do you deal with that?

PENCE:  That`s a very good question.

BIRX:  Yes, that`s a great question. And what we will be doing is monitoring how much we have to use in phase one to really help inform phase two.

Because the really unknown in this, to be completely transparent, is asymptomatic and asymptomatic spread. And so, if we find that there is a lot of asymptomatic individuals that we find in this active monitoring in what we are very much concerned about, the most vulnerable. Then we will have to have increased testing to cover all of those -- all of those sites.

PENCE:  And as we`ve made clear to the governors and other health officials, we are going to continue to scale the testing. As the president has made clear, we want -- we want governors and stats to manage the testing operations in their states.

We`ve given -- we`ve given criteria. We have given guidance for how we think that would best operate. But we are looking for the states, we`re looking for the governors to manage it. In the midst of that, all these great experts working with all these great facilities are going to continue to use that great American ingenuity to scale and increase the availability of testing for states to be able to implement as they move closer and closer to that day that the president speaks up often where we reopen America put all of America back to work.

Mr. President?

DONALD TRUMP, PRESIDENT OF THE UNITED STATES:  They did well. They all did well, I think. I bet they did. Please go ahead.

UNIDENTIFIED MALE:  Mr. President, thank you. Earlier today, Jay Inslee said that your tweets encouraging operations --

(CROSSTALK)

TRUMP:  Who said that?

UNIDENTIFIED MALE:  Jay Inslee. Said your tweets encouraging liberation in Michigan, Minnesota, Virginia were fomenting rebellion. I`m wondering how does that squares with the sober and methodical guidance that you issued yesterday?

TRUMP:  I think we do have a sobering guidance but I think some things are too tough. And if you look at some of the states you just mentioned, they`re too tough. Not only relative to this but what they`ve done in Virginia with respect to the Second Amendment, is just a horrible thing. They did a horrible thing. The governor, and he`s a governor under a cloud to start off with.

So, when you see what he said about the Second Amendment, when you see what other states have done, no, I think I feel very comfortable. Go ahead.

UNIDENTIFIED MALE:  Thank you, Mr. President. Just to be clear when you talk about these states, Michigan, Minnesota, Virginia, do you think they should lift their stay-at-home orders? Or can you talk sort --

(CROSSTALK)

TRUMP:  I think elements of what they have done is too much. I mean, it`s just too much. You know the elements because I`ve already said but certainly a Second Amendment and Second Amendment having to do with the state of Virginia, what they`ve done in Virginia is just incredible. OK, please print

UNIDENTIFIED MALE:  Sir, are you concerned though that people coming out in protest are going to spread COVID to other people? They are congregating in ways that health experts have said they should not.

TRUMP:  No, these are people expressing their views. I see where they are and I see the way they are working and they seem to be very responsible people to me. But it`s a -- you know, they`ve been treated a little bit rough. Please.

UNIDENTIFIED FEMALE:  Thanks, Mr. President. I`m curious about some of the dynamics we might see as the country begins reopening, as you kind of like, a puzzle.

TRUMP:  Yes.

UNIDENTIFIED FEMALE:  So, as you`ve mentioned, we have states where we`re already seeing their curves begin to flatten, but then there are others like Florida, or more rural parts of the country where they aren`t projected to peak for weeks or even months.

So, can you talk a little bit about some of the difficulties that those later peaking states might face, if they need to stay locked down for longer even as other places around them are starting to open back up.

TRUMP:  We are seeing great numbers in almost every state. We are seeing big drops. We`re really seeing in terms of beds, the numbers we have to look at are he beds, the beds being occupied. People going which is essentially people going in. That means that you have fewer people that are sick. Fewer people that feel they have to go to a hospital. And those numbers are dropping really precipitously.

So, I think that we just need a lot of good signs. Now, a place like New York, New Jersey in certain parts of Louisiana. Louisiana has been incredible and you look at that drop. That drop has really been great.

Michigan is at a hard time but it`s starting to do well. So, I just think - - Illinois is another one. You know, you look at some of the numbers. But everyone is dropping and they are dropping rather quickly. We don`t have any hotspot that`s developed where all of a sudden where you say, well, other than we did have a meat packing plant or two where incredibly we had some, you saw the number was rather incredible, it took place in that plant. People could ask about that. I wonder who owns that company.

There`s a weird situation. But generally speaking, it`s been very good. The numbers have been really improving greatly. Please in the back.

UNIDENTIFIED FEMALE:  Thank you, Mr.

U.S. intelligence is saying this week that the coronavirus likely came from a level four lab in Wuhan. There`s also another report that the NIH under the Obama administration in 2015 gave that lab $3.7 million and a grant. Why would the U.S. give a grant like that to China?

TRUMP:  The Obama administration gave them a grant of 3.7 million. I`ve been hearing about that. And we`ve instructed that if any grants are going to that area, we are looking at it literally about an hour ago and also early in the morning. We will end the grant very quickly.

But it was granted quite a while ago. They were granted a substantial amount of money. We are going to look at it and take a look. But I understand it was a number of years ago. Right?

UNIDENTIFIED FEMALE:  So, you are --

(CROSSTALK)

TRUMP:  When did you hear -- when did you hear the grant was made?

UNIDENTIFIED FEMALE:  Twenty fifteen.

TRUMP:  twenty fifteen. Who was president then? I wonder. OK.

UNIDENTIFIED FEMALE:  And Mr. President, we know negotiations are underway for the next round of funding for small businesses.

TRUMP:  Yes.

UNIDENTIFIED FEMALE:  If tens of millions of dollars went in a matter of days the first time, will this next relief package be enough?

TRUMP:  Well, I think it will -- certainly it`s going to get us to a point that`s going to be rather beautiful. We think that that will be the point and it could be they want more but may be at a certain point we`re going stop.

It`s been a tremendous success. It`s been executed flawlessly. SBA has done a very good job. But the banks have done a great job, whether it was Bank of America, Wells Fargo. The community banks have been incredible.

I think we had over 4,000 community banks. A lot of people didn`t know you have that many banks. But 4,000 community banks. They gave the money out. It`s so organized. And it`s been such a great program.

And so essentially, we are waiting for $250 billion. The Democrats are refusing to do. This is money that essentially is going to the workers. It`s going to keep these companies whole. Restaurants and a lot of great companies. And it`s a small amount of money, relative to what it represents, because it represents small businesses. It represents them staying in business.

ARI MELBER, MSNBC HOST:  I`m Ari Melber.

And we have been watching the White House Coronavirus Task Force briefing. It has been going for about an hour and 20 minutes. We broadcast all of the medical parts, as well as the beginning. The president is taking questions.

We`re cutting away from that now, having gone an hour and 20 into it.

President Trump today has shown himself to be still on the defensive over aspects of the virus handling. We saw that in the briefing.

I`m about to be joined live by Speaker Nancy Pelosi. She has been in the news as well, with the president attacking her, including on Twitter.

Meanwhile, the battles continue in Congress. The big story that affects so many Americans` life is the fate of the Paycheck Protection Program. This was designed to give loans to small businesses. That is to help people who work in small businesses around the country.

It`s already run out of money. Now, leading Democrats have argued that the additional funding for the program should be provided within a bipartisan relief package that also includes new health care funding. Senate Republicans, led by Mitch McConnell, did not want to negotiate on that and, instead, tried to go it alone with a vote that did not succeed.

Republicans, though, are showing new signs they might be ready to work with Speaker Pelosi and others on the negotiations.

Let me show you the other developing news, House Minority Leader Kevin McCarthy saying he would come back to the table to negotiate with some of the Democratic proposals.

Having heard from the leader of the executive branch, we turn to the leader of the congressional branch.

House Speaker Nancy Pelosi joins me live.

Good evening. Thanks for joining me.

REP. NANCY PELOSI (D-CA):  My pleasure. I wish it were under other circumstances. But here we are.

MELBER:  Here we are. And I understand that.

Let`s go right to the heart of this issue that affects so many Americans. Walk us through what you`re trying to do, what you see as the solution in this small business program that came out the bill you passed that has apparently run into some shortages.

PELOSI:  Well, first of all, let me say that the lives and the livelihood of the American people are, of course, of the highest priority.

But you can`t have one without the other. We have to move in a science- based, evidence-based way, testing, testing, testing.

But getting back to your question, I will say this. The bill that we passed, CARES -- the CARES legislation, is something that was bipartisan. We passed three bills in the month of March, all of them bipartisan, because we all want to address and help the lives and the livelihood of the American people.

However, with the CARES Act, it was important for us to assert ourselves. And I was very proud that we, working together, House and Senate Democrats were able to flip a corporate trickle-down bill to a workers- and families- first bill, bubble up.

Now that, in the implementation, there is need for more money, we subscribe to that. We want to have more money for small business. We believe in that. The entrepreneurial spirit of America is so important.

But it is also important for us to have more funds for those on the front lines, the health care workers, the police and fire, EMS folks, and all those who really need help as they try to save lives.

So, we`re hoping that we can come to agreement. Again, we all want the initiative to succeed. And so, hopefully, we can come to a bipartisan agreement very soon.

MELBER:  Understood.

There`s been a lot of debate over keeping the country closed, for the most part, according to medical expertise.

The president, though -- I want to show some of the protests that we have seen around the country. You`re familiar. I think some of our viewers have seen this, but some of it quite heated, when we look at the photography here and some of the videos, folks protesting in Michigan, gathering together. In some of this footage, people will see the very protesters themselves obviously not following the distancing guidelines.

And then the president making headlines tonight, Madam Speaker, "The New York Times" reporting: "Trump foments anti-restriction protests, alarming governors." He was targeting specifically governors in Democratic states. Our viewers are seeing, again, some of that.

What is your response to what the president is doing there?

PELOSI:  I won`t take the bait.

This is another example of the distraction that they want to make from the fact that the president has said that this pandemic was a hoax -- and that`s not true -- that the president said it was magic -- it will magically disappear. That`s not true.

Again and again, he was in denial and delay in dealing with this. This is just a distraction. Don`t fall for that. Don`t take the bait.

MELBER:  Understood.

Looking at the economic hardship, which, of course, is part of the bill you mentioned that you`re working on, "Washington Post" reporting 22 million unemployed. This has wiped out a decade of job gains.

President Trump has, of course, declared a national emergency.

And it notes -- quote -- "a staggering loss of jobs" that`s wiped this out. The U.S. has not seen this level of job loss, "The Post" reports -- quote - - "since the Great Depression."

Speaker, do you view this as simply a product of this tough pandemic, or do you view this as a Trump recession?

PELOSI:  Well, it`s probably a combination.

But let`s right now talk about the pandemic, because that`s a matter of life and death. And we`re in the situation that we`re in because, early into this, the president refused to accept the facts.

On March 4, we sent the bill -- we passed a bill in the House about testing, testing, testing. You must have testing, testing, testing. That is the key to opening the door to letting us out to grow our economy. It has to be science-based.

Originally, the president said, in opening it up, I`m the -- I have full authority, total authority.

The next day, he said that -- following that, he said, oh, the governors, it`s up to them to open up. And following that, he criticized the governors for the approach they were taking, which was to follow the guidelines of the Centers for Disease Control.

So, let`s just say, we need -- we need truth. We have to insist on the truth as to what this is. We must have testing. We must have contact tracing, so that we can stop this.

People know. The American people are wise. They know that this is a threat to the health and well-being of their families. And, of course, they want to get back to work and want to grow our economy.

But the fact is, is that they take that -- the health and well-being of their families first and foremost. We can move forward. We can find a cure. We can find a vaccine. We have put money in that in that first testing, testing, testing bill.

The second bill was masks, masks, masks, and trying to facilitate the personal protective equipment that we don`t really have as much as we need it when we needed it, because the president wouldn`t do Defense Protection Act.

So, the situation we`re in is largely of his making, calling it a hoax, saying it would magically disappear, not calling upon the Defense Production Act to protect the workers who are trying to save lives, as they risk their own lives in doing so.

That`s why, in this package, we want to protect those on the front line, whether it`s in the hospitals or the PPE, the personal protective equipment, whether it`s our police and fire. And some of the emergency services people are the first ones to come in contact with somebody who is in need of care.

So, we have to have insistence on the truth. The truth is that the bill that the Republicans put forth would not pass with unanimous consent in the House of Representatives. It didn`t in the Senate either.

So, let`s find our common ground. We all supported CARES. We want to support a CARES 2, where we can go to the next step. But let`s not leave people behind and ignore the truth, which is the door to opening the economy, which is what we want to do with this small business initiative.

That door is opened by testing, testing, testing, contact tracing, evidence, and science.

MELBER:  You just -- and you just laid out your view of his failures coming from the Trump White House on down.

Do you think those failures cost lives?

PELOSI:  Yes, I do. I think delay and denial were deadly. I think they cost lives.

And so you say, OK, that`s was then, they didn`t know. And so the reason I`m speaking out, and I sent a letter to my colleagues, which I`m overwhelmed by the response I have received nationally and from my colleagues, about insisting on the truth, is, let`s not continue on a path of misrepresentation and falsehoods.

Let`s get right to the science, the evidence, the data, the facts. And that`s what we have in our proposal on the hospitals, is hopefully to have testing, with the data collection how racial differences are revealed and getting the facts and the data. That`s so important, and contact tracing, so that we can -- once we know who might be infected, what contacts he or she may have had with other people in their own families and the rest.

MELBER:  We cut away from the White House Coronavirus Task Force briefing in order to hear from you.

Now we have heard from, as I mentioned, the president`s side and your side, leading the House.

When you look at these daily briefings at this point, do you recommend that public officials and citizens watch them to get information? Or do you think it is better to avoid watching them?

PELOSI:  Well, people can do whatever they wish.

I think that it would be important for the president to tell the truth, and that the American people insist on the truth. Their lives and livelihoods depend on it.

And I don`t really watch them, because, every day, the president is contradicting himself, either within the same presentation or from the day before:  I`m fully in charge. I have full authority. Oh, it`s up to the governors. Oh, they`re following the guidelines, that`s wrong, and then putting in these distractions.

This is -- we need central command, central command, where we recognize this for the health challenge that it is and the economic challenge that it is, and the relationship between the two, and, again, the testing from the start, the shelter at home, so important, and the president being almost frivolous about that.

Some in the Republican Party saying, well, people will die, but that`s the lesser of two evils.

I don`t think we have to make that choice. And, by the way, I don`t think it is the lesser of two evils.

So, let us know -- really, this -- we don`t want this to be partisan. And I have hesitated to go to that path, as I said, three bills in March, all of them bipa -- strongly bipartisan.

But, as long as the president is going to misrepresent the facts, to present falsehoods, like, it`s a hoax, it`s magically going to disappear, and not insist that we have what we need to protect our workers -- you know, I`m an intelligence person from the -- for a long time in Congress.

And in intelligence and in national security, one of the things that we -- priorities that we have is, any time where we have force protection, we want to protect our troops.

We -- the president has said, we`re at war. We are, against a pandemic. But force protection isn`t there, because we did not protect our people who are on the front line. And we have to do better at that.

Why should it be that a health care provider in a New York hospital who goes there, instead of being equipped with the gown, the mask, the gloves, the rest, is given a New York Yankees rain poncho as her protection, and that people have to go from patient to patient with, actually, medical debris on their hands and on their faces?

Come on. Let`s just do this right.

MELBER:  Right.

PELOSI:  Let`s put whatever is behind us for an action -- after-action review later.

But we cannot allow the same falsehoods to be the basis for our decisions as we go forward. We must insist upon the truth. The lives of the American people depend on it. Their livelihoods do too. That is our priority.

And small business is the vehicle to that.

MELBER:  Understood. Understood on that work that you`re doing.

Before I lose you, a final question on a different issue.

As you know, there was an accusation of misconduct against Joe Biden. He has publicly denied it. He is the Democratic nominee.

Are you satisfied with his answer?

PELOSI:  Yes, I am.

I`m very much involved in this issue. I always want to give the opportunity that women deserve to be heard.

I am satisfied with his answer, yes.

MELBER:  Speaker Nancy Pelosi making time for us here.

We`re coming up against the end of our hour.

I really appreciate you joining me.

PELOSI:  My pleasure. Thank you.

I wish it, again, next time under better circumstances, I hope. Thank you.

MELBER:  Absolutely, to you and to everyone. And I wish your family well.

We`re going to turn right now for a little reaction. Again, we`re bumping up to the end of the hour, but I have White House AP reporter Jill Colvin and former RNC Chairman Michael Steele.

A lot has happened, Michael. Your thoughts?

MICHAEL STEELE, MSNBC POLITICAL ANALYST:  Yes.

I think the presser again, as you have noted, is just really Trump being on the defensive by saying he`s not on the defensive, and trying to push the onus and responsibility of where we are right now on someone else.

The testing thing is a glaring, glaring dropped ball. We`re three months into this, and only three million Americans have been tested. That`s a little over 1 percent of the population.

Oklahoma has a population of 3.9 million people. So, we haven`t -- we haven`t begun to scratch the surface around this idea of opening up the economy and the country, when we can`t even get the testing in place to make sure that people are and will be safe going forward.

MELBER:  Jill, we just heard the newsworthy interview from the speaker weighing in here while the president was still speaking.

Your reaction to her remarks here and her tangling with the president?

JILL COLVIN, WHITE HOUSE REPORTER, "ASSOCIATED PRESS":  Well, clearly, I mean, this all comes down to testing. That`s what she`s raising. It`s what business experts have told the president in phone calls. It`s what congressional leaders have continued to tell him.

And I think what you saw with the president`s briefing today that`s still ongoing is a recognition by this administration that testing really is the key.

Up until now, we have heard the president insist, oh, testing in the U.S. is better than any other country, we`re doing fabulously, which, of course, is not the reality. And, today, you had the medical experts still standing up there kind of laying out a scenario, getting us to what they described as the phase one opening for testings, but not making clear what happens after that.

They still don`t really have an answer here.

MELBER:  From your reporting, is -- from your reporting, Jill, where is the president`s mind state on these briefings?

COLVIN:  I mean, the president believes that these briefings are his best way to be out there every day. He can`t do rallies anymore. He can`t be out there on the stage surrounded by his supporters.

And so the best alternative he has is to be out there on the stage for a couple of hours every day speaking directly to the American people, making appeals to conservative media, and doing that unfiltered through the press.

You have got a situation here where this is a president who is very sensitive about how the media is portraying his handling of all of this. He`s been very angry about the stories suggesting that he didn`t act quickly enough.

And so he`s been out there every day trying to push back on that narrative.

MELBER:  Understood, and important context.

I want to thank Jill and Michael for your reporting and analysis, standing by through a very busy time.

And my thanks again to Speaker Pelosi.

We are about to head into "ALL IN WITH CHRIS HAYES" on MSNBC.

I`m Ari Melber. I have been anchoring with you.

I hope you have a good and pleasant weekend within the tough times we`re all living through.

And before we go to "ALL IN," we will take one more look at this White House press conference.

TRUMP:  ... 25 seats.

And I can`t -- I said, yes, but you`re not going to be there forever. And he didn`t really know that. He thought that they were going to take 150 seats, move it down to 25 to 50 seats, depending on the way he laid it out.

I said, don`t worry about it. Eventually, you`re going to be back to the scene that you used to have, which was -- look, I could tell you about -- and I`m not going to do it, because I didn`t even want to bring it up, but I could tell you about events that took place.

And I said things like, you will never do that again, or you will never do this again, or -- I don`t even want to mention the events. I don`t want to mention what you`re supposed to be doing, because -- and, you know, one of them was so horrible.

I said, a certain industry will be out of business, never happen again. Two weeks later, it was like nothing ever happened.

Hopefully, we get rid of this. We have tremendous talent up here and all over, including governors, including local governments, state governments.

I look forward to the time, to me, when we can really normalize.

But normalizing is being back to where we were.

Yes, please go ahead.

QUESTION:  Mr. President, some of your allies are calling for China to be stripped as host of the 2022 -- 2022 Olympics.

I`m wondering what you make of that. Is that something that you would consider, or...

TRUMP:  So, I just made a deal with China, where they`re going to put in $250 billion of product.

They`re going to be -- they`re going to be buying 250, 50 -- from $40 billion to $50 billion in farm.

I want to see what`s happening with China. I want to see how they`re doing on it. Are they fulfilling the deal, the transaction? We have a lot of discussions going on.

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